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PubMedDate not supplied

Development of a statewide Maternal and Child Health Information Network.

The Maternal and Child Health Information Network (MATCH) was a national demonstration project funded in 1983 by a Special Projects of Regional and National Significance (SPRANS) grant. The network's major objectives have been to correlate collected clinical service data items into usable information, to expand the database through linkage with other systems within the Ohio Department of Health, and to analyze the conjugated data in an effort to expand current knowledge of maternal and child health. The network is interactive between local funded agencies and the state Health Department. Both data entry and data retrieval are distributed at the end-user information centers. Training and support, major components of the project, are provided to each participant and user of the network. One advantage of MATCH is that it allows linkage of clinical service records with vital records as an outcome of prenatal care and/or a history for child health clients. This aspect of the system permits an expanded look at the population being served by funds designated for maternal and child health programs and the ultimate outcome of such services, and permits comparison with those not receiving preventive health services.

Child Health Services↗
PubMed1991

[Experiences with a Token Ring Network in blood bank administration of the Hannover medical university].

The Token Ring Network is a Local Area Network of IBM. It is a very helpful tool for modulating working processes by personal computers. The Token Ring is a network of the third generation and constructed like a star net. The blood bank of the Medical University of Hannover (MHH) is using the Token Ring for the administration of blood storage and donors. Medical data of foreign laboratories are transmitted into the blood bank computer. During the last year, we had no difficulties working with this software tool in response time and data security and it seemed to us a very cheap opportunity for data integration and data collection on decentralized systems.

Blood Banks↗
PubMed1992

Prototyping an institutional IAIMS/UMLS information environment for an academic medical center.

The paper describes a prototype information environment designed to link network-based information resources in an integrated fashion and thus enhance the information capabilities of an academic medical center. The prototype was implemented on a single Macintosh computer to permit exploration of the overall "information architecture" and to demonstrate the various desired capabilities prior to full-scale network-based implementation. At the heart of the prototype are two components: a diverse set of information resources available over an institutional computer network and an information sources map designed to assist users in finding and accessing information resources relevant to their needs. The paper describes these and other components of the prototype and presents a scenario illustrating its use. The prototype illustrates the link between the goals of two National Library of Medicine initiatives, the Integrated Academic Information Management System (IAIMS) and the Unified Medical Language System (UMLS).

Academic Medical Centers↗
PubMed1991

Developing trends in clinical computing.

With the emergence of personal computers and graphical interfaces during the 1980s, advanced computational power has at last become accessible and affordable for practising clinicians in both inpatient and outpatient settings. Many observers have accordingly noted the relatively low level of direct computer use by physicians in their practices. This paper summarises developing trends in clinical computing, emphasising the role of local and wide-access networks, the revolutionary potential of optical storage techniques, and the notion of integrated workstations that will bring a critical mass of diverse functions to the physician. An important lesson of this review is the current availability of most of the technologies needed for high-quality and acceptable clinical computing tools. The barriers to successful implementation tend to be logistical, financial, and political. Despite these obstacles, new technologies, coupled with educational efforts, should allow the computer to emerge as a crucial aid to clinicians in the decade ahead.

Attitude to Computers↗
PubMed1992

Three methods of implementing a picture archiving and communication system.

A picture archiving and communication system (PACS) is a system integration of many components, including radiologic image acquisition devices, computers, communication networks, image display workstations, and data base management systems. The author describes three general approaches to implementing a PACS. In the first approach, the department or institution acts as a systems integrator, designing and implementing the PACS. In the second approach, the PACS is planned on the basis of the department's operations and environment and then a manufacturer is contracted to design and build the system. The third approach is to purchase a turnkey system, with some modifications provided by the manufacturer for a specific clinical application. The author provides examples of each approach in the clinical environment and presents the disadvantages and advantages of each.

Computer Systems↗
PubMed1991

Initial experience with a radiology imaging network to newborn and intensive care units.

