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Transparent image access in a distributed picture archiving and communications system: The master database broker

JOURNAL OF DIGITAL IMAGING 1999年第2期12卷 175-177页

作者： Cox, RD Henri, CJ Rubin, RK McGill Univ Ctr Hlth Dept Diagnost Radiol Montreal PQ Canada

A distributed design is the most cost-effective system for small- to medium-scale picture archiving and communications systems (PACS) implementations. However, the design presents an interesting challenge to developers and implementers: to make stored image data, distributed throughout the PACS network, appear to be centralized with a single access point for users. A key component for the distributed system is a central or master database, containing all the studies that have been scanned into the PACS. Each study includes a list of one or more locations for that particular dataset so that applications can easily find it. Non-Digital Imaging and Communications in Medicine (DICOM) clients, such as our worldwide web (WWW)-based PACS browser, query the master database directly to find the images, then jump to the most appropriate location via a distributed web-based viewing system. The Master Database Broker provides DICOM clients with the same functionality by translating DICOM queries to master database searches and distributing retrieval requests transparently to the appropriate source. The Broker also acts as a storage service class provider, allowing users to store selected image subsets and reformatted images with the original study, without having to know on which server the original data are stored. Copyright (C) 7999 by W.B. Saunders Company.

关键词： CD-ROM 计算机通信网络/经济学费用效益分析数据库(主题)/分类数据库(主题)/经济学数据库(主题)/组织和管理诊断显像信息存储和检索因特网放射学信息系统/分类放射学信息系统/经济学放射学信息系统/组织和管理人类

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Reengineering the picture archiving and communication system (PACS) process for digital imaging networks PACS

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JOURNAL OF DIGITAL IMAGING 1999年第2期12卷 59-61页

作者： Horton, MC Lewis, TE Kinsey, TV USN Joint Imaging Technol Project Off Ft Detrick MD 21702 USA

Prior to June 1997, military picture archiving and communications systems (PACS) were planned, procured, and installed with key decisions on the system, equipment, and even funding sources made through a research and development office called Medical Diagnostic Imaging Systems (MDIS). Beginning in June 1997, the Joint Imaging Technology Project Office (JITPO) initiated a collaborative and consultative process far planning and implementing PACS into military treatment facilities through a new Department of Defense (DoD) contract vehicle called digital imaging networks (DIN)-PACS. The JITPO reengineered this process incorporating multiple organizations and politics. The reengineered PACS process administered through the JITPO transformed the decision process and accountability from a single office to a consultative method that increased end-user knowledge, responsibility, and ownership in PACS. The JITPO continues to provide information and services that assist multiple groups and users in rendering PACS planning and implementation decisions. Local site project managers are involved from the outset and this end-user collaboration has made the sometimes difficult transition to PACS an easier and more acceptable process for all involved. Corporately, this process saved DoD sites millions by having PACS plans developed within the government and proposed to vendors second, and then having vendors respond specifically to those plans. The integrity and efficiency of the process have reduced the opportunity for implementing nonstandard systems while sharing resources and reducing wasted government dollars. This presentation will describe the chronology of changes, encountered obstacles, and lessons learned within the reengineering of the PACS process for DIN-PACS. This is a US government work. There are no restrictions on its use.

关键词：行政管理人员生物医学工程资本筹集计算机通信网络/分类计算机通信网络/经济学计算机通信网络/组织和管理计算机用户培训费用节省决策诊断显像效率组织在职培训职业间关系军事医学所有权放射学信息系统/分类放射学信息系统/经济学放射学信息系统/组织和管理系统综合人类

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Enhancing availability of the electronic image record for patients and caregivers during follow-up care

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JOURNAL OF DIGITAL IMAGING 1999年第2期12卷 78-80页

作者： Mehta, A Dreyer, K Thrall, J Harvard Univ Massachusetts Gen Hosp Sch Med Dept Radiol Boston MA USA

Purpose: To develop a personal computer (PC)-based software package that allows portability of the electronic imaging record. To create custom software that enhances the transfer of images in two fashions. Firstly, to an end user, whether physician or patient, provide a browser capable of viewing digital images on a conventional personal computer. Second, to provide the ability to transfer the archived Digital Imaging and Communications in Medicine (DICOM) images to other institutional picture archiving and communications systems (PACS) through a transfer engine. Method/materials: Radiologic studies are provided on a CD-ROM. This CD-ROM contains a copy of the browser to view images, a DICOM-based engine to transfer images to the receiving institutional PACS, and copies of all pertinent imaging studies for the particular patient. The host computer system in an Intel based Pentium 90 MHz PC with Microsoft Windows 95 software (Microsoft Inc, Seattle, WA). The system has 48 MB of random access memory, a 3.0 GB hard disk, and a Smart and Friendly CD-R 2006 CD-ROM recorder (Smart and Friendly Inc, Chatsworth, CA). Results: Each CD-ROM disc can hold 640 MB of data. In our experience, this houses anywhere from, based on Table 1, 12 to 30 computed tomography (CT) examinations, 24 to 80 magnetic resonance (MR) examinations, 60 to 128 ultrasound examinations, 32 to 64 computed radiographic examinations, 80 digitized x-rays, or five digitized mammography examinations. We have been able to successfully transfer DICOM images from one DICOM-based PACS to another DICOM-based PACS. This is accomplished by inserting the created CD-ROM onto a CD drive attached to the receiving PACS and running the transfer engine application. Conclusions: Providing copies of radiologic studies performed to the patient is a necessity in every radiology department. Conventionally, film libraries have provided copies to the patient generating issues of cost of loss of film, as well as mailing costs. This

