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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↗
PubMed1997

Demonstrating minimal invasive therapy over the Internet.

Use of the Internet for multimedia conferencing began in the early 1990s. Multimedia conferencing allows people at multiple, distributed locations to communicate using audio, video and shared workspace programs; the Multicast Backbone of the Internet (MBONE) provides the technical solution to make the most efficient use of the limited Internet bandwidth for such interactions. The scope for using this technology in medical applications was recognised by the MICE project which, in November 1994, used Sun SPARC workstations connected to the MBONE to send video and commentary of live operations from Sweden and San Francisco to a workshop held in London. These sessions were marred by severe congestion experienced on the networks on the day, but the consensus of those organising and attending the workshop was that the exercise was worthwhile. The main lessons learnt from this first transmission were the need to provide better quality links and to ensure confidentiality. In December 1995, the MERCI project, funded by the European Union under the TELEMATICS for Research programme, began work to refine and further propagate the use of the multimedia conferencing software. Part of this work is to provide these improved facilities to transmit operations to two more workshops scheduled for 1997. MERCI will offer confidentiality through encryption facilities built into the conferencing programs, improved programs which cope better with adverse network conditions, use of the new high-speed JAMES network and access to a multimedia server from which recordings of operations and medical instrumentation can be delivered to the workshop participants.

Computer Communication Networks↗
PubMed1997

WWW creates new interactive 3D graphics and collaborative environments for medical research and education.

Virtual Reality Modelling Language (VRML) is the start of a new era for medicine and the World Wide Web (WWW). Scientists can use VRML across the Internet to explore new three-dimensional (3D) worlds, share concepts and collaborate together in a virtual environment. VRML enables the generation of virtual environments through the use of geometric, spatial and colour data structures to represent 3D objects and scenes. In medicine, researchers often want to interact with scientific data, which in several instances may also be dynamic (e.g. MRI data). This data is often very large and is difficult to visualise. A 3D graphical representation can make the information contained in such large data sets more understandable and easier to interpret. Fast networks and satellites can reliably transfer large data sets from computer to computer. This has led to the adoption of remote tale-working in many applications including medical applications. Radiology experts, for example, can view and inspect in near real-time a 3D data set acquired from a patient who is in another part of the world. Such technology is destined to improve the quality of life for many people. This paper introduces VRML (including some technical details) and discusses the advantages of VRML in application developing.

Computer Communication Networks↗
PubMed1988

Effective computing with clusters.

Fox Chase Cancer Center has adopted the "cluster concept" of networking to avoid redundancy and loss of computing time. In this manner, transfer of clinical and research data is easily accomplished.

Cancer Care Facilities↗
PubMed2001

Managing digital clinical photographs.

Digital cameras have been used for clinical photography in the Medical Illustration Department at Great Ormond Street Hospital NHS Trust for eight years. In that time methods have evolved to take advantage of both technological advances and experiences gained in operating a routine digital photographic service. The management of a large number of digital images requires assiduous attention to all stages of production. Current techniques are described for: controlling quality and exposure in the acquisition of images with a digital camera; temporary and permanent storage, backing up and archiving procedures; and cataloguing of clinical images. Planning for network delivery, the Electronic Patient Record and the management of images in teaching collections are discussed.

Computer Communication Networks↗
PubMedDate not supplied

Telemedicine by mobile communication.

A concept of mobile telemedicine has been proposed to provide emergency care in a moving vehicle. The practicality of this technique was investigated through technical considerations required to realize mobile telemedicine. Some problems with this technique were identified, and measures to resolve the problems were devised. Then, theoretical analysis verified the feasibility of the proposed technique. Different multiplexing techniques for the multiple medical data transmission by mobile communication were investigated. An experimental system that can simultaneously transmit color images, an audio signal, three-channel ECGs, and blood pressure from a moving vehicle to a fixed station was developed. Experiments on the transmission of multichannel medical data from a moving ambulance, a navigating ship, and a flying aircraft were conducted. The results of these experiments verified the practical feasibility of the proposed technique. In the practical application of this technique, there may be some legal problems: for example, whether medical treatment through a communication medium would be legally acceptable or not, and whether the transmission of medical data violates the protection of personal privacy. However, considering the emergency nature of this technique and the significance of the results, both problems seem to be either legally or technically solvable. This application of mobile communication to telemedicine is not confined to merely a proposal to use new techniques. It can also bring about a methodological change in the concept of conventional telemedicine by changing it from static to dynamic, and by enlarging its scope from a local area to a global or cosmic area. It may also have an impact on conventional emergency medicine in that it will open up a new field of application that applies to moving vehicles.

Aircraft↗
PubMed1994

Neurolink: a neurosurgical wide-area computer network.

A computerized system capable of transmitting digitally formatted images of the central nervous system has been used to develop a neurosurgical wide-area network in western Pennsylvania. This system links remote or primary care hospitals with a large, tertiary-care, Level 1 trauma center for the constant availability of neurosurgical evaluation by receiving and interpreting computed tomography and magnetic resonance images sent via ordinary public telephone lines. This network has been used in over 20 cases to receive and interpret transmitted cranial computed tomographic images consisting of subarachnoid hemorrhage, intracerebral hematoma, cerebral neoplasm, cerebral abscess, cerebrovascular accident, and normal studies. There has been no known instance of false-positive or false-negative interpretation or of a patient being adversely managed by this method. On the contrary, it appears that patient management has been positively affected through the ability of the neurosurgical evaluation to include a review of the radiological studies. The initial experience has led to the conclusion that this network is an effective, accurate, and cost-effective means of delivering neurosurgical care to underserved areas.

Brain Diseases↗
PubMed1997

Health information networking via the Internet with the former Soviet Union.

Because of the severe financial hardships associated with the transition to a market economy in the Newly Independent States (NIS) of the former Soviet Union, the Internet has become a major link to health care resources for many health care workers. In 1992, the University of Illinois at Chicago Library of the Health Sciences (UIC LHS) initiated a special support project with goals of enhancing access to international biomedical information and facilitating international professional networking for interested NIS organizations and individuals. Project objectives included an information needs assessment, development of culturally sensitive Internet training applications, information and referral services, and follow-up e-mail consultations for NIS participants. This paper reviews the historical context of the health care partnerships between the United States and the NIS, and of the UIC LHS International Health Information Networking Project. In the context of UIC, international networking cross-cultural observations, teaching techniques, a Russian training experience, and the development of a Web-based course are reported.

Computer Communication Networks↗
PubMed1987

From tangled webs to network integrity: computer security in hospital management. Part II.

This article is the second of two on the subject of computer security in hospital management in the first part, the authors dramatized the need for not only information security awareness but also the need for implementation of security measures to protect valuable information. This second article provides an overview of the components of a good computer security plan, contains a brief explanation of some of the new network security technology available today, and gives the reader several sources that can provide further information on information security.

Computer Communication Networks↗