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PubMed1994

Beyond clients and servers.

Computer scientists working in medical informatics have to face the problem that software offered by industry is more and more adopted for clinical use by medical professionals. A new challenge arises of how to combine commercial solutions with typical medical software that already exists for some years and proved to be reliable with these off-the-shelf solutions [1]. With the HERMES project, this new challenge was accepted and possible solutions to integrate existing legacy systems with state-of-the-art commercial solutions have been investigated. After a period of prototyping to assess possible alternative solutions, a system based on an indirect client-server model was implemented with help of the industry. In this paper, its architecture is described together with the most important features currently covered. Based on the HERMES architecture, both systems for clinical data analysis and patient care (cardiology) are currently developed.

Computer Systems↗
PubMed2001

Image understanding methods in biomedical informatics and digital imaging.

This paper will present new possibilities for the application of image recognition methods and AI application in biomedical informatics as well as semantically oriented analysis of 2D images of coronary arteries originating from coronography examinations. In particular this paper presents the possibilities for computer analysis and recognition of local stenoses of the lumen of coronary arteries via the application of syntactic methods of pattern recognition. Such stenoses are the result of the appearance of arteriosclerosis plaques, which in consequence lead to different forms of ischemic cardiovascular diseases. Such diseases may be seen in the form of stable or unstable disturbances of heart rhythm or infarction. Analysis of the correct morphology of these artery lumina is made possible with the application of syntactic analysis and pattern recognition methods, in particular with the attribute, context-free grammar of look-ahead LR(1) type.

Artificial Intelligence↗
PubMed2004

VEGA--an open platform to develop chemo-bio-informatics applications, using plug-in architecture and script programming.

In this paper we present the expandability and flexibility features of the VEGA program (downloadable free of charge at http://www.ddl.unimi.it), for the development of custom applications, using it as a multipurpose graphical environment. VEGA can be customized using both plug-in architecture and script programming. The first is useful to add new features and functions, using homemade routines, written with the VEGA Plug-in Development Kit (SDK). With the second approach it is possible to design scripts in VEGA, using the REBOL language, in order to (1) add new functions or customize existing ones; (2) automate common procedures; and (3) allow network communications, by creating a bridge between VEGA and other applications (or other PCs) through the TCP/IP protocol.

Computational Biology↗
PubMed2002

A review of medical imaging informatics.

This review of medical imaging informatics is a survey of current developments in an exciting field. The focus is on informatics issues rather than traditional data processing and information systems, such as picture archiving and communications systems (PACS) and image processing and analysis systems. In this review, we address imaging informatics issues within the requirements of an informatics system defined by the American Medical Informatics Association. With these requirements as a framework, we review, in four sections: (1) Methods to present imaging and associated data without causing an overload, including image study summarization, content-based medical image retrieval, and natural language processing of text data. (2) Data modeling techniques to represent clinical data with focus on an image data model, including general-purpose time-based multimedia data models, health-care-specific data models, knowledge models, and problem-centric data models. (3) Methods to integrate medical data information from heterogeneous clinical data sources. Advances in centralized databases and mediated architectures are reviewed along with a discussion on our efforts at data integration based on peer-to-peer networking and shared file systems. (4) Visualization schemas to present imaging and clinical data: the large volume of medical data presents a daunting challenge for an efficient visualization paradigm. In this section we review current multimedia visualization methods including temporal modeling, problem-specific data organization, including our problem-centric, context and user-specific visualization interface.

Databases, Factual↗
PubMed1993

European standardization efforts: an important framework for medical imaging.

For several years now, users have been waiting for standards allowing medical images to be exchanged, managed, stored and manipulated. Standards are prerequisites for the development of PACS and IMACS systems. It is because of the lack of standards that PACS have not yet widely been implemented. The ACR-NEMA committee (American College of Radiology--National Electronical Manufactures Association) are developing an image communication standard: DICOM 3.0. This should allow interconnection of different imaging modalities and other PACS nodes. Part of the DICOM 3.0 work will be demonstrated at RSNA 93 with involvement of Europe. In the European Standardization Committee (CEN), the technical committee responsible for the standardization activities in Medical Informatics (CEN TC 251), has agreed upon the directions and the scopes to be followed in this field. They are described in the directory of the European standardization requirements for health care informatics and programme for the development of standard adopted on 28 February 1991 by CEN TC 251. Top-down objectives describe the common framework and items like terminology, security, while the more bottom-up oriented items describe fields like medical imaging and multi-media. Since CEN TC 251 started working, an important coordination took place between Europe and the US and Japan, resulting in a common future approach. CEN TC 251 is setting the scene for a more technologically independent standard on a mid term basis. This standard will first have to be proto-typed before it can be published, because it must be possible to implement the standard, too much complexity will not be accepted by the industry. The European imaging standardization work based on the ISO/IPI standard, will be briefly explained; as well as the general framework model and object oriented model; the interworking aspects, and the relation to ISO standards. One should realize be realised that a standard is needed, which is not too ambitious. Because DICOM 3.0 will be ready soon, Europe has decided to support these activities and will concentrate on the next step to be taken.

