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PubMed1987

Implications of changes in healthcare for biomedical communications.

Payment for medical services on the basis of DRGs and other innovations in medical care are restricting the income of major medical institutions. This has resulted in decreased demand for biomedical communication services (and more cost awareness) in support of traditional educational and patient care programs and an increased demand for services to support institutional public relations and marketing programs. Biomedical communications will need to respond to this fluid environment by broadening its institutional role and adopting new information technologies.

Computer Communication Networks↗
PubMedDate not supplied

Remote site treatment planning.

Remote site treatment planning was one of the earliest methods of digital computer dose planning. Using batch-oriented or time-sharing mainframe computer systems, researchers in the late 1950s and early 1960s developed many of the basic algorithms used later in stand-alone systems. Although time-shared systems have continued in use, most of the emphasis on treatment planning in the last decade has been on using dedicated mini- and micro-computer systems. Recent developments in the computer industry, such as the use of networks and distributed computer processing, may lead to a resurgence of interest in remote computer systems for treatment planning.

Computer Communication Networks↗
PubMed1989

Adapting IAIMS to a hospital library level.

The Children's Hospital of Michigan Medical Library has adapted several of the Integrated Academic Information Management Systems (IAIMS) concepts and implemented them at a hospital library level. These have included features of network development, electronic interfacing and interlinking, and implementing an integrated information system in the library. The library has incorporated several information systems into library operations, including a variety of in-house, local, and national automated systems and telecommunication networks. Hospital libraries can incorporate IAIMS features and promote an institutional framework of interconnecting communication systems and electronic linkages.

Computer Communication Networks↗
PubMedDate not supplied

Community health behavior change through computer network health promotion: preliminary findings from Stanford Health-Net.

Computer-based health education has been employed in many settings. However, data on resultant behavior change are lacking. A randomized, controlled, prospective study was performed to test the efficacy of Stanford Health-Net (Stanford, CA, U.S.A.) in changing community health behaviors. Graduate and undergraduate students (N = 1003) were randomly assigned to treatment and control conditions. The treatment group received access to Health-Net, a health promotion computer network emphasizing specific self-care and preventive strategies. Over a 4-month intervention period, 26% of the treatment group used Health-Net an average of 6.4 times each (range 1-97). The most commonly cited reasons for use were curiosity, general health education, evaluation of current symptoms and anonymity of information. Users rated Health-Net favorably. The most commonly reported reasons for non-use were related to lack of health problems, limited time and lack of access to computer facilities. The mean number of ambulatory medical visits decreased 22.5% more in the treatment group than in the control group (P less than 0.05), while hospitalizations did not differ significantly between groups. In addition, perceived self-efficacy for preventing the acquisition of a sexually transmitted disease (STD) and herpes increased 577% (P less than 0.05) and 261% (P less than 0.01) more, respectively, in the treatment group than in the control group. These findings suggest that access to Stanford Health-Net can result in significant health behavior change. The advantages of the network approach make it a potential model for other communities.

Adult↗
PubMed1995

Integrating legacy laboratory information systems into a client-server world: the University of Minnesota Clinical Workstation (CWS) project.

The development of an innovative clinical decision-support project such as the University of Minnesota's Clinical Workstation initiative mandates the use of modern client-server network architectures. Preexisting conventional laboratory information systems (LIS) cannot be quickly replaced with client-server equivalents because of the cost and relative unavailability of such systems. Thus, embedding strategies that effectively integrate legacy information systems are needed. Our strategy led to the adoption of a multi-layered connection architecture that provides a data feed from our existing LIS to a new network-based relational database management system. By careful design, we maximize the use of open standards in our layered connection structure to provide data, requisition, or event messaging in several formats. Each layer is optimized to provide needed services to existing hospital clients and is well positioned to support future hospital network clients.

Artificial Intelligence↗
PubMed1992

Introduction to the ACR-NEMA DICOM standard.

In 1982, the American College of Radiology (ACR) and the National Electrical Manufacturers Association (NEMA) formed a committee to develop standards for the interconnection of digital imaging devices. Version 1.0 of the standard, published in 1985, specifies a hardware interface supporting point-to-point (not network) image transmission, a data dictionary (a set of rules for encoding information), and a set of commands to initiate transactions. Version 2.0, published in 1988, also addresses point-to-point image transmission and provides semantic rules by which messages (streams of bits representing information in transit from one device to another) are organized. Version 3.0, also referred to as DICOM (Digital Imaging and Communications in Medicine), will be finalized in 1992. The DICOM standard encourages open systems interconnection of imaging equipment over standard networks, while maintaining compatibility with earlier point-to-point connection standards. The DICOM standard conforms fully with the International Standards Organization reference model for network communications (ISORM), addresses the issue of conformance, and incorporates the concept of object-oriented design.

Computer Communication Networks↗
PubMed1992

Network information security in a phase III Integrated Academic Information Management System (IAIMS).

The developing Integrated Academic Information System (IAIMS) at Columbia-Presbyterian Medical Center provides data sharing links between two separate corporate entities, namely Columbia University Medical School and The Presbyterian Hospital, using a network-based architecture. Multiple database servers with heterogeneous user authentication protocols are linked to this network. "One-stop information shopping" implies one log-on procedure per session, not separate log-on and log-off procedures for each server or application used during a session. These circumstances provide challenges at the policy and technical levels to data security at the network level and insuring smooth information access for end users of these network-based services. Five activities being conducted as part of our security project are described: (1) policy development; (2) an authentication server for the network; (3) Kerberos as a tool for providing mutual authentication, encryption, and time stamping of authentication messages; (4) a prototype interface using Kerberos services to authenticate users accessing a network database server; and (5) a Kerberized electronic signature.

Computer Communication Networks↗
PubMed1989

Image management and communication systems: a new challenge in radiology.

The spectacular advances in diagnostic imaging technologies, such as CT, MRI, and NM, have improved the quality of radiological diagnosis. On the other hand, the vast amount of image data produced by these digital modalities have created unique problems in managing the information. The increased use of digital imaging systems has set the stage for the development of comprehensive medical image and information management systems for large medical facilities. These image management and communication systems (IMACS) vary, depending on imaging, display and output devices connected, network configurations used, and storage devices available. This paper will discuss the important technical aspects in developing an IMACS network, imaging devices ideally suited for connection to an IMACS, integration with computerized hospital and radiology information systems, performance issues, clinical acceptance and specific implementation experience.

Computer Communication Networks↗
PubMed1988

[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↗
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↗