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At least 667 records · Page 37Linked to original sources
PubMed1997

Experiences with ARTEMIS--an Internet-based telemedicine system.

ARTEMIS is one of the first systems to exploit the Internet/Intranet technologies for exchanging patient information among health care providers. The primary project goal was to develop and demonstrate a regional telehealth environment specifically to support real-time consultations among health care providers via a computer network, provide secure access to multi-media patient records and discharge summaries, facilitate authentication/digital sign-off, multi-media mail-based referrals, and network-based dictation/transcription. A prototype is deployed in southern West Virginia in a Community Care Network (CCN). The CCN consists of providers, hospitals, clinics, laboratories, that make up one "Virtual" clinic on the "Intranet". ARTEMIS employs new technologies such as Java and JavaScript for the browser, and CORBA-based "middleware" for interoperability at the server-end. Several experiments were designed for evaluating the impact of ARTEMIS on patient care. In this paper we discuss the challenges we faced and the means by which we plan to meet these challenges. We conclude by outlining new thrust areas in which we are concentrating in our next phase of development of ARTEMIS.

Computer Communication Networks↗
PubMed1992

Teleradiology via narrow-band integrated services digital network (N-ISDN) and Joint Photographic Experts Group (JPEG) image compression.

The importance of remote access to both radiological images and medical information has stimulated many demonstration projects that use a variety of telecommunications providers' offerings. Teleradiology, through modest cost channels, can achieve adequate response times using a combination of narrow-band integrated services digital network (N-ISDN) and data compression. A demonstration project, developed in collaboration with Southwestern Bell Technology Resources, Inc, uses the aggregate bandwidth of two B channels (achieving a rate of 120 kilobits per second) and a block-oriented discrete cosine transform compression/decompression implementation based on the Joint Photographic Experts Group Standard for Still Image Compression. System response measurements for an Inquiry and Display Station accessing the Mallinckrodt Institute of Radiology's Radiology Image and Information Management Testbed via the N-ISDN connection show response times to be within 20 seconds. Viewing applications have been shown at sites within St Louis and at Radiological Society of North America, 1990, in Chicago.

Computer Communication Networks↗
PubMed1996

Providing location-independent access to patient clinical narratives using Web browsers and a tiered server approach.

Health care today depends upon timely access to patient medical data and the latest medical knowledge. As we make the transition from a hospital-based organization to an integrated health care delivery system, patient care information must move throughout the organization quickly and efficiently over increasing distances. The emergence of widely-dispersed referral networks demands novel solutions to the problems of delivering patient care information to providers. We have developed a mechanism to provide location-independent access to clinical narrative reports using a multi-tiered server model and World Wide Web technologies for delivery. To successfully deploy such a system to sites separated by large distances, it is important to reduce complexity at the client site. Using a "thin client", such as a web browser, in our design facilitates deployment and support while reducing cost per user. This architecture allows the application to be updated without modification to the end-user software and eases maintenance over long distances.

Computer Communication Networks↗
PubMed2006

Temporal shape error concealment by global motion compensation with local refinement.

This paper presents an original temporal shape error concealment technique based on a combination of global and local motion compensation. For this technique, which is especially useful for object-based video applications in error-prone environments (e.g., mobile networks), it is assumed that the shape of the corrupted object at hand is in the form of a binary alpha plane and some of the shape data is missing due to channel errors. To conceal the corrupted shape, the decoder first assumes that a global motion model can describe the shape changes in consecutive time instants. This way, based on locally estimated global motion parameters, the decoder attempts to conceal the corrupted alpha plane by global motion compensating the shape data from the previous time instant. Afterwards, since a global motion model cannot perfectly describe all alpha plane changes, a local motion refinement is applied to improve the concealment in areas of the object with significant local motion.

Algorithms↗
PubMed1999

Barriers for dissemination of a national health care data network. A list of recommendations for better dissemination.

Establishment of a Danish Nation-wide Health Care Data Network for exchange of health care related information using standardised EDIFACT messages is agreed between the Danish Government, the Hospital Owners and the GPs organisations. The aim is, within year 2000 in the MedCom project, to reach a level of 66% of all messages between the secondary and primary health sector must be send electronically using EDIFACT. There are many barriers for reaching this goal, and to reveal this barriers an investigation was done, and a list of recommendations are set up. The investigation was based upon literature, interviews and most important a questionnaire among 200 GPs and specialists all over the country. After 6 months where the recommendations have been handled there is seen an increase in communicated messages on 40%, and from January 1999 more than 1.1 mill messages are exchanged each month.

Communication Barriers↗
PubMed1997

[Imaging networks, surgical simulation, computer-assisted neurosurgery].

