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PubMed1989

The integration of computer conferencing into the medical school curriculum.

A computer conference was developed for use with students, faculty, and staff at a large state-funded medical school. The conference was intended to increase communication among these groups which study, work, and train at a variety of locations across the state. To date, 583 participants (91% are students, 6% are faculty, and 2% are staff) have discussed a variety of academic, ethical, social, and administrative issues. Conference use is required during the obstetrics-gynecology third year clerkship, and has also been used to evaluate courses and critique course examinations. The procedures for creating a computer conference, implementing its use in the curriculum, and evaluating its effectiveness are discussed.

Communication↗
PubMedDate not supplied

EuroPACS: a catalyst for PACS in Europe.

The EuroPACS organization and its intended role in PACS development in Europe is briefly described. EuroPACS was initiated at Braunlage FRG, August 1984. Its aim is to stimulate mutual contacts between various groups in Europe being active in the PACS field. Its main activities are: organization of EuroPACS conferences (once or twice per year), publication of a newsletter and organization of special sessions in larger congresses.

Computer Communication Networks↗
PubMedDate not supplied

Teleradiology at Gunma University Hospital.

Using NEC MediFile 1000 and the public telephone system, the Department of Radiology of Gunma University Hospital and Saitama Medical School deliver image diagnosis to fellow clinicians and affiliated hospitals. The system consists of digitizing, filing, processing, retrieving and archiving units for radiographs and documents. Images were digitized by CCD and filed in 2 Gbyte double sided optical disk, which can accommodate 500 sheets of 14 x 17 films on 1500 of the smallest size slats without data compression. Image resolution was evaluated by ROC curve using multiple pulmonary nodules. The time taken for image transfer over 24 km was tested with various film sizes, image varieties and data compression rates.

Computer Communication Networks↗
PubMedDate not supplied

Background of the demonstrated IMAGIS activities and future expectations.

In The Netherlands a national PACS development programme has been started, supported by the Dutch Society of Radiology and funded by the Dutch Department of Health because of the national character of the project. Three main partners are cooperating in this development: the Utrecht University Hospital (AZU), BAZIS and Philips International (Product Division Medical Systems), with the Delft University of Technology as the main BAZIS subcontractor. The non-profit foundation BAZIS, developing and supporting the ZIS Hospital Information System (in use in some 30 Dutch hospitals, over 15,000 acute beds), initiated its current IMAGe Information System (IMAGIS) projects in 1984. The activities were later integrated into the Dutch PACS project started in 1986. The final goal of the project is to achieve a PACS which is fully integrated with already existing hospital information systems (HIS). The development and operation of a HIS-PACS include many aspects of technical and clinical. The current efforts of BAZIS are concentrated on three main issues: diagnostic image quality evaluation (e.g. effects of data compression); modelling, software simulation and technology assessment of a prototype PACS (both general and detailed aspects); and coupling and integration of PACS and HIS (e.g. the BAZIS ZIS). Philips, Hamburg, is supplying equipment, particularly prototype components. A systematic clinical evaluation will take place at the Utrecht University Hospital.2+ We outline the background of the intermediate results as demonstrated during the 6th EuroPACS Conference:the psychophysical software package for Feature Evaluation And System Inspection By Logged Experiments (FEASIBLE); the modelling and simulation software package for Medical Image Representation, Archiving and Communication, Learned by Extensive Simulation (MIRACLES); and first results of the coupling experiments.(ABSTRACT TRUNCATED AT 250 WORDS)

Computer Communication Networks↗
PubMedDate not supplied

Prediction and analysis of PACS performance with the simulation tool MIRACLES.

Since the construction of image information systems appears to be extremely difficult in practice, BAZIS has decided to use computer modelling and simulation as decision support tools. In order to support the construction of simulation models, the simulation package and modelling environment MIRACLES (Medical Image Representation, Archiving and Communication Learned from Extensive Simulation) has been developed by BAZIS. This paper describes modelling and simulation techniques in general, as well as the benefits of simulation within the scope of designing Picture Archiving and Communication Systems (PACS). In order to illustrate the theory, results of a concrete yet simple PACS, which has been simulated with MIRACLES, will be described and discussed.

