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At least 847 records · Page 47Linked to original sources
PubMed1996

The computer-based record: patient moving from concept toward reality.

In 1991 the Institute of Medicine issued a report on improving patient records which has proven to be a landmark for the many individuals and institutions involved in the development of computer-based patient records (CPRs). The report called Computer-based Patient Records: An Essential Technology for Health Care, recommended that CPRs become the primary form for patient records, and urged widespread implementation of CPRs within a decade. It also provides a framework for reviewing the current status of CPRs. In reviewing progress that has been made toward CPRs since the Institute of Medicine (IOM) report was released, it is useful to look beyond the IOM report's major focus on efforts in the USA and include international activities related to CPR development and implementation. Looking forward, CPR efforts are likely to be expedited through greater collaboration.

Computer Communication Networks↗
PubMed1996

Information technology in diabetes care 'Diabeta': 23 years of development and use of a computer-based record for diabetes care.

In this article we have stressed that a diabetes care information system should be useful to, usable and actually used by carers at the point of patient contact. Information resulting from such encounters should, at no extra cost, furnish the needs of communication, audit, research and management. Diabeta is a clinical record system for supporting the management of patients with diabetes. It has grown 'organically' within an academic clinical unit over a period of 23 years. It is used for each and every encounter with the clinicians in our diabetes team and as such, contains an immense amount of objective clinical experience. This experience can be interrogated very easily by computer-naive clinicians using a remarkable interactive program ('Datascan') which contains statistical procedures 'embedded' in the APL computer code, eliminating the need to 'export' the data into a statistical package. The latest PC-based version is incredibly fast and this immense amount of clinical experience can be carried around on a notebook PC and be available for exploration at any time. This makes 'evidence-based medicine' available in a remarkably flexible way since it shares the accumulated objective experience of literally 'dozens' of clinicians over a period which now extends to 23 years. It adds a completely new dimension to the term 'clinical experience' and is unattainable with manual records. It would be naive to assume that such systems are easy to design, build or implement, or that the initial capital outlay required will be small although costs are falling continuously. Medicine is a highly complex activity, the essential basis of which is human interaction. Introduction of a technology into this interaction requires sensitivity to the wishes and requirements of individuals, and protection of their exchanges from third parties. The potential of computers in diabetes care is so great that these issues must be addressed through continuing research, development, evaluation and funding of new systems. This must be led by the medical profession not the computer industry.

Ambulatory Care↗
PubMed1994

Software for the analysis of mutations at the human hprt gene.

Mutations at the human hypoxanthine-guanine phosphoribosyl transferase gene (hprt) are currently of great interest because mutations at this locus are being used as a biomonitor of human mutagenic exposure. Not only can somatic hprt mutants arising in vivo in humans be recovered and sequenced, but there is also a considerable body of information about the in vitro mutational spectra of different carcinogens at this locus. Previously, we reported the creation of a computerized database containing DNA-sequence information on human hprt mutants (Cariello et al. (1992) Environ. Mol. Mutagen., 20, 81-83). In the present manuscript, software for the analysis of mutations in the hprt database is described. Numerous routines have been developed for the analysis of single-base substitutions, including programs to (i) determine if two mutational spectra are different, (ii) display the number of mutations and mutable sites in each exon, (iii) determine if mutations show a DNA-strand bias, (iv) determine the frequency of transitions and transversions, (v) display the number and kind of mutations observed at each base in the coding region, (vi) perform nearest-neighbor analysis and (vii) display mutable amino acids in the hprt protein. The software runs only on IBM-compatible machines with MS-DOS. The software and hprt database is freely available via the INTERNET using remote file-transfer protocol. These programs simplify the analysis of the rapidly increasing information about hprt mutation. The programs permit the facile comparison between in vitro and in vivo data, as well as the identification of mutational patterns that may be of importance to experimenters using hprt as a biomonitor and and of importance to researchers studying mechanisms of mutation.

Amino Acids↗
PubMed1989

Evaluation of medical equipment on the basis of users' experiences and hazard registration.

Assessment of medical technologies is an important topic in health services research. The article describes a special aspect of user-related evaluation of devices in Norway. The Norwegian hospitals have high technical capacity and standards but the equipment is not assessed before being purchased by the hospitals. The idealistic rules for technology assessment are of no use in practical situations. The health authorities in Norway have established a national database for users' experiences and hazard registration. When assessing equipment, it is necessary to take into consideration the situation and the people handling the devices. A system-analytic perspective is proposed for better understanding. The database for experiences with devices stores information concerning maintenance, repair and service, i.e. the whole life history of the medical technology. All this information will be accessible for the hospitals through electronic mail or electronic meetings.

