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At least 811 records · Page 45Linked to original sources
PubMed2005

Automatic annotation of medical records.

One of the research projects running at the medical informatics department of the Institute of Computer Science AS CR explores the problem of medical information representation and development of electronic health record (EHR). With respect to this effort an interesting problem arises: how to transfer knowledge from a medical record written in a free text form into a structured electronic format represented by the EHR. Currently, this task was solved by writing extraction rules (regular expressions) for every element of information that is to be extracted from the medical record. However, such approach is very time consuming and requires supervision of a skilled programmer whenever the target area of medicine is changed. In this article we explore the possibility to mechanize this process by automatically generating the extraction rules from a pre-annotated corpus of medical records. Since we are currently in the phase of data acquisition and preliminary tests we will not present any final results, rather we will sketch the technologies we intend to use and describe the tools that were developed so far as a part of this project.

Electronic Health Records↗
PubMed1998

A global Intranet for an international scientific society.

The International Medical Informatics Association (IMIA) has built up a world-wide infrastructure which is using the Internet as a backbone for a global Intranet. The work has been supported by cost analysis and user acceptance monitoring. As one of the first international scientific societies, IMIA is offering professional electronic communication services to its members. This step has been taken to advance international cooperation and to support the dissemination and exchange of information on the Health Informatics Sector. The current ways of communication and Information Exchange do not meet the requirements of the Information Society because they are too slow and too expensive. The implementation of an Intranet based on the Internet provides a communication channel which is easily accessible for all IMIA members and which will allow efficient information exchange and built up links between IMIA related projects and organizations.

Communication↗
PubMed2000

Understanding terminological systems. I: Terminology and typology.

Terminological systems are an important research issue within the field of medical informatics. For precise understanding of existing terminological systems a referential framework is needed that provides a uniform terminology and typology of terminological systems themselves. In this article a uniform terminology is described by putting relevant fundamental notions and definitions used by standard organizations such as CEN and ISO into perspective, and interrelating them to arrive at a useful typology of terminological systems. This typology is illustrated by applying it to five well-known existing terminological systems.

Humans↗
PubMed2000

An end-to-end secure patient information access card system.

The rapid development of the Internet and the increasing interest in Internet-based solutions has promoted the idea of creating Internet-based health information applications. This will force a change in the role of IC cards in healthcare card systems from a data carrier to an access key medium. At the Medical Informatics Department of Kyoto University Hospital we are developing a smart card patient information project where patient databases are accessed via the Internet. Strong end-to-end data encryption is performed via Secure Socket Layers, transparent to transmit patient information. The smart card is playing the crucial role of access key to the database: user authentication is performed internally without ever revealing the actual key. For easy acceptance by healthcare professionals, the user interface is integrated as a plug-in for two familiar Web browsers, Netscape Navigator and MS Internet Explorer.

Computer Security↗
PubMed1999

Health informatics in the Asia Pacific region.

Although health informatics has been an established science in some Asia Pacific countries since the 1970s, its current degree of awareness among countries in this region can largely be attributed to the efforts of the Asia Pacific Association for Medical Informatics. These efforts have included the spawning of national health informatics associations in some countries, creating opportunities for cross-country scientific interactions at national health informatics meetings and promoting regional health informatics activities and expertise through the APAMI web site. This presentation gives a review of the current status of health informatics activities among APAMI member countries as well as a cross-section of some of their health informatics projects.

Australia↗
PubMed2002

Secure communication and co-operation of distributed Electronic Patient Records.

Electronic Health Records (EHR) are moving towards the core application of health information systems. Enabling informational interoperability of shared care environment including EHR, structure and function of components used have to follow open standards and publicly available specifications. This comprises also methods and tools applied. Security services needed have to be an integral part of architecture and operation of the specified and implemented components. Starting with basic architectural paradigms the Magdeburg Medical Informatics Department was involved in at the early nineties, the secure behaviour of components has been derived. For establishing the required trustworthiness, security models have been introduced and presented in the paper. Beside communication security services based on standardised Public Key Infrastructure (PKI) and security token such as Health Professional Cards (HPC), policy-defined application security services such as authorisation, access control, accountability, etc., of information recorded, stored and processed must be guaranteed. In that context, appropriate resource access decision services have to be established. As the HARP project result, a component-based EHR architecture has been specified and demonstrated for enforcing fine-grained security services by binding certificates to application components, by the way enforcing policies.

Computer Security↗
PubMed2005

Towards shared patient records: an architecture for using routine data for nationwide research.

