An inexpensive simple method of data retrieval.
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Information Systems↗
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[Scientific medical information--search and retrieval].
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Information Systems↗
[Scientific medical information--its search and retrieval].
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Information Systems↗
Enterprise-wide PACS: beyond radiology, an architecture to manage all medical images.
RATIONALE AND OBJECTIVES: Picture archiving and communication systems (PACS) have the vocation to manage all medical images acquired within the hospital. To address the various situations encountered in the imaging specialties, the traditional architecture used for the radiology department has to evolve. MATERIALS AND METHODS: We present our preliminarily results toward an enterprise-wide PACS intended to support all kind of image production in medicine, from biomolecular images to whole-body pictures. Our solution is based on an existing radiologic PACS system from which images are distributed through an electronic patient record to all care facilities. This platform is enriched with a flexible integration framework supporting digital image communication in medicine (DICOM) and DICOM-XML formats. In addition, a generic workflow engine highly customizable is used to drive work processes. RESULTS: Echocardiology; hematology; ear, nose, and throat; and dermatology, including wounds, follow-up is the first implemented extensions outside of radiology. CONCLUSION: We also propose a global strategy for further developments based on three possible architectures for an enterprise-wide PACS.
Cardiology↗
A computer-assisted filing system for urologic information.
Our increasingly inefficient, cumbersome, often ineffective and time-consuming manual mental cataloguing and retrieving system indicated to us that there must be a better technique available. However, our search of existing systems failed to reveal any matching our needs. Therefore, we developed a 4-category system for cataloguing and retrieving urologic materials. Our program is divided into 3 sections: 1) index, 2) catalogued data and 3) computer programs. We have used this system for more than a year and believe that it has satisfied our original requirements. It is easily adaptable to changes of information, allows for identification of unlimited types of material, offers thorough and accurate data retrieval techniques and is economical now that the expense of organizing the system is behind.
Abstracting and Indexing↗
Knowledge and utilization of Information Technology among health care professionals and students in Ile-Ife, Nigeria: a case study of a university teaching hospital.
BACKGROUND: The computer revolution and Information Technology (IT) have transformed modern health care systems in the areas of communication, teaching, storage and retrieval of medical information. These developments have positively impacted patient management and the training and retraining of healthcare providers. Little information is available on the level of training and utilization of IT among health care professionals in developing countries. OBJECTIVES: To assess the knowledge and utilization pattern of information technology among health care professionals and medical students in a university teaching hospital in Nigeria. METHODS: Self-structured pretested questionnaires that probe into the knowledge, attitudes and utilization of computers and IT were administered to a randomly selected group of 180 health care professionals and medical students. Descriptive statistics on their knowledge, attitude and utilization patterns were calculated. RESULTS: A total of 148 participants (82%) responded, which included 60 medical students, 41 medical doctors and 47 health records staff. Their ages ranged between 22 and 54 years. Eighty respondents (54%) reportedly had received some form of computer training while the remaining 68 (46%) had no training. Only 39 respondents (26%) owned a computer while the remaining 109 (74%) had no computer. In spite of this a total of 28 respondents (18.9%) demonstrated a good knowledge of computers while 87 (58.8%) had average knowledge. Only 33 (22.3%) showed poor knowledge. Fifty-nine respondents (39.9%) demonstrated a good attitude and good utilization habits, while in 50 respondents (33.8%) attitude and utilization habits were average and in 39 (26.4%) they were poor. While 25% of students and 27% of doctors had good computer knowledge (P=.006), only 4.3% of the records officers demonstrated a good knowledge. Forty percent of the medical students, 54% of the doctors and 27.7% of the health records officers showed good utilization habits and attitudes (P=.01) CONCLUSION: Only 26% of the respondents possess a computer, and only a small percentage of the respondents demonstrated good knowledge of computers and IT, hence the suboptimal utilization pattern. The fact that the health records officers by virtue of their profession had better training opportunities did not translate into better knowledge and utilization habits, hence the need for a more structured training, one which would form part of the curriculum. This would likely have more impact on the target population than ad hoc arrangements.
Adult↗
Personalizing retrieval of journal articles for patient care.
We present a system for patient-specific searches on a database of medical journal articles which uses natural language techniques to match search results against patient records. We performed an information retrieval experiment comparing the performance of this system to two strategies, one of which uses extensive medical knowledge, while the other uses the same patient information our system has. The results show that our system is useful in improving recall over the strategy simulating a human specialist, and clearly outperforms the strategy of using the patient record content without intelligent processing.
