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At least 19 recordsLinked to original sources
PubMed1992

Telephone modem access improves diabetes control in those with insulin-requiring diabetes.

OBJECTIVE: To assess whether modem access improves diabetes control in IDDM patients. RESEARCH DESIGN AND METHODS: Forty-two patients participated in the study and were followed for 12 wk. The patients were randomly divided into two groups at baseline, a modem group and a control group. There were no significant differences between HbA1c, random blood glucose, and weight between the groups at the beginning of the study. Patients were asked to perform five blood glucose determinations/day (before breakfast, before lunch, afternoon [1500], before dinner, and at bedtime) twice/week. The modem group transferred their data over the phone once/week. The control group would bring in their results on their regular visits every 6 wk. Patients in the modem group were counseled every week over the telephone after transferring results to adjust insulin and food intake if necessary. RESULTS: In the modem group, HbA1c improved from 0.106 to 0.092 (13.20%). The control group improved from 0.112 to 0.102 (8.9%). There was no significant change in weight, random blood glucose, or insulin. CONCLUSIONS: The use of telephone modem-based patient-monitoring systems in diabetes clinical research seems to stimulate the patient to keep closer control of blood glucose levels. It might be especially useful in rural settings, for which this study was designed.

Adolescent↗
PubMed1992

A computer-based, automated, telephonic system to monitor patient progress in the home setting.

In this report we describe an automated, telephonic system to monitor the progress of patients convalescing at home. The system includes a computerized central station that is capable of automated voice communication over the telephone, using voice reproduction, and touch-tone recognition. Peripheral hardware in multiple monitored homes need include only a touch-tone telephone, but may also be augmented by inexpensive, rudimentary diagnostic aids, such as a scale for body weight, a thermometer, or a blood pressure cuff and manometer. Current central hardware includes a NeXT computer, a fax modem, and a specialized telecommunications modem developed specifically for voice telecommunication using the NeXT. The central station acts like a robotic nurse in that it asks patients a series of questions and records the responses. The subjective questions to be asked are patient individualized and pre-selected by the physician from a question menu including items targeted specifically for the patient's disease or condition. In addition, clinical data such as body weight, blood pressure, and body temperature obtained from in-home diagnostic aids may be transmitted to the central station over the telephone using touch tones. The time-of-day and frequency of calling are pre-selectable, according to the patient's preference and clinical status. Data obtained by the central station can be easily accessed by the duty nurse via menu driven software. Reports depicting significant responses as a function of time are generated in graphical format to facilitate rapid identification of adverse trends. Hard copy reports can be dispersed directly by fax. Results from a pilot study show patients with cardiac disease readily use the system without difficulty or complaints. In one patient a five pound increase in body weight was detected, which prompted the patient's cardiologist to adjust his medication. In this way automated telephone follow-up can provide early detection of complications before they become severe, making the home environment safer and more secure for convalescence and contributing to reduced health-care costs.

Computer Systems↗
PubMed1988

A semiautomated system for measurement of 96 simultaneous spectrophotometric enzyme assays.

A semiautomated system for spectrophotometric measurement of enzyme activity is described. In comparison to a 1-ml reaction volume monitored continuously by a conventional spectrophotometer, this system requires 1/10 to 1/100 the volume of sample, and 1/8 to 1/4 the time for measurement and computation of 96 enzyme assays. The system hardware consists of a 96-well platereader interfaced to a personal computer. Absorbances of 96 reactions are measured at timed intervals. These data are transmitted electronically from the platereader to the computer through the modem port using a modem program. The reaction rates are computed from the timed absorbance readings using a spreadsheet program. Three enzyme assays are presented, but the method has been used for several other assays and is applicable to many spectrophotometric rate assays. Many laboratories currently possess one or both of the two major components of the relatively inexpensive system described.

Animals↗
PubMed1989

Evaluation of routine telephone transmission of nuclear medicine studies.

Rapid and reliable transmission of nuclear medicine studies using conventional telephone lines and commercially available modems and computer systems has been accomplished through use of software developed within the authors' hospital. Original digital images of all-night and weekend studies, acquired on any of the acquisition computers from different manufacturers, are now routinely sent for remote reading at the physician's home. Data, software, and letters are routinely exchanged using modems and standard telephone lines with a sister institution in Haifa, Israel. The software has been designed to achieve no loss data compression and minimal turnaround time loss. Thus, an average lung perfusion image or gallbladder study requires about 1-3 minutes of transmission time. Full analysis and display software is available on the remote computer.

Computer Communication Networks↗
PubMed1992

Grateful Med on an institutional local area network.

Grateful Med version 6.0 provides new features very desirable to network users. These include: a single copy of the application resident on a server providing access to many users; a new communications architecture which provides access to Medline via the Internet or local network modems; additional scripting capabilities allowing local customization. These new features reduce the overhead in installing and maintaining Grateful Med (GM), allow much quicker downloading of citations and abstracts from Medline, and remove the requirement of a local modem for each PC accessing Medline.

