CORBA在医院信息系统中的应用

医疗信息的开放和共享是医院信息系统发展的必然趋势 ,但是由于以前的医院信息系统在设计时没有过多考虑标准化问题 ,造成大量异构医院信息系统的存在 ,给信息共享造成了困难。作为分布对象技术主流的 CORBA体系结构 ,是解决异构信息系统集成问题的有效方案 ;尤其是 CORBAMed的提出 ,为异构环境下医院信息系统的集成提供了统一的规范。本文通过介绍 CORBA体系结构以及 CORBA - Med的五个重要规范 ,分析了 CORBAMed的特点 ,提出了基于CORBA建设医院信息系统的新方向     

CORBA在医院信息系统中的应用

医疗信息的开放和共享是医院信息系统发展的必然趋势,但是由于以前的医院信息系统在设计时没有过多考虑标准化问题,造成大量异构医院信息系统的存在,给信息共享赞成了困难,作为分布对象技术主流的CORBA体系结构,是解决异构信息系统集成问题的有效方案,尤其是CORBAMed的提出,为异构环境下医院信息系统的集成提供了统一的规范,本文通过介绍CORBA体系结构以及CORBA－Meb的五个重要规范,分析了CORBAMed的特点,提出了基于CORBA建设医院信息系统的新方向。     

DICOM医学图像扩展模型的研究

医学图像存档和通讯系统PACS(Picture Archivingand Communication System)促进了医学图像的共享，但是该系统只能提供基于关键字的医学图像检索，不能进行基于语义内容检索，本研究在现有图像处理、分析和理解技术的基础上对医学图像的内容信息进行了划分，并对PACS系统的医学成像和通讯标准DICOM(Digital Imaging and Communicationin Medicine)信息模型进行了扩充，增加有关图像内容的信息，提出了DICOM信息模型的扩展模型。通过该模型来组织医学信息的存储和检索可以满足基于关键词和基于图像语义内容检索的需要，最后在该模型的框架下实现了超声心动图像基于形状特征的检索。     

基于DICOM的医学影像设备接口设计与实现

医学影像存档与通讯系统(Picture Archiving and Communication Systems,PACS)是目前医院信息化建设的热点,医学数字成像和通信标准(Digital Imaging and Communication in Medicine,DICOM)是有关医学图像及其相关信息的数据编码及通讯的国际标准,支持DICOM标准是医学影像设备并入PACS网络的必要条件。为使目前尚不符合DICOM标准的影像设备有效并入PACS系统,必须为其添加DICOM接口。我们介绍了DICOM信息模型并实现了接口的软件系统,重点介绍了应用VisualC 编程实现DICOM服务中的C-STORE和DCM文件的读写功能。     

图像归档和通讯系统（PACS）的发展与应用

图像归档和通讯系统，是经通讯网络获取、存储、管理和显示放射医学图像的集成信息系统。近年来，国外的ＰＡＣＳ技术和应用已逐步进入成熟期，有大量的研究成果和应用实例；但我国的ＰＡＣＳ研究和应用因起步较晚，尚处在相对落后的局面。本介绍了ＰＡＣＳ系统发展历程，概述了国外ＰＡＣＳ研究和应用的现状，最后分析了国内ＰＡＣＳ的发展状况，展望了其在我国医疗信息系统发展中的应用前景。     

PACS与DICOM

近几年来随着医院信息化的深入发展及数字影像时代的到来，医学图像归档和通讯系统（picture archiving and communication system，PACS）在我国已开始逐渐发展起来。不少PACS软件产品都称是依据医学数字成像和交换（digital imaging and communication in medicine，DICOM）标准^[1]开发并与DICOM兼容的。但是对PACS、DICOM的理解及PACS究竟如何遵从DICOM标准都是一个值得深入探讨的问题。     

基于CORBA的医院信息系统与PACS的分布式集成研究

在实际医学应用中 ,医生需要及时获得病人的有关图像和文本记录信息。这些信息有助于医生进行病历诊断 ,临床试验和研究分析。但是这些信息分布零乱 ,并且位于不同的系统上 ,如图像管理和通信系统 (Picturearchiving and comm unication information systems,PACS) ,医院信息系统 (Hospital inform ation systems,HIS)等 ,这些系统使用不同的标准和协议 ,并且都不支持分布式操作 ,使系统间信息不能完全共享。为了实现各种医学系统间的分布式操作和信息的共享 ,本文结合当前流行的 WWW技术 ,利用分布式处理软件 (Common object requestbroker architecture,CORBA) ,提出了一种基于 WEB的 PACS和 HIS分布式集成方法 ,该方法将图像和文本信息系统及各种医学应用都看作是 CORBA组件对象 ,把对这些系统和应用的操作都当作是对应用对象的处理 ,利用面向对象的技术实现了对 PACS和 HIS系统的分布式集成和互操作 ,并且利用 WEB技术实现了信息的共享     