OBJECTIVE: In 1988, the neurosurgeons and neuroradiologists at the Val-de-Grâce hospital decided to create a stereotaxis site using advanced medical imaging date (CT-scan or MRI). METHODS: Two MRI machines and on CT unit were linked to a network (ETHERNET) available for radiologists in 1989. Neurosurgeons adapted stereotaxis sites using Leksell, Fisher and CRW software for MRI. A data processing program recognizing these sites was developed for stereotaxic biopsies based on MRI data. The network was extended in 1992 to the radiotherapy unit for multiple beam stereotaxic irradiations. Finally from 1994, when a computer-guided microscope (Zeiss MKM) was installed, nearly all neurosurgical procedures were conducted under stereotaxic conditions. RESULTS: Since 1989, approximately 900 computer-guided stereotaxic biopsies have been performed with precision in the millimeter range. Since 1994, the Zeiss MKM microscope has been used for 120 computer-guided procedures with the frameless stereotaxic technique guided from landmarks on the outer cranium or attached to the scalp. Mean precision obtained with landmarks was 1.2 mm and 2.8 mm with scalp markers. CONCLUSION: These techniques of computer-assisted neurosurgery based on advanced medical imaging techniques has been revolutionary for surgical approach to intracranial and intracerebral diseases. Smaller assess routes and precise pathways allow an approach to formerly inoperable lesions with minimal risk.

Biopsy↗
PubMed2002

[SIMS REIN: a multi-source information system for end-stage renal disease].

In France, the prevalence of End-Stage Renal Disease (ESRD) is not precisely known. The sources of information are scattered and not coordinated. Consequently, care is ill adapted to meet the demand. The Multi-Source Information System is the basis of the Renal Epidemiology and Information Network (REIN). It is dedicated to improve and organise our medical and epidemiological knowledge of ESRD and to aid public health decision-making in this area. The proposed approach is based on the datawarehouses. This model allows a unified vision of scattered data into distinct databases, for a better management, be it particular (patient follow-up) or global (regional follow-up), with a finality of aid in decision-making. Several categories of problems were considered: the global conception of the information system, the organisation of the datawarehouse, which offers different viewpoints of the data, the integration of heterogeneous data coming from different sources, data exchange and definition of a specific ontology.

Computer Communication Networks↗
PubMedDate not supplied

Telematics and sentinel health information system with general practitioners in Aquitaine, southwest France.

A sentinel health information system using a telematics system to collect epidemiological data from a network of general practitioners (GPs) making up 5% of the GP population was set up in October 1986 in Aquitaine, France. In the first year, four topics were under surveillance. The GPs reported data for each case diagnosed by filling out a questionnaire displayed on their home terminal (Minitel), which transmitted the data by standard telephone lines to a central minicomputer located in the Bordeaux University Medical Centre. Regular feedback was provided to the participating GPs, public health officials and the Bordeaux Medical School. A detailed report of GP participation is presented, the reliability of our findings is discussed in terms of the motivational factors of participants, and the usefulness of the system is evaluated both for immediate teaching implications and for future research possibilities.

Computer Communication Networks↗
PubMedDate not supplied

Arizona network improves providers' competitiveness.

In the September/October issue of Physician Executive, the Remote Practice Network (RPN) health care delivery system concept was introduced and explained. In this article, the concept is illustrated by a description of Arizona HealthSource (AHS), an RPN developed in Phoenix, Arizona. AHS's design, evolution, and operation demonstrate both the competitive pressures that force hospitals into taking new initiatives and the exciting alternative offered by an RPN. Arizona HealthSource serves the Phoenix, Ariz., region, a highly competitive health care marketplace. The organization was started by St. Joseph's Hospital and Medical Center in cooperation with Magliaro & McHaney, a consulting firm with offices in Atlanta, Ga., and La Jolla, Calif. AHS is currently managed under contract by Magliaro & McHaney, which develop the RPN concept and which designs, implements, markets, and manages health care delivery system.

Arizona↗
PubMed1997

The PartnerWeb Project: a component-based approach to enterprise-wide information integration and dissemination.

A component-based health information resource, delivered on an intranet and the Internet, utilizing World Wide Web (WWW) technology, has been built to meet the needs of a large integrated delivery network (IDN). Called PartnerWeb, this resource is intended to provide a variety of health care and reference information to both practitioners and consumers/patients. The initial target audience has been providers. Content management for the numerous departments, divisions, and other organizational entities within the IDN is accomplished by a distributed authoring and editing environment. Structured entry using a set of form tools into databases facilitates consistency of information presentation, while empowering designated authors and editors in the various entities to be responsible for their own materials, but not requiring them to be technically skilled. Each form tool manages an encapsulated component. The output of each component can be a dynamically generated display on WWW platforms, or an appropriate interface to other presentation environments. The PartnerWeb project lays the foundation for both an internal and external communication infrastructure for the enterprise that can facilitate information dissemination.