关键词： CD-ROM 计算机通信网络/经济学费用节省诊断显像随访研究磁共振成像乳房X线摄影术病案系统计算机化/经济学微型计算机病人医疗护理 X线影像增强放射学信息系统软件体层摄影术 X线计算机超声检查用户计算机接口 X线胶片/经济学人类

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INNOVATIVE DESK-TOP LEARNING TOOLS - IMPLICATIONS FOR RURAL HOSPITALS AND PHYSICIANS

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ANNALS OF THE NEW YORK ACADEMY OF SCIENCES-SERIES 1992年第1期670卷 76-90页

作者： OEFFINGER, JC HIEBELER, L SHERMAN, T GASKILL, M PORTANTE, T POLASEK, J LITTERER, K CUERO COMMUNITY HOSP CUERO TX 77954 USA SHEPPERD MEM HOSP BURNET TX 78611 USA

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.

关键词：计算机通信网络/经济学计算机通信网络/组织和管理计算机辅助教学/经济学计算机辅助教学/方法教育护理继续/经济学教育护理继续/组织和管理医院信息系统/经济学医院信息系统/组织和管理医院乡村/组织和管理病案管理员/教育模型组织管理人员医院/教育试点项目美国

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NEPHROPATHOLOGY CONSULTATION VIA DIGITIZED IMAGES

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ANNALS OF THE NEW YORK ACADEMY OF SCIENCES-SERIES 1992年第1期670卷 281-292页

作者： CRONENBERGER, JH HSIAO, H FALK, RJ JENNETTE, JC University of North Carolina at Chapel Hill School of Medicine Chapel Hill North Carolina 27599

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

关键词：活组织检查计算机通信网络/经济学计算机通信网络/仪器和设备计算机通信网络/组织和管理图像处理计算机辅助/经济学图像处理计算机辅助/仪器和设备图像处理计算机辅助/方法肾疾病/病理学肾脏病学/组织和管理病理学临床/组织和管理转诊和会诊/组织和管理远程医学人类

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Strategy and the new economics of information

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HARVARD BUSINESS REVIEW 1997年第5期75卷 70-&页

作者： Evans, PB Wurster, TS BOSTON CONSULTING GRP INC LOS ANGELESCA

We are in the midst of a fundamental shift in the economics of information-a shift that will precipitate changes in the structure of entire industries and in the ways companies compete. This shift is made possible by the widespread adoption of Internet technologies, but it is less about technology than about the fact that a new behavior is reaching critical mass. Millions of people are communicating at home and at work in an explosion of connectivity that threatens to undermine the established value chains for businesses in many sectors of the economy. What will happen, for instance, to dominant retailers such as Toys ''R'' Us and Home Depot when a search through the Internet gives consumers more choice than any store? What will be, the point of cultivating a long-standing supplier relationship with General Electric when it posts its purchasing requirements on an Internet bulletin board and entertains bids from anybody inclined to respond? The authors present a conceptual framework for approaching such questions-for understanding the relationship of information to the physical components of the value chain and how the Internet's ability to separate the two will lead to the reconfiguration of the value proposition in many industries. In any business where the physical value chain has been compromised for the sake of delivering information, there will. be an opportunity to create a separate information business and a need to streamline the physical one. Executives must mentally deconstruct their businesses to see the real value of what they have. If they don't, the authors warn, someone else will.

关键词：商业/经济学计算机通信网络/经济学经济竞争信息系统/经济学规划技术美国

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IEEE-P1157 MEDIX - A STANDARD FOR OPEN SYSTEMS MEDICAL DATA INTERCHANGE

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ANNALS OF THE NEW YORK ACADEMY OF SCIENCES 1992年第1期670卷 116-126页

作者： HARRINGTON, JJ Hewlett Packard Medical Products Group 3000 Minuteman Road Andover Massachusetts 01810

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An operational view of the role of health librarians in informatics.

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Health libraries review 1994年第3期11卷 161-166页

作者： Rambo, N. Regional Medical Library University of Washington Seattle 98195. United States

The National Library of Medicine is currently funding the Pilot Connections project to promote and support use of the INTERNET in community health care settings. With previous networking applications of this kind largely confined to academic and research environments, the health librarian has emerged as the agent with the unique knowledge and skills to participate in and manage organizational change. An experiment in applied informatics, the Pilot Connections project shows how health librarians should be aware of the expanding opportunities that exist for them to help their organizations cope more effectively with the external trends and forces currently affecting the role and value of information.

关键词：计算机通信网络/经济学计算机通信网络/组织和管理筹资政府医院信息系统医院社区/组织和管理卫生保健组织鉴定联合委员会图书馆高级馆员图书馆医院/组织和管理医学信息学应用国立医学图书馆(美国)/组织和管理美国西北部联机系统地区医疗规划/组织和管理美国

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Communicating on a budget

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Medical Reference Services Quarterly 1989年第2期8卷 77-82页

作者： Murphy, John Library Systems Instructor Biometrics and Computing Hahnemann University Philadelphia PA 19102-1192 United States

No abstract available for this article.

关键词：计算机通信网络/经济学计算机系统费用控制图书馆医学/经济学软件美国

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Publishing on the World Wide Web.

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Health information management : journal of the Health Information Management Association of Australia 1998年第1期28卷 29-30页

作者： Schulz, E. National Centre for Classification in Health School of Public Health Queensland University of Technology Kelvin Grove Australia

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