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At least 973 records · Page 54Linked to original sources
PubMed2000

An open architecture for medical imaging systems.

Integration of medical imaging is the goal of many standards. Interfile and Digital Imaging and Communications in Medicine (DICOM) standards have made great strides in this area. The impact of DICOM is greater owing to its wider acceptance. However, the lack of conformance testing makes interoperability difficult, often requiring expensive consulting teams in a mixed-vendor environment. DICOM is difficult to learn and deploy because it does not use modern software paradigms. Many hardware and software advances in computer architectures and communications could greatly enhance diagnostic imaging if they could be quickly incorporated into medical imaging standards. These problems led to consideration of a solution able to take advantage of state-of-the-art technology and to allow diverse implementations while ensuring the accurate interchange of information between health care providers. It is an object-oriented system information model, with the common object request broker architecture (CORBA) as the vehicle to ensure interoperability between different implementations of the model. This report presents the model.

Computer Communication Networks↗
PubMed2001

Development of a fully integrated analysis system for ions based on ion-selective optodes and centrifugal microfluidics.

A fully integrated, miniaturized analysis system for ions based on a centrifugal microfluidics platform and ion-selective optode membranes is described. The microfluidic architecture is composed of channels, five solution reservoirs, a measuring chamber, and a waste reservoir manufactured onto a disk-shaped substrate of poly(methyl methacrylate). Ion-selective optode membranes, composed of plasticized poly(vinyl chloride) impregnated with an ionophore, a proton chromoionophore, and a lipophilic anionic additive, were cast, with a spin-on device, onto a support layer and then immobilized on the disk. Fluid propulsion is achieved by the centrifugal force that results from spinning the disk, while a system of valves is built onto the disk to control flow. These valves operate based on fluid properties and fluid/substrate interactions and are controlled by the angular frequency of rotation. With this system, we have been able to deliver calibrant solutions, washing buffers, or "test" solutions to the measuring chamber where the optode membrane is located. An analysis system based on a potassium-selective optode has been characterized. Results indicate that optodes immobilized on the platform demonstrate theoretical responses in an absorbance mode of measurement. Samples of unknown concentration can be quantified to within 3% error by fitting the response function for a given optode membrane using an acid (for measuring the signal for a fully protonated chromoionophore), a base (for fully deprotonated chromoionophore), and two standard solutions. Further, the ability to measure ion concentrations by employing one standard solution in conjunction with acid and base and with two standards alone were studied to delineate whether the current architecture could be simplified. Finally, the efficacy of incorporating washing steps into the calibration protocol was investigated.

Calibration↗
PubMed2000

Flavor enhancement of reduced fat cheddar cheese using an integrated culturing system.

Mild cheese flavor in reduced fat Cheddar cheese was enhanced by using an integrated starter culture system. Three cultures, Lactococcus lactis subsp. cremoris SK11, L. lactis subsp. lactis biovar. diacetylactis JVI, and Lactobacillus casei 7A, were carefully selected to obtain a nonbitter, mildly acid, buttery flavored cheese. Cheeses were produced from all possible combinations of these cultures with the constraint that L. lactis subsp. cremoris SK11 was used as the primary acid-producing culture. Cheeses made with SK11 were compared to cheeses produced using an L. lactis subsp. cremoris commercial starter culture. Cheeses were ripened for 150 days and periodically sampled for chemical, microbiological, and sensory analysis. Cheeses produced with L. lactis subsp. cremorisSK11 had substantially lower bitterness intensity than the cheeses produced with commercial starter culture. L. lactis subsp. lactis biovar. diacetylactis JVI significantly increased diacetylacetoin and acetate concentrations. Sensory results indicate that these cheeses had increased buttery (diacetyl) flavor.

Cheese↗
PubMedDate not supplied

Health promotion and disease prevention in integrated delivery systems: the role of market forces.

This article proposes a framework for the study of the effects of market forces on health promotion and disease prevention (HP/ DP) in integrated delivery systems (IDSs). We describe the evolution of IDSs in the United States and review the limited research on the extent to which IDSs have integrated HP/DP. We propose a typology of HP/DP activities that provides a comprehensive model of the types of HP/DP services and functions that an IDSs may incorporate. Finally, we identify and discuss the major market stages through which IDSs are transitioning, and within each market stage we identify the major forces that may influence IDS decisions to incorporate HP/DP services.

Commerce↗
PubMed1997

Providing public health services through an integrated delivery system.

This article examines a recently implemented strategy to transfer responsibility for local public health service delivery from a county health department to a hospital-based integrated delivery system. Innovative quality management efforts at both local and state levels offer opportunities for sustained improvement in the availability and adequacy of public health services under this arrangement.

Contract Services↗
PubMed1997

Towards a component driven infrastructure for integrated healthcare systems.

A high level summarised description of the distributed clinical information system implemented in the hospital of the free university of Brussels (AZ-VUB) is described. It evolves towards a component based clinical distributed system that consists of a set of co-operating middelware software components running on a number of computers connected by a network that will foster the integration of applications, data servers and other resources in the medical field. This system is implemented in the University Hospital of Brussels (AZ-VUB) a full-service 800-bed university hospital that provides care for 23,000 inpatients, supports over 300,000 outpatient visits and receives 32,000 emergency patients a year.