A digital image network has been installed in the James Whitcomb Riley Hospital for Children on the Indiana University Medical Center to create a limited all digital imaging system. The system is composed of commercial components, Philips/AT&T CommView system, (Philips Medical Systems, Shelton, CT; AT&T Bell Laboratories, West Long Beach, NJ) and connects an existing Philips Computed Radiology (PCR) system to two remote workstations that reside in the intensive care unit and the newborn nursery. The purpose of the system is to display images obtained from the PCR system on the remote workstations for direct viewing by referring clinicians, and to reduce many of their visits to the radiology reading room three floors away. The design criteria includes the ability to centrally control all image management functions on the remote workstations to relieve the clinicians from any image management tasks except for recalling patient images. The principal components of the system are the Philips PCR system, the acquisition module (AM), and the PCR interface to the Data Management Module (DMM). Connected to the DMM are an Enhanced Graphics Display Workstation (EGDW), an optical disk drive, and a network gateway to an ethernet link. The ethernet network is the connection to the two Results Viewing Stations (RVS) and both RVSs are approximately 100 m from the gateway. The DMM acts as an image file server and an image archive device. The DMM manages the image data base and can load images to the EGDW and the two RVSs. The system has met the initial design specifications and can successfully capture images from the PCR and direct them to the RVSs.(ABSTRACT TRUNCATED AT 250 WORDS)

Computer Communication Networks↗
PubMed1992

M NET: a statewide referring physician computer network.

M NET, the Referring Physician Computer Network, is a joint project between the University of Michigan Medical Center (UMMC) and IBM. A graphical user interface was developed to allow referring physicians easy access to a variety of patient, clinical, and institutional data. File transfer mechanisms were created and current clinical database files and programs were enhanced and restructured to facilitate remote data transmission. M NET is currently installed in referring physician office sites across the state, with additional physician sites identified and program enhancements under development.

Computer Communication Networks↗
PubMed1991

Incorporating client-server database architecture and graphical user interface into outpatient medical records.

Computerized medical record systems require structured database architectures for information processing. However, the data must be able to be transferred across heterogeneous platform and software systems. Client-Server architecture allows for distributive processing of information among networked computers and provides the flexibility needed to link diverse systems together effectively. We have incorporated this client-server model with a graphical user interface into an outpatient medical record system, known as SuperChart, for the Department of Family Medicine at SUNY Health Science Center at Syracuse. SuperChart was developed using SuperCard and Oracle SuperCard uses modern object-oriented programming to support a hypermedia environment. Oracle is a powerful relational database management system that incorporates a client-server architecture. This provides both a distributed database and distributed processing which improves performance.

Ambulatory Care Information Systems↗
PubMed1990

How to build a connectionist idiot (savant).

This paper describes the development of a connectionist model of an idiot savant date calculator using a multi-layer back-propagation network. The model mimics the behaviour of idiot savant date calculators in learning to perform the date calculation task without the need either to develop arithmetical skills or to encode explicit knowledge about regularities in the structure of dates. However, the performance of the model highlights limitations on the use of back-propagation as a general-purpose learning algorithm in complex problem domains. Even with a relatively simple problem like date calculation back-propagation can only succeed when forced to take a highly structured and modular approach to learning.

Algorithms↗
PubMed1989

Epidemiological surveillance of suicides and attempted suicides in Aquitaine, south-west France, using an original computer network of sentinel general practitioners.

To improve the epidemiological study of suicide and attempted suicides in Aquitaine, France, we developed a comprehensive surveillance system based on the input of Sentinel General Practitioners (SGPs). From October 1986 to May 1988, for each case of suicide or attempted suicide, the SGPs reported epidemiological data to our system through a computer network of personal home terminals (Minitels). Data included age, sex, method and result of attempt and antecedents. In an analysis of the relationship between the suicidal method, antecedents and results of suicidal act, the principal findings were a high rate of antecedents of suicide attempts by drug overdoses, hangings and drownings; and no antecedents for attempts by the use of firearms. This may show that the increasing accessibility of firearms is making it more likely that impulsive suicide attempts will be lethal.

Adult↗
PubMed1992

Dial-in access to CD-ROM databases: beyond the local area network.

