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At least 145 records · Page 8Linked to original sources

PubMed2004

[Construction of a bed management system using widely available software: departmental information integration including the department of radiological technology].

In recent years, the distribution of medical information through Internet technology has been increasingly promoted as a result of the December 2001 initiative of the Ministry of Health, Labor and Welfare known as "the grand design for the application of welfare and medical care information technology in the field of health." In June 1999, we developed a bed management system that uses a local area network (LAN). The ultimate goals of this systems configuration were the development of an order-entry system, an electronic health-record system, and improved information sharing. The system, which was created by employing widely used software, rationalized daily work by integrating patient information, hospitalization information, radiological examination reservation information, physiological examination reservation information, and rehabilitation reservation information. The radiological examination reservation information system that our radiology department uses is one of these systems. Electronic preservation of the reservation list is carried out in the radiology department, and information on examinations is input. The resulting full-scale order-entry system was introduced in July 2002, and it has improved the sharing of information among staff members.

Bed Occupancy↗

PubMed2002

Using NetMeeting for remote configuration of the Otto Bock C-Leg: technical considerations.

Telehealth has the potential to be a valuable tool for technical and clinical support of computer controlled prosthetic devices. This pilot study examined the use of Internet-based, desktop video conferencing for remote configuration of the Otto Bock C-Leg. Laboratory tests involved connecting two computers running Microsoft NetMeeting over a local area network (IP protocol). Over 56 Kbs(-1), DSL/Cable, and 10 Mbs(-1) LAN speeds, a prosthetist remotely configured a user's C-Leg by using Application Sharing, Live Video, and Live Audio. A similar test between sites in Ottawa and Toronto, Canada was limited by the notebook computer's 28 Kbs(-1) modem. At the 28 Kbs(-1) Internet-connection speed, NetMeeting's application sharing feature was not able to update the remote Sliders window fast enough to display peak toe loads and peak knee angles. These results support the use of NetMeeting as an accessible and cost-effective tool for remote C-Leg configuration, provided that sufficient Internet data transfer speed is available.

Artificial Limbs↗

PubMed1989

Effective staff communications in a large I.C.U.

A byproduct of the Quality Assurance process is the continual review of individual and group practice. The aim is to eliminate errors and to improve care. For managers and directors to know what issues are currently important to the staff members an upward channel of communication is also needed. In our SICU with over 120 staff there was no documentation of communication in either direction. Casual survey did not reveal a major problem - but the need to document the dissemination of information, particularly new policies - especially to satisfy accrediting agencies - led us to develop MEMOS, an electronic mail system for staff members within the local area network (LAN) in the SICU. The system will run on an individual PC. The network is used because of the physical configuration of the intensive care units. The system is used by nurse managers to keep staff members up to date. Features include: Easy file maintenance. Individual password access. A defined group of system operators with access to all system functions Limited access to all other users. As many as 40 definable sub-groups for the purposes of mail distribution. Easy operator tallying of those delinquent in reading their mail. Hard copy with distribution list for all memos added to system. Browse feature to allow re-reading of old memos. Feedback channel regularly read by system operators. This system has improved the level of staff awareness in the SICU and helped build morale.

Computer Systems↗

PubMed1998

Platform independent implementation of DICOM-based miniPACS.

Platform independence is an important issue for a software designed to run across a hospital environment which is practically always heterogeneous one. This paper presents a simple miniPACS solution designed over an existing Intranet (Internet limited to a local area network). Platform independence is achieved with Java programming language which allows resulting code to be executed on virtually all machines. System consists of a server application providing DICOM (Digital Imaging and Communications in Medicine) services and clients that can use these services over a TCP/IP connection. The server application is capable of an image storage and supports a query mechanism to allow access to stored data, thus the clients may perform two major functions: providing image data for archiving or image retrieval for viewing. Presented client application provides both these functions. It retrieves stored images for further processing and returns calculated results to the archive. The parts of the system are connected through a DICOM interface. Consequently the system architecture is open and any devices like scanners or viewing stations supporting specific DICOM services may be attached.

