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PubMedDate not supplied

A cryptologic based trust center for medical images.

OBJECTIVE: To investigate practical solutions that can integrate cryptographic techniques and picture archiving and communication systems (PACS) to improve the security of medical images. DESIGN: The PACS at the University of California San Francisco Medical Center consolidate images and associated data from various scanners into a centralized data archive and transmit them to remote display stations for review and consultation purposes. The purpose of this study is to investigate the model of a digital trust center that integrates cryptographic algorithms and protocols seamlessly into such a digital radiology environment to improve the security of medical images. MEASUREMENTS: The timing performance of encryption, decryption, and transmission of the cryptographic protocols over 81 volumetric PACS datasets has been measured. Lossless data compression is also applied before the encryption. The transmission performance is measured against three types of networks of different bandwidths: narrow-band Integrated Services Digital Network, Ethernet, and OC-3c Asynchronous Transfer Mode. RESULTS: The proposed digital trust center provides a cryptosystem solution to protect the confidentiality and to determine the authenticity of digital images in hospitals. The results of this study indicate that diagnostic images such as x-rays and magnetic resonance images could be routinely encrypted in PACS. However, applying encryption in teleradiology and PACS is a tradeoff between communications performance and security measures. CONCLUSION: Many people are uncertain about how to integrate cryptographic algorithms coherently into existing operations of the clinical enterprise. This paper describes a centralized cryptosystem architecture to ensure image data authenticity in a digital radiology department. The system performance has been evaluated in a hospital-integrated PACS environment.

Algorithms↗

PubMedDate not supplied

Virtual private networks can provide reliable IT connections.

A VPN is a private network that uses a public network, such as the Internet, to connect remote sites and users together. Instead of using a dedicated hard-wired connection as in a trusted connection or leased lines, a VPN uses a virtual connection routed through the Internet from the organization's private network to the remote site or employee. Typical VPN services allow for security in terms of data encryption as well as means to authenticate, authorize, and account for all the traffic. VPN services allow the organization to use whatever network operating system they wish as it also encapsulate your data into the protocols needed to transport data across public lines. The intention of this IT World article was to give the reader an introduction to VPNs. Keep in mind that there are no standard models for a VPN. You're likely to come across many vendors presenting the virtues of their VPN applications and devices when you Google "VPN." However the general uses, concepts, and principles outlined here should give you a fighting chance to read through the marketing language in the online ads and "white papers."

Biotechnology↗

PubMed1999

Computerizing the cancer centre.

This article describes a PC-based computer network that caters for the clinical information needs of a cancer centre, crossing specialty boundaries and involving all members of the multidisciplinary team. Data are captured at all stages of patients' progress, from diagnosis through to treatment and follow-up. Office automation is integral to the system, which produces work-load and process audit information as well as clinical outcomes. Data are entered prospectively at the point of care by health care professionals, ensuring a high degree of clinical confidence. It incorporates internationally recognized datasets and its modular structure facilitates implementation and development.

Computer Communication Networks↗

PubMed1994

The Southeast Florida AIDS Information Network: a community outreach, specialized information system.

In the years ahead, end-user instruction will expand from the current models of curriculum- and institution-based programs for teaching MEDLINE to include outreach programs to unaffiliated users for teaching specialized database searching. The Southeast Florida AIDS Information Network (SEFAIN), a community-based information system targeting health care providers in a tri-county area, is an example of this new model. The components of SEFAIN and the results of the outreach and educational programs are presented. The advantages of these programs to both providers and librarians are highlighted. Comparisons are drawn between end users who take specialized information courses and those who take MEDLINE courses or no courses. These data will assist librarians in the justification and development of specialized information systems.

Acquired Immunodeficiency Syndrome↗

PubMed1992

Information technologies. Physician-hospital networks.

Patient care efficiencies and quality of care improvements require progressive efforts to integrate the patient information systems and allow for on-demand accessibility to authorized information users. The dilemma facing the designers and managers of these systems is that each step toward improving accessibility seems to introduce another potential information leakage point. We are reminded once again that information is a very difficult resource to control because it is possible to steal it without removing it physically from its storage place. The essence of information security in physician links is captured by establishing mechanisms for identifying system users, limiting user authority, assuring the privacy of transmitted data, and monitoring system use and users.

Computer Communication Networks↗

PubMed2004

Implementing MDA-based distributed, interoperable, flexible, scalable, portable, and secure EHR systems.

Electronic Health Record (EHR) systems provide the kernel application of health information systems and health networks which should be independent of complexity, localisation constraints, platforms, protocols, etc. Based on shared care information systems' requirements for high level interoperability, a generic component architecture has been introduced. For implementing, running and maintaining acceptable and useable health information systems components, all views of the ISO Reference Model-Open Distributed Processing have to be considered. Following the Model Driven Architecture paradigm, a reference model as well as concept-representing domain models both independent of platforms must be specified, which are combined and harmonised as well as automatically transferred into platform-specific models using appropriate tools.

Computer Communication Networks↗

PubMed1998

Availability of software services for a hospital information system.