有关PACS构建的几点讨论

1　前言医学图像归档和通讯系统 (ｐｉｃｔｕｒｅａｒｃｈｉｖｉｎｇａｎｄｃｏｍｍｕｎｉｃａｔｉｏｎｓｙｓｔｅｍ ,ＰＡＣＳ)的构建是目前各大医院网络化的热门话题 ,目前情况下 ,ＰＡＣＳ是否尽快上马 ,上什么类型的ＰＡＣＳ (Ｍｉｎｉ -ＰＡＣＳ ,Ｌｏｃａｌ -ＰＡＣＳ或全院性的大型ＰＡＣＳ) ,采取什么方式进行ＰＡＣＳ建设及ＰＡＣＳ与ＨＩＳ合成等等 ,都是有关ＰＡＣＳ建设需要考虑的关键问题。本文结合我院ＰＡＣＳ系统论证及初步构建方案的设想 ,讨论有关ＰＡＣＳ构建初期所面临的几个关键问题。2　ＰＡＣＳ的历史与目前我国ＰＡ…     

应用DICOM标准实现放射治疗计划系统的共享

我们基于医学数字图像通讯标准 (DICOM) ,设计了 RT S.S,RT Plan及 RT Image 3个 DICOM对象 ,完成了不同放射治疗计划系统之间的信息共享 ,实现不同设备厂商不同放射治疗计划系统之间的信息交换和共享。     

图像归档和通讯系统(PACS)的发展与应用

图像归档和通讯系统 (Picture Archiving and Communication System,PACS) ,是经通讯网络获取、存储、管理和显示放射医学图像的集成信息系统。近年来 ,国外的 PACS技术和应用已逐步进入成熟期 ,有大量的研究成果和应用实例 ;但我国的 PACS研究和应用因起步较晚 ,尚处在相对落后的局面。本文介绍了 PACS系统发展历程 ,概述了国外 PACS研究和应用的现状 ,最后分析了国内 PACS的发展状况 ,展望了其在我国医疗信息系统发展中的应用前景。     

The design and development of a physician-oriented PACS for the enhancement of e-hospital facilities

Recent advancements in modern medical diagnoses have required a huge increase of the use of equipment such as CT and ultrasound machines. Correspondingly, the storage and dissemination of these medical images have become an important issue to medical professionals. Unfortunately, management of these images has traditionally been slow and cumbersome. With the prevalence of the personal computer, however, along with increased network bandwidth, it is now possible to handle this information electronically as well as wirelessly. The Picture Archiving and Communication System (PACS) is at the forefront of this revolution. Yet, commercially available PACS software is generally prohibitively expensive for hospitals with limited financial resources. A dilemma among many hospitals is deciding how to acquire and implement the proper PACS system without unduly affecting the budget. In this paper, a full function, efficient, and economical PACS system is presented as a viable, non-compromising option for many small and medium-sized hospitals. This system, designed and developed mainly by the physicians and technicians of Puli Christian Hospital (PCH), with the assistance from academia, allows for customization to fit the needs of individual hospitals. This system can be used as the foundation of a hospital's health information infrastructure and to enhance e-hospital service.     

The Information Security Needs in Radiological Information Systems—an Insight on State Hospitals of Iran, 2012

Picture Archiving and Communications System (PACS) was originally developed for radiology services over 20 years ago to capture medical images electronically. Medical diagnosis methods are based on images such as clinical radiographs, ultrasounds, CT scans, MRIs, or other imaging modalities. Information obtained from these images is correlated with patient information. So with regards to the important role of PACS in hospitals, we aimed to evaluate the PACS and survey the information security needed in the Radiological Information system. First, we surveyed the different aspects of PACS that should be in any health organizations based on Department of Health standards and prepared checklists for assessing the PACS in different hospitals. Second, we surveyed the security controls that should be implemented in PACS. Checklists reliability is affirmed by professors of Tehran Science University. Then, the final data are inputted in SPSS software and analyzed. The results indicate that PACS in hospitals can transfer patient demographic information but they do not show route of information. These systems are not open source. They don’t use XML-based standard and HL7 standard for exchanging the data. They do not use DS digital signature. They use passwords and the user can correct or change the medical information. PACS can detect alternation rendered. The survey of results demonstrates that PACS in all hospitals has the same features. These systems have the patient demographic data but they do not have suitable flexibility to interface network or taking reports. For the privacy of PACS in all hospitals, there were passwords for users and the system could show the changes that have been made; but there was no water making or digital signature for the users.     

