bluuebunny/crossref_metadata_2025 huggingface dataset:
Emergency Protocols in Prehospital Emergency Medicine in Slovenia
Authors: Leskovšek Jožica  , Žmavc Andrej
Published: February 2025

Emergency medicine is a branch of medicine in which prompt and accurate information is of crucial importance, because a patient’s survival and the final outcome of a treatment very often depends on it. Therefore the standardization of prehospital emergency service administration with uniform documentation, methods of annotation of technical data as well as uniform gathering and data analysis are necessary. Wanting to process a fair amount of data and specially to disburden personnel, a need for computer aided processing is evident. Application that was developed in strong collaboration with EMS project team and information science engineers definitely improves data quality. Firstly when team members, especially physicians, are constrained to fulfill paper forms and secondly when data are entered into the computer, because all inconsistencies are being reconsidered and corrected if necessary. The developed application also gave the opportunity to the emergency team for prompt and accurate information.
Towards a multi-professional patient record - a study of the use of headings
Authors: Åhlfeldt Hans  , Ehnfors Margareta  , Ridderstolpe Lisa
Published: February 2025

This paper reports on the differences and similarities of used headings among Swedish health care professionals; nurses, occupational therapists, physiotherapists, dietetics, logopedics, welfare officers and general practitioners. The background of the study is a national project where representatives of the different health care professionals compiled used headings from clinical practice. Based on that survey, a hierarchical system of headings was constructed in accordance with the notion of record items and record item complexes described in the European Health Care Record Architecture (EHCRA). The work was done separately by the different health care professionals, leading to separate lists of headings. The current study reports on an analysis of these multi-professional lists of headings with respect to structure, degree of specialization, synonyms and homonyms. The study is descriptive in nature, giving a status report of the variety of used headings in clinical practice, providing necessary material for a normative approach with focus on a truly multi-professional patient record in the future.
Constructing Scenarios for validating the Electronic Health Care Record Architecture
Authors: Kay Stephen  , Marley Tom  , Lundgren Per Arne  , Broberg Helen  , Prytz Hanne
Published: February 2025

The CEN TC 251 Electronic Health Care Record Architecture is the first part of a four part communication prestandard intended to facilitate the safe communication of clinical information, irrespective of circumstances related to time, distance, and responsibility. The work has important implications for a diversity of stakeholders and must embody clinical principles if it is to succeed. The issue at hand is how to enable clinicians to validate the reference architecture, which is necessarily a technical document, so that they have confidence that it can meet the clinical requirement for safe communication. A model of communication that has been used to ground the architecture is shown to be useful in creating relevant clinical scenarios to permit the first steps towards coherent validation in a systematic way.
Donor And The Health Insurance Card
Authors: Posega Alenka  , Pleterski Rigler Dušica
Published: February 2025

The health insurance card is a new electronic identification document of insured persons and facilitates smoother communication between the health insurance information system and the Slovene health care service provider information systems. The card stores the insured person's identification details as well as the information on the selected personal physician. Another procedure also to be hosted on the card, will be the card holder's personal decision about being voluntary donor of organs and tissues for transplant purposes. This data item will, supported by the enhancement of technological infrastructure, improve the control of the donorship information. In Slovenia, registering, recording and application of the organ and tissue donorship data is carried out, on a pilot basis, in the region of Posavje.
Galen : a third generation terminology tool to support a multipurpose national coding system for surgical procedures
Authors: Trombert-Paviot B  , Rodrigues JM  , Rogers JE  , Baud R  , van der Haring E  , Rassinoux AM  , Abrial V  , Clavel L  , Idir H
Published: February 2025

GALEN has developed a new generation of terminology tools based on a language independent concept reference model using a compositional formalism allowing computer processing and multiple reuses. During the 4th framework program project Galen-In-Use we applied the modelling and the tools to the development of a new multipurpose coding system for surgical procedures (CCAM) in France. On one hand we contributed to a language independent knowledge repository for multicultural Europe. On the other hand we support the traditional process for creating a new coding system in medicine which is very much labour consuming by artificial intelligence tools using a medically oriented recursive ontology and natural language processing. We used an integrated software named CLAW to process French professional medical language rubrics produced by the national colleges of surgeons into intermediate dissections and to the Grail reference ontology model representation. From this language independent concept model representation on one hand we generate controlled French natural language to support the finalisation of the linguistic labels in relation with the meanings of the conceptual system structure. On the other hand the classification manager of third generation proves to be very powerful to retrieve the initial professional rubrics with different categories of concepts within a semantic network.
A Computerised Guideline for Pressure Ulcer Prevention
Authors: Quaglini Silvana  , Grandi Manuela  , Baiardi Paola  , Mazzoleni M.Cristina  , Fassino Clara  , Franchi Giorgio  , Melino Stefania
Published: February 2025