Computer Communication Networks↗
PubMed2005

An eConsent-based System Architecture Supporting Cooperation in Integrated Healthcare Networks.

OBJECTIVES: The economical need for efficient healthcare leads to cooperative shared care networks. A virtual electronic health record is required, which integrates patient related information but reflects the distributed infrastructure and restricts access only to those health professionals involved into the care process. Our work aims on specification and development of a system architecture fulfilling these requirements to be used in concrete regional pilot studies. METHODS: Methodical analysis and specification have been performed in a healthcare network using the formal method and modelling tool MOSAIK-M. The complexity of the application field was reduced by focusing on the scenario of thyroid disease care, which still includes various interdisciplinary cooperation. RESULTS: Result is an architecture for a secure distributed electronic health record for integrated care networks, specified in terms of a MOSAIK-M-based system model. The architecture proposes business processes, application services, and a sophisticated security concept, providing a platform for distributed document-based, patient-centred, and secure cooperation. A corresponding system prototype has been developed for pilot studies, using advanced application server technologies. The architecture combines a consolidated patient-centred document management with a decentralized system structure without needs for replication management. An eConsent-based approach assures, that access to the distributed health record remains under control of the patient. CONCLUSION: The proposed architecture replaces message-based communication approaches, because it implements a virtual health record providing complete and current information. Acceptance of the new communication services depends on compatibility with the clinical routine. Unique and cross-institutional identification of a patient is also a challenge, but will loose significance with establishing common patient cards.

Communication↗
PubMed1994

The component-based architecture of the HELIOS medical software engineering environment.

The constitution of highly integrated health information networks and the growth of multimedia technologies raise new challenges for the development of medical applications. We describe in this paper the general architecture of the HELIOS medical software engineering environment devoted to the development and maintenance of multimedia distributed medical applications. HELIOS is made of a set of software components, federated by a communication channel called the HELIOS Unification Bus. The HELIOS kernel includes three main components, the Analysis-Design and Environment, the Object Information System and the Interface Manager. HELIOS services consist in a collection of toolkits providing the necessary facilities to medical application developers. They include Image Related services, a Natural Language Processor, a Decision Support System and Connection services. The project gives special attention to both object-oriented approaches and software re-usability that are considered crucial steps towards the development of more reliable, coherent and integrated applications.

Computer Communication Networks↗
PubMed1997

Experiences with the german teleradiology system MEDICUS.

This paper introduces the teleradiology system, MEDICUS, which has been developed at the Deutsches Krebsforschungszentrum (German Cancer Research Center) in Heidelberg, Germany. The system is designed to work on ISDN lines as well as in a local area network. The global software architecture is explained in the article. Special attention has been given to the design of the user interface and data security, integrity and authentication. The software has been evaluated in a German field test at 13 radiology departments in university clinics, small hospitals, private practices and research institutes. More than 30 thousand images have been transmitted using this system during a 9 month period. Realized application scenarios are: in-house communication, image and report delivery to referring hospitals, remote reporting, radiotherapy treatment planning and research cooperation. Experience has shown that the system is easy to use and saves time. It obviates the need for patient transport and reduces film costs. Experiences of individuals while using the system during the field test helped define the functionality of the second generation teleradiology system which is even more flexible and is also available as a commercial product.

Computer Communication Networks↗
PubMedDate not supplied

Willow: a uniform search interface.

The objective of the Willow Project is to develop a uniform search interface that allows a diverse community of users to retrieve information from heterogeneous network-based information resources. Willow separates the user interface from the database management or information retrieval system. It provides a graphic user interface to a variety of information resources residing on diverse hosts, and using different search engines and idiomatic query languages through networked-based client-server and Transmission Control Protocol/Internet Protocol (TCP/IP) protocols. It is based on a "database driver'' model, which allows new database hosts to be added without altering Willow itself. Willow employs a multimedia extension mechanism to launch external viewers to handle data in almost any form. Drivers are currently available for a local BRS/SEARCH system and the Z39.50 protocol. Students, faculty, clinicians, and researchers at the University of Washington are currently offered 30 local and remote databases via Willow. They conduct more than 250,000 sessions a month in libraries, medical centers and clinics, laboratories, and offices, and from home. The Massachusetts Institute of Technology is implementing Willow as its uniform search interface to Z39.50 hosts.

Computer Communication Networks↗
PubMed2006

Design and development of a secure DICOM-Network Attached Server.