Humans↗

PubMed1993

Data interface between a radiology information system and a computed radiography system using a personal computer and standard software.

We describe the implementation of a simple data interface between a radiology information system and a computed radiography system that uses personal computers and standard software. The radiology information system was developed in house and runs in a local area network of personal computers. The computed radiography system is connected to a picture archiving and communication system. We have implemented a software data interface on a microcomputer, allowing automated transfer of patient data from the radiology information system program to the computed radiography scheduling program. The interface adds essential information used by the picture archiving and communication system to handle work lists, routing, and archiving algorithms. We have improved the user interface, shortened the scheduling time, enabled coherence of data bases, and eased the use of computed radiography and examination routing in the picture archiving and communication system. We have been using this interface for more than 1 year without difficulties. This custom solution addresses the problem of interconnecting existing equipment, avoiding proprietary restrictions or the lack of effective standards. This approach can be applied to any radiology environment that uses personal computers.

Humans↗

PubMed1995

Evaluation of the medical diagnostic imaging support system based on 2 years of clinical experience.

The Medical Diagnostic Imaging Support (MDIS) system at Madigan Army Medical Center (MAMC) has been operational in a phased approach since March 1992. Since then, nearly all image acquisition has been digital with progressively increasing primary softcopy diagnosis used. More than 375,000 computed radiography (CR) images as well as other modality images have been archived. Considerable experience in installation and implementation phasing has been gained. The location and ergonomic aspects of equipment placement were refined with time. The original clinical scenario was insufficiently detailed and additions were made to facilitate smoother and more complete transition toward a filmless environment. The MDIS system effectiveness and performance have been good in terms of operational workload throughout, background operations, and reliability. The important areas regarding reliability are image acquisition, output, display, database operations, storage, and the local area network. Fail-safe strategies have been continually improved to maintain continuous clinical image availability during the times when the MDIS system or components malfunction. Many invaluable lessons have been learned for effective quality assurance in a hospital-wide picture archiving and communication system. These issues include training, operational quality control, practical aspects of CR image quality, and increased timeliness in the generation and distribution of radiographic reports. Clinical acceptability has been a continuous process as each phase has been implemented. Clinical physicians quickly used the workstations soon after the start of MDIS at MAMC. The major advantage for clinicians has been the amount of time saved when retrieving multimodality images for review. On the other hand, the radiologists have been slower in their acceptance of the workstation for routine use.(ABSTRACT TRUNCATED AT 250 WORDS)

Computers↗

PubMed2001

Wireless LANs in healthcare.

Wireless local area networks (WLANs) function much like conventional LANs, except that the information they carry is transmitted using radio-frequency (RF) signals and sometimes infrared signals rather than copper or fiberoptic cables. Using devices that communicate over a WLAN has several benefits: For example, the devices can be used virtually anywhere in the facility without needing access to a hardwired data terminal, and they are often easier to install since they don't need additional wiring. But WLANs also have drawbacks. They can't transfer as much data at one time as wired systems, for example, or transfer it as quickly. Because they require new technology, they may carry greater costs. And because they operate in a frequency band that isn't protected from interference, they require special techniques to maximize the quality of their signals--techniques that, themselves, require a number of challenging decisions. In this article, we describe the basic operating and purchasing considerations involved in deciding whether to invest in WLAN technology and which type of system to choose.

Hospital Information Systems↗

PubMed2006

Hospital-wide physiological surveillance-a new approach to the early identification and management of the sick patient.