Algorithms↗
Interfacing the radiology information system to the modality: an integrated approach.
The radiology information system (RIS) provides patient and examination information that is used in setting up and performing a radiologic procedure. In a digital imaging environment, information from the RIS can also be used to populate fields in the Digital Imaging and Communications in Medicine (DICOM) image header. Ideally, information from the RIS should be available at the modality at the time of the examination, and automatically be attached to the image in the appropriate DICOM fields before storage in the picture archiving and communications system (PACS). We have designed a highly integrated RIS interface for a digital radiography (DR) system. This interface employs browser technology to make RIS information conveniently available at the modality, and DICOM modality performed procedure step (MPPS) for RIS/DR information exchange. A novel feature of our approach is that a single display screen at the modality is used to alternatively display either the modality control window or the RIS window. Full access to RIS capabilities is available at the modality, including worklists and prior reports.
Computer Systems↗
Bridging the gap: linking a legacy hospital information system with a filmless radiology picture archiving and communications system within a nonhomogeneous environment.
A health level 7 (HL7)-conformant data link to exchange information between the mainframe hospital information system (HIS) of our hospital and our home-grown picture archiving and communications system (PACS) is a result of a collaborative effort between the HIS department and the PACS development team. Based of the ability to link examination requisitions and image studies, applications have been generated to optimise workflow and to improve the reliability and distribution of radiology information. Now, images can be routed to individual radiologists and clinicians; worklists facilitate radiology reporting; applications exist to create, edit, and view reports and images via the internet; and automated quality control now limits the incidence of "lost" cases and errors in image routing. By following the HL7 standard to develop the gateway to the legacy system, the development of a radiology information system for booking, reading, reporting, and billing remains universal and does not preclude the option to integrate off-the-shelf commercial products.
Computer Communication Networks↗
An epilepsy information system to support routine and research.
An epilepsy information system is described that supports routine patient care, research, and medical management. The patient's clinical data is ordered in time by the date of the patient contact when the data was collected. The clinical data is also classified into six categories. An unrestricted text group has text subjects in each of these groups as well as in a general free text area. The system is integrated with other information subsystems (e.g. patient registration, clinical chemistry laboratory, EEG department and pharmacy) as well as with the routinely used text processor. Data inquiries for research and medical management purposes are programmed in a Structured Query Language (SQL). The data needed to answer these queries are taken from the data collected in daily routine. The integration of the system is very useful because data only have to be entered once and can be used when and where needed. Patient data stored in this system is more accessible in general as well as more usable for research purposes compared with the patient data previously stored only on paper.
Data Collection↗
A vocabulary development and visualization tool based on natural language processing and the mining of textual patient reports.
Medical terminologies are critical for automated healthcare systems. Some terminologies, such as the UMLS and SNOMED are comprehensive, whereas others specialize in limited domains (i.e., BIRADS) or are developed for specific applications. An important feature of a terminology is comprehensive coverage of relevant clinical terms and ease of use by users, which include computerized applications. We have developed a method for facilitating vocabulary development and maintenance that is based on utilization of natural language processing to mine large collections of clinical reports in order to obtain information on terminology as expressed by physicians. Once the reports are processed and the terms structured and collected into an XML representational schema, it is possible to determine information about terms, such as frequency of occurrence, compositionality, relations to other terms (such as modifiers), and correspondence to a controlled vocabulary. This paper describes the method and discusses how it can be used as a tool to help vocabulary builders navigate through the terms physicians use, visualize their relations to other terms via a flexible viewer, and determine their correspondence to a controlled vocabulary.
Algorithms↗
Incorporating ideas from computer-supported cooperative work.
Many information systems have failed when deployed into complex health-care settings. We believe that one cause of these failures is the difficulty in systematically accounting for the collaborative and exception-filled nature of medical work. In this methodological review paper, we highlight research from the field of computer-supported cooperative work (CSCW) that could help biomedical informaticists recognize and design around the kinds of challenges that lead to unanticipated breakdowns and eventual abandonment of their systems. The field of CSCW studies how people collaborate with each other and the role that technology plays in this collaboration for a wide variety of organizational settings. Thus, biomedical informaticists could benefit from the lessons learned by CSCW researchers. In this paper, we provide a focused review of CSCW methods and ideas-we review aspects of the field that could be applied to improve the design and deployment of medical information systems. To make our discussion concrete, we use electronic medical record systems as an example medical information system, and present three specific principles from CSCW: accounting for incentive structures, understanding workflow, and incorporating awareness.