This work illustrates the implementation of a computerised guideline for the pressure ulcers prevention. In particular, we describe the site-specification of a guideline delivered by the Agency for Health Care Policy Research, its integration with the electronic patient record, and its introduction within the clinical routine. The system facilitates trained nurses in the patient management by producing daily work-plans, and novice nurses by running as an educational tool.
How can we improve informatics education for German nurses ?
Authors: Bürkle Thomas  , Schrader Ulrich
Published: February 2025

For German nurses it is difficult to join training in health informatics besides their professional activity. The authors have successfully established a German nursing informatics summer school in shape of a 5 day intensive curriculum which they offer to German nurses during the summer hollidays. The summer school introduces nurses into health informatics and nursing informatics. It targets interested nursing staff, nurse executives, and nurse teachers. It promotes self learning abilities for continued self education of the participants. One of its goals is to enable participants to formulate their own requirements in health information processing and to influence system design and system introduction. The paper presents the curriculum, talks about first experiences, and demonstrates the results of an evaluation among the participants. Conclusions are drawn in a set of statements on informatics education of nurses.
Navigation System for Neurosurgery with PC Platform
Authors: Akatsuka Yuichiro  , Shibasaki Takao  , Saito Akito  , Kosaka Akio  , Matsuzaki Hiroshi  , Asano Takeo  , Furuhashi Yukihito
Published: February 2025

This paper presents a navigation system for a surgical microscope and an endoscope which can be used for neurosurgery. In this system, a wireframe model of a target tumor and other significant anatomical landmarks are superimposed in real-time onto live video images taken from the microscope and the endoscope. The wireframe model is generated from a CT/MRI slice images. Overlaid images are simultaneously displayed in the same monitor using the picture-in-picture function so that the surgeon can concentrate on the single monitor during the surgery. The system measures the position and orientation of the patient using specially designed non-contact sensing devices mounted on the microscope and the endoscpe. Based on this real-time measurement, the system displays other useful information about the navigation as well as the rendered wireframe. The accuracy of registration between the wireframe model and the actual live view is less than 2mm. We tested this system in actual surgery several times, and verified its performance and effectiveness.
Surgical Simulators Using the WWW
Authors: John Nigel W.  , Phillips Nicholas
Published: February 2025

This paper will describe a suite of surgical simulators that we have designed and implemented to run on the WWW. The procedures that have been modelled include simulations of ventricular catheterisation, and lumbar puncture. We will present a detailed overview of implementation and operation of these simulators, and indicate results from early use. The advantages and disadvantages of our approach will be discussed.
Modeling and Modification of Medical 3D Objects. The Benefit of Using a Haptic Modeling Tool
Authors: Kling-Petersen Torben  , Rydmark Martin
Published: February 2025

The Computer Laboratory of the medical faculty in Goteborg (Mednet) has since the end of 1998 been one of a limited numbers of participants in the development of a new modeling tool together with SensAble Technologies Inc [http://www.sensable.com/]. The software called SensAble FreeForm was officially released at Siggraph September 1999. Briefly, the software mimics the modeling techniques traditionally used by clay artists. An imported model or a user defined block of “clay” can be modified using different tools such as a ball, square block, scrape etc via the use of a SensAble Technologies PHANToM haptic arm. The model will deform in 3D as a result of touching the “clay” with any selected tool and the amount of deformation is linear to the force applied. By getting instantaneous haptic as well as visual feedback, precise and intuitive changes are easily made.
Planning and Rehearsal of Surgical Interventions in the Volume Model
Authors: Pflesser B.  , Leuwer R.  , Tiede U.  , Höhne K.H.
Published: February 2025

Visualization of 3D medical data is routinely used in a wide range of applications. However, for the planning and rehearsal of surgical interventions more sophisticated techniques for interaction have to be developed. The realistic specification and visualization of free form cuts is needed to allow the ‘look and feel’ close to a real dissection. The problem here is, since these cuts are not represented by intensity changes, that the gray-level-gradient-method can not be used for the estimation of surface normals. In addition, the interactive repositioning of dissected fragments has to be simulated. We have developed an extended ray-casting algorithm for visualization of object motion in the volume model.
Investigating 3D Tumor Distribution for Optimized Diagnosis of Prostate Cancer
Authors: Zeng Jianchao  , Bauer John J.  , Yao Xiaohu  , Zhang Wei  , McLeod David G.  , Sesterhenn Isabell A.  , Connelly Roger R.  , Moul Judd W.  , Mun Seong K.
Published: February 2025