Computer Communication Networks↗
PubMed1999

Developing a reliable medical informatics network.

As medical informatics increasingly places demands on computer resources, healthcare organizations need to plan for and develop fully integrated, enterprisewide communications networks. Healthcare systems should invest in upgradable equipment that is compatible with industry standards and select specialized contractors familiar with the infrastructure required for healthcare networks. The potential for downtime should be minimized through remote diagnostics that assist repair capabilities. The fully integrated network should be supported by staff who are provided with ongoing training and overseen by a knowledgeable network manager.

Computer Communication Networks↗
PubMed1995

The status of healthcare standards in the United States.

Healthcare standards in the US are produced by six standard developers organizations: ACR/NEMA, ASC X12N, ASTM, HL7, IEEE, and NCPDP. The activities of these groups are coordinated through the ANSI HISPP. While considerable progress has been made in the area of data interchange standards, little progress has been made in the area of vocabulary standards.

Computer Communication Networks↗
PubMed2005

The unexpected high practical value of medical ontologies.

Ontology is no longer a mere research topic, but its relevance has been recognized in several practical fields. Current applications areas include natural language translation, e-commerce, geographic information systems, legal information systems and biology and medicine. It is the backbone of solid and effective applications in health care and can help to build more powerful and more interoperable medical information systems. The design and implementation of ontologies in medicine is mainly focused on the re-organization of medical terminologies. This is obviously a difficult task and requires a deep analysis of the structure and the concepts of such terminologies, in order to define domain ontologies able to provide both flexibility and consistency to medical information systems. The aim of this special issue of Computers in Biology and Medicine is to report the current evolution of research in biomedical ontologies, presenting both papers devoted to methodological issues and works with a more applicative emphasis.

Computational Biology↗
PubMed2004

Information technology as an infrastructure for patient safety: nursing research needs.

This article describes the process utilized to create research questions which promote technology as an infrastructure to enable safe nursing practice. Beginning with scenarios of safety problems related to nursing practice, the team identified information technology including hardware, software, and organizational and operational components to help improve the safety aspects addressed in the scenarios. Further discussed are characteristics of technology necessary at each step in the nursing process and finally recommendations are presented for various research questions that would be needed to enable research on the use of the proposed technologies.

Computers↗
PubMed2006

Test the artefact--develop the organization. The implementation of an electronic medication plan.

OBJECTIVE AND METHODS: The paper aims to develop further insights into the process of implementation of IT in health care by describing findings from a study of a trial implementation of a newly developed electronic medication plan (EMP) in three hospitals in a county in Denmark. A sociotechnical perspective is applied to data acquired by the qualitative methods of participant observation and semi-structured open-ended interviews. CONCLUSIONS: The achievement of fit between IT technology and work processes in health care involves the establishment of new organizational structures that cut across the existing divisionalized hospital organization and a detailed alignment of artefact, functionality and work process. This process can be furthered by supporting 'communities of practice', i.e. informal groups of engaged clinicians. A sociotechnical perspective is beneficial to the analysis of such processes.

Artifacts↗
PubMed2006

Medical image compression using DCT-based subband decomposition and modified SPIHT data organization.

OBJECTIVE: The work proposed a novel bit-rate-reduced approach for reducing the memory required to store a remote diagnosis and rapidly transmission it. METHOD: In the work, an 8x8 Discrete Cosine Transform (DCT) approach is adopted to perform subband decomposition. Modified set partitioning in hierarchical trees (SPIHT) is then employed to organize data and entropy coding. The translation function can store the detailed characteristics of an image. A simple transformation to obtain DCT spectrum data in a single frequency domain decomposes the original signal into various frequency domains that can further compressed by wavelet-based algorithm. In this scheme, insignificant DCT coefficients that correspond to a particular spatial location in the high-frequency subbands can be employed to reduce redundancy by applying a proposed combined function in association with the modified SPIHT. RESULTS AND CONCLUSIONS: Simulation results showed that the embedded DCT-CSPIHT image compression reduced the computational complexity to only a quarter of the wavelet-based subband decomposition, and improved the quality of the reconstructed medical image as given by both the peak signal-to-noise ratio (PSNR) and the perceptual results over JPEG2000 and the original SPIHT at the same bit rate. Additionally, since 8x8 fast DCT hardware implementation being commercially available, the proposed DCT-CSPIHT can perform well in high speed image coding and transmission.

Algorithms↗
PubMed2006

How to write health dialog for a talking computer.

Automated dialogue systems delivered over the telephone offer a promising approach to delivering health-related interventions to populations of individuals at low-cost. Over the past two decades, an automated telephone system called Telephone-Linked Care or TLC has been successfully designed and evaluated by the authors and their colleagues. This work has resulted in over twenty systems for various health-related conditions and lifestyle behaviors. This paper describes our approach to developing and writing dialogue for these automated telephone systems, including determining the program objectives, defining the target population, and selecting a theory of behavior change to guide the intervention. Both macro and micro issues are considered in constructing dialogue systems that are engaging for the target population, easy to use, and effective at promoting positive health behaviors and outcomes.

Communication↗