Ubiquitous information is currently one of the most challenging slogans in medical informatics research. An adequate architecture for shared electronic patient records is needed which can use data for multiple purposes and which is extensible for new research questions. We introduce eardap as architecture for using routine data for nationwide clinical research in a multihospital environment. eardap can be characterized as terminology-based. Main advantage of our approach is the extensibility by new items and new research questions. Once the definition of items for a research question is finished, a consistent, corresponding database can be created without any informatics skills. Our experiences in pediatric oncology in Germany have shown the applicability of eardap. The functions of our core system were in routine clinical use in several hospitals. We validated the terminology management system (TMS) and the module generation tool with the basic data set of pediatric oncology. The multiple usability depends mainly on the quality of item planning in the TMS. High quality harmonization will lead to a higher amount of multiply used data. When using eardap, special emphasis is to be placed on interfaces to local hospital information systems and data security issues.

Biomedical Research↗
PubMed2000

The development of a new information model for a pediatric cancer registry on late treatment sequelae in The Netherlands.

Worldwide, the need is felt for life time follow up of survivors of childhood cancer and for the establishment of registries of the late effects of pediatric oncology treatments. There is however little consensus about how this all should take place. For example, agreement on the nature of this follow up and the type of data to be collected in view of the earlier diagnosis and treatment of the patient is lacking. In a close collaboration between the 'Late Effects Study Group' (consisting of the Pediatric Oncology department of the Emma Children's Hospital and the department of Medical Oncology at the Academic Medical Center), the Netherlands Cancer institute/Antoni van Leeuwenhoek Hospital, and the department of Medical Informatics of the University of Amsterdam, consensus was reached on a new dataset on adverse late effects of pediatric oncology treatment. This dataset was used in developing an information model for the design of a computerized documentation system, PLEKsys. PLEKsys covers both standardized documentation of all relevant data items for evaluating late effects and review facilities on individual patient basis and on patient cohorts. We will install PLEKsys at all Dutch pediatric oncology centers and use the information model as a starting point in developing a National Pediatric Oncology Follow up Registry. A national programme encompassing all Dutch pediatric oncology centers has already been set up to co-ordinate the construction of this national registry.

Child↗
PubMed1999

The "mediator service", a component to ease the integration of medical applications in the SynEx framework.

Interoperability is a key issue and a long-term domain of research for distributed healthcare information systems. The European project SynEx provides an open and standard integration platform for both new and legacy medical applications. It allows the collaboration of distributed and heterogeneous healthcare records and services. It aims to provide access to Hospital Information Services, to remote sources of medical data and to medical knowledge, in a seamless way, hiding the distribution aspects and the heterogeneity of systems. In this project, the Medical Informatics Department of the Broussais University Hospital is responsible for the development of the "Mediator Service". It is a software component of the SynEx platform which is used as a "glue" mechanism to provide a flexible way to facilitate the interchange between any pair of systems, with different nomenclatures and data structures. The Mediator Service uses a generic model of mediators to create, through specialization, specific mediators for practical cases. Based on this model, it offers a C++ library to be used as the tool case by the programmers, to reduce the development effort. The use of XML as a powerful data interchange format and as a data structure descriptor is proposed and evaluated.

Computer Communication Networks↗
PubMed2002

Remodeling of legacy systems in health care using UML.

Research projects in the field of Medical Informatics often involve the development of application systems. Usually they are developed over a longer period of time, so that at a certain point of time a systematically planned reimplementation is necessary. The first step of reimplementation should be a systematic and comprehensive remodeling. When using UML for this task a systematic approach for remodeling activities is missing. Therefore, we developed a method for remodeling of legacy systems (Qumquad) and applied it to DOSPO, a documentation and therapy planning system for pediatric oncology. Qumquad helps to systematically carry out three steps: the modeling of the current actual state of the application system, the systematic identification of weak points and the development of a target concept for reimplementation considering the identified weak points. Results show that this approach is valuable and feasible and could be applied to various application systems in health care.

Diagnosis-Related Groups↗
PubMed1994

Case-based telematic systems towards equity in health care. Introduction to the symposium.

