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Many healthcare facilities are exploring document imaging solutions and enjoying the benefits of increased accessibility and faster workflows. The transition requires significant planning, however. In this article, learn how several healthcare organizations implemented document imaging systems and how their facilities have changed as a result.
The principal product produced by the clinical laboratory is information. This is true whether or not an automated system is used to organize and retrieve this information. It follows that great care must be exercised in ensuring that the stored data are accurate in the sense that they truly and always represent those data that were meant to be recorded. Various forces may act to compromise this information including (1) accidents, such as fire, floods, or earthquakes; (2) human error; and (3) deliberate acts, such as sabotage or theft of information. An organized plan for systematically managing the "information resource" has become critical. To safeguard against the potential catastrophic loss of information, a formal information resource management policy must be adopted within the clinical laboratory and directed by a specific individual, under the guidance of the director of pathology.
Using the "Natural" computer language a menu-guided system for cataloguing, processing and evaluating bacteriological and chemical water analyses was designed. The program can be employed to different blocs of analyses, e.g. "TrinkwV"-analyses, standard-analyses, those on volatile chlorinated hydrocarbons and bacteriological water analyses as well. For each water sample the actual, the last and the next to the last value, also arithmetical means, minimal and maximal are stored and can be retrieved. The evaluation of the bacteriological analyses and those of the volatile chlorinated hydrocarbons is carried out by a choice of text variants, whereas the TVO- and standard-analyses are interpreted automatically. Managing laboratory data has become much easier during our three years experience using this system for information storage, search and retrieval in water research and routine; even untrained users are able to handle it after a short period of tuition.
Data in the health care environment can encompass a wide range of contents, each representing one aspect of health care delivery. Examples of such a diverse and yet related content are diagnostic images, laboratory results, patient history, hospital administration, and insurance and payer coverage. The focus of this article is the handling of diagnostic imaging in general and radiographic imaging in particular, therefore fundamental concepts and issues are presented and discussed.
BACKGROUND: Rural physicians need access to digital health sciences libraries (DHSLs) that is easy and reasonably rapid. The goal of this project was to study rural hospitals' access to a DHSL on the Internet, by comparing differing access speeds with differing costs and their acceptability for retrieving text, image, and video information in a DHSL. METHODS: DHSL system response time was measured at three different times during the day over three different types of network connections (T1, Frame Relay, Modem). Text, image, and video information was retrieved. Costs were determined for installation and operation of the different types of network connections. RESULTS: System response times were consistent at the three different testing times for each media type retrieved by each of the three network connection types. System response times for text retrieval met literature standards for all connections. Image retrieval met literature standards for T1 and Frame relay connections. No connection met literature standards for video retrieval. CONCLUSIONS: High speed access to DHSLs is preferable; Frame relay connections provide substantively similar service as T1 connections at less cost. However, access via modem to a DHSL can provide access to the majority of information--text--in a DHSL with an acceptable system response time.
BACKGROUND: The Clinical Information Access Program (CIAP), an online evidence retrieval system, provides NSW health professionals in public hospitals with 24 h access to information supporting evidence-based practice. AIM: To assess the frequency and type of CIAP usage by senior and junior medical staff and doctors' attitudes to CIAP. METHODS: A convenience sample of 25% of doctors from 65 randomly selected public hospitals completed a survey. Junior (n = 392) and senior (n = 684) doctors' responses were compared using chi2 analyses and t-tests. RESULTS: Most doctors had heard of CIAP (71.8%) and 60.6% had used it. More junior (72.4%) than senior (53.8%) doctors had used CIAP and junior doctors found it easier to use. Of the users 93.5% believed CIAP had the potential to improve patient care; 55.2% had directly experienced this. Most usage (61.5%) occurred at point-of-care; 74% of users found all/most of the information they sought and 71.6% found the search time to be 'good/excellent'. Users had increased their usage in the past year and predicted increased future usage. The most popular databases were Medline and MIMS. Age, access to other evidence, and lack of training, time and computer skills were associated with non-usage. Junior and senior users differed in 4 of 15 reasons for using CIAP. CONCLUSIONS: CIAP is used and valued by the majority of doctors. Patterns of usage, online experiences and the attitudes toward CIAP of senior doctors who use CIAP are relatively similar to those of junior doctors.