Belgium↗
PubMed1993

An integrated software system for quality assurance-related kappa coefficient analysis of intraoperative transesophageal echocardiography interpretive skills.

This report describes the development of a quality assurance-oriented integrated software system designed for an anesthesiology-based intraoperative transesophageal echocardiography service. Entry data include patient and operation demographics, two-dimensional echocardiographic, saline-contrast, and color flow/pulsed Doppler assessments of the heart and great vessels, presented in a defined sequence. A statistical analysis component (kappa coefficient analysis) allows for comparison of intraoperative real-time interpretations with laboratory interpretations made by experienced full-time echocardiographers on a field-by-field basis. This provides a means of quantifying expertise in each individual aspect of the patient examination sequence. We believe that such self-appraisal data are essential for delineating the status and tracking the progress of service being provided.

Echocardiography, Transesophageal↗
PubMed2006

Use of the University of California Los Angeles Integrated Staging System (UISS) to predict survival in localized renal cell carcinoma in an Asian population.

OBJECTIVES: To evaluate the applicability of the University of California Los Angeles Integrated Staging System (UISS) in predicting the prognosis of Chinese patients with localized renal cell carcinoma after radical nephrectomy, with reference to that reported by Patard et al in an international multicenter study (J Clin Oncol 2004, 22:3316-3322). METHODOLOGY: One hundred and twenty-eight Chinese patients with localized renal cell carcinoma were stratified into low risk (LR), intermediate risk (IR) and high risk (HR) groups according to the UISS, based on the TMN staging and Fuhrman grading of the tumor and the Eastern Cooperative Oncology Group performance status of the patients. The survival curves of each risk group were then calculated. RESULTS: The number of patients in the LR, IR and HR was 24 (18.8%), 94 (73.4%) and 10 (7.8%) respectively. The estimated 2-year survival rates were 100%, 89.9% and 100% for the LR, IR and HR groups respectively. Whereas the estimated 5-year survival rates were 93.3%, 72.4% and 80% for the LR, IR and HR groups respectively. The LR and IR patients had comparable 2-year and 5-year estimated survival rates with those reported by Patard et al. However, the estimated survival rate for HR patients was better than that reported. CONCLUSIONS: UISS provided a valuable tool in predicting the survival of Chinese patients with localized renal cell carcinoma of LR and IR groups, as reported in other international centers. Further large scale study may be needed to confirm the applicability in HR population.

Carcinoma, Renal Cell↗
PubMed1976

Research data integrity: a result of an integrated information system.

The toxicologic problems of today frequently require long-term, multidisciplinary experimentation involving large numbers of animals. In order to provide the extensive safety evaluation necessary to produce data that can be reasonably extrapolated to humans, automated research support systems have transcended the position of useful tools and have become an integral part of the total design of experimental protocols. For an automated information system to fully represent the reality of the experiment, it must be able to assure integrity, as well as provide for the storage, calculation, and retrieval of data values of the quality and quantity necessary for fulfilling protocol requirements. Guarantees against error and loss of data, in addition to flexibility and easy access, must be an inherent part of the system if the acceptance and condifence of the investigator are to be obtained. This paper discusses the criteria, philosophies, and benefits of integrated data systems that ensure integrity of toxicologic research support.

Computers↗
PubMedDate not supplied

Online support functions of prescription order system and prescription audit in an integrated hospital information system.

The role of the online prescription support functions of a prescription order entry system was analysed and the results of the prescription audit by pharmacists were examined. In the Kochi Medical School Hospital, an online prescription order system has been developed as part of an integrated hospital information system named IMIS (the Integrated Medical Information System), in which all the physicians enter their prescription orders into online display terminals. The prescription order entry system is provided with prescription support functions, which check the entered prescription data, issue warnings, and offer information about drugs or patients. The prescription order system reduces the incidence of simple prescription mistakes and greatly decreases the cases of inquiries by pharmacists. However, results of the analysis show that such functions as warnings of double order and repeated prescription of a drug do not work as well as expected. The system would thus require some kind of intelligence like that of the auditing pharmacists or that of the physicians with accurate knowledge of clinical pharmacology.

Drug Prescriptions↗
PubMed2001

Developing decision support systems for integrated coastal management in the tropics: is the ICM decision-making environment too complex for the development of a useable and useful DSS?

Integrated coastal management in the tropics requires the conservation of vulnerable and diverse ecosystems such as coral reefs and mangroves as well as the management of land and marine-based human activities. Decision-making for integrated coastal management involves multiple decision-makers and multiple stakeholders often with conflicting needs and interests. Decision support systems can be developed to improve our understanding of the inter-relationships between the natural and socio-economic variables and hence result in improved decision-making. The question is whether this decision making environment is actually too complex for the development of useful and useable decision support systems. This paper describes the components of the decision making environment and the components of a decision support system. It also explores the various techniques available to deal with different modelling needs, the constraints of inadequate data and the multi-objective decision making environment. In addition, different techniques of developing decision support systems can play important roles within integrated coastal management. Three coastal decision support systems are evaluated in terms of their design and role in integrated coastal management and are used to evaluate the potential to develop decision support systems for integrated coastal management.

