Internally developed medical equipment management system: a viable alternative

A medical equipment management computer system, internally developed by Rhode Island Hospital, is presented. Hospital biomedical engineering departments must contend with ever-increasing regulatory requirements for patient-care equipment. Computerization is a viable solution to meeting the documentation standards dictated by healthcare governing bodies. Rhode Island Hospital's system consists of a Macintosh computer, Panorama database software, and Psion LZ64 Organiser handheld computer. Files were set up on equipment data, JCAHO-required historical documentation, service, inspections, part codes and locations, and vendor contact information. Technician inspection data recording time was reduced by approximately 30%.     

Microcomputer application: an image database system for electron microscopy.

An electron microscopist in a small electron microscopy laboratory that processes 200 cases per year can generate at least 2000 electron micrographs within this time period. These electron micrographs are stored in filing cabinets, which slowly encroach on existing laboratory space. Related image data are often located in separate filing systems. This type of storage system is inefficient for rapid retrieval of sets of electron micrographs for research, teaching, or retrospective review of patient material. An electron microscopy image base, which is implemented on a microcomputer, can provide flexible and simultaneous access to both digitized electron micrographs and their relevant textual data. In addition to the advantage of more efficient retrieval, electronic storage of textual data and digitized electron micrographs also offers the advantage of decreased storage space for this type of data. Implementation of the initial version of the electron microscopy image base demonstrated that future versions must provide improved resolution of the digitized electron micrograph and sufficient electronic mass storage to support such a large image base. Ongoing developments in database technology and mass storage make it worthwhile to pursue additional refinements of the electron microscopy image base.     

Microcomputer Application: An Image Database System for Electron Microscopy

An electron microscopist in a small electron microscopy laboratory that processes 200 cases per year can generate at least 2000 electron micrographs within this time period. These electron micrographs are stored in filing cabinets, which slowly encroach on existing laboratory space. Related image data are often located in separate filing systems. This type of storage system is inefficient for rapid retrieval of sets of electron micrographs for research, teaching, or retrospective review of patient material. An electron microscopy image base, which is implemented on a microcomputer, can provide flexible and simultaneous access to both digitized electron micrographs and their relevant textual data. In addition to the advantage of more efficient retrieval, electronic storage of textual data and digitized electron micrographs also offers the advantage of decreased storage space for this type of data. Implementation of the initial version of the electron microscopy image base demonstrated that future versions must provide improved resolution of the digitized electron micrograph and sufficient electronic mass storage to support such a large image base. Ongoing developments in database technology and mass storage make it worthwhile to pursue additional refinements of the electron microscopy image base.     

Redundant array of independent disks: Practical on-line archiving of nuclear medicine image data

While various methods for long-term archiving of nuclear medicine image data exist, none support rapid on-line search and retrieval of information. We assembled a 90-Gbyte redundant array of independent disks (RAID) system using 10-, 9-Gbyte disk drives. The system was connected to a personal computer and software was used to partition the array into 4-Gbyte sections. All studies (50,000) acquired over a 7-year period were archived in the system. Based on patient name/number and study date, information could be located within 20 seconds and retrieved for display and analysis in less than 5 seconds. RAID offers a practical, redundant method for long-term archiving of nuclear medicine studies that supports rapid on-line retrieval.     

Use of microcomputer for histopathology: system using IBM PC and dBaseIII.

A microcomputer program for use in the storage and retrieval of histopathology records is described. The program was written using dBaseIII, a commercially available data management system. The program provides for efficient storage and rapid retrieval of pathology reports and facilitates clinical research. Downloading of data on to a mainframe computer is possible.     

A computer based system for collection, storage, retrieval and reporting accession information in a veterinary medical diagnostic laboratory

Substantial data collected from large numbers of accessions, the need for comprehensive reporting of negative as well as positive laboratory findings, and the necessity for obtaining rapid diagnostic correlations prompted the development of a computer based system of accession data management for collection, storage, rapid retrieval, reporting, concording, and administrative compiling in a state-university Veterinary Medical Diagnostic Laboratory.     

