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PubMed1997

[Legal aspects of teleradiology].

It is hoped that the implementation of teleradiology will improve the quality and economic effectiveness of health care in the future. The German federal government has submitted a bill for a legal statute, thereby creating the necessary framework to guarantee the essential "document security". The responsibility of those involved with orderly data transmission as well as the limited responsibility for physicians' findings are both governed by general liability. General principles apply also with regard to professional discretion. Authorized utilization of external networks depends upon the quality of data security. Networks with unlimited-public access may not be used without explicit consent from those concerned.

Computer Communication Networks↗
PubMed1997

Records on the Internet.

Many in health care see great promise in transmitting clinical information over the Internet because the protocols and technologies that make the global network of computer networks function are widely used and accepted. But so far, only a handful of organizations are actually using the Internet to send medical information. More are testing the concept on intranets, private networks that use Internet protocols and technologies. Security and reliability of the Internet remain top concerns for providers.

Computer Communication Networks↗
PubMed1999

Information resources assessment of a healthcare integrated delivery system.

While clinical healthcare systems may have lagged behind computer applications in other fields in the shift from mainframes to client-server architectures, the rapid deployment of newer applications is closing that gap. Organizations considering the transition to client-server must identify and position themselves to provide the resources necessary to implement and support the infrastructure requirements of client-server architectures and to manage the accelerated complexity at the desktop, including hardware and software deployment, training, and maintenance needs. This paper describes an information resources assessment of the recently aligned Pennsylvania regional Veterans Administration Stars and Stripes Health Network (VISN4), in anticipation of the shift from a predominantly mainframe to a client-server information systems architecture in its well-established VistA clinical information system. The multimethod assessment study is described here to demonstrate this approach and its value to regional healthcare networks undergoing organizational integration and/or significant information technology transformations.

Computer Communication Networks↗
PubMed1988

A local network for sharing resources and technical support: BACS/PHILNET.

Within the framework of large regional and national networks, local libraries can benefit by working together. We report the establishment of an online health sciences library network to share resources and technical support in the greater St. Louis area. BACS/PHILNET has evolved beyond a local automated interlibrary loan network to pilot off-site integrated library and information management systems in hospitals.

Computer Communication Networks↗
PubMed1995

Initial experience with asynchronous transfer mode for use in a medical imaging network.

Picture archiving and communication Systems (PACS) for medical imaging have always suffered from band-width limitations, throughput, and proprietary protocols. Commercially available local area networks have been hard pressed to meet the requirements of image transfer in a time consistent with patient-care needs. Recent technologic advances provide potential solutions to these constraints. Asynchronous transfer mode (ATM) provides the aggregate bandwidth and throughput that may be sufficient to satisfy the medical imaging community. Networks using prototype ATM technology have been available and commercial hardware is now becoming available. This report presents initial performance results of an ATM network and its suitability for use in a digital imaging network. Throughput of 10 Mbytes/sec was attained with Transmission Control Protocol/Internet Protocol using commercially available hardware.

Computer Communication Networks↗
PubMed1997

Health telematics in Ukraine: problems and prospects.

The state of medical telecommunication networks in Ukraine is described. The concepts of creating and architecture of the National Direct Access Computer Network 'UkrMedNet' are given.

Computer Communication Networks↗
PubMed1998

Network computing.

Pioneering health care organizations are saving money and gaining greater control of their networks by trading their PCs in for thin clients. But the devices are far from pervasive in health care.

Computer Communication Networks↗
PubMedDate not supplied

A European and global strategy for a nursing information network.

Information at every nurse researcher's fingertips. That is the goal of an information system for nursing services in Europe. Not only would it be able to provide fast information for analyzing and developing nursing but it also aspires to end the costly duplication of research work regionally and worldwide. Below, a report on how a European network can be developed to become a potential hub for a global nursing system.

Computer Communication Networks↗
PubMed1994

An information network for community medical care.