Transrectal Ultrasonography (TRUS) based systematic needle biopsy of the prostate has been widely used clinically in the diagnosis of prostate carcinoma. Current protocols for prostate biopsy, such as the Sextant Protocol, however, have been proven to be insufficient in cancer detection since these protocols were built without having accurate information on 3D distribution of prostate cancers. In this research, our goal is to optimize prostate biopsy protocols by statistically investigating spatial distributions of prostate cancers. Based on the low-resolution nature of ultrasound imaging and the current clinical conventions, we propose to divide each individual prostate gland into different zones that are can be recognized and accessed by the urologists with ultrasound images during biopsy. By calculating cancer appearance inside each of these zones using a large number of prostate samples, we get the overall distributions of prostate cancers based on which an optimal biopsy protocol can be developed.
Radiological Tele-Immersion for Next Generation Networks
Authors: Ai Zhuming  , Dech Fred  , Rasmussen Mary  , Silverstein Jonathan C.
Published: February 2025

Since the acquisition of high-resolution three-dimensional patient images has become widespread, medical volumetric datasets (CT or MR) larger than 100MB and encompassing more than 250 slices are common. It is important to make this patient-specific data quickly available and usable to many specialists at different geo-graphical sites. Web-based systems have been developed to provide volume or surface rendering of medical data over networks with low fidelity, but these cannot adequately handle stereoscopic visualization or huge datasets. State-of-the-art virtual reality techniques and high speed networks have made it possible to create an environment for clinicians geographically distributed to immersively share these massive datasets in real-time. An object-oriented method for instantaneously importing medical volumetric data into Tele-Immersive environments has been developed at the Virtual Reality in Medicine Laboratory (VRMedLab) at the University of Illinois at Chicago (UIC).
Cognitive Studies of Ethical Reasoning Based on the KARDIO-simulator
Authors: Holm Søren  , Øhrstrøm Peter  , Rossel Peter  , Pedersen Stig Andur
Published: February 2025

Empirical investigations in medical ethics are often questionnaire studies relying on the respondents' written responses about their attitudes and actions. This approach is valuable, but there may be quite large discrepancies between responses and actual behaviour. Unfortunately actual behaviour is often difficult to observe, especially where sensitive or very time dependent clinical decisions are concerned.
Toward an Information Society for All: Challenges in Health Telematics
Authors: Emiliani Pier Luigi
Published: February 2025

In the emerging information society each hospital is supposed to become a node of a complex networked information system that has to be accessible to a variety of users. These include doctors, nurses, administrators and the patients themselves, whose role is briefly described. This asks for a new approach to the implementation of the interfaces of the information system, which are used to carry out different tasks by people with different interests and computer literacy. A new approach to the implementation of such interfaces, based on the concepts of User interfaces for All, is briefly outlined, describing the scientific and technical achievements in some projects partially funded by the European Commission and the activities of the International Scientific Forum “Towards an Information Society for All” set-up to discuss and promote the relevant scientific concepts and technical issues.
Health Telematics Applications and User Acceptance from a Medical Student's point of view
Authors: Agathagelidis Filon
Published: February 2025

The goal of the workshop is dual. The first is to convince health care professionals of health telematics applications' usefulness by demonstrating convincing cases and the second is to examine the practical side of the story which is education and training in health telematics. The purpose of this paper is to present the way health telematics appeal to a medical student. After all it's the medical student and the young practitioner whose lifetime practice will depend on the health telematics applications that are today under development.
7. Security Infrastructure for a Regional Electronic Medical Record
Authors: Blobel Bernd  , Pharow Peter
Published: February 2025

This chapter looks at the security infrastmcture around a regional electronic medical record. It considers first the generic security model and then the specific case study of the Regional Cancer Register in Magdeburg/Saxony Anhalt which was part of the TrustHealth 1 project.
Retooling Practitioners in the Information Age
Authors: Rienhoff Otto
Published: February 2025

For “retooling” one needs two components: new hardware and new skills. “Hardware” in the Medical Informatics environment includes not only hardware in a narrow definition, but operating and application software, network services, security services etc. Since the sixties, Medical Informatics has slowly moved from fighting computer hardware to fighting the complexity of application software and its installation. Thus the hardware part in the retooling process has changed but did not decrease in importance. Retooling medical professionals also means retraining of professionals - often a major investment. Regarding the necessary skills, we have to adapt existing medical curricula and continuous medical education (CME). So far, these have not successfully been adjusted to the retooling needs. The international community has to address these matters, specifically in the context of medical curriculum and CME.
Opportunities for Improving Quality in the Health Care Industry
Authors: Corrigan Janet M.
Published: February 2025

This paper discusses the current state of health care quality and describes some of the factors that are hindering efforts to move toward evidence-based practice. The President's Advisory Commission on Consumer Protection and Quality spent one year looking at the state of health care quality and developed a set of recommendations to tackle the serious quality problem in the health care industry. The Institute of Medicine has started an initiative, Quality of Health Care in America Project, which is addressing many of the quality of care areas identified by the President's Advisory Commission on Consumer Protection and Quality. This paper discusses the work of these two groups and concludes with key issues in the advancement of quality health care.
Information Services that Make Patients Co-Producers of Quality Health Care
Authors: Bopp Kenneth D.
Published: February 2025

