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At least 649 records · Page 36Linked to original sources
PubMed2001

Integrating medical applications in an open architecture through generic and reusable components.

Allowing exchange of information and cooperation among network-wide distributed and heterogeneous applications is a major need of current health care information systems. It forces the development of open and modular integration architectures. Major issues in the development include defining a flexible and robust federation model, developing interaction and communication facilities as well as the mechanism insuring semantic interoperability. We developed generic and reusable software components to ease the construction of any integration platform. The Pilot and the Mediator Service components facilitate the execution of services and the meaningful transformation of information. They have been tested in the context of the SynEx European project to construct a multi-agents based integration architecture. The possibility of such architectures to take into account the issue of semantic interoperability is further discussed.

Computer Communication Networks↗
PubMedDate not supplied

I2Cnet: Content-based similarity search in geographically distributed repositories of medical images.

The retrieval of images by content is rapidly gaining acceptance as an important function of image database systems. This paper discusses the architecture of I2Cnet, a network of servers which provide content-based query services through a WWW browser. In I2Cnet, algorithms for the representation, storage, and retrieval of medical images based on different descriptions of image content are implemented using description types. AttributeMatch, a description type supported by I2Cnet, aims to capture the knowledge of medical experts in queries by using a similarity criterion which can be tailored to user preferences. We present results showing the query response time of AttributeMatch, obtained with image classes of various sizes, and the degree of similarity of retrieved images to the query image under different similarity criteria.

Algorithms↗
PubMed2006

GOP-based channel rate allocation using genetic algorithm for scalable video streaming over error-prone networks.

In this paper, we address the problem of unequal error protection (UEP) for scalable video transmission over wireless packet-erasure channel. Unequal amounts of protection are allocated to the different frames (I- or P-frame) of a group-of-pictures (GOP), and in each frame, unequal amounts of protection are allocated to the progressive bit-stream of scalable video to provide a graceful degradation of video quality as packet loss rate varies. We use a genetic algorithm (GA) to quickly get the allocation pattern, which is hard to get with other conventional methods, like hill-climbing method. Theoretical analysis and experimental results both demonstrate the advantage of the proposed algorithm.

Algorithms↗
PubMed1995

Use of the Remote Access Virtual Environment Network (RAVEN) for coordinated IVA-EVA astronaut training and evaluation.

This paper presents a unique virtual reality training and assessment tool developed under a NASA grant, "Research in Human Factors Aspects of Enhanced Virtual Environments for Extravehicular Activity (EVA) Training and Simulation." The Remote Access Virtual Environment Network (RAVEN) was created to train and evaluate the verbal, mental and physical coordination required between the intravehicular (IVA) astronaut operating the Remote Manipulator System (RMS) arm and the EVA astronaut standing in foot restraints on the end of the RMS. The RAVEN system currently allows the EVA astronaut to approach the Hubble Space Telescope (HST) under control of the IVA astronaut and grasp, remove, and replace the Wide Field Planetary Camera drawer from its location in the HST. Two viewpoints, one stereoscopic and one monoscopic, were created all linked by Ethernet, that provided the two trainees with the appropriate training environments.

Astronauts↗
PubMed1990

Integrated computerized databases for medical data management beyond the bedside.

Computers are beginning to be utilized extensively for direct patient care, assisting nursing and medical staff with data collection and review at the bedside. However, most clinical data management systems are optimized for bedside patient care and offer limited resources for multi-patient data analysis. At Cedars-Sinai Medical Center, a network of computer systems has been developed to provide linkages between clinical, administrative and outcome data for Surgical Intensive Care Unit (SICU) patients. Increasingly, such data is needed to evaluate the relationship between severity of illness and patient outcome and the utilization of expensive critical care resources. Over the parts 3 years, comprehensive data on 6,755 consecutive SICU patients receiving 18,394 days of care have been accumulated by our PDMS. Using linkages constructed to other hospital systems and databases, trends for severity of illness, severity adjusted survival, census, bed utilization, nursing utilization and many other parameters have been constructed. These linkages are valuable in documenting cost-effective and medically-effective patient care practices.

Computer Communication Networks↗
PubMed1997

Design of access control methods for protecting the confidentiality of patient information in networked systems.