Hospitalised patients, who suffer cardiac arrest and require unanticipated intensive care unit (ICU) admission or die, often exhibit premonitory abnormalities in vital signs. Sometimes, the deterioration is well documented, though there is little discernable evidence of intervention. In other cases, monitoring and recording of vital signs is infrequent or incomplete. Healthcare providers have introduced "track and trigger" systems to allow early identification of patients with physiological abnormalities, and rapid response teams to facilitate rapid and appropriate management. However, even when "track and trigger" systems are used, the recording of vital signs, patient chart completion and team activation remain sub-optimal. We have developed a system for collecting routine vital signs data at the bedside using standard personal digital assistants (PDA). The PDAs act as "thin clients" linked by a wireless local area network (W-LAN) to the hospital's intranet system, where raw and derived data are integrated with other patient information, e.g., name, hospital number, laboratory results. It is possible for raw physiology data, early warning scores (EWS), vital signs charts and oxygen therapy records to be made instantaneously available to any member of the hospital healthcare team via the W-LAN or hospital intranet. Early and direct contact with members of the patient's primary clinical team or rapid response team can be made through an automated alerting system, triggered by the EWS data. The ability to capture physiological data at the bedside, and to make these available to anyone with appropriate access rights at any time and in any place, should provide previously unattainable, clinical and administrative benefits. Analysis of the raw physiological data and patient outcomes will also make it possible to validate existing and future "track and trigger" systems.

Computers, Handheld↗

PubMed1998

The German teleradiology system MEDICUS: system description and experiences in a German field test.

MEDICUS is a teleradiology system which has been developed in a joint project of the German Cancer Research Center (Deutsches Krebsforschungszentrum) and the Transfer Center Medical Informatics (Steinbeis-Transferzentrum Medizinische Informatik) in Heidelberg, Germany. The system is designed to work on ISDN lines as well as in a local area network. Special attention has been given to the design of the user interface and data security, integrity, and authentication. The software is in use in 13 radiology departments in university clinics, small hospitals, private practices, and research institutes. More than 25 thousand images have been processed in 6 months. The system is in use in six different application scenarios. MEDICUS is running under the UNIX operating system. The connection of the modalities could in most cases not be realized with the DICOM protocol as older machines were not equipped with this standard protocol. Clinical experiences show that the MEDICUS system provides a very high degree of functionality. The system has an efficient and user friendly graphical user interface. The result of a comparison with other systems shows that MEDICUS is currently the best known teleradiology system. Cost reductions are already obvious, but additional research has to be performed in this field. An even more powerful commercial successor is currently under construction at the Steinbeis-Transferzentrum Medizinische Informatik in Heidelberg.

Ambulatory Care Facilities↗

PubMed2000

Infrared transmission of electronic information via LAN in the operating room.

Recent advances in technology have brought many kinds of monitoring devices into the operating room (OR). The information gathered by monitors can be channeled to the operating ward information system via a local area network (LAN). Connecting patients to monitors and monitors to the LAN, however, requires a large number of cables. This wiring is generally inconvenient and particularly troublesome if the layout of the OR is rearranged. From this point of view, wireless transmission seems ideally suited to clinical settings. Currently, two modes of wireless connectivity are available: radio-frequency (RF) waves or infrared (IR) waves. Some reports suggest that RF transmission is likely to cause electromagnetic interference (EMI) in medical devices such as cardiac pacemakers or infusion pumps. The risk of malfunctioning life-sustaining devices and the catastrophic consequences this would have on seriously ill patients rules out the use of RF. Here, we report an IR system using IR modems for LAN connectivity in the OR. In this study, we focused on the possible detrimental effects of EMI during wireless connectivity. In our trial, we found no evidence of EMI of IR modems with any of the medical devices we tested. Furthermore, IR modems showed similar performance to a wired system even in an electrically noisy environment. We conclude that IR wireless connectivity can be safely and effectively used in ORs.

Hospital Information Systems↗

PubMed1992

PADS (Patient Archiving and Documentation System): a computerized patient record with educational aspects.