Grateful Med↗
PubMed1991

[Computer-assisted report generation and image transmission in bedside chest x-rays in intensive therapy units].

Since a few years ago, in our department the bedside chest X-rays of intensive care patients have been reported by means of a computer program which has also storing function. This computer program is a guideline for the radiologist and is organized in pages having a logical sequence. The program has proved very useful in learning the correct reporting of bedside chest X-rays. The nosographic data of the patients, the ventilatory and the technical data are stored for a better clinico-radiological correlation. The last four reports are displayed on the monitor to better understand the patient's history. The other reports become part of a "historical" archive. Most important is the cooperation with the referring physician: to make the most of it, a system has been implemented which sends the images from the Radiology Department to Intensive Care. The images are filmed with a camera and then digitalized on 1024 x 768 matrix with 16 million colors and 256 gray levels. Each workstation is composed of: AT286 computer with 60-MB hard disk, hardware or the digitalization and compression of images, a high-resolution monitor, an intercommunication system, and a modem. It is possible to zoom on the images, but a close-up on the image with the camera is better for improved spatial resolution. The images are stored on the hard disk: each image requires 3M bytes, but it can be compressed down to 25:1 with no detail loss. The images are transmitted via modem in at least 20 seconds/image. More images can be sent out-line. During transmission, it is possible to talk by the intercommunication system, pointing out structures on the monitor or drawing objects on both sides of the system. In our experience, image quality is good. We are therefore considering extending the network to other Departments and making the transmission of images of pathologic specimens possible. The natural evolution of this system is the teleconsult.

Computer Communication Networks↗
PubMedDate not supplied

Microcomputer-assisted transmission of disaster data by cellular telephone.

Voice communication of information during disasters is often inadequate. In particular, simultaneous transmission by multiple callers on the same frequency can result in blocked transmissions and miscommunications. In contrast, nonvoice transmission of data requires less time than does voice communication of the same data, and may be more accurate. We conducted a pilot study to test the feasibility of a microcomputer assisted communication (MAC) network linking the disaster scene and the command hospital. The radio chosen to transmit data from the field disaster site to the command hospital was a cellular telephone connected to the microcomputer by modem. Typed communications between the microcomputer operators enabled dialogue between the disaster site and the hospitals. A computer program using commercially available software (Symphony by Lotus, Inc.) was written to allow for data entry, data transmission, and reports. Patient data, including age, sex, severity of injury, identification number, major injuries, and hospital destination were successfully transmitted from the disaster site command post to the command hospital. This pilot test demonstrated the potential applicability of MAC for facilitating transmission of patient data during a disaster.

Computer Communication Networks↗
PubMed1990

Automated measurement of transplantable solid tumors using digital electronic calipers interfaced to a microcomputer.

Data collection for transplantable solid tumors has been automated with electronic digital calipers and a balance which have been coupled through an RS-232 interface to a microcomputer. BASIC programs handle data entry, calculations and data storage. A "PROTOCOL" program accepts keyboard input of sample name, notebook number, submitter and dose along with necessary information on tumor system, and then initial animal weights for treatment groups are sent from balance to computer. Data is stored as an ASCII file on floppy disks, and protocol reports are printed. When the test is to be measured, a "MEASURE" program prompts the user for keyboard entry of toxic deaths in each group. Then the computer requests input of width and length of tumors for each animal. These tumor dimensions are sent to microcomputer by pressing a button on the calipers. When a group is completed, final animal weights are sent from balance to microcomputer. Then tumor weights and percent inhibition as compared to appropriate control groups are calculated, and the data is appended to the file for that test. A hard copy is generated as tumors are measured, and reports including percent inhibition can be printed immediately after a test is measured. The data as an ASCII file is transferred via modem to mainframe computer, where another program transfers the information to a database management program. These automated procedures for tumor measurement save time and lessen the chance for error by eliminating manual recording of solid tumor dimensions and subsequent reentry of this data for calculation.

Animals↗
PubMed1992

Portable system for acquisition and transmission of ECG parameters.

A simple inexpensive bedside automatic ECG data-collection system is presented. The main parameter measured is the R-R interval length that can be used in the construction of a heart rate variability signal. Another parameter measured is the shape of the T-wave in the ECG signal. The collected data are transferred to a remote host computer through the public telephone network, by means of a modem. The system can function through the whole range of human heart rates. The described solution differs from most existing ones by utilising the existing ECG monitoring equipment in hospitals, which usually does not store any information. This equipment is connected by a portable, independent, special-purpose system to a remote host computer which can further analyse and store the data.

Computer Communication Networks↗
PubMed1990

A multiuser system for whole body plethysmographic measurements and interpretation.

