ChronoBioNet: global and local area networking in the chronobiological sciences.
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Picture archiving and communication systems (PACS) use local area networks (LANs) for the transfer of images and image-related data. There are several aspects of LANs that are used to describe and categorize them: topology, the media used for transmission, and the medium access control (MAC) protocols. The four basic topologies are the bus, tree, ring, and star; the four primary types of media used for LANs include coaxial cable, twisted-pair wire, fiberoptic cables, and wireless. The wireless LANs that use infrared and radio frequencies are new but promising. Of the three MACs presently being used--Ethernet, fiber distributed data interface (FDDI), and UltraNet--Ethernet is the most common. LANs can be interconnected by means of the repeater, bridge, router, and gateway internetworking devices. The future of LAN development lies in increased standardization and increased connectivity in order to make teleradiology a reality.
This paper describes the planning and implementation of a Local Area Network (LAN) for the nursing service of a 504-bed urban teaching hospital. The major goals of the network were: support for nurse executives, nurse managers, and the departmental assistants assigned to administrative offices; increased efficiency and effectiveness of the nursing administrative areas; and improved communication systems. Collaboration between the nursing service and the Computer Information Center (CIC) resulted in a network of over 70 workstations, spanning 11 buildings. The network provides access to multiple programs that support clinical, managerial, and research activities. Gateways provide access to the hospital's two mainframes.
This report focuses on the planning and realization of an interdisciplinary local area network (LAN) for medical research at the University of Heidelberg. After a detailed requirements analysis, several networks were evaluated by means of a test installation, and a cost-performance analysis was carried out. At present, the LAN connects 45 (IBM-compatible) PCs, several heterogeneous mainframes (IBM, DEC and Siemens) and provides access to the public X.25 network and to wide-area networks for research (EARN, BITNET). The network supports application software that is frequently needed in medical research (word processing, statistics, graphics, literature databases and services, etc.). Compliance with existing "official" (e.g., IEEE 802.3) and "de facto" standards (e.g., PostScript) was considered to be extremely important for the selection of both hardware and software. Customized programs were developed to improve access control, user interface and on-line help. Wide acceptance of the LAN was achieved through extensive education and maintenance facilities, e.g., teaching courses, customized manuals and a hotline service. Since requirements of clinical routine differ substantially from medical research needs, two separate networks (with a gateway in between) are proposed as a solution to optimally satisfy the users' demands.
Efficient control over the purchase and receipt of radioactive material is a necessary part of any radiation safety program. We describe a novel computerized method for monitoring the flow of radioactive material within a large broad-licensed medical research complex. The Local Area Network (LAN) described interfaces the radiation safety office with radionuclide receiving, the authorized user, grants and contracts, special accounts, and purchasing. Task-specific software enables the authorized user to place an order and allows the monitoring of possession/ordering limits, personnel, date of order, and time of receipt via the screen. The resultant data base is easily annexed for specific information. The system is user-friendly and adaptable to any set of circumstances.
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Grateful Med version 6.0 provides new features very desirable to network users. These include: a single copy of the application resident on a server providing access to many users; a new communications architecture which provides access to Medline via the Internet or local network modems; additional scripting capabilities allowing local customization. These new features reduce the overhead in installing and maintaining Grateful Med (GM), allow much quicker downloading of citations and abstracts from Medline, and remove the requirement of a local modem for each PC accessing Medline.
Personal computer (PC) driven digital imaging devices are now becoming available in the market place for use in radiation oncology to produce what are known as real time portal images. These limited contrast images are used to verify the patient anatomy under treatment by megavoltage x-rays and are a vital part of the patient treatment. The current generation of devices can produce both single and movie loop images in real time for physician review and approval. To disseminate these images and other digital images used in the planning and delivery of radiation therapy, a PC-based picture archiving and communications system has been developed that is tailored to the special needs of radiation oncology.
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.
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.
Predictions are that the integration of multiple information systems of a medical center will change the way doctors work and practice medicine in the future. Several major steps must be taken by an institution to make this a reality. The IAIMS program sponsored by the NLM is designed to achieve integration of resources in the medical center environment. The purpose of the IAIMS project at Georgetown is to develop a medical decision support system by bringing together multiple sources of information that reside on disparate computers and different database systems. This immense and complex task is described in this paper from an organizational, academic and technical perspective. Georgetown is developing a Biotechnology and Biomedical Knowledge Network which includes several informational and clinical databases, a variety of scholar workstations, instruction on use of computers, a campus-wide network with local area network nodes and a modular approach to systems integration. The IAIMS project is spearheaded by the medical library which has enabled a broad body of medical center users to benefit directly from new, dynamic services.
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.
A computer network system has been developed in the Orthodontic Clinic, Osaka University Dental Hospital, to improve treatment efficiency and patient service. The system consists of a 32-bit host computer, its peripheral units, and personal computers connected to the host computer by data-transmission circuits, making up a local area network (LAN). It is possible in this system to integrate various types of data, such as the patient's basic information, treatment records, image data, and diagnostic analysis results to construct a relational database. It has been shown that the computer system developed in the orthodontic clinic has various clinical advantages.
The intent of the MAClinical Workstation Project is to develop computer workstations for medical students of the sort they will use in future medical practice. The idea is to instill information query habits in the daily clinical activities of these young physicians-in-training. The Georgetown University Medical Center Library spearheads the project in conjunction with the School of Medicine. The library handles technical support, including software development, user training, equipment maintenance, and network installations. The project began in 1988 with nine Macintosh computers; today thirty machines are distributed throughout the Georgetown University Hospital conference rooms, faculty and resident offices, and at four affliated hospitals. The Macintosh computers are connected to the medical center's local area network (LAN) with access to the Integrated Academic Information Management System (IAIMS) and Library Information System (LIS) databases. The MAClinical workstations serve multiple educational purposes in the clinical setting. Primarily, students gain experience in medical informatics by using a variety of software systems installed at the stations: the H&P Writer, a history and physical system written in the C programming language, can be used by students to prepare the admission record on patients they examine; also, students can keep patient records, check findings against a diagnostic system, look up drugs and treatment protocols, develop medical sketches, and find additional information when needed in the medical literature.
The Department of Anesthesiology and Critical Care Medicine (DACCM) has substantially upgraded its computer resources within the past two years by installing a local area network (LAN) and replacing low-end PC's with PC's utilizing Intel 80286 or 80386 microprocessor technology. Data base development has now become a priority. Data bases are being developed for both clinical and administrative purposes. We are replacing the traditional method of "keypunching" with optical card scanners which results in faster and more accurate data entry directly into the data bases. Previously, such card scanners have been confined to large organizations. We describe a method of data capture and data base development with wide applicability in medicine.