Computer Communication Networks↗
PubMedDate not supplied

Transaction processing using remote procedure calls (RPC) for a heterogeneous distributed clinical information system.

The Johns Hopkins Hospital is developing a distributed clinical information system that integrates functionally several UNIX, IBM MVS/CICS and MUMPS computer systems. Distributed application development is accomplished by interprocess communications across Ethernet using remote procedure calls. The remote procedure call (RPC) protocol provides a standard approach to the development of distributed applications using the metaphor of a subroutine call. The Sun Microsystems RPC and XDR (external data representation) protocols have been implemented in these environments. The systems, the distributed model, RPC implementations and applications examples are discussed.

Computer Communication Networks↗
PubMedDate not supplied

Present status and performance of PACS at Kyoto University Hospital.

A pilot PACS project, named KIDS, has been running in Kyoto University Hospital. The purpose of the system is to establish a small PACS that includes all digital imaging modalities and to evaluate it. The project has been continued from the first phase (KIDS-1) to the second phase (KIDS-2). In the first phase, a small-scale PACS was developed. In the second phase, the expansion of coverage of modalities and completion of the image database was intended. At present, the database contains image data of 16264 patients amounting to 150 Gbytes. Simulation of the retrieval process to the database shows that 154.3 s per patient is required for retrieving his/her entire image data. This calculated value is close to the actual time.

Computer Communication Networks↗
PubMedDate not supplied

Planning for PACS at Osaka University Hospital.

We have a plan to adopt PACS as a medical image information system in the new hospital. In order to construct PACS suitable for our hospital, a preliminary survey was carried out to determine how PACS should be introduced and what are the physicians requirements for a new medical image system. The most important requirement of the physicians was a good quality workstation. Our plan of a new medical image information system is as follows. A primary database will be constructed according to each of modalities in the Department of Radiology. In the Department of Medical Information Science, we will make a secondary database according to the patient. Although it may be difficult for us to obtain a sufficient budget digitalizing all medical images by our move to the new hospital, our goal is to establish total PACS throughout the new hospital in 1995.

Computer Communication Networks↗
PubMedDate not supplied

Telephone line transfer using a local filing system in Hokkaido.

An image-data transfer system using a public telephone line has been constructed between Hokkaido University Hospital (HUH) and Nakashibetsu Town Hospital (NTH). The latter is situated about 420 km from Sapporo and does not have full-time radiologists. A local filing system coupled with a film reader and an optical disk had been installed in HUH in 1986, and in NTH in 1988. Both systems were connected by a public telephone line along which the transfer speed is 9600 bps. Images originating at NTH, mostly CT, were digitized by the film reader and sent to HUH after compression at a ratio of about 5:1 to 10:1. Clinical information concerning a patient was also sent to HUH using facsimile. Radiologists interpreted the transferred data (12 CT images on a film) on the CRT and sent back a written report to NTH using facsimile. The system and its image quality are largely acceptable, especially in an emergency case for brain and abdomen, although the transfer of a film takes about 7 to 20 min.

Computer Communication Networks↗
PubMedDate not supplied

Diagnostic performance of a teleradiology system in primary health care.

Open health care needs proper basic radiological services. Teleradiology makes it possible to get the radiologist's consultation in rural and remote areas and allows the transmission of images between hospitals. A microcomputer-based teleradiology system using a 512 x 512 x 8 bit image matrix with image-processing capabilities and obtainable at a cost of US$ 20,000 was evaluated in daily practice. Images from 372 conventional roentgen examinations were digitized and transmitted via a 64 Kbits/s telephone line from a rural health center to a university hospital, where they were interpreted by two radiologists. The original radiographs were interpreted later and the two reports compared to evaluate the diagnostic performance of system. Slight deterioration of image quality was noticed, though the images were non-diagnostic only in a few cases. The image-processing capability of the system was assessed as useful. Major discrepancies between CRT and film readings were noted in 3.9% of the cases interpreted. The accuracy of CRT readings was about 2% poorer in chest examinations and 5% poorer in bone examinations than in film readings. The teleradiology system proved sufficient for consultation in most conventional radiographs in daily practice, although a system based on a 1024 x 1024 matrix is desirable.