Hospital information systems (HISs) are becoming more important and covering more parts in daily hospital operations as order-entry systems become popular and electronic charts are introduced. Thus, HISs today need to be able to provide necessary services for hospital operations for a 24-h day, 365 days a year. The provision of services discussed here does not simply mean the availability of computers, in which all that matters is that the computer is functioning. It means the provision of necessary information for hospital operations by the computer software, and we will call it the availability of software services. HISs these days are mostly client-server systems. To increase availability of software services in these systems, it is not enough to just use system structures that are highly reliable in existing host-centred systems. Four main components which support availability of software services are network systems, client computers, server computers, and application software. In this paper, we suggest how to structure these four components to provide the minimum requested software services even if a part of the system stops to function. The network system should be double-protected in stratus using Asynchronous Transfer Mode (ATM) as its base network. Client computers should be fat clients with as much application logic as possible, and reference information which do not require frequent updates (master files, for example) should be replicated in clients. It would be best if all server computers could be double-protected. However, if that is physically impossible, one database file should be made accessible by several server computers. Still, at least the basic patients' information and the latest clinical records should be double-protected physically. Application software should be tested carefully before introduction. Different versions of the application software should always be kept and managed in case the new version has problems. If a hospital information system is designed and developed with these points in mind, it's availability of software services should increase greatly.

Computer Communication Networks↗

PubMed1992

Dial-in access to CD-ROM databases: beyond the local area network.

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.

CD-ROM↗

PubMed1996

Early results of user profiles: physicians' opinions on the use of information technology.

The role of physicians in today's managed care context is viewed as that of economic partner and clinical decision-maker, operating under the rules of professional autonomy and independence. To a considerable degree, physicians need to feel intrinsically motivated in order to change and adapt to new forms of health care delivery and information management. Today, health information managers use the rapid advances in telecommunications and computing technologies to plan and build vast health information networks, while at the same time receiving little support from systematic research to help understand, segment, and address the range of physicians' concerns and perceptions regarding these systems. This study's design employs a novel combination of qualitative and quantitative methods: first, to identify individual physician opinion profiles, and second, to group these profiles into clusters of similar perceptions. Opinions were obtained from primary care physicians in the Chicago area and resulted in four distinctly different profiles: Early Adopter, Traditional Family Doctor, Hesitant-Defensive Acceptor, and Unwilling-Uneasy Participant.

Adult↗

PubMed1994

Security Audit Center--a suggested model for effective audit strategies in health care informatics.

As dependence upon interorganizational and international health care informatics becomes absolute, and with increased vulnerability of information networks and applications and the cunning sophistication of computer criminals, it becomes imperative to implement tight information systems security to ward off any possible threat to these vital life-dependent information systems. In a rapidly decentralizing environment, the author proposes centralized security control, implemented in a Security Audit Center under the direct supervision of an Information Systems Security Manager who is a high-ranking organization staff member. Of the various components of the Security Audit Center, the most significant is the security audit expert systems which analyze audit data files according to security rules and present a precise status of systems security and realtime suspicion alert of the various breaches and intrusions.

Automation↗

PubMed2001

MEDNET: a medical simulation network grand challenge.

The need to improve war-fighter training led to significant advancements in simulator technology. Now, simulator technology is ready to be applied to a new challenge: an evolutionary approach to training military medical personnel that will result in improved combat casualty care. With the exception of the introduction of helicopter evacuation support during the Korean War, changes in combat casualty care have not significantly altered the percentage of wounded soldiers lost in combat since World War II. The introduction of battlefield simulator training has improved strategic planning and combat readiness. It is time to apply these same tools to improve medical planning, military medical readiness and execution of casualty care.

Computer Communication Networks↗

PubMed1993

A study on the development of a filing system for funduscopic images with a personal computer for Twin AMHTS.

A filing system for ocular funduscopic image data was developed by using a personal computer for the Twin AMHTS. The development of the system was tried as one of the data transfer system including image data between two similar AMHTSs named the Twin AMHTS through the information network system. The filing system is capable of storing 26782 data of ophthalmoscopic pictures with a data compression mode by using a magneto-optical disk (MOD) whose storage capacity of both sides is 616 MB. It takes no long time for retrieval and display of the image data in the filing system. Good quality of compression and decompression obtained and reproducibility of the ocular fundus picture is favorable regardless of normal or abnormal cases. As a result, it is suggested that the developed system has practical utility although it requires more improvement.

Computer Communication Networks↗

PubMed1989

Ultra-high-speed teleradiology with ISDN technology.

A solid-state, personal computer-based, image digitization and transmission system was developed that uses integrated services digital network (ISDN), a technology under development for ultra-high-speed data transmission over normal phone lines. Thousands of images have been transmitted to a site more than 15 miles away, with data rates exceeding 56,000 bits or 7,000 bytes (1 byte = 8 bits) per second with nearly perfect accuracy. Present modification of the system hardware and software should increase the data rate to 128,000 bits, or 16,000 bytes, per second. With this rate of transmission, remote radiologic image transmission should become a practical, routinely available diagnostic tool.