It is not easy to connect a web-based server with an existing DICOM server, and using a web-based server on the INTERNET has risks. In this study, we designed and developed the secure DICOM-Network Attached Server (DICOM-NAS) through which the DICOM server in a hospital-Local Area Network (LAN) was connected to the INTERNET. After receiving a Client's image export request, the DICOM-NAS sent it to the DICOM server with DICOM protocol. The server then provided DICOM images to the DICOM-NAS, which transferred them to the Client using HTTP. The DICOM-NAS plays an important role between DICOM protocol and HTTP, and only temporarily stores the requested images. The DICOM server keeps all of the original DICOM images. When unwanted outsiders attempt to get into the DICOM-NAS, they cannot access any medical images because these images are not stored in the DICOM-NAS. Therefore, the DICOM-NAS does not require large storage, but can greatly improve information security.

Computational Biology↗
PubMed1994

The technical conditions for an open architecture.

The development of Open Systems Architecture and the extensive networked interconnection of Health and Hospital Information Systems (HIS) offer great opportunities for improved care, but simultaneously these facilities pose a great danger to the overall security of the information held. The Geneva University Hospital which has built up it centralized informatics system over the last twenty years must now bring about the conditions for a migration towards open system, for although during the last ten years there have been declarations of intent, this architecture is still a long way from final implementation. Like others, the DIOGENE system (the Geneva HIS) has had to face difficult choices especially due to its own successful situation at the end of the eighties. This paper gives a brief explanation of the technical conditions needed in order to fully migrate towards an open system. The first choices towards obtaining optimum communication standards, operating systems and database management systems were the easiest. The real difficulties occurred when deciding on the choice for management tools in this open environment.

Computer Communication Networks↗
PubMed2005

Hierarchical Kohonenen net for anomaly detection in network security.

A novel multilevel hierarchical Kohonen Net (K-Map) for an intrusion detection system is presented. Each level of the hierarchical map is modeled as a simple winner-take-all K-Map. One significant advantage of this multilevel hierarchical K-Map is its computational efficiency. Unlike other statistical anomaly detection methods such as nearest neighbor approach, K-means clustering or probabilistic analysis that employ distance computation in the feature space to identify the outliers, our approach does not involve costly point-to-point computation in organizing the data into clusters. Another advantage is the reduced network size. We use the classification capability of the K-Map on selected dimensions of data set in detecting anomalies. Randomly selected subsets that contain both attacks and normal records from the KDD Cup 1999 benchmark data are used to train the hierarchical net. We use a confidence measure to label the clusters. Then we use the test set from the same KDD Cup 1999 benchmark to test the hierarchical net. We show that a hierarchical K-Map in which each layer operates on a small subset of the feature space is superior to a single-layer K-Map operating on the whole feature space in detecting a variety of attacks in terms of detection rate as well as false positive rate.

Algorithms↗
PubMed1999

Performance and function of a high-speed multiple star topology image management system at Mayo Clinic Scottsdale.

Mayo Clinic Scottsdale (MCS) is a busy outpatient facility (150,000 examinations per year) connected via asynchronous transfer mode (ATM; OC-3 155 MB/s) to a new Mayo Clinic Hospital (178 beds) located more than 12 miles distant. A primary care facility staffed by radiology lies roughly halfway between the hospital and clinic connected to both. Installed at each of the three locations is a high-speed star topology image network providing direct fiber connection (160 MB/s) from the local image storage unit (ISU) to the local radiology and clinical workstations. The clinic has 22 workstations in its star, the hospital has 13, and the primary care practice has two. In response to Mayo's request for a seamless service among the three locations, the vendor (GE Medical Systems, Milwaukee, WI) provided enhanced connectivity capability in a two-step process. First, a transfer gateway (TGW) was installed, tested, and implemented to provide the needed communication of the examinations generated at the three sites. Any examinations generated at either the hospital or the primary care facility (specified as the remote stars) automatically transfer their images to the ISU at the clinic. Permanent storage (Kodak optical jukebox, Rochester, NY) is only connected to the hub (Clinic) star. Thus, the hub ISU is provided with a copy of all examinations, while the two remote ISUs maintain local exams. Prefetching from the archive is intelligently accomplished during the off hours only to the hub star, thus providing the remote stars with network dependent access to comparison images. Image transfer is possible via remote log-on. The second step was the installation of an image transfer server (ITS) to replace the slower Digital Imaging and Communications in Medicine (DICOM)-based TGW, and a central higher performance database to replace the multiple database environment. This topology provides an enterprise view of the images at the three locations, while maintaining the high-speed performance of the local star connection to what is now called the short-term storage (STS). Performance was measured and 25 chest examinations (17 MB each) transferred in just over 4 minutes. Integration of the radiology information management system (RIMS) was modified to provide location-specific report and examination interfaces, thereby allowing local filtering of the worklist to remote and near real-time consultation, and remote examination monitoring of modalities are addressed with this technologic approach. The installation of the single database ITS environment has occurred for testing prior to implementation.

Arizona↗