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At least 811 records · Page 45Linked to original sources
PubMed1997

[Multi-media presentation of radiologic image data with the Internet].

AIM: Recent developments of the Internet (World Wide Web) allow the integration of audio, video, digital film sequences, and three-dimensional data. The applicability of these innovations for medical documentation is demonstrated. METHODS: Our existing software for medical image processing and 3D reconstruction was extended to provide images, film sequences, and complex 3D models in an Internet-compatible data format. RESULTS: The multimedia results of the image processing were integrated into Internet documents. Specialized programs are no longer necessary for visualization. The Internet software allows for user-friendly handling and interactive presentation of the 2D and 3D data. CONCLUSIONS: The Internet offers public-domain software for display of images, audio/video, and 3D data. Thus, the tools of the Internet represent an ideal basis for local hospital information systems, computer-aided medical education, and teleconferencing.

Computer Communication Networks↗
PubMed1997

[Possible applications of the KAMEDIN teleradiology system with special reference to an economic analysis].

INTRODUCTION: Different concepts and applications of teleradiology systems have been realised. However, their cost-effectiveness is still questionable. Therefore, a cost-benefit analysis of three different scenarios of the new teleradiology system Kamedin (Kooperatives Arbeiten und rechnergestützte Medizinische Diagnostik auf innovativen Netzen der Deutschen Telekom) was performed. METHODS: CT examinations were transmitted from an Advantage Windows (GE) workstation to a Kamedin workstation using DICOM 3 protocol. Afterwards a teleconference was established with a Kamedin workstation in the intensive care unit within the hospital via FDDI/Ethernet, with an external workstation in a radiology department 6 km away via ISDN and with a Kamedin PC located with radiologist on duty 22 km away via ISDN. On average, 36 CT slices per patient were transferred. A break-even analysis was performed with respect to costs of hardware, software, support, use of ISDN and staff, as well as benefits like the decrease in transportation or film documentation costs. RESULTS: Owing to the different reductions in transportation costs, two applications (intensive care unit and external PC) showed a break-even of 1817 and 528 teleconferences/year, respectively. Further optimisation of cost-effectiveness is possible on condition that existing hardware can be used and an automatic data transfer without staff control is available. When all optimisation factors were combined, the break-even decreased to a minimum of 167 and 77 teleconferences/ year, respectively. CONCLUSION: Teleconferences with high image quality can be set up between workstations and PCs using the Kamedin system. Depending on the possible decrease in transportation costs, teleconferencing is cost-effective under certain conditions. Teleradiology has additional advantages, such as the acceleration and optimisation of patient management.

Computer Communication Networks↗
PubMed1997

[Strategy for securing medical documents by electronic signature and encryption].

The paper presents a survey of security strategies for the protection of medical documents which are generated, stored, and exchanged electronically. It is not meant to provide a precise technical background but to give a guideline for interested medical professionals. A systematic approach for the definition of appropriate security requirements is outlined, and generally accepted security functions (services) are described. The major part of the paper is dedicated to a technical introduction to state-of-the-art security mechanisms based on cryptographic methods. Finally, actual implementation problems and perspectives are discussed from a German/European viewpoint.

Computer Communication Networks↗
PubMed2000

[Internet communication in radiology].

UNLABELLED: E-mail is an Internet service that can be used for sending messages and binary files between individuals as well as for participating in discussion groups. For sending and receiving these types of messages, the users must use either a dedicated e-mail client or one of the several mailing facilities of the World Wide Web. The news-groups enable like-minded people to discuss subjects on a group-wide basis, but access is generally not limited, and the participants cannot be selected. CONCLUSION: The objective of this paper is to give radiologists an introduction to using e-mail, mailing lists and news-groups, the three most important communication services of the Internet. The function of these services is explained, and the advantages of implementing them in a radiology practice are discussed. Potential problems and concerns including security matters are highlighted, and ways in which they can be resolved are suggested.

Communication↗
PubMed2004

Evaluation of radiological workstations and web-browser-based image distribution clients for a PACS project in hands-on workshops.