A surgical pathology reporting and encoding system using industry-standard hardware and software

I describe an efficient, inexpensive, industry-standard computer system that is designed for word processing of surgical pathology reports as well as encoding in Systematized Nomenclature of Medicine (SNOMED) and data storage. This system is capable of maintaining a large database of patient information with coded diagnoses. It is designed to be utilized with readily available stock computer hardware and software without significant customization or any additional programming. The hardware is easily purchased from and can be maintained by a retail, business-oriented computer store. The system described incorporates WordPerfect for word processing and the CAP/SNOMED system for diagnosis encoding and data storage and retrieval.     

A case for automated tape in clinical imaging

Electronic archiving of radiology images over many years will require many terabytes of storage with a need for rapid retrieval of these images. As more large PACS installations are installed and implemented, a data crisis occurs. The ability to store this large amount of data using the traditional method of optical jukeboxes or online disk alone becomes an unworkable solution. The amount of floor space, number of optical jukeboxes, and off-line shelf storage required to store the images becomes unmanageable. With the recent advances in tape and tape drives, the use of tape for long term storage of PACS data has become the preferred alternative. A PACS system consisting of a centrally managed system of RAID disk, software and at the heart of the system, tape, presents a solution that for the first time solves the problems of multi-modality high end PACS, non-DICOM image, electronic medical record and ADT data storage. This paper will examine the installation of the University of Utah, Department of Radiology PACS system and the integration of automated tape archive. The tape archive is also capable of storing data other than traditional PACS data. The implementation of an automated data archive to serve the many other needs of a large hospital will also be discussed. This will include the integration of a filmless cardiology department and the backup/archival needs of a traditional MIS department. The need for high bandwidth to tape with a large RAID cache will be examined and how with an interface to a RIS pre-fetch engine, tape can be a superior solution to optical platters or other archival solutions. The data management software will be discussed in detail. The performance and cost of RAID disk cache and automated tape compared to a solution that includes optical will be examined.     

Computerized material management, inventory control, and purchase orders in the clinical laboratory.

The management of supplies, purchase orders, and equipment is of critical importance to the operation of the clinical laboratory. The InvMan software program has reduced hands-on time for performing the counting of inventory and the time required to generate purchase orders. These changes save the laboratory about $11,170 per year in personnel costs. While the use of a structured system does impose some constraints on the user, the program has helped the laboratory organize all of its supply, vendor, location, PO, and equipment data. It has allowed the laboratory to respond more rapidly and accurately to inquiries related to inventory. The varied functions of InvMan provide flexibility to the laboratory and permit it to define the inventory as best fits a particular situation. The application is well suited to its target audience. The program has performed well, allowing the laboratory to make significant improvements to its material management system.     

Medical imaging equipment service in Kaiser Permanente, Northern California

As the largest department in Biomedical Engineering, Medical Imaging Services (MIS) provides comprehensive equipment service for all imaging modalities in Kaiser Permanente, Northern California Region. MIS is customer-focused and committed to exploring better ways to deliver service, control costs and implement business strategies to meet customers' changing needs. Service extends beyond conventional preventive/corrective maintenance to include technology assessment, regulatory compliance, education and training, and managed vendor relationships. Program enhancements include film processor and solutions service, a second-source parts program, and a machine shop. In recent years, operations expanded to the Kaiser Permanente Northwest Region. Significant savings are available to any healthcare organization willing to embrace a new, expanded view of equipment management.     

提高检索语言与信息素养教育的思考

 在网络与信息技术不断发展的进程中,医学生文献检索课程的教学理念与内容不可避免地向信息素养教育转变。北京协和医学院检索语言与信息组织课程与传统检索语言教学相比,增加了临床信息组织工具内容,概念范围也从单一的检索语言延伸到信息组织范畴,重点讲述检索语言与信息的关系、检索语言与信息组织的关系,信息组织与个人发展的关系。应用七何分析法（5W2H）比较检索语言与临床问诊语言的特点,加深医学生对信息组织工具的认识与理解。课堂上采取提出问题,分组讨论、代表汇报、全班分享的方式,激发学生的学习兴趣。教学效果经分析显示,对学生了解信息素养、检索与组织信息有一定帮助。     