Although it has meant additional work, CDLink has enhanced the productivity and effectiveness of the library's public services program. CDLink enables the library to offer dial-in access to databases, either in CD-ROM or other MS-DOS formats. The VAX MS-DOS connection is a cost-effective way to combine the benefits of remote access and multiple simultaneous use. From the user's perspective, CDLink provides free, twenty-four-hour remote access to databases in a friendly, menu-driven environment. For the library staff, the CDLink service represents the achievement of a long-awaited goal.

CD-ROM↗
PubMed1989

Ultra-high-speed teleradiology with ISDN technology.

A solid-state, personal computer-based, image digitization and transmission system was developed that uses integrated services digital network (ISDN), a technology under development for ultra-high-speed data transmission over normal phone lines. Thousands of images have been transmitted to a site more than 15 miles away, with data rates exceeding 56,000 bits or 7,000 bytes (1 byte = 8 bits) per second with nearly perfect accuracy. Present modification of the system hardware and software should increase the data rate to 128,000 bits, or 16,000 bytes, per second. With this rate of transmission, remote radiologic image transmission should become a practical, routinely available diagnostic tool.

Computer Communication Networks↗
PubMed1990

Integrated computerized databases for medical data management beyond the bedside.

Computers are beginning to be utilized extensively for direct patient care, assisting nursing and medical staff with data collection and review at the bedside. However, most clinical data management systems are optimized for bedside patient care and offer limited resources for multi-patient data analysis. At Cedars-Sinai Medical Center, a network of computer systems has been developed to provide linkages between clinical, administrative and outcome data for Surgical Intensive Care Unit (SICU) patients. Increasingly, such data is needed to evaluate the relationship between severity of illness and patient outcome and the utilization of expensive critical care resources. Over the parts 3 years, comprehensive data on 6,755 consecutive SICU patients receiving 18,394 days of care have been accumulated by our PDMS. Using linkages constructed to other hospital systems and databases, trends for severity of illness, severity adjusted survival, census, bed utilization, nursing utilization and many other parameters have been constructed. These linkages are valuable in documenting cost-effective and medically-effective patient care practices.

Computer Communication Networks↗
PubMed1992

GCI: a network server for interactive 3D graphics.

The Graphics Command Interpreter (GCI) is an independent server module that can be interfaced to any program that needs interactive three-dimensional (3D) graphics capabilities. The principal advantage of GCI is its simplicity. Only a limited set of powerful features have been implemented, including object management, global and local transformations, rotation, translation, clipping, scaling, viewport operations, window management, menu handling and picking. GCI and the master (client) program it serves run concurrently, communicating over a local or remote TCP/IP network. GCI sets up socket communication and provides a 3D graphics window and a terminal emulator for the master program. Communication between the two programs is via ASCII strings over standard I/O channels. The implied language for messages is very simple. GCI interprets messages from the master program and implements them as changes of graphical objects or as text messages to the user. GCI provides the user with facilities to manipulate the view of the displayed 3D objects interactively, independently of the master program, and to communicate mouse-controlled selection of menu items or 3D points as well as keyboard strings to the master program. The program is written in C and initially implemented using the Silicon Graphics GL graphics library. As the need to link special libraries to the master program is completely avoided, GCI can very easily be interfaced to existing programs written in any language and running on any operating system capable of TCP/IP communication. The program is freely available.

Computer Communication Networks↗
PubMed1992

The impact of IAIMS at Georgetown: strategies and outcomes.

Integration of multiple information systems of a medical center will change the way physicians work and practice medicine in the future. Several major steps must be taken by an institution to make this a reality. Since 1983, Georgetown has been engaged in an Integrated Academic Information Management System (IAIMS) project to bring together multiple sources of information that reside on different computers and database systems. Georgetown is developing a Biotechnology and Biomedical Knowledge Network that includes informational and clinical databases, scholar workstations, instruction on computer use, a campuswide network with local area network nodes, and a modular approach to systems integration. The IAIMS project, spearheaded by the medical library, has enabled a broad spectrum of health professionals to benefit directly from new, dynamic information services. The network is heavily used; in 1991, more than 2,100 individual users conducted more than 148,500 computer functions and more than 104,000 searches. There is economy of scale in high-volume use. Overall, the average search cost is $1.57; for high use databases the cost is $0.38, and for low use, it is $9.41. As described in this paper, IAIMS offers a cost-effective means of enhancing patient care by improving information services to physicians. At Georgetown, IAIMS has advanced the concept of integration, accelerated use of computers in education, increased user acceptance of advanced technologies, and established cost factors for providing information resources. While progress made in improving the transfer of medical information is impressive, it is clear that IAIMS requires several more years of support to achieve full implementation.