The methodology and outcome of a hands-on workshop for the evaluation of PACS (picture archiving and communication system) software for a multihospital PACS project are described. The following radiological workstations and web-browser-based image distribution software clients were evaluated as part of a multistep evaluation of PACS vendors in March 2001: Impax DS 3000 V 4.1/Impax Web1000 (Agfa-Gevaert, Mortsel, Belgium); PathSpeed V 8.0/PathSpeed Web (GE Medical Systems, Milwaukee, Wis., USA); ID Report/ID Web (Image Devices, Idstein, Germany); EasyVision DX/EasyWeb (Philips Medical Systems, Eindhoven, Netherlands); and MagicView 1000 VB33a/MagicWeb (Siemens Medical Systems, Erlangen, Germany). A set of anonymized DICOM test data was provided to enable direct image comparison. Radiologists ( n=44) evaluated the radiological workstations and nonradiologists ( n=53) evaluated the image distribution software clients using different questionnaires. One vendor was not able to import the provided DICOM data set. Another vendor had problems in displaying imported cross-sectional studies in the correct stack order. Three vendors (Agfa-Gevaert, GE, Philips) presented server-client solutions with web access. Two (Siemens, Image Devices) presented stand-alone solutions. The highest scores in the class of radiological workstations were achieved by ID Report from Image Devices ( p<0.005). In the class of image distribution clients, the differences were statistically not significant. Questionnaire-based evaluation was shown to be useful for guaranteeing systematic assessment. The workshop was a great success in raising interest in the PACS project in a large group of future clinical users. The methodology used in the present study may be useful for other hospitals evaluating PACS.

Computer Communication Networks↗
PubMed2005

Standardization of teleradiology using Dicom e-mail: recommendations of the German Radiology Society.

Until recently there has been no standard for an interoperable and manufacturer-independent protocol for secure teleradiology connections. This was one of the main reasons for the limited use of teleradiology in Germany. Various teleradiology solutions have been developed in the past, but the vast majority have not been interoperable. Therefore an ad hoc teleradiology connection was impossible even between partners who were already equipped with teleradiology workstations. Based on the evaluation of vendor-independent protocols in recent years the IT Working Group (AGIT) of the German Radiology Society set up an initiative to standardize basic teleradiology. An e-mail based solution using the Dicom standard for e-mail attachments with additional encryption according to the OpenPGP standard was found to be the common denominator. This protocol is easy to implement and safe for personalized patient data and fulfills the legal requirements for teleradiology in Germany and other countries. The first version of the recommendation was presented at the 85th German Radiology Convention in 2004. Eight commercial and three open-source implementations of the protocol are currently available; the protocol is in daily use in over 50 hospitals and institutions.

Computer Communication Networks↗
PubMed1998

Integrating HIS-RIS-PACS: the Freiburg experience.

With the integration of different formerly isolated information systems, such as Hospital Information System (HIS). Radiology Information System (RIS), Picture Archiving and Communication System (PACS) and modalities, we evolve towards an architecture of distributed information processing in radiology, the data being stored in distributed databases. The frontier between the cooperative information systems becomes more subtle than in the past, and it seems more convenient to distinguish the different computer functionalities or services used in radiology than to detail the functions of RIS and PACS. This paper opens with a description of the different computer services used in radiology and how they relate one to another. It also shows how these functionalities could be integrated within a global Radiology Information and Archiving System. Finally, it shows the degree of systems interconnection that can be achieved presently, using the PACS-RIS installation at the University Hospital of Freiburg as an example.

Computer Communication Networks↗
PubMed1999

Speech processing in radiology.

The goal of this study was to evaluate the recognition rate, learning potential and amount of time needed to complete a report with the Philips speech recognition system SP 6000 (Philips, Best, The Netherlands). Four radiologists dictated reports of interventional radiology, MRI examinations of the musculoskeletal system and CT examinations of the thorax and abdomen with the Philips system using the German language. The recognition rate of each report and improvement rate after each learning phase of the Philips system was assessed. The time needed to complete a report using the Philips system was then compared with the time needed to complete a report using the tape-based system via a time analysis. The average recognition rate for the four radiologists using the Philips system was 79.6 %, which improved to 92.5 % after the third adaptation. Initially, the average time demand to dictate and correct one report was approximately 16.8 min, but this time decreased to 8.1 min after the third adaptation. In contrast, only 3. 6 min were needed to dictate and correct one report using the tape-based system. However, with the speech recognition system, dictation, correction and transcription of the report can be completed within 15 min, whereas with the tape-based system, it takes nearly 1 day. With the Philips system, speech recognition can reach as high as 95 % since each adaptation of the system improves the recognition rate by approximately 5 %. While the Philips system is associated with longer dictation times than the tape-based system, turn-around time for a complete report is substantially shorter with the Philips system than the tape-based system.