Public awareness of the potential for violation of personal privacy in clinical information systems is increasing. Much of this increase can be attributed to the popularity and publicity of the World Wide Web. Nightly news reports of intruder break-ins and flaws in Internet software security have stimulated public interest in the security of clinical information systems available over the web. As part of the development of systems designed to provide clinical narratives to physicians over the Internet, we are exploring designs that provide additional protection and security to these systems. Specifically, we are developing and testing automated access control measures based on provider-patient relationships for controlling access to personally identifiable patient information.

Computer Communication Networks↗
PubMed2002

Real-time transmission of pediatric echocardiograms using a single ISDN line.

We tested the adequacy of a videoconferencing system using a single integrated systems digital network (ISDN) line (128 kilobits per second) for the remote diagnosis of children with suspected congenital heart disease (CHD). Real-time echocardiogram interpretation was compared to subsequent videotape review in 401 studies with concordance in 383 (95.5%) studies. A new diagnosis of CHD was made in 98 studies. Immediate patient transfer was arranged based upon a real-time diagnosis in five studies. In 300 studies, a normal diagnosis obviated further evaluation. A single ISDN line is adequate for transmission of pediatric echocardiograms and it allows for remote management of patients with CHD.

Adolescent↗
PubMed1996

An electronic consumer health library: NetWellness.

NetWellness is a community-based, consumer-defined grant program supporting the delivery of electronic health information to rural residents of southern Ohio and urban and suburban communities in the Greater Cincinnati tri-state region. NetWellness is a collaboratively developed and publicly and privately funded demonstration project. Information is delivered via ISDN, standard dial, dedicated network connections, and the Internet. TriState Online (Greater Cincinnati's Free-Net) and other southern Ohio Free-Nets are key access points in the larger project communities. The other access points are more than forty workstations distributed at public sites throughout the project's primary geographical area. Design strengths and limitations, training initiatives, technical issues, and the project's impact on medical librarianship are examined in this paper. Also discussed are ways of determining community needs and interest, building political alliances, finding and developing funding sources, and overcoming technical obstacles. NetWellness's Internet address is: http:@www.netwellness.org.

Community Participation↗
PubMed1994

The HELIOS Medical Connection Services.

This paper presents the design and implementation of the HELIOS software component that deals with integration of medical applications in health information networks. The problem of interoperability between health information systems based on different data exchange syntaxes is first discussed. A meta-model, relying on CEN TC251 recommendations, is then presented as a possible solution to this problem and a message description language including these recommendations is proposed. Using this meta-model, the Medical Connection Services that comprises a generic message processing automaton, a resource manager and a mapper is able either to interpret messages expressed in a given syntax (e.g., EDIFACT, ASTM) and map them to the application objects or to automate the translation of the messages in another syntax. Special focus is given on the position of the Medical Connection Services within the HELIOS integration strategy (i.e., through data, presentation and communication). The problem of semantic heterogeneity is then discussed.

Computer Communication Networks↗
PubMed1992

GCI: a network server for interactive 3D graphics.

The Graphics Command Interpreter (GCI) is an independent server module that can be interfaced to any program that needs interactive three-dimensional (3D) graphics capabilities. The principal advantage of GCI is its simplicity. Only a limited set of powerful features have been implemented, including object management, global and local transformations, rotation, translation, clipping, scaling, viewport operations, window management, menu handling and picking. GCI and the master (client) program it serves run concurrently, communicating over a local or remote TCP/IP network. GCI sets up socket communication and provides a 3D graphics window and a terminal emulator for the master program. Communication between the two programs is via ASCII strings over standard I/O channels. The implied language for messages is very simple. GCI interprets messages from the master program and implements them as changes of graphical objects or as text messages to the user. GCI provides the user with facilities to manipulate the view of the displayed 3D objects interactively, independently of the master program, and to communicate mouse-controlled selection of menu items or 3D points as well as keyboard strings to the master program. The program is written in C and initially implemented using the Silicon Graphics GL graphics library. As the need to link special libraries to the master program is completely avoided, GCI can very easily be interfaced to existing programs written in any language and running on any operating system capable of TCP/IP communication. The program is freely available.

Computer Communication Networks↗
PubMed2002

The strategy to be "paperless" via a cost-effective filmless plan.

