Investigations into a digitized image communications system were prompted by a need to bring expert consultation to physicians in community practice. Pathologists desired the capability to concomitantly view, annotate...
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Investigations into a digitized image communications system were prompted by a need to bring expert consultation to physicians in community practice. Pathologists desired the capability to concomitantly view, annotate, and discuss images with referring physicians at distant sites. Methods included evaluation of the human and procedural domain into which the system was to be integrated. The GDCN computer consultation system has the consultant nephropathologist first evaluate the processed biopsy slides, digitize representative images, transmit them with the diagnosis to referring nephrologist, and, finally, conduct an interactive consultation and review of the biopsy and case. Image resolution and compression variables must be set for each individual medical consulting application. For the GDCN, it was found that the 640 x 496 x unlimited color with compression ratios not exceeding 1:32 are acceptable. An obvious improvement of this computerized system over the noncomputerized review sessions is the ability to immediately share and discuss a new image that had not been previously sent. In the old noncomputerized consultation, only images that had been mailed could be discussed. The computerized sessions allow transmission (10 sec) of a new image that the consultation might demand. The computerized sessions also provide the ability to show the referring nephrologist an area of biopsy interest that the pathologist had not previously transmitted. Biopsy slides can be viewed during the consultation, an area digitized, and that image transmitted to the nephrologist during the consultation. Hardware and costs for the sending station were: [table: see text] This system far exceeds the requirements for this particular application; however, it is sufficient to support future, higher-technology computer applications. If necessary, this same system could be used with a less expensive computer, a less expensive camera, software compression, and a single monitor. These alteration
Innovative methods of providing workplace education for health care professionals may be a key to the survival of rural hospitals in America. Such methods must overcome time, distance, cost and organizational constrai...
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Innovative methods of providing workplace education for health care professionals may be a key to the survival of rural hospitals in America. Such methods must overcome time, distance, cost and organizational constraints, and take into account the structure of the learning experience. The Texas Hospital Education and Research Foundation has recently been involved in two programs that tested new approaches to worker education using distance-learning strategies. The projects--resource sharing among rural directors of nursing and training for cancer tumor registrars--used computer-conferencing technology. A new model using existing satellite, audio-conferencing, and computer-based instruction augmented by computer conferencing is proposed. The Computer-Related Assisted Distance Learning Enhancement (CRADLE) model integrates existing technologies to provide education to health care workers at their desktop. The Cancer Learning Center (CLC) tested peer collaboration, the primary component of the model. The ultimate goal is to have the system available to all tumor registrars in Texas, and to secure funding to implement rural nursing and rural high-school health occupations education projects. Current projects from set-up through results are presented.
For computer networking the most suitable operating systems are UNIX or MS-DOS. As networking software UUCP and TCP/IP are most common. Hardware requirements are derived from the operating system and from the networki...
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For computer networking the most suitable operating systems are UNIX or MS-DOS. As networking software UUCP and TCP/IP are most common. Hardware requirements are derived from the operating system and from the networking software. Low-cost solutions, for example, uuPC, a public domain version of UUCP, require only an 8088 processor and a 2400-baud modem. TCP/IP fares better with more powerful processors and requires permanent lines between the connecting computers. In developing countries the introduction of computer networks is hampered by several factors: lack of foreign exchange, price of hardware and software, unreliable electricity and telephone lines, lack of hardware and software support, large distances to the nearest center, and incompatibilities between existing systems and the network. Important aspects for clinical networking in developing countries include appointment scheduling in the referral hospitals, access to laboratory and pathology results from the central laboratory, and primary health care information such as epidemiologic data. Advanced systems, for example, for image processing, are not yet feasible in developing countries.
This project tested the importance of enhanced information transfer of home monitoring results to health care providers. The study tested whether computer-assisted communication of medical information between the chro...
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This project tested the importance of enhanced information transfer of home monitoring results to health care providers. The study tested whether computer-assisted communication of medical information between the chronic care patient and the physician can result in health care benefit. The information tools were constructed/adapted as a test of this hypothesis for diabetes mellitus. Patients connected a glucometer to an intelligent modem weekly for six to nine months. Graphical and mathematical tools extracted and emphasized the information content of the home monitoring data arriving at the central site. Data smoothing, trend analysis, and calculation of quality control statistics were incorporated into a graphical time series oriented report that was used by the health care provider during an outpatient visit. The integrated home monitoring system was tested on 20 patients with diabetes in a double cross-over design over a 15-month period. A significant improvement in serum glucose control as measured by glycated hemoglobin was shown in the study group, but not in the control group.
Research and academic computer networks provide e-mail and other services to all members of participating institutions. Their usage by biomedical researchers and clinicians is still limited because of several reasons,...
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Research and academic computer networks provide e-mail and other services to all members of participating institutions. Their usage by biomedical researchers and clinicians is still limited because of several reasons, including limited awareness of the available network resources. An increased use of these networks within the biomedical community would allow fast, effective communications and convenient remote access to information sources. As an example and pilot study, we prepared two network tools to make some information services maintained by our institution also accessible through e-mail. Both tools were implemented using PMDF e-mail software on a DEC MicroVAX connected to the Italian academic and research network (GARR), which is linked to the U.S. Internet. A network server takes care of automatic distribution of documents (files) reporting results of an oncology research/education project. An information server provides for semiautomated support of a consulting service on use of drugs. The feasibility of implementing these tools, based on existing software, further illustrates the potential usefulness of research computer networks for the dissemination of biomedical information.
作者：
KAGETSU, NJABLOW, RCDepartment of Radiology
St. Luke's-Roosevelt Hospital Center Columbia University College of Physicians and Surgeons 428 West 59th Street New York New York 10019
The organization and development of MIST were a response to the needs of health professionals in Alabama, principally rural physicians, who expressed a desire to access the knowledge of the faculty at the UAB Medical ...
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The organization and development of MIST were a response to the needs of health professionals in Alabama, principally rural physicians, who expressed a desire to access the knowledge of the faculty at the UAB Medical Center. MIST provides free service on a 24-hour, 7-day-a-week basis for physicians around the world. At any time, practitioners can obtain specific medical information and discuss possible diagnoses or patient-related problems with UAB specialists. MIST, the first and largest medical professional telephone consultation program of its kind, receives numerous requests from other institutions seeking information and advice on developing similar programs. Such programs now exist in many states. One reason for the success of MIST is that it has always enjoyed high visibility with UAB physicians, credibility with the physician callers, and priority within UAB's Office of the Vice President for Health Affairs. As a consultative system, MIST continues to contribute to improved health care for citizens of Alabama and beyond and to save patients and taxpayers the expense of unnecessary or inappropriate treatment. MIST provides consultation and continuing education at the moment of need for the professional in private practice. In return, UAB specialists are given access to vital research and demographic information, as well as patient referrals. MIST plays an important role in removing barriers to education and consultation for busy medical personnel and in facilitating patient referrals to an acclaimed center of research and excellent patient care. Rather than searching for the proper contact, one call to an easy-to-remember number puts the health professional in touch with the appropriate source. Rural doctors, as well as medical personnel working in urban areas, can feel that they are practicing 'right next door' to an outstanding university medical center where colleagues who are ready and able to offer expert consultation and support at the critical moment o
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