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At least 793 records · Page 44Linked to original sources
PubMed1999

A picture archiving and communications system featuring multiple monitors using Windows98.

We present an effective approach to manage, review, and distribute Digital Imaging and Communications in Medicine (DICOM) images with multiple monitors using Windows98 (Microsoft Corp, Redmond, WA) that can be implemented in an office-based setting. Computed tomography (CT), magnetic resonance imaging (MRI), and angiographic DICOM images were collected, compressed, and stored using Medweb (Medweb, Inc, San Francisco, CA) software. The Medweb server used the Linux/UNIX operating system on a Pentium 333-MHz processor with 128 MB of RAM. Short-term storage capacity was about 2 weeks with routine usage of an 11-GB hard drive. Images were presented for reading on a dual-monitor Windows98 Pentium display station with 160 MB of RAM using a Medweb/Netscape (Netscape Communications Corp, Mountain View, CA) viewer. There was no significant discrepancy in diagnosis between electronic and conventional film images. Mean reading time for 32 cases was 118 seconds. The Medweb JAVA plug-in viewer loaded the first image within 30 seconds of selecting the case for review. Full uncompressed 16-bit images allowed different window settings to better assess for pathology. Multiple monitors allowed viewing various hanging protocols. Cine viewing was also possible. Key diagnostic images were electronically transmitted to referring physicians. On-call radiologists were able to access images through the Internet. By combining Medweb, DICOM, and web-browser software using desktop personal computers (PCs), an easily accessible picture archiving and communications system (PACS) is available to radiologists and referring physicians. Multiple monitors are easily configured and managed using Windows98. This system can sustain changes and can be extended to provide variable functions using inexpensive PCs.

Angiography↗
PubMed1999

New picture archiving and communications system plus new facility equals critical path planning challenge.

The architectural design and construction of a new imaging department is one of the most complex challenges in healthcare architecture. When a client also plans a simultaneous change in basic operating system technology from film-based to filmless imaging, the challenge for both hospital management and the facility/technology design team is even more complicated. A purposeful planning process plus a carefully composed team of internal and external experts are the two essentials for success in executing this difficult conversion of both facility and technology.

Computer Communication Networks↗
PubMed1999

Branching out with filmless radiology.

Texas Children's Hospital, a 456 bed pediatric hospital located in the Texas Medical Center, has been constructing a large-scale picture archiving and communications system (PACS), including ultrasound (US), computed tomography (CT), magnetic resonance (MR), and computed radiography (CR). Until recently, filmless radiology operations have been confined to the imaging department, the outpatient treatment center, and the emergency center. As filmless services expand to other clinical services, the PACS staff must engage each service in a dialog to determine the appropriate level of support required. The number and type of image examinations, the use of multiple modalities and comparison examinations, and the relationship between viewing and direct patient care activities have a bearing on the number and type of display stations provided. Some of the information about customer services is contained in documentation already maintained by the imaging department. For example, by a custom report from the radiology information system (RIS), we were able to determine the number and type of examinations ordered by each referring physician for the previous 6 months. By compiling these by clinical service, we were able to determine our biggest customers by examination type and volume. Another custom report was used to determine who was requesting old examinations from the film library. More information about imaging usage was gathered by means of a questionnaire. Some customers view images only where patients are also seen, while some services view images independently from the patient. Some services use their conference rooms for critical image viewing such as treatment planning. Additional information was gained from geographical surveys of where films are currently produced, delivered by the film library, and viewed. In some areas, available space dictates the type and configuration of display station that can be used. Active participation in the decision process by the clinical service is a key element to successful filmless operations.

Computer Communication Networks↗
PubMed1999

Evolution of a filmless digital imaging and communications in medicine-conformant picture archiving and communications system: design issues and lessons learned over the last 3 years.

This presentation describes our experience and lessons learned over the first 3 years of developing and operating a filmless picture archiving and communications system (PACS) for all computed tomography (CT), magnetic resonance (MR), ultrasound, and nuclear medicine studies in our hospital. The PACS conforms to the Digital Imaging and Communications in Medicine (DICOM) standard and includes a sophisticated Worldwide Web (WWW)-based interface to complement the regular DICOM services. The PACS has undergone many design modifications from its inception, which have addressed performance, functionality, support, and maintenance issues. The lessons we have learned through making these modifications are described here and may prove to be helpful to anyone planning to deploy a PACS of their own.