A new era of consumerism is emerging. Increasingly educated consumers are demanding convenience, choice, and self-efficacy or self-mastery. These educated consumers are causing businesses in a variety of service industries, including health care, to change their business design in response to changing consumer preferences. Increased consumer pressures to change health care business designs are evidenced by a flood of state and federal legislation and managed care organizations broadening their networks and product offerings to respond to consumer complaints about lack of choice. These pressures are also evidenced by educated patients, armed with information they have gathered via the Internet and other sources going to their physician and saying, “Together let's figure out how I can do this myself.”
Introduction of a Clinical Information System in a Regional General State Hospital of Athens, Greece
Authors: Sarivouyioukas John  , Vagelatos Aristides
Published: February 2025

The introduction of a Clinical Information System (CIS) in a healthcare organisation is a particularly complex process, requiring thorough design and the close co-operation of many key-position people within the organisation. Moreover the whole process is extremely time-consuming. This contribution presents the first phases of such an introduction in a regional state hospital in Greece. During these phases a number of preparatory actions took place in order to establish and set available in the hospital all the necessary infrastructure. Then the CIS was introduced in two pilot clinics, interconnected with the existed administrative system and customised in order to meet the needs of the various clinical departments.
Teaching Computer Classes at the University Hospital of Münister – Evaluation of Long-Term Results
Authors: Veltmann U.  , Eschmann U.  , Prokosch H.U.
Published: February 2025

With the increasing use of computers in the hospital, staff have to face working with a new medium and technology. Computer training is required to in- crease user acceptance. After a brief presentation of the current teaching concept, the effectiveness and long-term results of computer classes that have been offered at the University Hospital of Munster since August 1998 are evaluated. A questionnaire was sent to 300 course participants covering aspects of motivation, confidence, satisfaction, reluctance and some general data. Overall results were very positive. Some comments have led to considerations regarding some alterations to the program as for instance adjusting the program more to the differing needs of various professional groups or reconsidering the ways of its distribution.
Technology Development and Implementation in the Public Health Institutions: A strategic and pedagogical task for the learning organization
Authors: Wentzer Helle S.
Published: February 2025

The article presents two overall problem issues for IT in the health sector. A strategic problem: Which organization structure and which work routines should be enhanced by technology? A pedagogical problem: How does the personnel learn to think, act and express work through IT-tools? The suggested solution is to put technology development and implementation together within a theoretical frame for the learning organization where reciprocal demands and terms exist for both the IT-tools and the personnel. The personnel makes demands to which goals should be reached through technology and technology demands that the personnel is acquainted with hardware and software. As a communication system, technology offers new possibilities of realizing other forms of cooperation. The suggested solution is a synthesis between the strategy for organization development through technology and the implementation of IT as a learning process for the personnel. The synthesis between the mutual demands of the organization and its personnel provides for IT-tools which are in concordance with the principal values of the health practice rather than merely economic and management values. The analysis builds on a qualitative, in-depth investigation of IT-implementation in the secondary sector. The investigation indicated that the use of IT is a learning process which requires three types of knowledge and that continued IT-development in the organization requires a new fourth knowledge.
Stabile multivariate Tests aus der Sicht der zugehörigen Konfidenzbereiche
Authors: Kropf Siegfried  , Läuter Jürgen
Published: February 2025

Stabile multivariate Tests ([l]-[4]) sind ein effektives Werkzeug für die statistische Analyse in medizinischen Studien. Im Fall der score-basierten Zwei-Gruppen-Vergleiche wird untersucht, wie die zugehörigen Konfidenzbereiche für die Mittelwertsdifferenz beschaffen sind. Dies reflektiert gleichzeitig einige Möglichkeiten der Tests. Da die Darstellungsmöglichkeiten im p-dimensionalen Originalraum beschränkt sind, wird nach Konfidenzintervallen für die Scores gesucht. Hierzu sind Modifikationen der Tests nötig.
Internetbasierte Anwendungsbeobachtung in gastroenterologischen Schwerpunktpraxen — Aspekte der Qualitätskontrolle
Authors: Ose Claudia  , Hirche Herbert  , Jockel Karl-Heinz  , Küppers Bruno  , Warth Lothar  , Rammler Barbara
Published: February 2025

In dem Zeitraum November 1999 bis Mai 2001 wird in 50 niedergelassenen Praxen in Deutschland eine Anwendungsbeobachtung zum Thema “Lansoprazol bei Refluxosophagitis” durchgefuhrt. 9000 Patienten sollen aufgenommen werden.
Informationsergänzung aus einer Tumordatenbank zu einem PDMS-Moglichkeiten und Grenzen
Authors: Fahlbusch T  , Gansert UA  , Brenk P
Published: February 2025

