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PubMed1988

Simulation of patient flow in a picture archival and communications system network.

As hospital radiology departments expand their use of digitally formatted imaging devices, these machines will be connected in local area networks called Picture Archival and Communications Systems (PACS). The purpose of this paper is to demonstrate the use of computer simulation to analyze the process of patients using a PACS. The flexibility of using simulation on a proposed PACS is shown, starting with the description of a basic model. Different machine networks are run and the results compared. Simulation modeling provides a valuable tool to hospital and department administrators in detecting possible problem areas which may occur with proposed PACS configurations under assumed patient loads.

Computer Communication Networks↗

PubMed1991

Network system: the integrated picture archiving and communication system with the hospital information system.

We describe the outline of Hokkaido University picture archiving and communication system (HU-PACS) and its network functions. HU-PACS processes 0.5 Gbytes of images daily through 10 acquisition devices. Functional integration of hospital information system (HIS) and PACS has been implemented. The HU-PACS can access common data base with HIS. Multi-image data-base systems provide fast throughput of image retrieval. The system is composed of 4 modules: (1) 2 image data-base systems (IDS), (2) 1 image management system (IMS), (3) image display terminals (IDT), and (4) 8 image acquisition nodes interfaced to 10 modalities and 1 film scanner. These 4 modules are connected by branch and loop type local area networks (LAN). HU-PACS has functions other than basic PACS functions. Images in optical disk library (ODL) are loaded onto magnetic disks (MD) in advance according to patient booking information, the images expected to be viewed are transferred to the local storage automatically, and the desired images can be pre-downloaded into local storage by instruction through HIS terminals.

Computer Communication Networks↗

PubMed1991

[Computer networks in clinical practice--a histology data bank system].

In hospital and in private practice huge amounts of data have to be managed. Conventional storage and documentation techniques are being replaced more and more by the use of computers. Local area networks based on the interconnection of stand-alone PC workstations offer several advantages over non-communicating systems. The use of computer networks solves many communication problems and in this way improves the flow of information. The interconnection may be achieved by step-by-step integration of preexisting elements. This paper presents a database system for archiving routine histology data and illustrates the use of a computer network in a dermatology department.

Computer Communication Networks↗

PubMed1988

[The PACS model plan at the Freiburg University Clinic. A first step toward a radiologic picture archiving and communication system].

In a study performed at several clinical departments of the University of Freiburg, West Germany, it was found that approximately 180,000 patient examinations based on computed tomography, magnetic resonance, nuclear medicine, ultrasound as well as digital and conventional radiography, produce over 1,000,000 pictures. It was assumed that modern technologies can greatly facilitate the handling of such a quantity of images. This applies to diagnosis and therapy planning as well as to communication and archiving of this large amount of data. The study also assumes that the technologies to be considered, e.g. fiber optical networks, optical archives and medical work stations, which represent the main components of PACS, should be introduced in a stepwise manner following a clear overall conception. As the first step the implementation of a local area network (LAN) in the departments of radiology and general surgery is planned. Important criteria for the selection of these particular departments are improvements in health care for a maximum number of patients and in the working profiles for the greatest possible number of physicians and assistant personnel. A cost reduction as compared to the present system through more efficient communication and archiving of the digital images is expected. New perspectives for medical research as well as for medico-technical developments are also expected. Examples are the 3-D representations of human anatomy and the manufacturing of custom-designed prothetic devices. Scheduling and budgetary plans for equipment and manpower are further study results for the Freiburg PACS-Project.

Germany, West↗

PubMedDate not supplied

Data communications within a health authority.

This paper describes the data communication network installed in four hospitals in the Hammersmith and Queeen Charlotte's Special Health Authority to support several hundred microcomputers, terminals and printers and several host systems, including the integrated computerized hospital information system which is currently under development. Broadband local area network and wide area network technologies have been employed to provide a flexible system, which is capable of being expanded to meet the increasing demand for data communications within the authority. The broadband networks are the first such installations in a health authority in Britain.

Computer Communication Networks↗

PubMed1985

Techniques of networking in the computer world.