Computer Communication Networks↗
PubMedDate not supplied

HIS-PACS coupling: BAZIS/ZIS and Philips/MARCOM on speaking terms.

Nowadays a growing number of experts in the PACS field agree on the necessity of having an integrated HIS-PACS combination available in modern hospitals in order to manage the enormous amounts of patient data, both textual, numerical and image information, in an effective way. Since 1986 BAZIS (the Development and Support Group of the Hospital Information System), Philips Medical Systems and the University Hospital of Utrecht (AZU) are partners in the so-called Dutch PACS Project in the development and evaluation of a fully integrated image information system. The first phase of the coupling (sub)project consists of establishing a communication link between the BAZIS/ZIS and the Philips/MARCOM system with the following restrictions: the only data sent concerns the inpatients of one ward; data will only flow one way, from BAZIS/ZIS to Philips/MARCOM. In the second phase two-way communication will be realized and more departments can be part of the experiment. In phase 3 a more general HIS-PACS interface will be developed, independent of the manufacturers of HIS and PACS. In this paper the technical solution chosen for the first phase coupling, the format of the messages being transferred, and the events which result in sending the messages, will be described. Also, reference is made to the demonstration of the working HIS-PACS link, given during the 6th EuroPACS meeting in Utrecht and Leiden on 25-26 April 1988.

Computer Communication Networks↗
PubMedDate not supplied

Legal aspects of digital image management and communication.

This paper outlines the legal issues that arise in digital image management and communication systems (IMACS). At the heart of this study is the digital image which is manipulated, processed, communicated, stored, compressed and archived, and which is difficult to ascertain from a legal point of view because of its intangible nature. On the one hand, personal data protection and the patient's right to privacy need to be protected through a data protection and security policy. This is particularly important in view of the capacity of IMACS to integrate with other systems such as HIS and RIS, since the information generated by the totality of these systems offers a very complete picture of any patient. On the other hand, the evanescent nature of the digital image creates legal uncertainties as to questions of evidence, of procedural and legal admissibility and acceptability and of liability.

Belgium↗
PubMedDate not supplied

The RICHE Reference Architecture.

The RICHE Reference Architecture defines an open framework for health care information systems. Developed within the ESPRIT II programme, it is now the basis of several implementations in hospitals in Italy, Portugal, Ireland, France and the UK, and of follow-up initiatives such as EDITH (ESPRIT, no. 7508), NUCLEUS (AIM II, no. 2025) and REFERENCE (a French hospitals' project). This contribution describes the RICHE Reference Architecture in detail. Special concern is centred on the modulus that constitute the basic platform of RICHE, and on the methodology applied to design the interactions between them.

Artificial Intelligence↗
PubMedDate not supplied

Essential data set for computer management of distributed primary care services.

Reported here is a personal computer-based registration program of medical consultations in general practice that has been implemented in six communities ('primary health care districts'; total population 112623) in the county of Jönköping, southern Sweden. The program enabled decentralized monitoring and management of the primary health care organization in the communities. The objective of the present paper is to give, from one year's experience of about 137000 recorded visits, a broad overview of the program structure, briefly considering the questions associated with routine registration of medical consultations, to discuss how the system is used for decision and steering support as well as to summarize its overall performance, results and costs in relation to the general utility of accurate information on health service delivery and consumption in the population.

Computer Communication Networks↗
PubMedDate not supplied

Application of database systems in diabetes care.

The St Vincent Declaration includes a commitment to continuous quality improvement in diabetes care. This necessitates the collection of appropriate information to ensure that diabetes services are efficient, effective and equitable. The quantity of information, and the need for rapid access, means that this must be computer-based. The choice of architecture and the design of a database for diabetes care must take into account available equipment and operational requirements. Hardware topology may be determined by the operating system and/or netware software. An effective database system will include: user-friendliness, rapid but secure access to data, a facility for multiple selections for analysis and audit, the ability to be used as part of the patient consultation process, the ability to interface or integrate with other applications, and cost efficiency. An example of a clinical information database for diabetes care, Diamond, is described.