数字化医学技术与脊柱外科的临床应用

背景：随着现代科学技术尤其是计算机技术和医学技术的迅猛发展,现代脊柱外科进入了一个崭新的时代,呈现出数字化、个性化、显微化、精确化和人工智能化的发展趋势。 目的：探讨数字化技术在脊柱外科中的应用研究进展。 方法：文章检索词为“脊椎(spine);腰椎(lumbar);颈椎(cervical);数字化(digitization);脊柱外科(spinal surgery);数字骨科学(digital orthopedics);有限元模型(the finite element model);计算机辅助设计(computer assisted design,CAD);微创技术(minimally invasive technology);三维重建(three dimensions reconstruction, 3D);CT;磁共振成像(MRI);计算机仿真(computer emulation);内窥镜(endoscope);椎间盘(intervertebral disc);经皮内窥镜激光椎间盘切除术(percutaneous endoscopic laser-assisted discectomy, PELD)”,对有限元、计算机导航技术、微创技术以及医学影像在脊柱外科中的应用文献进行深入分析,探讨数字化脊柱外科手术的特点,临床效果以及安全性。 结果与结论：数字化医学在有限元模型、计算机导航技术、微创技术、医学影像等领域研究进展的基础上,建立独特的脊柱外科新方法,并将其广泛应用于临床骨科。有限元模型最大的优势在于可以反映集体内部的应力变化情况,有限元分析应用于医学生物力学后,取得了很大的进步与发展。计算机导航技术的工作原理是利用数字化影像信息通过媒介体输入计算机工作站,经运算处理后重建三维模型影像,通过相关软件,在此影像基础上进行术前计划并模拟进程,通过高解像度的显示屏从各个方位观察到当前的手术入路以及各种参数,完成微创手术。微创脊柱外科采用微小切口或穿刺通道,运用特殊的器械或装置在影像仪器监视下或导航技术的引导下进行手术。医学影像分析作为信息科学技术为基础的交叉学科研究,对脊柱外科的临床诊断和观察具有参考价值。数字化医学高效率、高精度、三维立体地了解疾病的分布、形态、结构,最大程度减少手术创伤,在脊柱外科应用中的前景广阔。     

Tools to manage the enterprise-wide picture archiving and communications system environment

The presentation will focus on the implementation and utilization of a central picture archiving and communications system (PACS) network-monitoring tool that allows for enterprise-wide operations management and support of the image distribution network. The MagicWatch (Siemens, Iselin, NJ) PACS/radiology information system (RIS) monitoring station from Siemens has allowed our organization to create a service support structure that has given us proactive control of our environment and has allowed us to meet the service level performance expectations of the users. The Radiology Help Desk has used the MagicWatch PACS monitoring station as an applications support tool that has allowed the group to monitor network activity and individual systems performance at each node. Fast and timely recognition of the effects of single events within the PACS/RIS environment has allowed the group to proactively recognize possible performance issues and resolve problems. The PACS/operations group performs network management control, image storage management, and software distribution management from a single, central point in the enterprise. The MagicWatch station allows for the complete automation of software distribution, installation, and configuration process across all the nodes in the system. The tool has allowed for the standardization of the workstations and provides a central configuration control for the establishment and maintenance of the system standards. This report will describe the PACS management and operation prior to the implementation of the MagicWatch PACS monitoring station and will highlight the operational benefits of a centralized network and system-monitoring tool.     

整形外科的数字化研究

目的应用数字技术,解决整形美容外科的技术难题,提高管理和工作效率;方法计算机图像分析技术、数据库管理技术、移动通讯技术和计算机编程技术;结果建立了整形美容外科数字资料管理系统、容貌定量诊断评价系统、色素斑痣定量评价系统、求美心理定量测评系统和医患沟通信息化系统;结论紧密结合专科特点,通过将最新数字信息技术应用到临床专科,可以大大提高专科管理和工作效率,提升科研和学术水平,带来显著的社会和经济效益,是非常值得深入研究的领域。     

基于内容的脑部MRI影像搜索的医学信息系统的研制

挖掘数字医学影像信息并为辅助检测服务是当前医学信息管理领域急需解决的问题.基于内容的医学影像检索方法(content based information retrieval,CBIR)是解决此问题有效手段.本文总结了建立基于内容图像检索的300万张脑部MRI的影像数据库和信息系统开发的应用的一些技术和方法,包括数据库的建立、搜索方法的实现等,为临床应用提供服务.     