Computer Communication Networks↗
PubMed1999

Developing a framework for worldwide image communication.

The increasing mobility of the population and frequent changes in healthcare coverage, in both the government and private sectors, require integration of medical records not only longitudinally, but also across a variety of healthcare providers. Early in 1998, the federal government decided to solve this problem by constructing a framework for access to medical records by all of the government's health care facilities, called the Government Computer-Based Patient Record (GCPR). The government consortium chose a proposal by Litton PRC, a partnership of 11 companies with complementary areas of expertise. The framework is based on open systems, which use publicly available standards, and includes a Master Patient Information Locator that allows access to medical information from remote facilities, based on creating a unique identifier for each and every individual patient. PRC will use the Digital Imaging and Communications in Medicine (DICOM) imaging standard for radiology, supplemented by Health Level Seven (HL7).

Computer Communication Networks↗
PubMed1990

Electronic imaging in a teaching hospital intensive care unit: evaluation of the clinical review system.

An intrahospital image-communication and display system was installed and is in continuous use. All images obtained in the medical intensive care unit (MICU) are digitized in the radiology department, then transmitted, stored and retrieved at the nurses' station in the MICU. This unit was easy to install, required minimal user training, and has been in continuous use for 1 year with negligible down time. The details of this system are provided in this report.

Computer Communication Networks↗
PubMed2001

A simple mechanism for sharing and transporting medical digital case information across disparate computer language and data storage environments.

It is challenging to remotely share generic medical case information without an agreed upon definition of a medical digital teaching file (DTF). By utilizing an application of the extensible markup language (XML) called web-distributed data exchange (WDDX) along with an agreed upon WDDX structure, it is technically easy to share or syndicate medical case DTFs across computing environments that use different information models and computer languages. Thus, this easily implemented technology offers us an immediately available means to share and increase the value of scientific knowledge.

Computer Communication Networks↗
PubMed2005

[Telematics in the health system and data protection].

In the health system, telematics are to be used for the benefit of patients and to make it possible for them to receive better medical care. Telematics must be employed in accordance with the guidelines of data protection and this means in particular that the patient must remain the master of his data. Therefore, he must be able to decide in which situation and to whom he wants to reveal his medical data. For this reason, the exact implementation of the introduction of the electronic medical smart card envisaged by the law requires detailed access authorisations and limitations, which must be reinforced by ample technical security measures. These measures must be transmitted to the patients through co-operation of doctors and health insurance companies in such a transparent way that they recognise the advantages of the new technology. The higher the acceptance is on the patients' side, the more they will be willing to participate voluntarily in telematic projects.

Computer Communication Networks↗
PubMed2005

[Electronic health professional cards as indispensable elements of the upcoming health telematics infrastructure. Interactions with electronic patient data cards].

The German law for the modernization of statutory health care defines a functional framework for the upcoming telematics infrastructure in health care based on electronic health professional cards, electronic patient data cards and the necessary information, communication and security infrastructure. The currently ongoing discussion for the implementation is strongly influenced by diverse particulate interests often hindering systematic development. This article presents the fundamental technical mechanisms usable for a stepwise and expandable solution. The interdependence of the components is illustrated using the example of the ATG concept for an electronic patient record. These facts call for a stepwise implementation of telematic infrastructure based on the presented mechanisms.

Computer Communication Networks↗
PubMed2005

[The introduction of the electronic health card in Germany].

From 2006 onwards all members of the health insurance system in Germany will be issued an electronic health card which will replace the current health insurance card. The new health card will be technically upgraded to also include patient-related health data or provide access to such data in addition to its administrative functions. Therefore, it is evident that the health card be fitted with a microprocessor that permits authentication (electronic identity check), encryption and the electronic digital signature, thus ensuring maximum data safety and security. For easy identification of the insured person, the electronic health card will bear a photograph of the card holder.

Computer Communication Networks↗
PubMed2005

[Ten critical theses for patient applied telematic applications in health care].