Current large-scale information sources are designed to support general queries and lack the ability to support scenario-specific information navigation, gathering, and presentation. As a result, users are often unable to obtain desired specific information within a well-defined subject area. Today's information systems do not provide efficient content navigation, incremental appropriate matching, or content correlation. We are developing the following innovative technologies to remedy these problems: 1) scenario-based proxies, enabling the gathering and filtering of information customized for users within a pre-defined domain; 2) context-sensitive navigation and matching, providing approximate matching and similarity links when an exact match to a user's request is unavailable; 3) content correlation of documents, creating semantic links between documents and information sources; and 4) user models for customizing retrieved information and result presentation. A digital medical library is currently being constructed using these technologies to provide customized information for the user. The technologies are general in nature and can provide custom and scenario-specific information in many other domains (e.g., crisis management).
Numerous examples exist of the benefits of the timely access to information in emergencies and disasters. Information technology (IT) is playing an increasingly important role in information-sharing during emergencies and disasters. The effective use of IT in out-of-hospital (OOH) disaster response is accompanied by numerous challenges at the human, applications, communication, and security levels. Most reports of IT applications to emergencies or disasters to date, concern applications that are hospital-based or occur during non-response phases of events (i.e., mitigation, planning and preparedness, or recovery phases). Few reports address the application of IT to OOH disaster response. Wireless peer networks that involve ad hoc wireless routing networks and peer-to-peer application architectures offer a promising solution to the many challenges of information-sharing in OOH disaster response. These networks offer several services that are likely to improve information-sharing in OOH emergency response, including needs and capacity assessment databases, victim tracking, event logging, information retrieval, and overall incident management system support.
BACKGROUND: The rapid growth of online publications such as the Medline and other sources raises the questions how to get the relevant information efficiently. It is important, for a bench scientist, e.g., to monitor related publications constantly. It is also important, for a clinician, e.g., to access the patient records anywhere and anytime. Although time-consuming, this kind of searching procedure is usually similar and simple. Likely, it involves a search engine and a visualization interface. Different words or combination reflects different research topics. The objective of this study is to automate this tedious procedure by recording those words/terms in a database and online sources, and use the information for an automated search and retrieval. The retrieved information will be available anytime and anywhere through a secure web server. RESULTS: We developed such a database that stored searching terms, journals and et al., and implement a piece of software for searching the medical subject heading-indexed sources such as the Medline and other online sources automatically. The returned information were stored locally, as is, on a server and visible through a Web-based interface. The search was performed daily or otherwise scheduled and the users logon to the website anytime without typing any words. The system has potentials to retrieve similarly from non-medical subject heading-indexed literature or a privileged information source such as a clinical information system. The issues such as security, presentation and visualization of the retrieved information were thus addressed. One of the presentation issues such as wireless access was also experimented. A user survey showed that the personalized online searches saved time and increased and relevancy. Handheld devices could also be used to access the stored information but less satisfactory. CONCLUSION: The Web-searching software or similar system has potential to be an efficient tool for both bench scientists and clinicians for their daily information needs.
Structured reporting systems allow health-care workers to record observations using predetermined data elements and formats. The author developed the Data-entry and Reporting Markup Language (DRML) to provide a generalized representational language for describing concepts to be included in structured reporting applications. DRML is based on the Standard Generalized Markup Language (SGML), an internationally accepted standard for document interchange. The use of DRML is demonstrated with the SPIDER system, which uses public-domain internet technology for structured data entry and reporting. SPIDER uses DRML documents to create structured data-entry forms, outline-format textual reports, and datasets for analysis of aggregate results. Applications of DRML include its use in radiology results reporting and a health status questionnaire. DRML allows system designers to create a wide variety of clinical reporting applications and survey instruments, and helps overcome some of the limitations seen in earlier structured reporting systems.
OBJECTIVES: In this article we present grids as an architecture for medical image processing and health-care networks. We argue that confidential patient data should not be stored unprotected on a grid and explain why access control systems alone do not offer sufficient protection. The objective of our work is to propose a method that complements access control systems on a grid architecture and thus makes the storage of confidential data more secure. METHODS: Effective protection can be achieved by storing confidential data in encrypted form. This raises the problem of how authorized users get access to the data, since they need to have the decryption keys. RESULTS: Our proposal details a key management architecture, that allows encrypted storage and still enables users to access decryption keys for data they are authorized to see. To achieve this functionality we use distributed keyservers storing redundant shares of the keys. CONCLUSIONS: The resulting architecture achieves our primary objective of making the storage of confidential data more secure without loosing the data sharing properties of the grid architecture. Furthermore our architecture is robust against breakdowns and denial of service attacks. It scales well with the number of users and does not introduce a single point of failure into the system.