An information network for community medical care was established by the Himeji Medical Association in 1987. The network interconnects through public telephone a central computer located at the office of the Medical Association with personal computers installed in the offices of members of the Association. An overview of the network, which is in full operation, is given, and current problems and future directions are discussed.

Community Health Services↗
PubMed1997

Promoting continence as a health issue.

Urinary incontinence is a common condition affecting hundreds of millions of people worldwide but for which up to 70% of sufferers seek no help. Continence promotion activities must target not only the incontinence sufferers and their families but also the general community, health professionals, the industry that manufactures continence products and drugs, and the Government which is responsible for funding directly or indirectly various programmes. Continence promotion programmes must therefore be sufficiently flexible to target these groups about what incontinence is, what can be done about it, and where to get help, and most importantly to de-stigmatise this condition. Continence promotion is taking place internationally through the efforts of the International Continence Society and locally through various national non-profit-making organisations. Activities include public awareness and professional education programmes; continence prevention strategies; and establishing mechanisms for improved communication. 'CONTInet', a dedicated Internet facility, is evolving as a major tool to achieve many of these goals.

Community Networks↗
PubMed1990

A cost analysis of film image management and four PACS based on different network protocols.

Picture Archive and Communication Systems (PACS), which allow the electronic acquisition, storage, transportation, and viewing of medical images, hold the eventual promise of reduced costs, improved image-management logistics, and ultimately, improved patient care. But at what point in the future will PACS really cost less than film-based image management for a given hospital size; and how are these costs affected by the choice of the digital communication network? To address these questions, a static differential cost model has been constructed. PAC systems based on two high-speed networks (less than 150 megabytes per second Mbps) and two low-speed networks, as well as film, were considered for five different sized hospitals (ranging from 15,000 to 125,000 procedures per year) and two time periods (1995 and 2000). PACS equipment was assumed to have a payoff of five years. The model considered all capital and supply costs and personnel costs for the PACS and for film storage and retrieval. It did not consider any possible cost savings from logistics improvement likely to result from the adoption of a PACS. Based on the assumptions outlined, high-speed-network PACS are less costly than those based on low-speed networks for all scenarios considered. Further, even though all possible PACS cost savings were not considered, high-speed network PACS appear to be less costly than film for hospitals larger than 60,000 procedures in 1995 and larger than 15,000 in 2000, while low-speed-network PACS should cost less than film for 60,000 and 30,000 procedure hospitals in 1995 and 2000 respectively.

Computer Communication Networks↗
PubMed1998

Enabling student nurses to use the information superhighway.

Nursing graduates must be sophisticated in the use of information technologies and understand how these technologies interface with various health care systems. The purpose of this project was to evaluate the impact of a newly developed Internet course, focusing on current information technologies, on 20 RN-to-MSN students. Author-developed instruments were used to measure weekly computer use, perceived computer skill, and knowledge related to the information superhighway. The Stronge & Brodt Nurses Attitudes Toward Computerization Questionnaire was used to assess attitudes toward computerization. Qualitative data was elicited using weekly evaluation forms. When compared to 23 students at a similar stage of their nursing program, quantitative findings indicated that, at the end of the semester, students in the pilot course had more computer knowledge, reported greater computer skill, and used computers more. Qualitative findings suggested that pilot students: * Were connected with nursing networks and expressed their intent to maintain these networks. * Were able to use current health information found on the Internet in their nursing practices. * Used skills learned in the pilot class to complete projects in other classes. * Communicated with classmates via the Internet, thus forming a potentially valuable professional support system. * Used the library and librarians early in their programs. * Understood the relevancy of telemedicine and the Internet to the future survival of nursing in a changing health care arena. While the authors caution that an adequate infrastructure must be available to support such an endeavor, they emphasize that knowledge of the relevancy and use of the information superhighway is crucial to the future survival of nursing in a rapidly changing health care arena.

Adult↗
PubMed1995

An overview of the CERC ARTEMIS project.