Eine Tumordatenbank stellt für den onkologischen Schwerpunkt im Klinikum Ludwigshafen ein Bindeglied zwischen Krankenblattarchiv und PatientenDatenManagementSystem (PDMS) dar. Ersteres umfafßt die Unterlagen aller stationären Patienten auf Papier, letzteres umfaßt digitalisiert die einzelnen Behandlungsfälle mit den abrechnungsrelevanten Diagnosen. Die Tumordatenbank enthält eine patientenbezogene Mischung administrativer mit medizinischen Daten.
Use of Linear Mixed Models to Detect Irregular Fetal Growth
Authors: König Jochem  , Bruss Claudia  , Hendrik Hans-Joachim
Published: February 2025

Ultrasonographic fetal biometry data can be used to estimate fetal weights repeatedly over time. Different types of reference bands have been presented to judge such data. But relevant aspects of an individual growth curve are not taken in to account. How can individual growth curves be used efficiently to detect irregular fetal growth? Linear mixed model analysis of a sample of 167 uncomplicated pregnancies with 304 ultrasonic measurements revealed that a random intercept model is sufficient and heterogeneity in slopes is neglegible.
Semantic Analysis of Medical Free Texts
Authors: Romacker Martin  , Hahn Udo  , Schulz Stefan  , Klar Rüdiger
Published: February 2025

The semantic interpretation of natural language utterances is usually based on a large number of transformation rules which map syntactic structures (parse trees) onto some kind of meaning representation. However, those interpretation rules exhibit an insufficient degree of abstraction so that the scalability and portability of such natural language processing systems is hard to maintain. In this paper, we introduce an approach that is able to cope with a wide variety of semantic interpretation patterns in medical free texts by applying a small inventory of abstract semantic interpretation schemata. These schemata address generalized graph configurations within syntactic dependency parse trees, which abstract away from specific syntactic constructions.
IPHIE: an International Partnership in Health Informatics Education
Authors: Jaspers M.W.M.  , Gardner R.M.  , Gatewood L.C.  , Haux R.  , Leven F.J.  , Limburg M.  , Ravesloot J.H.  , Schmidt D.  , Wetter T.
Published: February 2025

Medical informatics contributes significantly to high quality and efficient health care and medical research. The need for well educated professionals in the field of medical informatics therefore is now worldwide recognized. Students of medicine, computer science/informatics are educated in the field of medical informatics and dedicated curricula on medical informatics have emerged. To advance and further develop the beneficial role of medical informatics in the medical field, an international orientation of health and medical informatics students seems an indispensable part of their training. An international orientation and education of medical informatics students may help to accelerate the dissemination of acquired knowledge and skills in the field and the promotion of medical informatics research results on a more global level. Some years ago, the departments of medical informatics of the university of Heidelberg/university of applied sciences Heilbronn and the university of Amsterdam decided to co-operate in the field of medical informatics. Now, this co-operation has grown out to an International Partnership of Health Informatics Education (IPHIE) of 5 universities, i.e. the university of Heidelberg, the university of Heilbronn, the university of Minnesota, the university of Utah and the university of Amsterdam. This paper presents the rationale behind this international partnership, the state of the art of the co-operation and our future plans for expanding this international co-operation.
AUDIX: A Knowledge-based System for speech-therapeutic auditory discrimination exercises
Authors: Grawemeyer Beate  , Cox Richard  , Lum Carmel
Published: February 2025

AUDIX is a knowledge-based multimedia system for auditory discrimination exercises. The aim of AUDIX is to provide patients with a computer-based therapy system which they can use between sessions with the human therapist, at home on an ‘on-demand’ basis. It is centered around computer based cognitive rehabilitation therapy whereas most existing programs in this area are only used for assessment. The auditory discrimination exercise system is designed for adult people who are speech-impaired as a result of a stroke. These people have auditory perceptual problems. The nature of the perceptual problem is an inability to perceive differences between phonemes. This requires a type of therapy called auditory discrimination training. The system provides computer-based auditory discrimination training. Through the knowledge- based design the domain dependent therapy knowledge is separated from the system core and provides a way for the therapist to add new knowledge, as new stimuli, or to create a new knowledge base to provide special exercises for an individual patient. The AUDIX architecture is described and the advantages of computer- based therapy are discussed.
MUSTANG: Wiederverwendbare UMLS-basierte terminologische Dienste
Authors: Ingenerf Josef  , Reiner Jörg
Published: February 2025

