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More than just a pamphlet: development of an innovative computer-based education program for cancer patients.

Patients with cancer continue to lack practical information regarding their illness and report low levels of awareness and use of patient services. The challenge to educators is to find cost-effective and timely ways to deliver a complex mix of interesting and high-quality information and expertise to this large and diverse audience, while still tailoring the content to individual needs and situations. In the present article, we describe the Princess Margaret Hospital (PMH) computer-based patient education program. The program is aimed toward empowering those dealing with cancer and provides comprehensive medical information and support via an interactive Intranet web site containing information about cancer (the Oncology Interactive Education Series), library resources, Internet links, information about PMH services, and a hospital calendar of events. Preliminary evaluation results have provided valuable direction for on-going program development and suggest that the program is easy to use, informative, and enjoyable for patients, families, volunteers, and health professionals.

Computer Communication Networks↗

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Computer Communication Networks↗

Internet sites of interest to pediatric nurse practitioners.

This article describes the internet and outlines information on the World Wide Web. Connecting to the internet is covered briefly. An evaluation tool for World Wide Web sites is described. Selected Internet sites of interest to pediatric nurse practitioners are reviewed applying the evaluation tool. A general nurse practitioner e-mail discussion group is explained with examples of how electronic forums can aid in nurse practitioner practice.

Computer Communication Networks↗

Universal interface for exchange of medical images via magneto-optical discs.

Digital images are the ever-growing basis of modern medical imaging and treatment. Despite the advent of the DICOM 3.0 standard for medical image communication it still requires cumbersome efforts to export images from imaging modalities to other computer systems. This is true especially for smaller institutions, which often have limited resources for standardized image transfer. To gain access even to these data we developed an exchange interface on the basis of magneto-optical discs (MO-discs), as they are usually available in most of the imaging modalities in use today. Unfortunately images on MO-discs are usually stored in formats specific for each manufacturer. Therefore special routines to access the data on MO-discs had to be developed for each company or even each scanner. Over 10,000 CT and MRI images including their header information from different General Electric and Siemens scanners were extracted successfully from MO-discs. The interface proved to be reliable and easy to handle by technicians. Support of additional manufacturers and of the DICOM 3.0 standard are work in progress.

Computer Communication Networks↗

The visible embryo project: embedded program objects for knowledge access, creation and management through the World Wide Web.

We have designed a prototype knowledge management online environment for the biomedical sciences which integrates access to online representations of the scientific literature, bibliographic databases, high-performance visualization technologies, large-scale scientific databases, and tools for authoring new-generation scientific publications. This system will provide widespread access to its resources by using the World Wide Web for its underlying architecture. This system expands upon our Weblet Interactive Remote Visualization (IRV) server technology to produce a set of dedicated Internet "visualization servers" which provide interactive control of real-time visualizations from the Visible Embryo Project database from within Web pages viewed with our WebRouser software package. This system will be used to develop a set of prototype applications for both online education of medical students in developmental anatomy and for an interactive patient education system for expectant parents. We recognize that knowledge represented by these national resource databases is not static, therefore it is essential to include tools for both the creation of new "compound documents" which incorporate embedded objects, as well as for managing the peer-review of scholarly publications, in order to ensure the integrity of new knowledge as it is added to these databases in the future. We have therefore begun to design integrated tools for our system which facilitate both the creation of and the validation of new generations of scientific knowledge.

Anatomy, Cross-Sectional↗

A hierarchical model for PACS.

In this paper, a hierarchical model for Picture Archiving and Communication Systems (HPACS) is presented and implemented at Taichung Veterans General Hospital (TCVGH) in Taiwan. Despite the fact that the HPACS is built on the architecture of the second generation PACS, it offers many improved features and has advantages over the second generation PACS, such as the user security control, fast resource dispatch and efficient resource management. This HPACS can be used as a reference model for a hospital with any scale-size. The real implementation of HPACS is currently undertaken in the Taichung Veterans General Hospital (TCVGH), Taiwan, Republic of China and consists of four phases with the first two phases already completed. It is the first pilot system ever to be implemented successfully in a large-scale hospital in Taiwan. The experiences have illustrated the great promise of the HPACS in the future.

Computer Communication Networks↗

Multilevel adaptive process control of acquisition and post-processing of computed radiographic images in picture archiving and communication system environment.

Computed radiography (CR) has become a widely used imaging modality replacing the conventional screen/film procedure in diagnostic radiology. After a latent image is captured in a CR imaging plate, there are seven key processes required before a CR image can be reliably archived and displayed in a picture archiving and communication system (PACS) environment. Human error, computational bottlenecks, software bugs, and CR system errors often crash the CR acquisition and post-processing computers which results in a delay of transmitting CR images for proper viewing at the workstation. In this paper, we present a control theory and a fault tolerance algorithm, as well as their implementation in the PACS environment to circumvent such problems. The software implementation of the control theory and the algorithm is based on the event-driven, multilevel adaptive processing structure. The automated software has been used to provide real-time monitoring and control of CR image acquisition and post-processing in the intensive care unit module of the PACS operation at the University of California, San Francisco. Results demonstrate that the multilevel adaptive process control structure improves CR post-processing time, increases the reliability of the CR images delivery, minimizes user intervention, and speeds up the previously time-consuming quality assurance procedure.

Algorithms↗

Image storing system for radiation therapy (radiation oncology information system: ROIS) as a branch of diagnostic PACS; implementation and evaluation.

We have implemented the new system that is called as ROIS for storing medical images of the patients underwent radiotherapy as a branch of medium-scale diagnostic PACS. It was estimated that, for about nine years, we can store all medical images of the patients who received radiation therapy under the on-line storage condition. Further, we can retrieve all medical images of the radiotherapy patients on ROIS faster than conventional film library or on the diagnostic PACS, even if the patient had been treated many years ago. Implementation of ROIS provided us a great help in our clinical work.

Computer Communication Networks↗

Developing and implementing a user-driven departmental database system--implications for the Royal College of Radiologists' COIN proposal.

With the increasing availability of computers, more departments are using word processors in place of typewriters. In the course of typing patient discharge summaries and letters, a large amount of information of potential use for audit or research purposes is entered into the computer but in a form inaccessible for analysis. We have developed a data-base system, based on information entered by departmental staff in the course of their work, rather than by designated data managers. The aim of the system is to replace word-processed clinical summaries. We describe the design, implementation and possible advantages and disadvantages of such a system and implications for the COIN proposal of the Royal College of Radiologists.

Computer Communication Networks↗