Networks can play an important role for nurses in user-to-user communication because they can be used both within and outside the health care delivery system. The choices include an information exchange, which can be an effective strategy for sharing personal concerns, problems, and achievements about the computer; commercial data bases with their vast sources of information and research data; or local area networks, effective in an office or campus setting. All of these networks can put worlds of information and services just a few words or keyboard strokes away, because they offer, outside of your own computer, a whole new dimension of retrieval, storage, reference, and communication capabilities. These networks can significantly enhance computing potential by providing an overall expansion of information.

Commerce↗

PubMed1985

Use of a microcomputer network for history taking in a prenatal clinic.

A stand-alone microcomputer was installed at St. Bartholomew's Hospital to obtain the booking (first prenatal) history. This system has many well-documented advantages over the manual method, particularly with respect to the completeness and quality of the history produced. However, a single microcomputer system is unable to deal with the load of a busy clinic, and initially, several independent terminals were required. We now describe the installation of a local area network to link several microcomputers with a single database in the Antenatal Clinic at Queen Charlotte's Maternity Hospital.

Computers↗

PubMed1991

Coronary artery quantitation and data management system for paired cineangiograms.

A computerized system designed to optimize the quantitation of coronary vessels on 35 mm cineangiograms is described and validated. Because the system has two cine film digitizers, it processes paired coronary arteriograms for the evaluation of serial changes in coronary arteries. A database system was specifically designed for the storage of coronary artery quantitation data which resides on a file server in a local area network and may be accessed by multiple workstations. In radiographic phantom studies of nine contrast-filled lucite cylinders of known size, the overall accuracy and precision for the measured diameters were 0.069 mm and 0.066 mm respectively. Measurements of minimum diameter and percent diameter stenosis of 21 coronary lesions selected from 17 routine cineangiograms showed high degree of intraobserver and interobserver reproducibility.

Cineangiography↗

PubMed1991

A distributed approach to integrated inquiry and display for radiology.

Picture archive and communications (PACS) systems should be flexible and modular in design so that new advances in storage, computation, and display technology can be introduced into the system without a significant redesign of existing software. The acquisition, storage, and management of radiologic images must be carefully integrated with a radiology information system. Our architecture is based on a four-level data model: (1) patient information, (2) examination information and reports, (3) image information, and (4) instances of images. The PACS being developed at the Mallinckrodt Institute of Radiology within the Electronic Radiology Laboratory consists of three primary components: application clients, database servers and image servers. One type of application client is an image-capable workstation that supports a radiology image viewing application. The application client queries the database server for information regarding patient and examination data in response to user-level requests. The database server responds to the request by retrieving the appropriate patient demographics and examination information, along with a pointer to the image/instance data from a central database. The client then uses the image data pointer to query the image server for the actual pixel data. The image server responds by transmitting the pixel data to the requesting application client or a designated auxiliary display device. Other clients act as image data acquisition nodes. Queries to the database servers are made via a library of callable subroutines. Software integrity is maintained throughout the system by dynamically loading software from a code-control database. Inquiry and display transactions, supported on a local-area network (Ethernet), have been measured and analyzed. Results and observations are presented.

Computer Communication Networks↗

PubMed1983

Protocols for unifying distributed systems in hospitals.

Data pertinent to any one hospital patient are often distributed across several independent heterogeneous computer systems serving different functional areas of the hospital. A global, integrated hospital information system can evolve from this situation if existing computer systems are linked by a local area network and the systems are modified to employ a set of protocols that enable information exchange. This paper provides a high-level description of the required protocol functions.

Computers↗

PubMed1992

Acquisition of ICU data: concepts and demands.

As the issue of data overload is a problem in critical care today, it is of utmost importance to improve acquisition, storage, integration, and presentation of medical data, which appears only feasible with the help of bedside computers. The data originates from four major sources: (1) the bedside medical devices, (2) the local area network (LAN) of the ICU, (3) the hospital information system (HIS) and (4) manual input. All sources differ markedly in quality and quantity of data and in the demands of the interfaces between source of data and patient database. The demands for data acquisition from bedside medical devices, ICU-LAN and HIS concentrate on technical problems, such as computational power, storage capacity, real-time processing, interfacing with different devices and networks and the unmistakable assignment of data to the individual patient. The main problem of manual data acquisition is the definition and configuration of the user interface that must allow the inexperienced user to interact with the computer intuitively. Emphasis must be put on the construction of a pleasant, logical and easy-to-handle graphical user interface (GUI). Short response times will require high graphical processing capacity. Moreover, high computational resources are necessary in the future for additional interfacing devices such as speech recognition and 3D-GUI. Therefore, in an ICU environment the demands for computational power are enormous. These problems are complicated by the urgent need for friendly and easy-to-handle user interfaces. Both facts place ICU bedside computing at the vanguard of present and future workstation development leaving no room for solutions based on traditional concepts of personal computers.(ABSTRACT TRUNCATED AT 250 WORDS)

Artificial Intelligence↗

PubMed1992

Proposal of a computerized algorithm for continuous wave CO2 laser on-line control during orthopaedic surgery. Phase I: theoretical introduction and first in vitro trials.