Das UMLS-System (Unified Medical Language System) als weltweit umfangreichste Terminologie- Ressource wird bis heute in Deutschland weniger als erwartet eingesetzt. Sowohl ein effektiver Zugriff auf Online-Wissen mit den Standard-Problemen des Information Retrieval (Vollständigkeit, Korrektheit) als auch die Integration heterogener Anwendungssysteme können von UMLS-basierten Dolmetscher-Diensten profitieren. Das MUSTANG-System (Medical UMLS based Terminology Server for Authoring, Navigating and Guiding the Retrieval to Heterogeneous Knowledge Sources) bietet genau solche Dienste an. Auf mehreren technischen Ebenen (z.B. Web-basierter Zugang, CORBA-basierte Schnittstelle) lassen sich diese Dienste abgreifen. Die sogenannten “Lexical Services” des CORBAmed-Standards wurden bei der Spezifikation der Dienste berucksichtigt. Die generelle Bereitschaft, autonom entwickelte Systeme zu integrieren beziehungsweise deren Dienste wiederzuverwenden hangt unter anderem davon ab, ob die jeweilige Autonomic zugunsten von Standards zur Warming einer iibergreifenden Konsistenz und Transparenz aufgegeben wird. Ober erste Anwendungen des MUSTANG-Systems wird berichtet.
Data Mining and Structuring of Executable Data Analysis Reports: Guideline Development and Implementation in a Narrow Sense
Authors: Karlsson Johan  , Eklund Patrik
Published: February 2025

In this paper we present a data mining scenario that supports development of automated web-based documenta- tion of data analysis for diagnosis and treatment. The documents can be seen as guidelines in a narrow sense, and are designed to include executable modules for the corresponding decision support systems. Our aim is to discuss the possibilities of identifying certain types of diagnoses and treatments for which guidelines can be generated and computerised more systematically.
Implementation and Deployment of Healthcare Management Information System
Authors: Zelic Igor  , Bercic Bostjan  , Pikec Marjana  , Slavec Smiljana
Published: February 2025

In the following article we present development of the Management Information System, an implementation of our own Data Warehouse, build on top of the existing Healthcare Information System. We discuss requirements and phases of development of the system, we present the structure of the system, the experiences with end users and obstacles that we met, as well as possible improvements end extensions of the system. The system is designed as a framework that works with workload measurement sub-systems, which are defined as multidimensional arrays, and are observed through different units of time. Each of the axis has several hierarchical structures build on top of it. Setting up the system is a difficult task, because it requires a good knowledge of organisational structure of a particular hospital. We used an incremental approach in defining the organisational structure. On top of the framework we build a user customisable graphical user interface, which enables different types of end users to efficiently use the system.
Planning and Introduction of Clinical Documentation in an University Hospital
Authors: Callegari Verena  , Pfeiffer Karl Peter
Published: February 2025

At the Innsbruck University Hospital the documentation planning for the new hospital information system started by designing the structure of free text documents. This paper analyzes the needs of the physicians to document and retrieve information on a patient’s visits and history. Considerations for the realization of these needs are outlined. Based on our experiences the organizational constraints e.g. validation of clinical information are demonstrated and discussed.
Strategic Information Management for a Dutch University Hospital
Authors: Hasselbring Wilhelm  , Peterson Ryan  , Smits Martin  , Spanjers Ronald
Published: February 2025

Strategic Information management in hospitals gives directives for the development of the hospital's information system. This paper discusses the specific situation of strategic information management for a university hospital that is subject to the Dutch healthcare environment. Central issues for the discussion are the involved internal and external stakeholders that have some direct or indirect interest with respect to information management in the hospital. The complexity and heterogeneity of the hospital requires the development of multiple strategic plans that reflect the specific requirements of the different stakeholders.
Das DRG-System stellt neue Dokumentationsanforderungen an die Krankenhäuser
Authors: Kolodzig Christine  , Thurmayr Roswitha G.
Published: February 2025

Die Einführung eines neuen Vergütungssystems für den Krankenhausbereich auf der Grundlage der DRGs (Diagnoses Related Groups) zum 01.01.2003 stellt die Krankenhäuser vor neue, höhere Dokumentationsanforderungen. Der Beitrag geht auf die für die DRGs erforderlichen Datengrundlagen ein und zeigt auf, in welchen Bereichen Anpassungen erforderlich sind. Dazu gehören Anpassungen der Klassifikationen und ihres Regelwerkes und klare Definitionen der Dateninhalte ebenso wie die Erweiterung des Datensatzes nach § 301 SGB V. Weiter werden Losungswege und Handlungskonsequenzen für die organisatorische Umsetzung der Dokumentation unter den neuen Rahmenbedingungen aufgezeigt.
The Future of Telemedicine
Authors: Wilson Meg
Published: February 2025

Despite a decade of tremendous advances in telemedicine, it still has potential far beyond current reality. New technologies are making the use of telemedicine ever more compelling and cost and payment barriers are being tackled so fewer barriers will impede the broad adoption of a now-proven cost-saving delivery of a variety of health care services. Adoption of telemedicine will accelerate with the aging of the Baby Boomer generation and globalization forces will broaden adoption and drive cost down.
The Future of Highly Personalized Health Care
Authors: Robson Barry  , Gamier Jean
Published: February 2025