Animals↗
PubMed1999

Information resources assessment of a healthcare integrated delivery system.

While clinical healthcare systems may have lagged behind computer applications in other fields in the shift from mainframes to client-server architectures, the rapid deployment of newer applications is closing that gap. Organizations considering the transition to client-server must identify and position themselves to provide the resources necessary to implement and support the infrastructure requirements of client-server architectures and to manage the accelerated complexity at the desktop, including hardware and software deployment, training, and maintenance needs. This paper describes an information resources assessment of the recently aligned Pennsylvania regional Veterans Administration Stars and Stripes Health Network (VISN4), in anticipation of the shift from a predominantly mainframe to a client-server information systems architecture in its well-established VistA clinical information system. The multimethod assessment study is described here to demonstrate this approach and its value to regional healthcare networks undergoing organizational integration and/or significant information technology transformations.

Computer Communication Networks↗
PubMed2002

Framework for measuring sustainable development in catchment systems.

Integrated catchment management represents an approach to managing the resources of a catchment by integrating environmental, economic, and social issues. It is aimed at deriving sustainable benefits for future generations, while protecting natural resources, particularly water, and minimizing possible adverse social, economic, and environmental consequences. Indicators of sustainable development, which summarize information for use in decision-making, are invaluable when trying to assess the diverse, interacting components of catchment processes and resource management actions. The Driving-Forces--Pressure--State--Impact--Response (DPSIR) indicator framework is useful for identifying and developing indicators of sustainable development for catchment management. Driving forces have been identified as the natural conditions occurring in a catchment and the level of development and economic activity. Pressures include the natural and anthropogenic supply of water, water demand, and water pollution. State indicators can be split into those of quantity and those of quality. Impacts include those that affect the ecosystems directly and those that impact the use value of the resource. It core indicators are identified within each of the categories given in the framework, most major catchment-based management issues can be evaluated. This framework is applied to identify key issues in catchment management in South Africa, and develop a set of indicators for evaluating catchments throughout the country.

Conservation of Natural Resources↗
PubMed1993

Characterization of the binding sites of two proteins involved in the bacteriophage P2 site-specific recombination system.

Integration of the bacteriophage P2 genome into the Escherichia coli host chromosome occurs by site-specific recombination between the phage attP and E. coli attB sites. The phage-encoded 38-kDa protein, integrase, is known to be necessary for both phage integration as well as excision. In order to begin the molecular characterization of this recombination event, we have cloned the int gene and overproduced and partially purified the Int protein and an N-terminal truncated form of Int. Both the wild-type Int protein and the integration host factor (IHF) of E. coli were required to mediate integrative recombination in vitro between a supercoiled attP plasmid and a linear attB substrate. Footprint experiments revealed one Int-protected region on both of the attP arms, each containing direct repeats of the consensus sequence TGTGGACA. The common core sequences at attP and attB were also protected by Int from nuclease digestion, and these contained a different consensus sequence, AA T/A T/A C/A T/G CCC, arranged as inverted repeats at each core. A single IHF-protected site was located on the P (left) arm, placed between the core- and P arm-binding site for Int. Cooperative binding by Int and IHF to the attP region was demonstrated with band-shift assays and footprinting studies. Our data support the existence of two DNA-binding domains on Int, having unrelated sequence specificities. We propose that P2 Int, IHF, attP, and attB assemble in a higher-order complex, or intasome, prior to site-specific integrative recombination analogous to that formed during lambda integration.

Bacterial Proteins↗
PubMed1993

Graphical electrocardiogram waveforms as part of an integrated hospital system's patient record.

The U.S. Department of Veterans Affairs (VA) has an ongoing project to integrate diagnostic images into its existing text-based hospital information system. High-quality images from cardiology, pulmonary medicine, gastroenterology, endoscopy, pathology, radiology, hematology and nuclear medicine can be displayed for clinicians quickly and conveniently on workstations throughout the hospital. As a part of this endeavor, diagnostic-quality computer generated 12-lead electrocardiograms, including both median and rhythm data, can be viewed as a part of the on-line patient record of an integrated hospital information system. Now computer generated graphics can be included in the longitudinal patient record. Incorporating generated graphics and images into a text based patient record is another step towards the next generation of integrated hospital information system with multimedia patient records.

District of Columbia↗
PubMed2005

The impact on patient safety of free-text entry of nursing orders into an electronic medical record in an integrated delivery system.

The introduction of Computerized Provider Order Entry (CPOE) has been shown to reduce the incidence of medication-related errors in hospitals. Successful implementation of CPOE and electronic health records requires redesigning workflows and analysis of information collected and training of staff to use these new systems. However, well intentioned processes that seem to solve a unique problem can sometimes go in an unanticipated direction for several reasons. This can have unintentional consequences, especially when the built-in safeguards are not engaged. This poster describes one organization's efforts to identify the causes of one such breakdown, and how the obvious solutions were inappropriate.

Delivery of Health Care, Integrated↗