The group of folks assigned to the project were identified, and on April 23, 2001, an Request For Information (RFI) was released to 11 preidentified Picture Archiving Communication System (PACS) vendors. Our project was unique in 2 respects. First, there was an aggressive timeline. Second there was specific outpatient environment requirements. There was a need to move images and other patient-related data between several sites while depending heavily on the Wide Area Network (WAN) design rather than the typical Local Area Network (LAN) configuration. We learned quickly that there was not one live site, at which we could visit to observe our vision in action, nor had any solution been built to accomplish our specific objectives. The months of May, June, and July consisted of vendor meetings, RFI response reviews and, clinical and corporate visits ending on August 9, 2001 when our prime vendor of choice was selected. During this process, we identified deal breakers outlining specific needs for "go live," which is targeted for Q2 (2nd Quarter) 2002. The biggest workflow opportunity is to be paperless as well as filmless. By this we not only mean traditional RIS information but also patient documents (insurance information, physician script) as well as modality-patient-specific information. All of this information needs to be available electronically to accomplish) any patient record, any place, any time! The month of August was filled with WAN and LAN solution investigations. The solution of choice will be both cost effective and challenged to achieve 99.9% reliability. A cost-benefit analysis was performed and reviewed to better understand our return on investment. The months of September and October have been dedicated to Computerized Radiography (CR) technology. The TEAM reviewed 3 solutions, which consisted of both sit-down sessions as well as clinical site assessments. Again, "deal breaker" criteria were summarized and a solution chosen. Contract negotiations will soon conclude, and an aggressive implementation will begin!

Ambulatory Care Facilities↗
PubMed2004

An assessment of PKI and networked electronic patient record system: lessons learned from real patient data exchange at the platform of OCHIS (Osaka Community Healthcare Information System).

To enhance medical cooperation between the hospitals and clinics around Osaka local area, the healthcare network system, named Osaka Community Healthcare Information System (OCHIS), was established with support of a supplementary budget from the Japanese government in fiscal year 2002. Although the system has been based on healthcare public key infrastructure (PKI), there remain security issues to be solved technically and operationally. An experimental study was conducted to elucidate the central and the local function in terms of a registration authority and a time stamp authority in contract with the Japanese Medical Information Systems Organization (MEDIS) in 2003. This paper describes the experimental design and the results of the study concerning message security.

Access to Information↗
PubMed1992

The impact of IAIMS at Georgetown: strategies and outcomes.

Integration of multiple information systems of a medical center will change the way physicians work and practice medicine in the future. Several major steps must be taken by an institution to make this a reality. Since 1983, Georgetown has been engaged in an Integrated Academic Information Management System (IAIMS) project to bring together multiple sources of information that reside on different computers and database systems. Georgetown is developing a Biotechnology and Biomedical Knowledge Network that includes informational and clinical databases, scholar workstations, instruction on computer use, a campuswide network with local area network nodes, and a modular approach to systems integration. The IAIMS project, spearheaded by the medical library, has enabled a broad spectrum of health professionals to benefit directly from new, dynamic information services. The network is heavily used; in 1991, more than 2,100 individual users conducted more than 148,500 computer functions and more than 104,000 searches. There is economy of scale in high-volume use. Overall, the average search cost is $1.57; for high use databases the cost is $0.38, and for low use, it is $9.41. As described in this paper, IAIMS offers a cost-effective means of enhancing patient care by improving information services to physicians. At Georgetown, IAIMS has advanced the concept of integration, accelerated use of computers in education, increased user acceptance of advanced technologies, and established cost factors for providing information resources. While progress made in improving the transfer of medical information is impressive, it is clear that IAIMS requires several more years of support to achieve full implementation.

Academic Medical Centers↗
PubMedDate not supplied

The remote practice network: new concept in health care delivery.

It is widely acknowledged that a trend toward greater competition is creating dramatic changes in the way that health care is provided in the United States. Physicians and hospitals, in particular, face a difficult period of adjustment as the nation's health care system increasingly turns toward the competitive model. Physicians, particularly those in leadership positions, must meet the challenge of competition by developing and implementing effective coping strategies. Medical directors and other physicians in key leadership and decision-making positions have a responsibility to their institutions, their patients, and indeed their own careers to recognize and understand the implications of current trends in health care delivery. This article discusses an innovative approach to competition in today's challenging health care marketplace.