We can surely lean well towards the optimistic in envisioning health care. In the world 10-25 years ahead of us. This optimism is based on rapid developments in genomics, the essential basis of molecular medicine, and on advances in computer power. At the time of writing this paper, the Human Genome Project was planned to have a working draft by 2000 and indeed completion was announced on June 26th from Washington. This paper describes the situation and vision at that time. Though there has been much subsequent more thought about the influence of genomics on healthcare, the aspirations and visions have not fundamentally changed from those of 2000, except for the greater attention to practical details that comes from increased confidence in the practicality of the vision.
Future of Technology to Augment Patient Support in Hospitals
Authors: Bers Marina U.  , Gonzalez-Heydrich Joseph  , Demaso David Ray
Published: February 2025

This chapter explores the potential of using computer technology to support and augment psychotherapeutic interventions in hospitals, communities and homes. We describe two applications piloted at Children's Hospital Boston. The first pilot explored how patients with pediatric heart disease used the Storytelling Agent Generation Environment (SAGE) computer program to create interactive storytellers and share their personal stories. The second involved youngsters on hemodialysis for end stage renal disease using the Zora graphical multi-user environment to create a virtual city and form a therapeutic virtual community. In this chapter we show how computer technology can be used to help patients explore their identity, cope with their illness and provide mutual support and interaction. We also present design recommendations for future interventions of this kind.
The Future of Medical Computing
Authors: Middleton Blackford
Published: February 2025

The practice of medicine is inherently dependent upon health technology. Clinicians use a wide variety of technologies in diagnosing, treating, and assessing the care of their patients [1]. In this book, The Future of Health Technology, many different aspects of health technology are discussed in detail. Considering this breadth of coverage, it is challenging to ascertain what remains to be discussed in this chapter on “the future of medical computing”. Given this considerable coverage, this chapter will open with a brief vision of the future of medical computing from three perspectives — the Patient, the Ambulatory Provider, and the Hospitalist. Discussion follows on the current and future driving forces for change in healthcare technology, and an overview of the unresolved issues that must be addressed. Necessarily, this chapter will not provide more than an overview of these topics and issues. Rather, it is the author’s intent to present several visions of the future of medical computing and outline the issues, which must be overcome to achieve the vision.
A Meshless Numerical Technique for Physically Based Real Time Medical Simulations
Authors: De S.  , Kim J.  , Srinivasan M.A.
Published: February 2025

This work introduces, for the first time, a meshless modeling technique, the method of finite spheres, for physically based, real time rendering of soft tissues in medical simulations. The technique is conceptually similar to the traditional finite element techniques. However, while the finite element techniques requires a slow mesh generation process, this new technique has significant potential for multimodal medical simulations of the future since it does not use a mesh. Several examples are presented showing the effectiveness of the scheme.
A Virtual Reality Surgical Trainer for Navigation in Laparoscopic Surgery
Authors: Haluck Randy S.  , Webster Roger W.  , Snyder Alan J.  , Melkonian Michael G.  , Mohler Betty J.  , Dise Mike L.  , Lefever Andrew
Published: February 2025

A virtual reality trainer was designed to familiarize students and surgeons with surgical navigation using an angled laparoscopic lens and camera system. Previous laparoscopic trainers have been devoted to task or procedure training. Our system is exclusively devoted to laparoscope manipulation and navigation. Laparoscopic experts scored better than novices in this system suggesting construct validity. The trainer received favorable subjective ratings. This simulator may provide for improved navigation in the operating room and become a useful tool for residents and practicing surgeons.
Web-based Surgical Educational Tools
Authors: John Nigel W.  , Riding Mark  , Phillips Nicholas I.  , Mackay Sean  , Steineke Leif  , Fontaine Bernard  , Reitmayr Gerhard  , Valenčič Vojko  , Zimic Nikolaj  , Emmen Ad  , Manolakaki Elena  , Theodoros Diamantis
Published: February 2025

This paper describes work being undertaken as part of the WebSET (Web- based Standard Educational Tools) project. The project is producing a standardised suite of interactive three-dimensional educational tools, delivered across the WWW. The major focus will be the use of open technology and standards, and the production of learning components that can be used as building blocks for further development in a wide range of application areas. Two learning disciplines have been selected for the development of the WebSET tools: surgical training, and physiological education. A high quality consortium from across Europe has been assembled with complementary skills in the technologies needed by the project. The project is partly funded by the European Commission.
An endoscopic navigation system
Authors: Kübler Carsten  , Raczkowsky Jörg  , Wörn Heinz
Published: February 2025

Endoscopy is an important procedure for the diagnostic and therapy of various pathologies. We develop extensive and automated systems for this field. Due to application of these new systems, a patient is subject to considerably less strains, as opposed to prevailing commercial systems. The capability of such instruments, unlike the presently used systems, to independently follow anatomical peculiarities of the body means also a reduced risk of complications for a patient. A further advantage is that difficult to access regions deep inside the body, like the small intestine or peripheraLsparts of the bronchial tubes, can thus be reached. We use a complex navigation system for our new endoscopic system.
An Enabling System for Echocardiography Providing Adaptive Support Through Behavioral Analysis
Authors: Trochim Sabine  , Weidenbach Michael  , Pieper Stefan  , Wick Christoph  , Berlage Thomas
Published: February 2025

