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Computer network security for the radiology enterprise.

As computer networks become an integral part of the radiology practice, it is appropriate to raise concerns regarding their security. The purpose of this article is to present an overview of computer network security risks and preventive strategies as they pertain to the radiology enterprise. A number of technologies are available that provide strong deterrence against attacks on networks and networked computer systems in the radiology enterprise. While effective, these technologies must be supplemented with vigilant user and system management.

Computer Communication Networks↗

Expanding M NET: lessons from the development of a referring physician computer network.

M NET, the University of Michigan Medical Center's statewide referring physician computer network, was implemented as a pilot project in 1990. After three years of design, development and implementation, M NET has progressed from its pilot project status to a production system within the institution's strategic plan for hospital networking. This paper describes the evolution of M NET from a small pilot project to its current production status encompassing all clinical departments and hundreds of physicians across the state. The lessons learned from the pilot, the requirements of both the referring physicians and the Medical Center, and the development of a flexible and robust network architecture to allow network expansion are addressed.

Academic Medical Centers↗

[Online retrieval of patient information by asynchronous communication between a general purpose computer and a stand-alone personal computer].

Asynchronous communication was made between host (FACOM M-340) and personal computer (OLIBETTIE S-2250) to get patient's information required for RIA test registration. The retrieval system consists of a keyboard input of six numeric codes, patient's ID, and a real time reply containing six parameters for the patient. Their identified parameters are patient's name, sex, date of birth (include area), department, and out- or inpatient. Linking this program to RIA registration program for individual patient, then, operator can input name of RIA test requested. Our simple retrieval program made a useful data network between different types of host and stand-alone personal computers, and enabled us accurate and labor-saving registration for RIA test.

Computer Communication Networks↗

Networked information and clinical decision making: the experience of Birmingham Heartlands and Solihull National Health Service Trust (Teaching).

OBJECTIVES: The paper presents the findings of the evaluation of a pilot project to introduce networked information resources into clinical settings in a large NHS Trust and describes the subsequent developments of networked information within the Trust. DESIGN: The main purpose of the evaluation was to ascertain whether access to electronic journals and other resources via a networked system offered real benefits to clinical effectiveness. SETTING: Birmingham Heartlands and Solihull NHS Trust (Teaching). SUBJECTS: Medical and administrative staff at Birmingham and Solihull NHS Trust. RESULTS: The main conclusions of the evaluation were that: (1) appropriate location of terminals close to clinical areas is vital to ensure that best use is made of networked information resources; (2) rapid access to networked information services saves staff time and allows educational opportunities to be realized; (3) networked information resources enhance rather than replace existing information sources; (4) training and support are essential to maximizing the benefits of networked information services, and (5) such a network can support clinical decision making. CONCLUSIONS: With the development of clinical governance, the clinical network has assumed even greater importance within the Trust. Timely and easy access to clinical and educational information is crucial to the practice of evidence-based medicine which underpins high quality clinical care. The evaluation led to a number of recommendations which have since been used to develop the clinical network at Birmingham Heartlands and Solihull NHS Trust.

Adult↗

[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↗

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↗

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↗

ARCHIMED: a Network of Integrated Information Systems.

ARCHIMED is a Network of Integrated Information Systems (NIIS). This novel concept of hospital information system has a major advantage over the currently used distributed systems. The normalized representation structure of its databases enable its Navigators to reach simultaneously not only the data coming from different hospital departments, laboratories, and other hospital facilities, but also the data from different hospitals associated in the network.

Computer Communication Networks↗

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↗

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↗

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↗

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↗

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↗

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↗

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↗

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↗