Bone and Bones↗
PubMed1992

A universal data acquisition program for use with anesthetic monitors and Windows 3.0.

A method is described whereby a single program can acquire data from any patient monitor which has a data output facility. No changes are necessary to the program for different monitors. It provides a method of standardizing data transfer between computers and monitors. The program runs in the Microsoft Windows 3.0 operating system. It utilizes Dynamic Link Libraries (DLL) which enable the operating system to communicate with monitors. Each kind of monitor will use a unique DLL in order to provide a standard interface to the Windows 3.0 operating system.

Anesthesiology↗
PubMed1995

The image related services of the HELIOS software engineering environment.

This paper describes the approach of the European HELIOS project to integrate image processing tools into ward information systems. The image processing tools are the result of the basic research in image analysis in the Department Medical and Biological Informatics at the German Cancer Research Center. These tools for the analysis of two-dimensional images and three-dimensional data volumes with 3D reconstruction and visualization ae part of the Image Related Services of HELIOS. The HELIOS software engineering environment allows to use the image processing functionality in integrated applications.

Computer Communication Networks↗
PubMed1995

X-HUSAR, an X-based graphical interface for the analysis of genomic sequences.

Management and analysis of nucleotide and protein sequence and structure data constitute a traditional area of bioinformatics. Since the analytical programs are frequently developed by researchers, rather than software engineers, they tend to suffer from idiosyncratic and non-ergonomic man-machine interfaces. We report on HUSAR, our 140+ collection of third-party, as well as in-house developed or adapted, sequence manipulation and analysis tools, well integrated into the UNIX operating system environment and accessible via consistent menu-aware interface. Most of the HUSAR programs can be completely specified by UNIX command-line options; they can thus be run in batches or combined into pipes. Adding such a program into the HUSAR environment is almost a 'plug-and-play' exercise. HUSAR has been recently complemented with a graphical client interface, X-HUSAR, to support users on UNIX platforms with X11 windowing systems. The whole X-HUSAR interface is based on a single generic program, COMLIGEN, and a number of specific configuration files. COMLIGEN interprets those files and renders appropriate windows, menus, and other interactive elements, which help the end user in selecting application programs and specifying their options. Efforts of extending both HUSAR and X-HUSAR are roughly linear to the size of the collection.

Animals↗
PubMed1994

European Integrated Picture Archiving and Communication Systems, CEC/AIM.

A Picture Archiving and Communication System, supported by a multi-media medical distributed image data-base, will be integrated with all other components of a Hospital Information System (HIS). Several services will be set up for intra- and inter-hospital communication. A EurIPACS infrastructure will be implemented, validated and demonstrated. Integration and a user driven approach are the key elements: integrated in a hospital environment stressing the need for having clinical useful systems; integrated with the other information systems; the departmental systems; integrated by means of standards and coordination with CEN TC 251. These key objectives are in stages of pre-prototying. The first systems are being tested in the labs and prepared for the move to the clinical environment. The implementations will result in a second generation distributed PACS architecture test bed, in '95, installed at several clinical sites in Europe.

Computer Communication Networks↗
PubMed1994

MILORD: Multi-media Interaction with Large Object-oriented Radiological and clinical Databases.

The MILORD project concerns the storage, communication, and processing of large multi-media clinical information in an integrated environment. Advanced information technologies are exploited: new knowledge representation languages and tools, friendly human-computer interaction, 3D graphical processing and displaying of medical images, high performance parallel architectures, large-scale distributed data storage, federated environments for clinical cooperation. The project is developing an environment for designing and handling medical workstations. New turn-key marketable systems are expected after the end of the project. From its first version, the system is installed and under evaluation in large hospitals.

Computer Communication Networks↗
PubMed1994

OpenLabs: the application of advanced informatics and telematics for optimization of clinical laboratory services.

OpenLabs has four major objectives: to improve the efficiency and effectiveness of clinical laboratory services by the integration of Knowledge Based Systems (KBSs) with Laboratory Information Systems (LISs) and equipment; to provide and implement standard solutions for Electronic Data Interchange (EDI) between laboratories and other medical systems; to specify a fully Open architecture for an integrated Clinical LIS and demonstrate the integration of various KBS modules on the open architecture platform; and to demonstrate the integration of OpenLabs modules with existing LISs.

Clinical Laboratory Information Systems↗