Echocardiography requires the integrated application of a broad spectrum of cognitive and practical skills, e.g. diagnostic knowledge (symbolic), image interpretation (visual perception) and handling of the ultrasound probe (sensorimotor). This complex expertise is acquired through extensive practical training guided by a skilled cardiologist that is often incompatible with clinical reality.
Immersive Virtual Reality Used as a Platform for Perioperative Training for Surgical Residents
Authors: Witzke Donald B.  , Hoskins James D.  , Mastrangelo Jr. Michael J.  , Witzke Wayne O.  , Chu Uyen B.  , Pande Shirish  , Park Adrian E.
Published: February 2025

Perioperative preparations such as operating room setup, patient and equipment positioning, and operating port placement are essential to operative success in minimally invasive surgery. We developed an immersive virtual reality-based training system (REMIS) to provide residents (and other health professionals) with training and evaluation in these perioperative skills. Our program uses the qualities of immersive VR that are available today for inclusion in an ongoing training curriculum for surgical residents. The current application consists of a primary platform for patient positioning for a laparoscopic cholecystectomy. Having completed this module we can create many different simulated problems for other procedures. As a part of the simulation, we have devised a computer-driven real- time data collection system to help us in evaluating trainees and providing feedback during the simulation. The REMIS program trains and evaluates surgical residents and obviates the need to use expensive operating room and surgeon time. It also allows residents to train based on their schedule and does not put patients at increased risk. The method is standardized, allows for repetition if needed, evaluates individual performance, provides the possible complications of incorrect choices, provides training in 3-D environment, and has the capability of being used for various scenarios and professions.
Measuring In Vivo Animal Soft Tissue Properties for Haptic Modeling in Surgical Simulation
Authors: Brouwer Iman  , Ustin Jeffrey  , Bentley Loren  , Sherman Alana  , Dhruv Neel  , Tendick Frank
Published: February 2025

To provide data for the design of virtual environments and teleoperated systems for surgery, it is necessary to measure tissue properties under both in vivo and ex vivo conditions. The former provides information about tissue behavior in its physiological state, while the latter can provide better control over experimental conditions. We have developed devices to measure tissue properties under extension and indentation, as well as to record instrument-tissue interaction forces. We are creating a web database of data recorded from porcine abdominal tissues.
A Virtual Environment for Simulated Rat Dissection
Authors: Bruyns Cynthia  , Montgomery Kevin  , Wildermuth Simon
Published: February 2025

Animal dissection for the scientific examination of organ subsystems is a delicate procedure. Performing this procedure under the complex environment of microgravity presents additional challenges because of the limited training opportunities available that can recreate the altered gravity environment. Traditional crew training often occurs several months in advance of experimentation, provides limited realism, and involves complicated logistics. We have developed an interactive virtual environment that can simulate several common tasks performed during animal dissection. In this paper, we describe the imaging modality used to reconstruct the rat in virtual space, provide an overview of the simulation environment and briefly discuss some of the techniques used to manipulate the virtual rat.
Ontological and Epistemological Views of ‘Headings’ in Clinical Records
Authors: Kay Stephen
Published: February 2025

This paper presents a theoretical framework for analyzing the structure and use of headings in clinical narrative. We are researching the proposed UK national standard of headings for communicating clinical information. We investigate three topics with respect to these headings: 1) conformance to standards and systems, 2) coverage and reliability, 3) navigation and interpretation. The method described here is used to analyse the three distinct topics in a coherent and systematic way deploying a variant of functional analysis to consider the meaningfulness and interpretation of headings from both the clinician’ and system ‘ perspectives.
An Adaptive Medical E-Learning Environment: The MEDIDACTE Project
Authors: Soula Gerard  , Pagesy Rolly  , Giorgi Roch  , Fieschi Dominique  , Gouvernet Joanny  , Daniel Laurent  , Fieschi Marius
Published: February 2025

Most e-learning systems offer the same tools and resource materials to students who are different in terms of motivations, training backgrounds, technical skills and learning objectives. Adaptive systems development is a challenge intended to improve the efficiency of these systems. This communication presents the design and implementation of an adaptive medical e-learning environment. The authors describe the MEDIDACTE architecture developed in three levels namely, the educational resource, educational project and user level. Current MEDIDACTE implementation and integration in Marseille Medical University curriculum are presented.
Comparison between the Effects of Traditional and Distance Learning Nursing Informatics Courses
Authors: Yamanouchi Kazushi  , Muranaka Yoko  , Egawa Koji  , Kaizu Toru
Published: February 2025

The effects of distance learning tools on our nursing informatics program were investigated. Some problems were observed. However, the use of Internet services not only did not hinder the students from learning our program but also provided more personal support, and most of the students showed a satisfactory level of answer in their reports.