Computer Communication Networks↗

PubMedDate not supplied

Sharing digital micrographs and other data files between computers.

It ought to be easy to exchange digital micrographs and other computer data files with a colleague even on another continent. In practice, this often is not the case. The advantages and disadvantages of various methods that are available for exchanging data files between computers are discussed. When possible, data should be transferred through computer networking. When data are to be exchanged locally between computers with similar operating systems, the use of a local area network is recommended. For computers in commercial or academic environments that have dissimilar operating systems or are more widely spaced, the use of FTPs is recommended. Failing this, posting the data on a website and transferring by hypertext transfer protocol is suggested. If peer to peer exchange between computers in domestic environments is needed, the use of Messenger services such as Microsoft Messenger or Yahoo Messenger is the method of choice. When it is not possible to transfer the data files over the internet, single use, writable CD ROMs are the best media for transferring data. If for some reason this is not possible, DVD-R/RW, DVD+R/RW, 100 MB ZIP disks and USB flash media are potentially useful media for exchanging data files.

Computer Communication Networks↗

PubMed2000

Power of heterogeneous computing as a vehicle for implementing E(3) medical decision support systems.

A computer system of PCs, workstations, minicomputers etc. connected together via a local area network or wide area network represents a large pool of computational power. Our aim is to use this power for the implementation of an E(3) (efficiency, effectiveness, efficacy) medical decision support system, which can be based on different models, the best providing an explanation together with an accurate and reliable response. One of the most viable among models is decision trees, already used for many medical decision-making purposes. In this paper, we present a parallel implementation of a genetic algorithm on a heterogeneous computing system for the induction of decision trees with the application on solving the mitral valve prolapse syndrome. Our approach can be considered as a good choice for different real-world decision making, with respect to the advantages of our model, especially the great computational power.

Algorithms↗

PubMed2000

Paperless hospital: reality, dream or a nightmare?

Public Hospitals of Styria (KAGes) are implementing new hospital information system (MEDOCS--MEdical and nursing DOcumentation and Communication network of Styria) in its 21 hospitals. One of the outstanding features of this system is the coverage of virtually all communication and documentation functions related to the patient. This should be the way to fulfill the conditions for gradually removing the paper as an information medium from daily hospital practice. This approach will be tested in the MEDOCS project at two evaluation sites. In this paper the authors discuss in form of "pros and contras" the chances and risks of this approach, as well as possible strategies during the steps of implementing the "paperless" hospital. Besides of general technological, medical and cultural considerations the paper discuss also the technical and economical aspects of "paperless" hospital implementation and production.

Austria↗

PubMed1996

Prism: a new approach to radiotherapy planning software.

PURPOSE: We describe the capabilities and performance of Prism, an innovative new radiotherapy planning system with unusual features and design. The design and implementation strategies are intended to assure high quality and clinical acceptability. The features include Artificial Intelligence tools and special support for multileaf collimator (MLC) systems. The design provides unusual flexibility of operation and ease of expansion. METHODS AND MATERIALS: We have implemented Prism, a three-dimensional (3D) radiotherapy treatment-planning system on standard commercial workstations with the widely available X window system. The design and implementation use ideas taken from recent software engineering research, for example, the use of behavioral entity-relationship modeling and the "Mediator Method" instead of ad-hoc programming. The Prism system includes the usual features of a 3D planning system, including Beam's Eye View and the ability to simulate any treatment geometry possible with any standard radiotherapy accelerator. It includes a rule-based expert system for automated generation of the planning target volume as defined in ICRU Report 50. In addition, it provides special support for planning treatments with a multileaf collimator (MLC). We also implemented a Radiotherapy Treatment Planning Tools Foundation for Prism, so that we are able to use software tools form other institutions without any source code modification. RESULTS: The Prism system has been in clinical operation at the University of Washington since July 1994 and has been installed at several other clinics. The system is run simultaneously by several users, each with their own workstation operating from a common networked database and software. In addition to the dosimetrists, the system is used by radiation oncologists to define tumor and target volumes and by radiation therapists to select treatment setups to load into a computer controlled accelerator. CONCLUSIONS: Experience with the installation and operation has shown the design to be effective as both a clinical and research tool. Integration of software tools has eased the development and significantly enhanced the clinical usability of the system. The design has been shown to be a sound basis for further innovation in radiation treatment planning software and for research in the treatment planning process.

Computer Communication Networks↗

PubMed1997

Internet-enabled solutions for health care business problems.

Many health care delivery organizations have built, installed, or made use of Nets. As single entities merge with others, and independent institutions become part of much larger delivery networks, the need for collaboration is critical. With the formation of such partnerships, existing platforms will become increasingly available from which it will be possible to build disparate technologies that must somehow be part of a single working "system." Nets can enable this leveraging, allowing access from multiple technological platforms. The collaboration, distribution, application integration, and messaging possibilities with the Nets are unprecedented. We believe that meeting a health care delivery organization's needs without these benefits will soon be unthinkable. While Nets are not the answer to the challenges facing health care delivery today, they certainly are a large contributor to the solution.

Computer Communication Networks↗