Computer Communication Networks↗
PubMed2001

Adobe acrobat: an alternative electronic teaching file construction methodology independent of HTML restrictions.

The goal of the project was to create a method by which an in-house digital teaching file could be constructed that was simple, inexpensive, independent of hypertext markup language (HTML) restrictions, and appears identical on multiple platforms. To accomplish this, Microsoft PowerPoint and Adobe Acrobat were used in succession to assemble digital teaching files in the Acrobat portable document file format. They were then verified to appear identically on computers running Windows, Macintosh Operating Systems (OS), and the Silicon Graphics Unix-based OS as either a free-standing file using Acrobat Reader software or from within a browser window using the Acrobat browser plug-in. This latter display method yields a file viewed through a browser window, yet remains independent of underlying HTML restrictions, which may confer an advantage over simple HTML teaching file construction. Thus, a hybrid of HTML-distributed Adobe Acrobat generated WWW documents may be a viable alternative for digital teaching file construction and distribution.

Computer Communication Networks↗
PubMed2002

Challenges in image acquisition and distribution for clinical image service.

We have developed a centralized application for acquiring images from multiple picture archiving and communication systems (PACS) and distributing images to a clinical image web server and other repositories. Our flexible strategy addresses a number of administrative challenges associated with delivering images into clinical, research, and test environments. DICOM images flow from PACSs and modalities to a UNIX-based "distributor" application, which relays them to one or more destinations. Image volume and transmission times were collected and analyzed. Three distributors receive an average of 34 gigabytes of image data per day. Images are sent concurrently to two web-based image servers, one used clinically by physicians and one used for testing. Transmission of certain classes of studies is prioritized for key physician groups. Delivery to research systems is also supported. Acquiring images from multi-vendor PACS for distribution to a web server for clinical image viewing is a challenging task. Centralizing the acquisition and distribution process reduces both the administrative effort and the impact on clinical operations associated with maintaining dynamic clinical, testing, and research environments.

Computer Communication Networks↗
PubMed2004

Personal digital assistants.

Personal digital assistant sales are growing exponentially, and as medical technology advances the amount of information available becomes staggering, making a handheld device, with the ability to store a great amount of information, progressively more valuable to health care providers. Mobile computing allows for a great deal of knowledge in a small package, creating a "walking library" with a mobile collection of data always accessible. There are many diverse types of PDAs, and this article discusses the history of PDAs, general purchasing issues, general PDA features, and the most significant differences between the Palm and the Windows CE operating systems.

Computer Communication Networks↗
PubMed2004

Security middleware infrastructure for DICOM images in health information systems.

In health care, it is mandatory to maintain the privacy and confidentiality of medical data. To achieve this, a fine-grained access control and an access log for accessing medical images are two important aspects that need to be considered in health care systems. Fine-grained access control provides access to medical data only to authorized persons based on priority, location, and content. A log captures each attempt to access medical data. This article describes an overall middleware infrastructure required for secure access to Digital Imaging and Communication in Medicine (DICOM) images, with an emphasis on access control and log maintenance. We introduce a hybrid access control model that combines the properties of two existing models. A trust relationship between hospitals is used to make the hybrid access control model scalable across hospitals. We also discuss events that have to be logged and where the log has to be maintained. A prototype of security middleware infrastructure is implemented.

Access to Information↗
PubMed2004

Integrating multiple clinical information systems using the Java Message Service framework.