Computer Communication Networks↗
PubMedDate not supplied

The World Wide Web: a review of an emerging internet-based technology for the distribution of biomedical information.

The Internet is rapidly evolving from a resource used primarily by the research community to a true global information network offering a wide range of databases and services. This evolution presents many opportunities for improved access to biomedical information, but Internet-based resources have often been difficult for the non-expert to develop and use. The World Wide Web (WWW) supports an inexpensive, easy-to-use, cross-platform, graphic interface to the Internet that may radically alter the way we retrieve and disseminate medical data. This paper summarizes the Internet and hypertext origins of the WWW, reviews WWW-specific technologies, and describes current and future applications of this technology in medicine and medical informatics. The paper also includes an appendix of useful biomedical WWW servers.

Computer Communication Networks↗
PubMed2002

Enterprise-wide worklist management.

Radiologists in multi-facility health care delivery networks must serve not only their own departments but also departments of associated clinical facilities. We describe our experience with a picture archiving and communication system (PACS) implementation that provides a dynamic view of relevant radiological workload across multiple facilities. We implemented a distributed query system that permits management of enterprise worklists based on modality, body part, exam status, and other criteria that span multiple compatible PACSs. Dynamic worklists, with lesser flexibility, can be constructed if the incompatible PACSs support specific DICOM functionality. Enterprise-wide worklists were implemented across Generations Plus/Northern Manhattan Health Network, linking radiology departments of three hospitals (Harlem, Lincoln, and Metropolitan) with 1465 beds and 4260 ambulatory patients per day. Enterprise-wide, dynamic worklist management improves utilization of radiologists and enhances the quality of care across large multi-facility health care delivery organizations. Integration of other workflow-related components remain a significant challenge.

Community Networks↗
PubMed1999

Results of European projects enabling secure regional, national and international health care networks.

Based on the work of the ISHTAR, the TRUSTHEALTH1, the EUROMED-ETS and the MEDSEC project funded by the European Commission, the synergetic results of these different projects in providing a security infrastructure for the test environment of an oncological network will be demonstrated. The ISHTAR project investigated security issues in Health Care Establishments (HCE). It provides guidance for threat and risk analysis, and defines a schema for specification and implementation of appropriate security services and mechanisms to respond to the HCE security requirements of both communication and application security concepts. The TRUSTHEALTH1 project dealt with specification and test implementation of basic security services and mechanisms based on Health Professional Cards (HPC) and Trusted Third Party (TTP) services. Within the EUROMED-ETS project, the security solution has been extended to the Internet environment and WWW tools, successfully creating an Internet-based international TTP structure between the universities of Athens, Calabria, and Magdeburg. Finally, in the MEDSEC project the specification and implementation of a generic EDI security solution has been delivered to provide secure communication between applications and sites. In the ongoing TRUSTHEALTH2 project, the results of all these projects will be implemented in a real environment of cancer care.

Algorithms↗
PubMed2001

An open, component-based information infrastructure to support integrated regional healthcare networks.

A fundamental requirement for achieving continuity of care is the seamless sharing of multi-clinical information. Several different technological approaches can be followed to enable the sharing of health record segments. In all cases interoperability between systems is a prerequisite and this requires presently a major technological challenge. Inter-operability can be achieved either through messages or through a more advanced approach based on a federation of autonomous systems. Message based integration is centered mainly on the exchange of HL7 and DICOM messages for achieving the functional integration of clinical information systems (CIS) at institutional or regional level. The federated approach is principally used for facilitating the virtual view of the Integrated Electronic Health Record (I-EHR), without having to replicate unnecessary information. Within the context of HYGEIAnet, which is the regional health telematics network of Crete, both approaches have been utilized for providing end users with seamless access to clinical information. Both are based on an open architecture, which provides the framework for the reuse of standardized common components and public interfaces. This work presents the experiences related to the implementation of "messaging" and "federating" in HYGEIAnet, which are used complementary to each other. A comparison of the two parallel approaches, together with their strengths and weaknesses is described, and evaluation is given from the technological as well as the end users' perspective. Emphasis is given on the technological challenges in developing open, component-based information infra-structure to support integrated service delivery.

Computer Communication Networks↗