Telematics applications in health care improve patient care in many ways. Especially the improvements through electronic communication, documentation and cooperation between the different providers have high potential for a qualitative and effective health care. Immaterialization of patient records enables their availability as health records across all health care institutions that are involved in the treatment of a patient. However, the realization of a telematic platform in health care raises new questions concerning ethical and technical issues. These questions must be answered in consideration of the interests of citizens, patients, health care providers and insurance companies. Against this background ten critical theses regarding patient-oriented applications in health telematics are presented and discussed. Special attention is paid to the changes in the relationship between patients and physicians and the necessity to establish a new cooperative medical documentation culture, based on controlled vocabularies and where patients and physicians together decide, which information should be added to the central health record, as well as the creation of the necessary trustworthiness and the balance of effective benefit of health telematics and the informational self determination of the patient.

Computer Communication Networks↗
PubMed2005

[User acceptance of health telematics applications].

The user acceptance of health telematics in medical care plays a critical role in mediating the success of its implementation. Model assumptions evolving from different fields such as industry, health care and medical psychology are presented, and various perspectives for patients and providers involved in these models are highlighted. The impact of health telematics on health care results from four components: (a) the improvement of work characteristics and communication processes, (b) the enhancement of diagnostic and treatment quality via telematics, (c) technical and economic advantages and (d) communication tools for patient. The evidence concerning clinical, economic and psychosocial criteria within these domains is reviewed according to the published literature. Despite the fact that a considerable benefit of health telematics has been shown in individual studies, the evidence concerning the improvement of health care, the improvement of work and communication processes as well as concerning its clinical and cost effectiveness is still scarce. It is recommended to further integrate health telematics and health service research.

Attitude of Health Personnel↗
PubMed2005

[Electronic health records in Germany].

Electronic health records (EGA), as overall medical applications for the documentation of medical information under the guidance and sovereignty of the patient, change the traditional doctor-patient relationship. Unlike the electronic patient record (EPA), which the treating physician is in charge of, the patient has the sole right to decide who may insert which data into it and who may see his electronic health record (EGA). Thus, the patient's right of informational self-determination and his possibilities to get involved in the treatment process are substantially strengthened. The current situation of the EGA in Germany is described and the parallel development of EGA and EPA is discussed. The electronic health record acquires extensive significance, especially in line with the imminent introduction of the electronic health card on the basis of a standardised telematics infrastructure in Germany.

Computer Communication Networks↗
PubMed2004

[Interdisciplinary surgery and telemedicine].

Surgical therapy is becoming increasingly complex. Besides new surgical techniques, sophisticated diagnostic methods and innovative interventional procedures must be integrated into the therapeutic concept to increase the efficacy of surgery. Accurate application of these techniques requires close cooperation between surgeons, other medical specialists, and technicians. Consequently, there is a significant need for structures promoting efficient communication, organization, and interaction in surgical departments. New techniques developed from telecommunication and information technology enable the transferal of complex medical data at any time to any place and are therefore the basis for telemedical applications. Telemedicine and other new techniques such as virtual operation planning, simulation, and intraoperative navigation promise to increase the efficacy of surgical therapy in the future. This paper provides an overview of the applications of telesurgery and currently available techniques.

Computer Communication Networks↗
PubMed1998

[Teleconference and telesurgery].

Interchange of information has become possible independent of the user's place or time by modern telemedical services and opens up new dimensions for diagnostic and therapeutic procedures. For teleconferences and teleconsultations in surgery, the intraoperative high-quality transmission of live images is essential without disturbing the sterility and operation routine. The clinical specifications require special systems for broadband, stereoscopic online image transmission both intra- and inter-institutionally. Moreover, a telemedical concept integrates the communication equipment suitable for the different diagnostic and functional facilities of a clinic, a digital multimedia patient record and modules for cooperative working. These implementations are a prerequisite for extensive telesurgical interventions using navigational tools, guided instruments or autonomous roboter systems. The realization of such a comprehensive telesurgical concept (OP 2000) is presented.

Computer Communication Networks↗
PubMed2003

[Does the digital signature of the DICOM standard meet the requirements of German law?].

The DICOM standard offers the possibilities to generate electronic signatures, valid according to German laws. This enhances the reliability of the correlation between image and patient data. However, only so called qualified electronic signatures--conveniently issued by an accredited supplier--are permissible and not rejectable as evidence in German jurisdiction and are completely equivalent to the handwritten signatures. These qualified electronic signatures can be executed only by individuals, whereas the former are not applicable to technical apparatus like image generating modalities. In consequence, a modality is able to provide its pictures with a "common or advanced signature" solely. This limits the use of the digital signature of the DICOM standard for further applications, e.g. the verifiability within the teleradiology.

Algorithms↗