This article describes an application for capturing, delivering, and tracking urgent radiology exam results. Urgent exam findings are entered using a Web form embedded within the Picture archiving and communication system (PACS) display station. The findings are then accessible via soft copy using the PACS display stations, hospital information system (HIS) terminals, or wireless-enabled personal digital assistants (PDAs) or via hard copy printouts that are generated automatically or on demand. Additionally, quality control is performed on those findings entered by radiology residents and fellows, the results of which are used for both performance tracking and educational activities. The application was developed using Sun Microsystems' Java programming language. The Java Message Service (JMS) was used to manage the delivery of findings. JMS provides a robust, flexible framework for exchanging messages between disparate applications. The application is now used for all urgent exams; completely replacing the original paper-based system. The use of JMS provides the necessary level of reliability needed by this application.

Computer Communication Networks↗
PubMed2006

A multisite telemammography system for remote management of screening mammography: an assessment of technical, operational, and clinical issues.

OBJECTIVE: This paper describes a high-quality, multisite telemammography system to enable "almost real-time" remote patient management while the patient remains in the clinic. One goal is to reduce the number of women who would physically need to return to the clinic for additional imaging procedures (termed "recall") to supplement "routine" imaging of screening mammography. MATERIALS AND METHODS: Mammography films from current and prior (when available) examinations are digitized at three remote sites and transmitted along with other pertinent information across low-level communication systems to the central site. Images are automatically cropped, wavelet compressed, and encrypted prior to transmission to the central site. At the central site, radiologists review and rate examinations on a high-resolution workstation that displays the images, computer-assisted detection results, and the technologist's communication. Intersite communication is provided instantly via a messaging "chat" window. RESULTS: The technologists recommended additional procedures at 2.7 times the actual clinical recall rate for the same cases. Using the telemammography system during a series of "off-line" clinically simulated studies, radiologists recommended additional procedures at 1.3 times the actual clinical recall rate. Percent agreement and kappa between the study and actual clinical interpretations were 66.1% and 0.315, respectively. For every physical recall potentially avoided using the telemammography system, approximately one presumed "unnecessary" imaging procedure was recommended. CONCLUSION: Remote patient management can reduce the number of women recalled by as much as 50% without performing an unreasonable number of presumed "unnecessary" procedures.

Ambulatory Care Facilities↗
PubMed2005

GNARE: automated system for high-throughput genome analysis with grid computational backend.

Recent progress in genomics and experimental biology has brought exponential growth of the biological information available for computational analysis in public genomics databases. However, applying the potentially enormous scientific value of this information to the understanding of biological systems requires computing and data storage technology of an unprecedented scale. The Grid, with its aggregated and distributed computational and storage infrastructure, offers an ideal platform for high-throughput bioinformatics analysis. To leverage this we have developed the Genome Analysis Research Environment (GNARE)--a scalable computational system for the high-throughput analysis of genomes, which provides an integrated database and computational backend for data-driven bioinformatics applications. GNARE efficiently automates the major steps of genome analysis including acquisition of data from multiple genomic databases; data analysis by a diverse set of bioinformatics tools; and storage of results and annotations. High-throughput computations in GNARE are performed using distributed heterogeneous Grid computing resources such as Grid2003, TeraGrid, and the DOE Science Grid. Multi-step genome analysis workflows involving massive data processing, the use of application-specific tools and algorithms and updating of an integrated database to provide interactive web access to results are all expressed and controlled by a "virtual data" model which transparently maps computational workflows to distributed Grid resources. This paper describes how Grid technologies such as Globus, Condor, and the Gryphyn Virtual Data System were applied in the development of GNARE. It focuses on our approach to Grid resource allocation and to the use of GNARE as a computational framework for the development of bioinformatics applications.

Computational Biology↗
PubMed2005

Electronic clinical path system based on semistructured data model using personal digital assistant for onsite access.

Clinical Paths (Paths) have been introduced by different hospitals for patient care management. An Electronic Clinical Path (ECP) with onsite access provision seems to improve the efficiency of medical staffs because they can share vast medical information about patients at a time and also can reuse accumulated data easily, which is impossible with paper-based Path. Data model is the basis for implementing ECP. However, there is no established model for ECP. The purpose of this study is to introduce a model for ECP and implement an ECP with onsite access system. We introduced a Semistructured Data Model (SSDM) for ECP, and implemented a Web application system based on this model using Personal Digital Assistant (PDA) as inputting device. Our system functioned as expected with wireless LAN, and users handled the data on bedside using PDA. By introducing SSDM, we showed the correspondence between schema of Paths and implementation of ECP.

Access to Information↗