Artificial Intelligence↗
Bioinformatics integration and agent technology.
Vast amounts of life sciences data are scattered around the world in the form of a variety of heterogeneous data sources. The need to be able to co-relate relevant information is fundamental to increase the overall knowledge and understanding of a specific subject. Bioinformaticians aspire to find ways to integrate biological data sources for this purpose and system integration is a very important research topic. The purpose of this paper is to provide an overview of important integration issues that should be considered when designing a bioinformatics integration system. The currently prevailing approach for integration is presented with examples of bioinformatics information systems together with their main characteristics. Here, we introduce agent technology and we argue why it provides an appropriate solution for designing bioinformatics integration systems.
Algorithms↗
Natural language processing to extract medical problems from electronic clinical documents: performance evaluation.
In this study, we evaluate the performance of a Natural Language Processing (NLP) application designed to extract medical problems from narrative text clinical documents. The documents come from a patient's electronic medical record and medical problems are proposed for inclusion in the patient's electronic problem list. This application has been developed to help maintain the problem list and make it more accurate, complete, and up-to-date. The NLP part of this system-analyzed in this study-uses the UMLS MetaMap Transfer (MMTx) application and a negation detection algorithm called NegEx to extract 80 different medical problems selected for their frequency of use in our institution. When using MMTx with its default data set, we measured a recall of 0.74 and a precision of 0.756. A custom data subset for MMTx was created, making it faster and significantly improving the recall to 0.896 with a non-significant reduction in precision.
Algorithms↗
Data mining and visualization for decision support and modeling of public health-care resources.
This paper proposes an innovative use of data mining and visualization techniques for decision support in planning and regional-level management of Slovenian public health-care. Data mining and statistical techniques were used to analyze databases collected by a regional Public Heath Institute. We also studied organizational aspects of public health resources in the selected Celje region with the objective to identify the areas that are atypical in terms of availability and accessibility of public health services for the population. The most important step was the detection of outliers and the analysis of availability and accessibility deviations. The results are applicable to health-care planning and support in decision making by local and regional health-care authorities. In addition to the practical results, which are directly useful for decision making in planning of the regional health-care system, the main methodological contribution of the paper are the developed visualization methods that can be used to facilitate knowledge management and decision making processes.
Database Management Systems↗
Challenges of building clinical data analysis solutions.
Increasingly, owners of clinical information systems are turning to clinical data warehouses (CDWs) to store and to analyze their data. The CDW allows institutions to make better use of their clinical data that has been collected through its information systems. A CDW extracts data from these systems, transforms it into a usable form, and then allows users to view and analyze years of data across a large cross section of patient charts. Although warehouses have existed in healthcare for some time, there are relatively few institutions that maintain patient charts in a CDW. This is, in part, because of the challenges often seen when attempting to warehouse this type of data. These include integrating a diverse set of care practices and a variety of definitions for common data elements like medications, observations, treatments, units of measure, and even unique patient identifiers. In addition, these systems often struggle with a high level of inconsistent and/or incomplete data that must be cleaned up on a regular basis. Unlike other data warehouse systems, CDWs are often expected to gather data around the clock and in a manner that has minimum impact to the performance of the source Clinical Information Systems. Finally, CDWs often have a diverse range of clinical and administrative users. This often leads to a need for a variety of applications and/or tools for viewing and analyzing the data.
Database Management Systems↗
Realisation of the computerised patient record; relevance and unsolved problems.
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Computer Communication Networks↗
A search engine for virtual patient records.
Virtual patient records provide a means for integrated access to patient information that may be scattered around different healthcare settings. Within the boundaries of a health district providing all levels of care, this concept can be implemented in an Intranet environment to support longitudinal patient care activities across the participating healthcare providers. Since medical information is stored on multiple Intranet sites in various forms (e.g. codified data, transcribed documents, and images), a suite of appropriate tools is needed to enable access to such information in combined form. In most cases, however, access to medical information should be restricted to authorized users. To serve this purpose, a prototype search engine incorporating an authorization and access control functionality has been developed and presented in this paper. The system is based on the signature file access method and an experimental implementation written in JAVA is also described.
Database Management Systems↗