New data obtained from treating polymethylmethacrylate (PMMA) with a non-moving cw- 10 watt-CO2 laser-beam focused at 2.5'', 5'', 7.5'' and 15.75'' are presented. . The final equations R(tc) and Z(tc) for each focal length are proposed. A very interesting correlation between the focal lengths in use and the integrated values of R and Z between 0 and 2 sec has been identified and discussed. This result has been used as basis to define a convenient operative protocol to follow during the planning phase of critical osteotomies or bone cement removal operations using a continuous-wave CO2 laser-beam set to any output power and focused by a set of most common, moving or non-moving focal lengths placed on the operating area. With a simple equation, it is possible to compare craters obtained with moving and non-moving laser-beams at different operative conditions between 0 and 2 sec, time interval which covers the majority of cases. A value of 2.3 +/- 0.1 between ablated volumes of PMMA and bone tissue has been identified. Several case studies regarding orthopaedic procedures from Literature are here reported and compared to the present LCA model. The computerized on-line flow of information for the laser-beam optimization and safety control is also described. Finally, a method for the simultaneous data collection from several operating rooms via a Local Area Network (LAN-Industry Standard IEEE) onto a central data base for later consultation is proposed in its general design.

Algorithms↗

PubMed1989

A multimedia medical communication link between a radiology department and an emergency department.

The most critical aspect of a radiologist's work is communicating his findings to the attending physician responsible for the patient's care. This is also the part of the process that is least well organized and the most subject to failure. At the University of Ottawa Medical Communications Research Centre we are investigating technical means to improving communications between radiologists and attending physicians. We first introduce the radiology communication service problem and show why it is essentially a multimedia communication problem. We then briefly describe a multimedia communication system designed and implemented by our research team. The multimedia system consists of several work stations linked by the Hospital's local area network (LAN). Each physician work station comprises a Compaq 386/20-Mhz microcomputer with 16 Mbytes of RAM, a 500-Mbyte image disk, and an image memory that drives a 1,000-line monochrome monitor. The images are digitized using a Konica laser-based film digitizer (2430 by 2000 10-bit pixels for a standard chest radiograph). The multimedia file server manager station is built around a PC-AT compatible with a Northern Telecom Meridian SL-1ST digital PBX and a Meridian Mail digital voice messaging system. This last device is used to store voice data and is linked via the PBX to the workstations' digital telephones. A Sytek 6,000 LAN links all work stations to the file server. All data, image, and graphic information is transmitted via this network, while the twisted pair connections linking the digital PBX to the telephone sets are used for transmitting voice data.(ABSTRACT TRUNCATED AT 250 WORDS)

Computer Communication Networks↗

PubMed1991

128-channel cable-telemetry EEG recording system for long-term invasive monitoring.

A 128-channel cable-telemetry EEG monitoring system has been developed for use on patients undergoing intensive neurodiagnostic monitoring with invasive intracranial electrodes. A unique head mounted preamplifier/multiplexor design allows continuous recording from any combination of intracerebral, subdural, epidural or surface electrodes. A computer is used to delay or buffer all 128 channels by 2 min or more. This computer is connected to a fileserver via a local area network and is used exclusively for data acquisition. Seizure files created by the activation of the seizure/event push button or detected by a second computer containing on-line seizure/spike detection algorithms are written directly on to the fileserver by the acquisition computer. The 128 channels of EEG recorded on the fileserver can then be remotely reviewed on a high resolution graphics terminal, printed out on a laser jet printer, archived or played out on paper, 16 channels at a time on any EEG machine. A time of day signal is also generated by the computer to permit time correlation with a continuous audio/video VCR unit which permits comparison of the EEG and clinical events. This system allows continuous EEG monitoring of extensive multichannel arrays not previously possible with conventional 16-, 32- or even 64-channel systems.

