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PubMed1995

A strategy for database interoperation.

To realize the full potential of biological databases (DBs) requires more than the interactive, hypertext flavor of database interoperation that is now so popular in the bioinformatics community. Interoperation based on declarative queries to multiple network-accessible databases will support analyses and investigations that are orders of magnitude faster and more powerful than what can be accomplished through interactive navigation. I present a vision of the capabilities that a query-based interoperation infrastructure should provide, and identify assumptions underlying, and requirements of, this vision. I then propose an architecture for query-based interoperation that includes a number of novel components of an information infrastructure for molecular biology. These components include a knowledge base that describes relationships among the conceptualizations used in different biological databases, a module that can determine the DBs that are relevant to a particular query, a module that can translate a query and its results from one conceptualization to another, a collection of DB drivers that provide uniform physical access to different database management systems, a suite of translators that can interconvert among different database schema languages, and a database that describes the network location and access methods for biological databases. A number of the components are translators that bridge the heterogeneities that exist between biological DBs at several different levels, including the conceptual level, the data model, the query language, and data formats.

Artificial Intelligence↗

PubMedDate not supplied

[Al-assisted, transputer based EMG system--concept, components and initial results].

An EMG system has been developed capable of doing an EMG analysis as well as providing diagnostic support with the aid of an integrated expert system. The goal of this EMG system is to reduce the time of examination and to increase the reliability of the diagnosis. In order to obtain many parameters from the EMG signal, different analysing methods capable of running in parallel are needed. The system has been realized with a transputer network. Thus it is possible to distribute the software components to different processors with high level of efficiency. For software development we use the operating system Helios. This makes it possible to use the standard I/O environment X-Windows.

Computer Communication Networks↗

PubMed1987

Information system linking a medical school with practitioners and hospitals.

A recently established medical information network uses computers and telephone lines to link rural Georgia medical practitioners, Georgia hospitals, and the Mercer University School of Medicine (MUSM) in Macon, Georgia. This network, the Georgia Interactive Network for Medical Information (GaIN), provides a service and educational support system for its members. The GaIN model embodies many of the educational and information management principles endorsed by two reports by the Association of American Medical Colleges: the 1984 report of the Project Panel on the General Professional Education of the Physician and a 1982 project report called "Academic Information in the Academic Health Sciences Center." The design, services, utilization patterns, and results of the GaIN project and implications for the network's future are described. Use of the GaIN has made MUSM students more at ease with computers, has connected MUSM with remote teaching sites and rural practices, and has served as a catalyst for Georgia physicians' investigation of computer applications to support health care delivery in the state.

Computer Communication Networks↗

PubMedDate not supplied

Design of remote control units for seniors.

HumRRO International, Inc. conducted a project to improve the human factors aspects of remote control unit (RCU) design. Although the research was oriented toward RCUs for future telerobots that older adults may use, the RCUs examined were currently available models. An observational study found that a sample of 18 persons aged 65-88 years made errors in performing a simple arithmetic task with four different handheld calculators and that 13 participants made errors operating 11 VCR remotes. Better human-machine designs in RCUs appear to be needed to reduce errors that might cause accidents in the future use of mobile telerobots and their manipulators. In addition, manufacturers of RCUs, gerontologists, and members of SeniorNet, a network of older adults interested in computers, were queried regarding the design of RCUs. The responses of these individuals and the participants in the observational study, together with human factors engineering analyses, suggested numerous design improvements that may be systematically examined.

Aged↗

PubMed1995

The crucial roles of standards and strategy in developing a regional health information network.

Contemporary medical practice increasingly involves the use of inter-professional teams and complex care protocols. Increasing emphasis on value for money, medical audit, quality assurance and optimal outcomes requires that the practitioner has ready access to large amounts of up-to-date information, and that various abstracts and summaries of cases are made available quickly to providers, purchaser/funders, statisticians and researchers, and others. Rapid movements of large quantities of information is vital for the future success of health care: development of health information networks are vital strategic goals. In 1991 New Zealand initiated a widespread process of health services reform, whose success depended upon better availability and faster movements of information. The first phase of a national network to support these needs was successfully implemented in mid 1993: this provided for a point of connection for all individuals and organisations involved in the health sector, using commercial networking services. Fundamental to this development has been the adoption adaptation and development of appropriate standards and specifications for interconnection profiles, communications protocols, message formats, privacy and security requirements classification and coding systems and data element definitions. These have been selected to provide the maximum utility whilst imposing the minimum of constraints on the diversity of end user systems.

Computer Communication Networks↗

PubMed1987

DXplain. An evolving diagnostic decision-support system.

DXplain is an evolving computer-based diagnostic decision-support system designed for use by the physician who has no computer expertise. DXplain accepts a list of clinical manifestations and then proposes diagnostic hypotheses. The program explains and justifies its interpretations and provides access to a knowledge base concerning the differential diagnosis of the signs and symptoms. DXplain was developed with the support and cooperation of the American Medical Association. The system is distributed to the medical community through AMA/NET--a nationwide computer communications network sponsored by the American Medical Association--and through the Massachusetts General Hospital Continuing Education Network. A key element in the distribution of DXplain is the planned collaboration with its physician-users whose comments, criticisms, and suggestions will play an important role in modifying and enhancing the knowledge base.