基于DICOM标准的TLS网络安全传输技术研究与实现

随着医疗信息化的发展,图像归档与通信系统(PACS)、医院信息系统/放射科信息系统(HIS/RIS)等医疗信息管理系统日渐普及和完善,这些系统之间的互操作越发频繁,通过网络由一个封闭的系统走向开放,走向区域化成为必然。而信息的传输安全是使之成为可能的前提条件。基于网络安全的必要性,着重研究了医学数字成像与通信(DICOM)标准和安全传输层(TLS)协议,并结合OpenSSL工具包和DCMTK工具包实现了DICOM医疗信息TLS安全传输。     

Clinical computer applications in the radiology department

The information society is currently developing. In the field of radiology, the PACS (picture archiving and communication system) and teleradiology are widely employed in medical practice. The Ministry of Health and Welfare (MHW) reported that physicians should consider some problems in Telemedicine in December 1997. The technology of storage media is improving and we encourage the standardization of data formatting and the transmission protocol to utilize medical electronic information. Several standards exist in the medical imaging field, the DICOM (digital imaging and communications in medicine) standard, the IS&C (image save and carry) standard and the Common Standard that the Medical Information System Development Center (MEDIS-DC) defined for the electronic storage. The PACS requires high transmission speed, integrated services digital network and an asynchronous transfer mode switching system. The MHW needed a technical requirement for the electronic image storage without films in March 1994. The requirement was divided into three parts, (1) security, (2) long-term reproducibility, (3) common usage. The MEDIS-DC published the Common Standards for electronic storage in 1996. When we use the PACS via network, we must consider the security. The present network may have low security, and falsification, such as illegal login may occur. In the future, these problems will be solved, and the network-wide PACS will likely become a commonly used system.     

R-PS一体化数字放射学科整合技术的研究

探讨了 R- PS一体化数字放射学科整合技术。通过对 RIS和 PACS的整合 ,使 R- PS中各个系统和各医学影像设备之间所有的数据信息交换都遵循 DICOM3.0标准并通过模块的接口和方法实现无缝连接。R- PS系统具有共享性、安全性、兼容性、实用性和操作简单等特点 ,可实现通信接口标准化、应用功能模块化和医学信息资源共享。     

Common object request broker architecture (CORBA)-based security services for the Virtual Radiology Environment

The US Army Great Plains Regional Medical Command (GPRMC) has a requirement to conform to Department of Defense (DoD) and Army security policies for the Virtual Radiology Environment (VRE) Project. Within the DoD, security policy is defined as the set of laws, rules, and practices that regulate how an organization manages, protects, and distributes sensitive information. Security policy in the DoD is described by the Trusted Computer System Evaluation Criteria (TCSEC), Army Regulation (AR) 380-19, Defense Information Infrastructure Common Operating Environment (DII COE), Military Health Services System Automated Information Systems Security Policy Manual, and National Computer Security Center-TG-005, “Trusted Network Interpretation.” These documents were used to develop a security policy that defines information protection requirements that are made with respect to those laws, rules, and practices that are required to protect the information stored and processed in the VREProject. The goal of the security policy is to provide, for a C2-level of information protection while also satisfying the functional needs of the GPRMC’s user community. This report summarizes the security policy for the VRE and defines the CORBA security services that satisfy the policy. In the VRE, the information to be protected is embedded into three major information components: (1) Patient information consists of Digital Imaging and Communications in Medicine (DICOM)-formatted fields. The patients information resides in the digital imaging network picture archiving and communication system (DIN-PACS) networks in the database archive systems and includes (a) patient demographics; (b) patient images from x-ray, computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound (US); and (c) prior patient images and related patient history. (2) Meta-Manager information to be protected consists of several data objects. This information is distributed to the Meta-Manager nodes and includes (a) radiologist schedules; (b) modality worklists; (c) routed case information; (d) DIN-PACS and Composite Health Care system (CHCS), messages, and Meta-Manager administrative and security information; and (e) patient case information. (3) Access control and communications security is required in the VRE to control who uses the VRE and Meta-Manager facilities and to secure the messages between VRE components. The CORBA Security Service Specification version 1.5 is designed to allow up to TCSEC’s B2-level security for distributed objects. The CORBA Security Service Specification defines the functionality of several security features: identification and authentication, authorization and access control, security auditing, communication security, nonrepudiation, and security administration. This report describes the enhanced security features for the VRE and their implementation using commercial CORBA Security Service software products.     

基于通用中间件接口服务器的远程医疗信息系统

在远程医疗信息系统共享平台的设计中,提出一种构建通用中间件接口服务器实现多家医院信息系统HIS与PACS的无缝连接方案。着重介绍了DICOM中间件、HL7消息中间件、生态识别和PKI技术在系统集成中的应用。