Rapid acquisition and analysis of information in an Intensive Care Unit (ICU) setting is essential, even more so the documentation of the decision making process which has vital consequences for the lives of ICU patients. We describe an Ethernet based local area network (LAN) with clinical workstations (Macintosh fx, ci). Our Patient Archiving and Documentation System (PADS) represents a computerized patient record presently used in a university hospitals' ICU. Taking full advantage of the Macintosh based graphical user interface (GUI) our system enables nurses and doctors to perform the following tasks: admission, medical history taking, physical examination, generation of problem lists and follow up notes, access to laboratory data and reports, semiautomatic generation of a discharge summary including full word processor capabilities. Furthermore, the system offers rapid, consistent and complete automatic encoding of diagnoses following the International Classification of Disease (ICD; WHO, [1]). For educational purposes the user can also view disease entities or complications related to the diagnoses she/he encoded. The system has links to other educational programs such as cardiac auscultation. A MEDLINE literature search through a CD-ROM based system can be performed without exiting the system; also, CD-ROM based medical textbooks can be accessed as well. Commercially available Macintosh programs can be integrated in the system without existing the main program thus enabling users to customize their working environment. Additional options include automatic background monitoring of users learning behavior, analyses and graphical display of numerous epidemiological and health care related problems. Furthermore, we are in the process of integrating sound and digital video in our system. This system represents one in a line of modular departmental models which will eventually be integrated to form a decentralized Hospital Information System (HIS).

Computer User Training↗

PubMed1997

Benchmarking the perioperative process. I. Patient routing systems: a method for continual improvement of patient flow and resource utilization.

The article presents an overview of the design and application of a real-time patient routing system, based on barcode and local area network technology, that was designed to track the progress of patients during the perioperative process. We present data on all patients undergoing ambulatory surgery. Patients' progress during their surgical stay was recorded at 17 strategic events using this real-time patient tracking technology. These times were used to identify inefficiencies in the perioperative process by identifying bottlenecks and areas of high variation. We found that both raw and actual operating room (OR) utilization efficiency was less than 50%. Points of high variation in a patient's progress occurred during the time from admit to the hospital until the patient was ready for the OR; the time from when a patient was ready for the OR until they were called for; and the time a patient spends in the OR preoperative holding room. Causes for variation were identified and traced back to individual procedures, activities, and work processes. Multidisciplinary improvement teams were created to improve the pinpointed problem areas. The real-time patient routing system is a process that has proven to be highly valuable to all participants in the surgical process in bringing about rational, data driven efficiencies in perioperative services. This process has the potential to facilitate multidisciplinary cooperation in efforts to contain and reduce costs of perioperative services.

Appointments and Schedules↗

PubMed1993

Prototype system for archiving and transmitting digitized radiographs.

A prototype system for archiving and transmitting digitized dental radiographs is described. The system uses a CCD video camera, IBM compatible personal computer with a frame-grabber and a high resolution VGA monitor. All archived images were compressed lossless by a factor of about 3. Digitized radiographs were archived together with their exposure data and assembled in an examination with a unique identifier and date of examination, together with the patient's history and reason for radiological examination. A radiological report with a list of differential diagnoses could be attached. Each examination could contain 50 digitized radiographs which could be converted to a tagged image file (TIFF) and printed halftone with a laser printer. Users of the system could receive examinations from the network-server and share the images in a local area network.

Humans↗

PubMed1996

[Current network in Hokkaido University School of Medicine].

Recently campus LAN (Local Area Network) HINES (Hokkaido university Information NEtwork System) has been popularized rapidly in Hokkaido University. A lot of personal computers have been connected to HINES. Although many people in our school of medicine are coming to be familiar with the Internet, the network has not been utilized sufficiently yet. Establishment of efficient education and research with network, that is the essential purpose of HINES, is the problem to be solved in the near future. In this document, how to set up both modem and ISDN (Integrated Services Digital Network) is also referred for the help of access to HINES from outside of the campus.

Computer Communication Networks↗

PubMed2001

Leading through rough times. An interview with Novell's Eric Schmidt. Interview by Bronwyn Fryer.