Artificial Intelligence↗

PubMed1995

Patient privacy in the era of medical computer networks: a new paradigm for a new technology.

For twenty five years the legal system has tried to protect the privacy of identified patient data contained in information systems. The rapid development of such technology has repeatedly frustrated the public policies incorporated into the legal system. However the newest information technologies provide the possibility of fundamentally changing the way information is stored in the health care system and, by "De personalizing the data," allow restoration of a reasonable level of personal privacy, without interfering with the legitimate needs for medical data. The system would require a secure "identifier control facility" and act as a network "file access table" able to reconstruct widely distributed bits of the patients record. A disaggregated "virtual record" would replace the integrated patient file, and the risks to data privacy inherent in the use of names or permanent identification numbers would be eliminated.

Computer Communication Networks↗

PubMed1991

An empirical analysis of likelihood-weighting simulation on a large, multiply connected medical belief network.

We are developing a probabilistic reformulation of the Quick Medical Reference (QMR) system. Our current probabilistic model of the QMR knowledge base of internal medicine consists of a two-level, multiply connected, belief network. Because of the size and connectivity of this belief network, most exact algorithms for calculating the posterior marginal probabilities of diseases are not applicable. In this paper, we analyze the convergence properties of an approximation algorithm, called likelihood-weighting simulation, on the QMR-DT belief network. Specifically, on two difficult diagnostic cases, we examine the effects of Markov blanket scoring, importance sampling, and self-importance sampling, demonstrating that the Markov blanket scoring and self-importance sampling significantly improve the convergence of the simulation on our model.

Algorithms↗

PubMed1995

Surfing the Internet.

More physicians are surfing the Internet than ever before, thanks to the recent launch of MSMSNET, the Michigan State Medical Society's new online service for physician members. If words like World Wide Web, E-mail, and Hypertext links send you into a state of confusion, then read on. This month's cover story discusses MSMS's launch into the information superhighway and training programs MSMS has in store for physician members. Also included is an examination of the Internet--past, present and future--by the president of Voyager Information Networks, Inc., a Michigan corporation specializing in Internet services for Michigan trade groups and other organizations, including MSMS. This cover story marks the beginning of a series of articles on the Internet which will appear in future issues of Michigan Medicine. Hop on board and enjoy the ride!

Computer Communication Networks↗

PubMed1996

Ka-boom! When disaster strikes.

When Hurricane Opal slammed Florida's gulf coast last October, Baptist Healthcare in Pensacola was in danger of a direct hit, putting the hospital's mainframe, minicomputers and telecommunications network--not to mention its patients--in peril. But Baptist had planned for just such a danger and, in the end, no harm was done. How would your hospital have fared? Here's what you can do now to make sure your hospital will keep running after disaster strikes.

Computer Communication Networks↗

PubMed1993

Operational departmentwide picture archiving communication system analysis using discrete event-driven block-oriented network simulation.

The accurate prediction of image throughput is a critical issue in planning for and acquisition of any successful picture archiving and communication system (PACS). Simulation plays an important role in this effort. The PACS image management chain is decomposed into eight subsystems. These subsystems include network transfers over three different networks and five software programs and/or queueing structures. This decomposition is used to create a simulation model that was effectuated using commercially available block-oriented network simulation software. From the PACS database, the traffic generation patterns of the imaging modality devices are used to drive the simulation. The simulation models the image file flow through the PACS for a 24-hour period. The behavior of the simulated traffic generators agreed well with the values derived from the PACS database. The mean delay for the simulated PACS is found to be 225 +/- 59 seconds. The delay time was found to vary during the simulated 24-hour cycle in a consistent manner with observations. This simulation provides estimates on what a radiological department can expect from a PACS in terms of throughput, utilization, and delay. The block-oriented network simulator (BONeS, Comdisco Systems Inc, Foster City, CA) simulation model of the modeled PACS is highly accurate. The models for the imaging modality traffic sources are validated with a high degree of accuracy. The simulation model allows for the study of what happens to the delay time under various loads. In this simulation, the reformatting process was determined to be the bottleneck causing a large increase in delay time under heavy loads.

Computer Communication Networks↗

PubMed1996

The networked environment and the challenge of change.

The way for librarians to manage the environment of the future is to hold fast to their traditional skills and professional abilities. The challenges in the future environment include technology adoption, copyright, scholarly communication, and the role of professional medical societies. Four major areas in which librarians have skills valuable in this environment are the organization of knowledge, quality assurance of information, custodianship, and user instruction.

Catalogs, Library↗

PubMed1994

Access to DNA and protein databases on the Internet.