The IUPS Physiome Project is an internationally collaborative open-source project to provide a public domain framework for computational physiology, including the development of modelling standards, computational tools and web-accessible databases of models of structure and function at all spatial scales. A number of papers in this volume deal with the development of specific mathematical models of physiological processes. This paper stands back from the detail of individual models and reviews the current state of the IUPS Physiome Project including organ and organ system continuum models, the interpretation of constitutive law parameters in terms of micro-structural models, and markup languages for standardizing cellular processes. Some current practical applications of the physiome models are given and some of the challenges for the next 5 years of the Physiome Project at the level of organs, cells and proteins are proposed.
UNLABELLED: BioNetBuilder is an open-source client-server Cytoscape plugin that offers a user-friendly interface to create biological networks integrated from several databases. Users can create networks for approximately 1500 organisms, including common model organisms and human. Currently supported databases include: DIP, BIND, Prolinks, KEGG, HPRD, The BioGrid and GO, among others. The BioNetBuilder plugin client is available as a Java Webstart, providing a platform-independent network interface to these public databases. AVAILABILITY: http://err.bio.nyu.edu/cytoscape/bionetbuilder/
One of the important research tasks of the European Centre for Medical Informatics, Statistics and Epidemiology - Cardio (EuroMISE Centre - Cardio) is the applied research in the field of electronic health record design including electronic medical guidelines and intelligent systems for data mining and decision support. The research in the field of data storage and data acquisition was inspired by several European projects and standards, mostly by the I4C and TripleC projects. Based on experience gathered during cooperation in the TripleC project we have proposed a description of a flexible information storage model. The motivation for this effort was the large variability of the set of collected features in different departments - including temporal variability. Therefore, a dynamically extensible and modifiable structure of items is needed. In our model we use two basic structures called the knowledge base and data files. The main function of the knowledge base is to express the hierarchy of collectable features - medical concepts, their characteristics and relations among them. The data files structure is used to store the patient's data itself. These two structures can be described using graph theory expressions. Based on this model, a three-layer system architecture named "Multimedia Distributed Record" (MUDR) has been proposed and implemented. During the implementation, modern technologies such as Web Services, SOAP and XML were used. For the practical usage of EHR MUDR, an intelligent application called MUDRc (MUDR Client) was created. It enables physicians to use EHR MUDR in a flexible way. During the development process, maximum emphasis was placed on user-friendliness and comfortable usage of this application. Several methods of data entry can be used: pre-defined forms, direct entry into the tree data structure of the EHR MUDR, or automatic unstructured free-text report parsing and data retrieval. The system enables fast and simple importing and exporting of data as well. The system integrates modern multimedia formats (X-ray photos, sonography and other pictures, video-sequences, audio records) as well as progressive methods of decision support systems realized by medical guidelines and other modules.
MOTIVATION: International sequencing efforts are creating huge nucleotide databases, which are used in searching applications to locate sequences homologous to a query sequence. In such applications, it is desirable that databases are stored compactly, that sequences can be accessed independently of the order in which they were stored, and that data can be rapidly retrieved from secondary storage, since disk costs are often the bottleneck in searching. RESULTS: We present a purpose-built direct coding scheme for fast retrieval and compression of genomic nucleotide data. The scheme is lossless, readily integrated with sequence search tools, and does not require a model. Direct coding gives good compression and allows faster retrieval than with either uncompressed data or data compressed by other methods, thus yielding significant improvements in search times for high-speed homology search tools.
The exchange of information between the working and long-term memory system (WMS and LTMS) was investigated. We analyzed evoked theta and upper alpha desynchronization in a special memory task, designed to study the transfer of information between both memory systems. The results show that during attempts to retrieve information from the LTMS, evoked theta oscillations spread from anterior to posterior recording sites. When information actually is retrieved, the direction reverses and theta spreads to frontal sites. This time point--when direction reverses--varies between subjects to a large extent but is significantly correlated with memory performance and the onset of upper alpha desynchronization. We conclude that this phenomenon reflects the transfer of information between the WMS and LTMS
In this paper, we argue that the foundations of chemistry rely as much on the methods of measurement as they do on categories of chemical substance. To some degree, chemists perform the work of knowledge engineering: designing complex systems for the efficient retrieval of information. Indeed, in some cases, methods of instrumental detection move to the forefront of attention. For example, researchers are expected to deploy optimization methods designed to maximize desired signal and minimize the damaging effects of noise. But in his important contributions to the development of high-resolution NMR spectrometers, Hans Primas used stochastic methods to reveal beneficial effects of noise for characterizing physical systems, demonstrating the value of noisy signals for nonlinear physical systems in chemistry.
In this paper we present a case study for data warehousing intended to support data mining and analysis. We also describe a prototype for data retrieval. Further we discuss some technical issues related to a particular choice of a patient record environment.