The basic premise of this effort is that health care can be made more effective and affordable by applying modern computer technology to improve collaboration among diverse and distributed health care providers. Information sharing, communication, and coordination are basic elements of any collaborative endeavor. In the health care domain, collaboration is characterized by cooperative activities by health care providers to deliver total and real-time care for their patients. Communication between providers and managed access to distributed patient records should enable health care providers to make informed decisions about their patients in a timely manner. With an effective medical information infrastructure in place, a patient will be able to visit any health care provider with access to the network, and the provider will be able to use relevant information from even the last episode of care in the patient record. Such a patient-centered perspective is in keeping with the real mission of health care providers. Today, an easy-to-use, integrated health care network is not in place in any community, even though current technology makes such a network possible. Large health care systems have deployed partial and disparate systems that address different elements of collaboration. But these islands of automation have not been integrated to facilitate cooperation among health care providers in large communities or nationally. CERC and its team members at Valley Health Systems, Inc., St. Marys Hospital and Cabell Huntington Hospital form a consortium committed to improving collaboration among the diverse and distributed providers in the health care arena. As the first contract recipient of the multi-agency High Performance Computing and Communications (HPCC) Initiative, this team of computer system developers, practicing rural physicians, community care groups, health care researchers, and tertiary care providers are using research prototypes and commercial off-the-shelf technologies to develop an open collaboration environment for the health care domain. This environment is called ARTEMIS--Advanced Research TEstbed for Medical InformaticS.

Computer Communication Networks↗
PubMedDate not supplied

Assessment of commercial compression algorithms, of the lossy DCT and lossless types, applied to diagnostic digital image files.

The need for diagnostic image compression of the lossy or irreversible type has been declining due to the rapid increase in commercially available formatted hard disk capacity. It is estimated that the latter has increased about three orders of magnitude in the past 14 years while the size of diagnostic image files has, of course, remained constant. During the same period, despite claims for significantly improved performance by vendors, it seems that only small progress has been made in commercial lossless and lossy compression algorithms. There is still no consensus for lossy compression to a level acceptable for diagnosis. This is mostly considered to be around a ratio of 10:1. However, acceptable compression ratios depend heavily on the type of images processed and may be compared with the 3:1 ratio produced by lossless algorithms. This last value was shown to increase to more than 5.5:1 for gamma-camera images when corrected for the noise content of individual bit planes and for the display capabilities of computer monitors. Therefore, any possible benefits of lossy over lossless compression become questionable when the currently available hard disk capacity and network transmission speed are considered against the inevitable loss of information in the lossy type of compression.

Algorithms↗
PubMed1999

Internet communication and discussion lists for perinatal nurses.

The article describes how electronic connectivity facilitates professional communication. A brief background in computer communication networks, telecommunications and Internet access, email, and electronic discussion lists prepares the reader to participate in this technology. Directions for subscribing to an online discussion list and guidelines for professional behavior on the Internet are outlined. The article concludes with a description of the Perinatal Nursing Discussion List, an established networking tool. Printed and electronic resources for locating additional lists and a glossary of online abbreviations and terms are included.

Communication↗
PubMed1989

All boats rising. Interview by Eric Skjei.

"When you're in big trouble is when opportunities appear. That's when you really begin to search the landscape for ways to change. It often takes dire straits or major stresses to effect change," says Frank Clark, Ph.D., chancellor for Information Services at the University of Tennessee, Memphis. In an interview with Computers in Healthcare, Dr. Clark says the university has begun building an ambitious information network, one that has attracted such partners as DEC, Apple, Siemens, U.S. Sprint and South Central Bell. With its underlying emphasis on information, resource sharing and preventive medicine, the Memphis Metropolitan Campus Network fits one cost-containment model that Clark believes we'll see more of in the future.

Academic Medical Centers↗
PubMed1996

Will the Internet supplant community health networks?

As issues of security, accountability and access are resolved, the Internet will act as the central infrastructure for a global as well as a community health information network. It will help nurses extend their services to the community and to educate specific patient populations.

Community Health Services↗