医学影像设备管理系统的设计与开发

目的：设计和开发出一套功能全面、操作简便而又实用的放射科设备管理信息系统。方法：本论文从软件工程的角度出发进行分析和设计,采用J2EE、SPRING、HIBERNATE等先进流行的Web框架技术,对一款医学影像设备管理维护系统进行初步设计和开发。结果：根据对现有医院影像设备管理的需求分析和实地调研,完成了一款医学影像设备管理维护系统的具体开发,系统主要功能模块包括系统管理、采购管理、设备信息管理、故障信息管理、设备维护管理、设备说明书管理等等。结论：该医学影像设备管理系统总体来说,功能全面、操作简便而又实用,能够满足医院影像设备管理的大部分需求,极大的提高了医学影像设备的管理效率。     

A generic concept for the implementation of medical image retrieval systems

This paper presents a technical framework to support the development and installation of system for content-based image retrieval in medical applications (IRMA). A strict separation of feature extraction, feature storage, feature comparison, and the user interfaces is suggested. This allows to reuse implemented components in different retrieval algorithms, which improves software quality, shortens the development cycle for applications, and allows to introduce standardized end-user interfaces. Based on the proposed framework, the IRMA engine has been established, which is currently used to evaluate content-based retrieval methods on a collection of 20,000 medical and 135,000 non-medical images.     

A Mobile Phone Integrated Health Care Delivery System of Medical Images

With the growing computing capability of mobile phones, a handy mobile controller is developed for accessing the picture archiving and communication system (PACS) to enhance image management for clinicians with nearly no restriction in time and location using various wireless communication modes. The PACS is an integrated system for the distribution and archival of medical images that are acquired by different imaging modalities such as CT (computed tomography) scanners, CR (computed radiography) units, DR (digital radiography) units, US (ultrasonography) scanners, and MR (magnetic resonance) scanners. The mobile controller allows image management of the PACS including display, worklisting, query and retrieval of medical images in DICOM format. In this mobile system, a server program is developed in a PACS Web server which serves as an interface for client programs in the mobile phone and the enterprise PACS for image distribution in hospitals. The application processing is performed on the server side to reduce computational loading in the mobile device. The communication method of mobile phones can be adapted to multiple wireless environments in Hong Kong. This allows greater feasibility to accommodate the rapidly changing communication technology. No complicated computer hardware or software is necessary. Using a mobile phone embedded with the mobile controller client program, this system would serve as a tool for heath care and medical professionals to improve the efficiency of the health care services by speedy delivery of image information. This is particularly important in case of urgent consultation, and it allows health care workers better use of the time for patient care.     

眼底图像参数测定系统

本文介绍一种能与传统的眼底相机匹配的眼底网像处理系统。该系统不仅具有能对患者的病历信息与眼底图像信息进行集成管理的小型数据库，还具有眼底图像处理和测量的功能模块。     

Do we really need standards in digital image management?

Convention dictates that standards are a necessity rather than a luxury. Standards are supposed to improve the exchange of health and image data information resulting in improved quality and efficiency of patient care. True standardisation is some time away yet, as barriers exist with evolving equipment, storage formats and even the standards themselves. The explosive growth in the size and complexity of images such as those generated by multislice computed tomography have driven the need for digital image management, created problems of storage space and costs, and created a challenge for increasing or getting an adequate speed for transmitting, accessing and retrieving the image data. The search for a suitable and practical format for storing the data without loss of information and medico-legal implications has become a necessity and a matter of 'urgency'. Existing standards are either open or proprietary and must comply with local, regional or national laws. Currently there are the Picture Archiving and Communications System (PACS); Digital Imaging and Communications in Medicine (DICOM); Health Level 7 (HL7) and Integrating the Healthcare Enterprise (IHE). Issues in digital image management can be categorised as operational, procedural, technical and administrative. Standards must stay focussed on the ultimate goal - that is, improved patient care worldwide.