During the past year, the number of biological databases that can be queried via Internet has dramatically increased. This increase has resulted from the introduction of networking tools, such as Gopher and WAIS, that make it easy for research workers to index databases and make them available for on-line browsing. Biocomputing in the nineties will see the advent of more client/server options for the solution of problems in bioinformatics.

Amino Acid Sequence↗

PubMed1995

Web-based access to an online atlas of anatomy: the Digital Anatomist Common Gateway Interface.

A World Wide Web Common Gateway Interface package is described for accessing existing online interactive atlases of anatomy. The Web interface accesses the same 2-D and 3-D images of human neuroanatomy, knee anatomy and thoracic viscera that are currently accessed by a custom interactive atlas in distance learning courses. Although the Web interface is too slow to replace the existing atlas, it provides a parallel access path that has much broader potential for development of a distributed distance learning network in anatomy. By maintaining both access methods to the same information sources we continue to satisfy the fast interactivity needs for our local courses, while at the same time providing a migration path to the Web as the capabilities of Web browsers evolve.

Anatomy, Artistic↗

PubMed1996

Privacy and security issues in a wide area health communications network.

In 1993 the first national health information service went live in New Zealand, using commercial network services for all communications. This system provides a point of connection for all health personnel, and for those with a legitimate interest in health care information (e.g. insurers): it also provides access to a number of information resources managed on behalf of the government of New Zealand (e.g. index of health care users), as well as to those developed by individual network service providers. Much of the data exchanged across this network is personalised. Since the recipient may not be known personally to the sender, it is vital that the sender has confidence that the recipient will treat personal information according to agreed criteria for privacy. A Code of Practice covering health information was developed under the New Zealand Privacy Act to ensure that the confidence to share confidential data was supported. For large organisations such as hospitals to function efficiently, they need the flexibility to be able quickly to assign user privileges to selected staff without the need for extra paperwork seeking approval from the centre. But the audit trail requires unique identification of the individual undertaking each transaction. This requirement has been addressed. Some of the data moved across the network relates to life-critical issues, e.g. clinical warnings about allergies or serious medical conditions. A failure of communications causing this vital information to be improperly represented in some way on the receivers system could have disastrous consequences. To ensure the integrity of data transfers, user installations have to be certified compliant with standard test scripts before they are authorized for access to these resources.

Accreditation↗

PubMed1995

The use of clinical computer workstations as an educational adjunct in prosthodontics.

Current computer systems improve the health professional's ability to store, retrieve, and present visual data in a way never before possible. Health professionals in general are beginning to use computer-based digital imaging to improve the diagnosis and treatment planning of disease processes. The use of computer-based networks to transmit medical and dental data is in its infancy but promises to be the main form of data transmission of the future. This article outlines a few applications presently being used and developed at the Ohio State University College of Dentistry in the preclinical and clinical courses in prosthodontics.

Computer Communication Networks↗

PubMed1996

A component-based, distributed object services architecture for a clinical workstation.

Attention to an architectural framework in the development of clinical applications can promote reusability of both legacy systems as well as newly designed software. We describe one approach to an architecture for a clinical workstation application which is based on a critical middle tier of distributed object-oriented services. This tier of network-based services provides flexibility in the creation of both the user interface and the database tiers. We developed a clinical workstation for ambulatory care using this architecture, defining a number of core services including those for vocabulary, patient index, documents, charting, security, and encounter management. These services can be implemented through proprietary or more standard distributed object interfaces such as CORBA and OLE. Services are accessed over the network by a collection of user interface components which can be mixed and matched to form a variety of interface styles. These services have also been reused with several applications based on World Wide Web browser interfaces.

Computer Communication Networks↗

PubMed1996

Remote instrument telemaintenance.

In the past decade, great technological progress has been made in telemaintenance of mainframe and mini computers. As hardware technology is now available at an acceptable cost, computer aided trouble-shooting can be adapted to laboratory instrumentation in order to significantly improve repair time, avoid instrument downtime by taking advantage of predictive methods, and provide general diagnostic assistance. Depending on the size of the instrument, the telemaintenance facility can be dedicated to a single instrument or alternatively a telemaintenance server can manage multiple distributed small instruments through a Local Area Network. As complex failures can occur, the local diagnosis capabilities may be exceeded and automatic dialing for connection to computerized Remote Maintenance Centers is needed. The main advantages of such a centre, as compared to local diagnosis systems, are the increased access to more information and experience of failures from instrument installations, and consequently the provision of training data updates for Artificial Neural Networks and Knowledge Based Systems in general. When an abnormal situation is detected or anticipated by a diagnosis module, an automatic alert is given to the user, local diagnosis is activated, and for simple solutions, instructions are given to the operator. In the last resort, a human expert can be alerted who, with remote control tools, can attend to the failures. For both local and remote trouble-shooting, the data provided by the instrument and connected workstation is of paramount importance for the efficiency and accuracy of the diagnosis. Equally, the importance of standardization of telemaintenance communication protocols is addressed.

Clinical Laboratory Information Systems↗