Electroencephalography↗

PubMed1989

BIOLAB--a computerized on-line system for physiological measurements in experimental animals.

An on-line system for the acquisition and analysis of physiological signals measured in experimental animals is described. The modular design makes it flexible and easily adaptable to various kinds of physiological measurements. Currently, the system includes support for hemodynamic and cardiac electrophysiological studies. The system is designed for intermittent recordings initiated either manually by the operator or automatically. The distributed computer system consists of three parts: the data acquisition subsystem, the on-line analysis subsystem, and the final data processing subsystem. The communication between the subsystem utilizes an Ethernet local area network, and the analysis and plot programs include support for RS/1 tables and graphs.

Animals↗

PubMedDate not supplied

Clinical application of a magneto-optical disk image filing system/image save and carry (ISAC) system.

We propose the utilization of portable magneto optical disks for image filing. The main problems in PACS are the need for a high-speed local area network (LAN) and a large mass storage device. An image filing system--image save and carry (ISAC)--is one solution for these problems in present PACS and requires minimal additional hardware and cost for the installation. Whenever a patient is examined, the clerk carries the medical record and the ISAC magneto-optical disk for recording image data, and after inspection records the image data into the magneto-optical disk. We investigated the number of image retrievals done for inpatients and outpatients in 1988 at our radiation therapy department. The data storage requirements were on the average 18.5 MB for outpatients and 173.9 MB for inpatients. An ISAC display console needs also an easy-to-use man/machine interface for specifying images and image display characteristics in order to realize the ISAC system.

Computer Systems↗

PubMed1990

'CO-CO' in nursing care planning: an innovative approach to student learning.

This qualitative study evaluated the application of a new real-time, synchronous computer conferencing technology (CO-CO) to assist student nurses develop effective nursing care planning skills. Using CO-CO, first-year undergraduate nurses collaborated across a local area network to produce nursing care plans based on given patient profiles. A convenience sample involved a total of eight students, working in pairs at different work stations. An initial training session introduced the students to the Unisys Icon microcomputer system and the CO-CO software application. In the second session the researcher displayed a patient case study in one of the CO-CO screen windows along with specific instructions. The students' objective was to co-operate and collaborate as a group in order to produce an appropriate nursing care plan. For the most part they worked independently of the teacher who was able to engage in other activities while remaining available to the group for occasional essential feedback. Later, a questionnaire was completed by the students. The students cited the ease with which they could use the software CO-CO to reach decisions about care. The sessions reportedly improved group process and group interaction. This computer conferencing system offers an alternative approach to the teaching of nursing care planning.

Adult↗

PubMed1989

Studying the isolated central nervous system; a report on 35 years: more inquisitive than acquisitive.

1. The CNS from invertebrate animals such as slugs, snails, leeches, and cockroaches, can be isolated and kept alive for many hours. 2. The electrical and pharmacological properties of invertebrate CNS neurons have many similarities and it is probable that the basic rules governing the CNS evolved more than 600 million years ago. 3. The nerve cells can show sodium action potentials, calcium action potentials, EPSP, IPSP, biphasic potentials, electrogenic sodium pump potentials, and a variety of potassium, sodium, calcium and chloride currents. 4. Invertebrate CNS ganglia contain identifiable individual nerve cells whose properties and responses to neurotransmitters and drugs are constant and repeatable from preparation to preparation. 5. It was possible to set up an isolated CNS-nerve trunk-muscle preparation and study the transport of radioactive material from the CNS to the muscle and from muscle to CNS. This has provided information about axoplasmic transport in both invertebrate and vertebrate preparations. 6. The methods developed from studies of invertebrate isolated CNS preparations have been applied to vertebrate isolated CNS preparations. 7. In addition to thin slices of the mammalian brain, it is possible to keep 5 cm lengths of the whole mammalian spinal cord and brain stem alive for many hours. 8. The isolated mammalian spinal cord has functional ipsilateral and contralateral reflexes, ascending and descending pathways, extensive sensory integrative local area networks, and inhibitory interneuron circuits. Much of the in vivo circuitry is functional in vitro. 9. The isolated mammalian spinal cord and brain stem can be developed to include functional higher brain circuits that will provide increased understanding of the control and integrative action of the mammalian central nervous system.

Animals↗