The theme of this International Symposium, co-sponsored by EFMI (the European Federation for Medical Informatics) and WHO-Eur (the European Office of the World Health Organisation) is made of four components: (1) an ethical principle: equity in health care, that aims to social justice; (2) measurements of equity that should be case-based/population related; (3) communication of this information at a wide scale, using telematics, e.g. integrated computer systems at distance; (4) actions to improve health care and equity in its delivery by using resource management tools and developing quality of care. The combination of these four elements is recommended as a coherent scheme for future actions of public authorities in health care. They were therefore associated in the somewhat complex title of the symposium. A special attention is given to the present degree of availability of a large number of case based/population related data sources in Europe, as well as on the need to develop generic models in telematics, rather than too strict standards at the user level. These information systems can be made easily accessible to clinicians and epidemiologists as an aid to their decision making in the European region.

Computer Communication Networks↗
PubMed2006

The INFOBIOMED Network of Excellence: facilitating training and mobility in biomedical informatics in Europe.

In this paper we present the work carried out within INFOBIOMED, the European Network of Excellence (NoE) in Biomedical Informatics, to facilitate training and mobility in the area. An analysis of past experiences in both Medical Informatics and Bioinformatics has led to various actions. In this scenario, we have elaborated three actions: (1) a survey of the training and mobility situation, needs and actions to be taken, (2) a Biomedical Informatics course database (ICD), and (3) a Mobility Brokerage Service (MBS). We describe the use of Web Services to build the MBS, designed to facilitate the exchange of professionals within the consortium, belonging to ten European countries. The goal of INFOBIOMED is to expand these initiatives to other NoEs and institutions within the European Union.

Europe↗
PubMed1999

Information technology leadership in academic medical centers: a tale of four cultures.

Persons and groups within academic medical centers bring consistent and predictable viewpoints to planning and decision making. The varied professional and academic cultures of these individuals appear to account primarily for the diversity of their viewpoints. Understanding these professional cultures can help leaders achieve some predictability in the complex environments for which they are responsible. Leaders in information technology in particular, in order to be successful, must become part-time anthropologists, immersing themselves in the varied workplaces of their constituents to understand the work they do and the cultures that have grown up around this work. Only in this way will they be able to manage the challenges that arise continuously as the technology and the needs it can address change over time. In this article, the author briefly describes the concept of culture, portrays four specific professional cultures that typically coexist in academic medical centers, and argues that understanding these cultures is absolutely critical to effective management and use of information resources.

Academic Medical Centers↗
PubMed2004

Radiology as a part of a comprehensive telemedicine and eHealth network in Northern Finland.

Oulu University Hospital is the northernmost tertiary hospital in Finland and its responsibility area is the largest in the country, covering nearly half of the Finnish territory, also including the arctic regions. Because of vast distances and a sparse population, Oulu has been a forerunner in developing telemedicine and eHealth services in the country. The development started in 1990 and has resulted in the establishment of teleradiology and televideoconferencing services, distance education and a multimedia medical record with remote access capabilities. Wireless technology has been a special focus area, as has the development of an efficient communication between primary care and secondary care. This review highlights some of the key success elements.

Arctic Regions↗
PubMed1995

Practice guidelines and healthcare telematics: towards an alliance.

This chapter reviews the motives behind the promotion, development and application of practice guidelines, defined as "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances'. It surveys the state of progress and future prospects for telematics applications in this area, and reports the action points recommended by the 1994 AIM Conference. There exists significant evidence that use of guidelines can improve healthcare process and outcome, and that computerised aids assist this effect, they may also enhance the potential uses of guidelines and protocols for audit, resource management and shared care. A standard generic model for computerised representation of guidelines as knowledge bases in a common format has been proposed and may be a key factor in future progress. The development of computerised patient records of adequate scope and quality is generally recognised as an essential condition for computer-aided guideline use. Support for development, dissemination and application of healthcare guidelines and use has emerged, notably through the AIM EPISTOL study, as a feasible and useful application area of medical knowledge-based systems. It is essential that telematics developments in this field are grounded in an understanding of the healthcare practices to which guidelines are being applied, and of the changes in practice which guideline use may entail.

Artificial Intelligence↗
PubMed1993

Investigation of syntaxes for existing interchange formats to be used in healthcare.

This paper gives a summary of the work done by CEN TC 251 PT 004. The project team objective has been to investigate syntaxes of existing interchange formats (IFs) to be used in healthcare. A set of evaluation criteria have been developed based on functional requirements from two healthcare domains. 5 IFs; ASN.1, ASTM E1238, EDIFACT, Euclides and ODA have been evaluated. ASN.1 scores highest in the evaluation. However mapping from General Message Models (GMDs) to IF dependent message models (IFMDs) shows that all the IFs can be used. The project team recommends a strategy for development of GMDs, IFs and IFMDs.

Computer Communication Networks↗