A multiuser system for whole body plethysmographic measurements and interpretation which has been developed under clinical conditions is described. The following measurements can be carried out in a rapid way and in one session with the patient: specific airway resistance during spontaneous breathing, determination of functional residual capacity, static lung volumes, and maximal forced expiratory data. Each section is normally measured twice and can be repeated up to ten times. The final results are displayed and printed together with a consistent system of normal reference values. All values and selected original curves are stored automatically in an integrated data base system. Obstructive patients are measured again after the inhalation of a bronchodilator. All results are evaluated by an automatic interpretation program. This analyzes and graduates airway obstruction, lung volumes, and pharmacological airway reversibility using standardized texts which are written below all numerical printouts and graphical plots. The interpretation algorithm is tree structured and uses the normal reference values as a knowledge base. The system supports up to four online laboratories with their own A/D converter and up to 20 video terminals, printers, plotters, and modems. Our laboratory performs 8,297 such complete measurements on 4,671 different patients per year with one body box.

Diagnosis, Computer-Assisted↗
PubMed1991

A lung function information system.

A lung function information system (LFIS) was developed for the data analysis of pulmonary function tests at different locations. This system was connected to the hospital information system (HIS) for the retrieval of patient data and the storage of the lung function variables of patients to generate follow-up reports and to support financial and administrative management. The application programs were developed in such a way that high flexibility was obtained with respect to the patient-computer-technician interaction. The sampled data are stored on a disc to correct earlier decisions, perform recalculations and reanalyse the data for research purposes. When the measurements performed on a patient are authorized, the sampled data are deleted, except for when they are needed for future research. A distributed computer system was chosen to combine the benefits of a centralized system with those of several stand-alone systems. The main tasks of the central unit are to store collected data and computer programs, generate a final lung function report on laser printer and provide a connection to the HIS. In the satellite computers, which are located close to the lung function equipment, the signals and raw data are processed. Furthermore, the satellite computers were in use for program development and several research projects, and for the offline data processing of the lung function measurements from two other hospitals by means of a modem connection. The LFIS improved the quantity and quality of data acquisition. It resulted in an increased capacity of about 50% concerning spirometry, and facilitated time-consuming complex analyses. It also avoided miscalculations and mistakes in reports previously experienced with hand calculations.

Computer Systems↗
PubMed1990

Linking and integrating computers for maternity care.

Functionally separate computer systems have been developed for many different areas relevant to maternity care, e.g. maternity data collection, pathology and imaging reports, staff rostering, personnel, accounting, audit, primary care etc. Using land lines, modems and network gateways, many such quite distinct computer programs or databases can be made accessible from a single terminal. If computer systems are to attain their full potential for the improvement of the maternity care, there will be a need not only for terminal emulation but also for more complex integration. Major obstacles must be overcome before such integration is widely achieved. Technical and conceptual progress towards overcoming these problems is discussed, with particular reference to the OSI (open systems interconnection) initiative, to the Read clinical classification and to the MUMMIES CBS (Common Basic Specification) Maternity Care Project. The issue of confidentiality is also briefly explored.

Confidentiality↗
PubMed1989

[Informational structure of the national registry of bone marrow donor volunteers].

Successful Bone Marrow Transplantations with unrelated donors can be performed providing that donor and recipient are totally HLA-A, B, DR identical. To find such a suitable donor it is necessary to type a large pool of volunteers for HLA in histocompatibility laboratories. We have built a network of 36 micro-computers AT 286 for updating local files and for translating data to the national file of donors maintained on a main computer (VAX 8250). The main computer communicates regularly using modems with local computers in order to update data and exchange information. After one year of functioning, users are well satisfied with the computers system which locates regularly potential donors for recipients waiting for a graft.

Bone Marrow Transplantation↗
PubMed1989

Automated spinal cord monitoring for spinal surgery.

A microcomputer-based automated spinal cord monitoring system was developed and 56 spinal operations have been carried out with it since 1986. The system comprises an electrodiagnostic system (Dantec 2000M), an FM tape recorder, a channel selector, an electrical relay, a Modem and a microcomputer which controls all of the elements. The program allowed for automated recording and analysis of evoked potentials during spinal surgery and alarm signals were generated according to the criteria of amplitude decrease and latency delay. It was demonstrated that automated spinal cord monitoring in the operating room was performed easily, reliably and safely allowing the surgeon to react quickly to possible compromise of the spinal cord. The design and usefulness of the system is described in this report.

Diagnosis, Computer-Assisted↗
PubMed1989

Remote monitoring of free flaps with telephonic transmission of photoplethysmograph waveforms.

Analog waveforms from bedside photoplethysmograph flap-monitoring devices have been transmitted via telephone lines to remote monitoring stations. Two methods for data transfer have been successfully used in clinical practice. One employs equipment similar to that used for transmission of EKG signals; the second uses paired microcomputers linked with telephone modems. These readily available technologies enable remote evaluation of the adequacy of perfusion of free tissue transfers.

Humans↗