Few large companies have soared as high, sunk as low, and struggled as long as the 18-year-old networking software maker Novell. For years, the company dominated the market for local area networks, but by 1997, it had faltered due to misguided acquisitions, product missteps, and large unsold inventories. That's when Eric Schmidt arrived from Sun Microsystems to take over as Novell's third CEO. He turned the company around with a deft combination of cost reductions, divestitures, and new product rollouts, and by 1998, it was back in the black. Unfortunately, the good times didn't last, and like most technology companies, Novell is once again struggling with a slowdown in demand. But Schmidt is optimistic about returning Novell to good health, and his strategies suggest ways for other organizations to handle themselves during downturns. He counsels against being overly cautious during such times. It may be necessary to eliminate excess inventory, cut costs, and reduce the size of the staff and the management team in order to stabilize a company. Working to retain those employees whom he calls the "smart people" and keeping them motivated will have long-term payoffs. Further, Schmidt says it is necessary to acknowledge and overcome a "culture of fear," the deadening environment of cynicism in which employees suppress thoughts and feelings because they're worried about layoffs. His additional advice: keep new products coming out to sustain the interest of customers and the press, pay attention to your cash position, stay focused on your desired outcomes, and take heart from other industry leaders.

Administrative Personnel↗

PubMedDate not supplied

Computer networking in an ambulatory health care setting.

Computers are a ubiquitous part of the ambulatory health care environment. Although stand-alone computers may be adequate for a small practice, networked computers can create much more powerful and cost-effective computerized systems. Local area networks allow groups of computers to share peripheral devices and computerized information within an office or cluster of offices. Wide area networks allow computers to securely share devices and information across a large geographical area. Either singly or in combination, these networks can be used to create robust systems to help physicians automate their practices and improve their access to important clinical information. In this article, we will examine common network configurations, explain how they function, and provide examples of real-world implementations of networking technology in health care.

Ambulatory Care↗

PubMed2003

Performance of Web-based image distribution: server-oriented measurements.

The aim of this study was to assess the performance of Web-based image distribution when multiple personal computers (PCs) are downloading images simultaneously for different server hardware configurations. Using specially developed software, the time-to-display (TTD) of different image types was measured with up to 16 concurrent PCs for various combinations of processor, random access memory (RAM), network connection and image compression. The TTD increased linearly with the number of concurrent PCs but remained under 5 s in most of the cases, even with 16 concurrent PCs. Only with a 10-Mbit/s network connection or with lossy compression were TTDs above 5 s obtained. Two processors instead of one led to a slight and constant improvement of the TTD. Reducing the amount of RAM increased the TTD mainly for computed radiography (CR) images. There was no difference between a 200- and 100-Mbit/s network, but 10 Mbit/s proved significantly worse. When increasing the number of clients lossless compression performed substantially better than lossy. A standard off-the-shelf server provides an appropriate download performance even with 16 concurrent clients. Processor speed and RAM amount are of minor importance, but it is highly recommended to use a 100-Mbit/s network connection and to avoid the application of on-demand lossy compression in a local area network.

Internet↗

PubMed2006

Design and development of a secure DICOM-Network Attached Server.

It is not easy to connect a web-based server with an existing DICOM server, and using a web-based server on the INTERNET has risks. In this study, we designed and developed the secure DICOM-Network Attached Server (DICOM-NAS) through which the DICOM server in a hospital-Local Area Network (LAN) was connected to the INTERNET. After receiving a Client's image export request, the DICOM-NAS sent it to the DICOM server with DICOM protocol. The server then provided DICOM images to the DICOM-NAS, which transferred them to the Client using HTTP. The DICOM-NAS plays an important role between DICOM protocol and HTTP, and only temporarily stores the requested images. The DICOM server keeps all of the original DICOM images. When unwanted outsiders attempt to get into the DICOM-NAS, they cannot access any medical images because these images are not stored in the DICOM-NAS. Therefore, the DICOM-NAS does not require large storage, but can greatly improve information security.

Computational Biology↗