Computer Communication Networks↗
PubMedDate not supplied

EDI system definition for a European medical device vigilance system.

EDI is expected to be the dominant form of business communication between organizations moving to the Electronic Commerce era of 2000. The healthcare sector is already using EDI in the hospital supply function as well as in the clinical area and the reimbursement process. In this paper, we examine the use of EDI in the healthcare administration sector and more specifically its application to the Medical Device Vigilance System. Firstly, the potential of this approach is examined, followed by the definition of the EDI System Reference Model and the specification of the required system architecture. Each of the architecture's components are then explained in more detail, followed by the most important implementation options relating to them.

Computer Communication Networks↗
PubMedDate not supplied

Design of CSCW applications for medical teleconsultation and remote diagnosis support.

Recent advances in telecommunication technology have permitted the implementation of tools for Computer Supported Cooperative Work (CSCW) based on real time transmission of different information types between two or more stations. The present paper describes methods for the design of both synchronous and asynchronous CSCW procedures suitable for the medical application area and specifically for the purpose of medical consultation and more generally, remote diagnosis support. The experimental implementation of such a CSCW system built upon a Personal Computer/Windows platform is detailed as an example of such a low-cost system suitable for adoption in a wide-range of medical teleconsultation applications.

Algorithms↗
PubMedDate not supplied

Utilization of a paediatric link collection by health professionals and laypersons.

The Internet is an evolving resource for health-care information. However little information exists on providers' and other web patrons' usage of the 'medical' Internet. This study aims to characterize the users of a large paediatric link collection, describe their objectives and track their use of the information provided by the site. We utilized a paediatric link collection called the Pediatric Points of Interest (POI) and a combination of a questionnaire, unique user identifier and link-tracking system to collect data about POI patrons' demographics and Internet resource utilization. During a five week period, 5216 individuals visited the POI and requested 36,187 links. The majority of users had less than one year of Internet experience and were first-time visitors to the POI. More than 83% of users were from North America. Medical professionals were more likely to return to the POI during the study period and reported visiting the POI mainly for 'medical education', 'research', 'resource identification', and 'disease specific information'; they proceeded primarily to the resource categories 'Medical Institutions and Agencies' (32%) and 'Professional Education and Resources' (28%). Laypersons expressed the greatest interest in 'disease specific information' and 'patient education' and most frequently visited the category. 'Patient Education' (42%). On average, users were able to identify resources related to their stated goals within one level of searching. Health care providers and other web patrons are actively utilizing Internet sites to seek medical information and are able to identify resources with a minimum of searching.

Adolescent↗
PubMedDate not supplied

Enhancing security and improving interoperability in healthcare information systems.

Security is a key issue in healthcare information systems, since most aspects of security become of considerable or even critical importance when handling healthcare information. In addition, the intense need for information exchange has revealed interoperability of systems and applications as another key issue. Standardization can play an important role towards both these issues. In this paper, relevant standardization activities are briefly presented, and existing and emerging healthcare information security standards are identified and critically analysed. The analysis is based on a framework which has been developed for this reason. Therefore, the identification of gaps and inconsistencies in current standardization, the description of the conflicts of standards with legislation, and the analysis of implications of these standards to user organizations, are the main results of this paper.

Algorithms↗
PubMed1997

Copyright protection of images in the digital environment.

All creators of copyright-protected works are re-assessing the protection and exploitation of their works in the digital environment. This article attempts to define 'digital' in a copyright context. It reminds artists and photographers of the essentials of copyright as they already apply in the UK before it looks at how those essentials may apply to images circulating in the digital environment. Finally it covers some of the key issues which artists and other creators are now having to address in their day to day work.

Computer Communication Networks↗