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A monitoring/auditing mechanism for SSL/TLS secured service sessions in Health Care Applications.

This paper analyzes the SSL/TLS procedures and defines the functionality of a monitoring/auditing entity running in parallel with the protocol, which is decoding, checking the certificate and permitting session establishment based on the decoded certificate information, the network addresses of the endpoints and a predefined access list. Finally, this paper discusses how such a facility can be used for detection impersonation attempts in Health Care applications and provides case studies to show the effectiveness and applicability of the proposed method.

Computer Communication Networks↗

Computer assistance in clinical functional analysis.

The use of computers in the dental practice has been primarily restricted to the acquisition of billing data. Additional possibilities for use of PCs exist in diagnostic data acquisition and evaluation; clinical functional analysis seems a particularly suitable application. Such software is now available: CMDfact. Dentally, it is based on a previously developed and published examination and documentation system, the graphic user interface of which is used in the newly developed software. After the examination data have been acquired by mouse click or numerical entry, these are available for evaluation. A special function, the "Diagnosis pilot" is integrated to support the user. This helps in the assignment of the appropriate "Initial diagnoses", since it brings together the individually existing principal symptoms and suitable diagnoses for the initial diagnosis in question and also states which diagnoses "would be appropriate" for this, but are not available. With 3D animation, the software also helps the dentist to explain aspects of CMD to patients. The software also assists the dentist with a detailed multimedia help system, which provides context-sensitive help for every examination step. These help functions explain the sense of the relevant examinations, their performance and evaluation in the form of short texts and explanatory photographs and videos.

Computer Graphics↗

A dynamic Web application within an n-tier architecture: a Multi-Source Information System for end-stage renal disease.

A Multi-Source Information System (MSIS) has been designed for the Renal Epidemiology and Information Network (REIN) dedicated to End-Stage Renal Disease. Interoperability has been considered at 4 levels: semantics, network, formats and contents. An n-tier architecture has been chosen at the network level. It is made out of a universal client, a dynamic Web server connected to a production database and to a data warehouse. The MSIS is patient-oriented, based on a regional organization. Its implementation in the context of a regional experimentation is presented with insights on the design and underlying technologies. The n-tier architecture is a robust model and flexible enough to aggregate multiple information sources and integrate modular developments. The data warehouse is dedicated to support health care decision-making.

Data Display↗

Medical education in Nigeria: are we ready for the paradigm shift?

The information revolution is changing the way medicine is practised globally. Patients can now access the storehouses of knowledge, which hitherto were out of bounds, to acquire, process and use the medical evidence from a variety of sources such as the World Wide Web. The way medicine is being taught is changing. Many medical and dental schools have revised, or are in the process of revising their curricula. The ability to access information resources and apply up to date information, diagnosis and therapeutic protocols to their practice calls for a paradigm shift. Cybermedicine is fast becoming the twenty-first century practice. The challenge is real. If emphasis is being placed on fluency with information technology in the developed countries, learning to use the computer remains, in our opinion, the place to start from in the developing countries.

Computer Literacy↗

Open, flexible and portable secure web-based health applications.

This paper presents a totally generic client-server model for accessing legacy and new databases according to the three tier architecture principles. It is based on an integrated environment that eases the dynamic creation and instantiation of secure web applications that access multiple database management systems. Emphasis is placed on the ability to query almost any type of relational database and queries can simultaneously address a multitude of data sources. The information is collected, assembled and presented to users depending on a possible set of user profiles. These profiles originate from work on securing the conduct of clinical studies. This has been achieved in the context of the EU funded project HARP (Harmonisation for the Security of Web Technologies and Applications). The generic character of the model is exploited through an accompanying set of development tools. This permits efficient and effective creation and maintenance of applications in several domains of health telematics and beyond. Main merit is the lightweight character of the resulting platform, whereby all necessary instantiations are accomplished through a set of related XML documents.

Computer Security↗

Open Source in the European Union: a future way for health applications?

Since 1999, the Open Source movement has aroused the interests of different players of the Information Society. M. E. Liikanen, European Commissioner for Enterprise and Information Society, has publicly expressed an interest for more security through the use of Open Source software. Municipalities deployed desktops and servers based on Open Source software in Spain, France, Austria and Belgium. Some health professionals see in this movement a way of obtaining better software, more secure and interoperable. This presentation explores the context and economical considerations at the basis of the Open Source movement, its rationale in a research programme publicly financed and some of the challenges ahead. It concludes on the observations that Open Source is high on several agendas but needs to quickly become an economical activity to deliver its promises.

Computer Security↗

The PICNIC approach to regional care networks.

PICNIC is a pioneering project to develop an architecture for next generation regional healthcare networks. This paper gives an overview of the project and some of the reasoning behind the interrelated technical and business choices.

Computer Communication Networks↗

European security framework for healthcare.

eHealth and telemedicine services are promising business areas in Europe. It is clear that eHealth products and services will be sold and ordered from a distance and over national borderlines in the future. However, there are many barriers to overcome. For both national and pan-European eHealth and telemedicine applications a common security framework is needed. These frameworks set security requirements needed for cross-border eHealth services. The next step is to build a security infrastructure which is independent of technical platforms. Most of the European eHealth platforms are regional or territorial. Some countries are looking for a Public Key Infrastructure, but no large scale solutions do exist in healthcare. There is no clear candidate solution for European-wide interoperable eHealth platform. Gross-platform integration seems to be the most practical integration method at a European level in the short run. The use of Internet as a European integration platform is a promising solution in the long run.

Computer Security↗

Italian telematics initiatives and achievements.

Depending on their legislation, the European countries have different telematics initiatives and different scenarios. Cultural roots cause differences even within a country or a region, and different organisational structures can cause further problems. With regard to the Italian telematics approach, the author intends to explain the basis and the main achievements in Italy and especially in the Lombaria region.

Computer Communication Networks↗

Secure exchange of medical data: requirements and solutions.

It is now common to access and to exchange data through computer networks. The major applications used are Web access and, e-mail. But while there is no security concern when accessing classical or anonymous data, the exchange of sensitive data (e.g. patient-related information) is subject to legal constraints. This paper summarizes the current legal obligations in Switzerland and presents state of the art techniques for applying the legal rules. A commercial implementation in Switzerland is taken as illustration.

Computer Security↗

Accurate volumetric measurements of anatomical cavities.

OBJECTIVES: The volumetric assessment of anatomical cavities is of high relevance for various applications in medicine. Based on 3D scanning (i.e., CT) of these cavities, the volume can be determined by counting the volume elements of a segmentation of that cavity. Unfortunately, elements on the boundary of the segmentation require special treatment to obtain accurate volumetric measurements. In this paper, we propose a novel technique that in particular increases the accuracy of the volume estimation for the boundary elements of segmented anatomical objects. METHODS: Based on a 3D segmentation of an anatomical cavity, we recursively subdivide boundary volume elements into a set of simple situations, where the volume can be estimated easily. RESULTS: We performed volumetric measurements on seven datasets of phantom models made of plexiglass (see Fig. 1) scanned by a biplane angiography unit and assessed the quality of our method by comparing the measured volume by our novel method and by the fluid required to fill the phantom cavities. CONCLUSIONS: Our method calculates a significantly more accurate volume of the segmented cavities than previous methods. Nevertheless, it is only slightly more computationally expensive.

Abdominal Cavity↗