Academic Medical Centers↗
PubMed1992

Teleradiology via narrow-band integrated services digital network (N-ISDN) and Joint Photographic Experts Group (JPEG) image compression.

The importance of remote access to both radiological images and medical information has stimulated many demonstration projects that use a variety of telecommunications providers' offerings. Teleradiology, through modest cost channels, can achieve adequate response times using a combination of narrow-band integrated services digital network (N-ISDN) and data compression. A demonstration project, developed in collaboration with Southwestern Bell Technology Resources, Inc, uses the aggregate bandwidth of two B channels (achieving a rate of 120 kilobits per second) and a block-oriented discrete cosine transform compression/decompression implementation based on the Joint Photographic Experts Group Standard for Still Image Compression. System response measurements for an Inquiry and Display Station accessing the Mallinckrodt Institute of Radiology's Radiology Image and Information Management Testbed via the N-ISDN connection show response times to be within 20 seconds. Viewing applications have been shown at sites within St Louis and at Radiological Society of North America, 1990, in Chicago.

Computer Communication Networks↗
PubMedDate not supplied

Telematics and sentinel health information system with general practitioners in Aquitaine, southwest France.

A sentinel health information system using a telematics system to collect epidemiological data from a network of general practitioners (GPs) making up 5% of the GP population was set up in October 1986 in Aquitaine, France. In the first year, four topics were under surveillance. The GPs reported data for each case diagnosed by filling out a questionnaire displayed on their home terminal (Minitel), which transmitted the data by standard telephone lines to a central minicomputer located in the Bordeaux University Medical Centre. Regular feedback was provided to the participating GPs, public health officials and the Bordeaux Medical School. A detailed report of GP participation is presented, the reliability of our findings is discussed in terms of the motivational factors of participants, and the usefulness of the system is evaluated both for immediate teaching implications and for future research possibilities.

Computer Communication Networks↗
PubMed1992

CD-ROM source data uploaded to the operating and storage devices of an IBM 3090 mainframe through a PC terminal.

A powerful method of processing MEDLINE and CINAHL source data uploaded to the IBM 3090 mainframe computer through an IBM/PC is described. Data are first downloaded from the CD-ROM's PC devices to floppy disks. These disks then are uploaded to the mainframe computer through an IBM/PC equipped with WordPerfect text editor and computer network connection (SONNGATE). Before downloading, keywords specifying the information to be accessed are typed at the FIND prompt of the CD-ROM station. The resulting abstracts are downloaded into a file called DOWNLOAD.DOC. The floppy disks containing the information are simply carried to an IBM/PC which has a terminal emulation (TELNET) connection to the university-wide computer network (SONNET) at the Ohio State University Academic Computing Services (OSU ACS). The WordPerfect (5.1) processes and saves the text into DOS format. Using the File Transfer Protocol (FTP, 130,000 bytes/s) of SONNET, the entire text containing the information obtained through the MEDLINE and CINAHL search is transferred to the remote mainframe computer for further processing. At this point, abstracts in the specified area are ready for immediate access and multiple retrieval by any PC having network switch or dial-in connection after the USER ID, PASSWORD and ACCOUNT NUMBER are specified by the user. The system provides the user an on-line, very powerful and quick method of searching for words specifying: diseases, agents, experimental methods, animals, authors, and journals in the research area downloaded. The user can also copy the TItles, AUthors and SOurce with optional parts of abstracts into papers under edition. This arrangement serves the special demands of a research laboratory by handling MEDLINE and CINAHL source data resulting after a search is performed with keywords specified for ongoing projects. Since the Ohio State University has a centrally founded mainframe system, the data upload, storage and mainframe operations are free.

CD-ROM↗