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A workflow-based approach to virtual patient record security.

Virtual patient records provide a means for integrated access to patient information that may be scattered around different healthcare organizations (or hospital departments). As Intranets provide, among others, secure access to medical information, they constitute an appropriate technological infrastructure for a virtual patient record implementation. In such cases, a security policy can be enforced by combining the security features of the Intranet with the security features of the intraorganizational systems. However, when a workflow system is implemented to automate interorganizational healthcare processes, an additional security layer is needed. An authorization architecture that serves this purpose is presented in this paper.

Computer Communication Networks↗

An architecture for the automatic acquisition of vital signs by clinical information systems.

An architecture is presented which provides clinical information systems with access to vital sign information from medical devices. Middleware components encapsulate details of communicating with devices whilst adoption of de facto and international standards maximizes interoperability with client software. An application in routine clinical use is described.

Blood Gas Analysis↗

Object-oriented modeling of patients in a medical federation.

This research explores the development of an object-oriented model to support inter-operation of simulations within a federation for the purpose of conducting medical analysis and training over a distributed infrastructure. The medical federation is referred to as the combat trauma patient simulation system and is composed using high level architecture. The infrastructure contains components that were separately developed and are heterogeneous in nature. This includes a general anatomical computer database capable of generating human injuries, referred to as operational requirements-based casualty assessment, an animated mannequin called the human patient simulator, and other components. The research develops an object model that enables bodily injury data to be shared across the simulation, conducts analysis on that data, and considers possible applications of the technique in expanded medical infrastructures.

Computer Communication Networks↗

Wireless clinical alerts for physiologic, laboratory and medication data.

A fully interfaced clinical information system (CIS) contains physiologic, laboratory, blood gas, medication and other data that can be used as the information base for a comprehensive alerting system. Coupled with an event driven rules engine, a CIS can generate clinical alerts which may both prevent medical errors and assist caregivers in responding to critical events in a timely way. The authors have developed a clinical alerting system which delivers alerts and reminders to clinicians in real time via a alphanumeric display pagers. This paper will describe the system, the type and number of alerts generated, and the impact on clinical practice. A major issue remains in measuring the impact of wireless alerts on patient outcomes.

Algorithms↗

Deblocking of block-transform compressed images using weighted sums of symmetrically aligned pixels.

A new class of related algorithms for deblocking block-transform compressed images and video sequences is proposed in this paper. The algorithms apply weighted sums on pixel quartets, which are symmetrically aligned with respect to block boundaries. The basic weights, which are aimed at very low bit-rate images, are obtained from a two-dimensional function which obeys predefined constraints. Using these weights on images compressed at higher bit rates produces a deblocked image which contains blurred "false" edges near real edges. We refer to this phenomenon as the ghosting effect. In order to prevent its occurrences, the weights of pixels, which belong to nonmonotone areas, are modified by dividing each pixel's weight by a predefined factor called a grade. This scheme is referred to as weight adaptation by grading (WABG). Better deblocking of monotone areas is achieved by applying three iterations of the WABG scheme on such areas followed by a fourth iteration which is applied on the rest of the image. We refer to this scheme as deblocking frames of variable size (DFOVS). DFOVS automatically adapts itself to the activity of each block. This new class of algorithms produces very good subjective results and PSNR results which are competitive relative to available state-of-the-art methods.

Algorithms↗

Optimized transmission of JPEG2000 streams over wireless channels.

The transmission of JPEG2000 images over wireless channels is examined using reorganization of the compressed images into error-resilient, product-coded streams. The product-code consists of Turbo-codes and Reed-Solomon codes which are optimized using an iterative process. The generation of the stream to be transmitted is performed directly using compressed JPEG2000 streams. The resulting scheme is tested for the transmission of compressed JPEG2000 images over wireless channels and is shown to outperform other algorithms which were recently proposed for the wireless transmission of images.

Algorithms↗

Low-rate and flexible image coding with redundant representations.

New breakthroughs in image coding possibly lie in signal decomposition through nonseparable basis functions that can efficiently capture edge characteristics, present in natural images. The work proposed in this paper provides an adaptive way of representing images as a sum of two-dimensional features. It presents a low bit-rate image coding method based on a matching pursuit (MP) expansion, over a dictionary built on anisotropic refinement and rotation of contour-like atoms. This method is shown to provide, at low bit rates, results comparable to the state of the art in image compression, represented here by JPEG2000 and SPIHT, with generally a better visual quality in the MP scheme. The coding artifacts are less annoying than the ringing introduced by wavelets at very low bit rate, due to the smoothing performed by the basis functions used in the MP algorithm. In addition to good compression performances at low bit rates, the new coder has the advantage of producing highly flexible streams. They can easily be decoded at any spatial resolution, different from the original image, and the bitstream can be truncated at any point to match diverse bandwidth requirements. The spatial adaptivity is shown to be more flexible and less complex than transcoding operations generally applied to state of the art codec bitstreams. Due to both its ability for capturing the most important parts of multidimensional signals, and a flexible stream structure, the image coder proposed in this paper represents an interesting solution for low to medium rate image coding in visual communication applications.

Algorithms↗