bluuebunny/crossref_metadata_2025 huggingface dataset:
Medico-economical use of the medical record or the bridge between minimal and detailed data
Authors: Borst F.  , Lovis Ch.  , Thurler G.  , Maricot P.  , Scherrer J.-R.
Published: February 2025

Medico-economical use of the medical record: the title encloses two different notions which represent two different trends within medical informatics. The first trend is worried about weighting aspects of health resources consumption, mainly about hospital acute care; their key-words are “DRG (Diagnostic Related Groups), Case-Mix, reimbursement by pathology, measurement of indicators (severity or outcome), costs”. The other trend is looking for deeper understanding of the medical process and for better diffusion of relevant information helping the day-to-day care process; they speak of “CPR (Computerized patient record), full text reports and corresponding retrieval, detailed data, medical records on Internet, large access to literature and databases”. It is mandatory to realize a bridge between these two trends for facing the information technology revolution entering into a self-revolutioning medicine. The purpose of this paper is to begin this bridge by showing what the DRG people expect from the CPR people and what the latter should receive from the former.
Artificial Intelligence Elements in Multimedia System for Surgery
Authors: Kącki Edward  , Stempczyńska Joanna
Published: February 2025

The paper presents a concept of a computer system designed to assist a surgeon’s work both before and during a surgical operation. The aim of multimedia in the system is to ensure comfort in communication between an operating surgeon and his assistants. The elements of artificial intelligence, on the other hand, are to assist the surgeon in taking optimal decisions in difficult and untypical situations.
Knowledge-Based In Vivo Analysis of Kidney Concretions from Digitized X-Rays
Authors: Petrov M.  , Dimitrov I.  , Baltadjiev D.
Published: February 2025

To make a right choice of a treatment approach in patients with nephrolithiasis it is very important for the clinicians to know the composition and structure of calculus. Conventional radiographic techniques and computerized tomography (CT) give information about the location and size of concretions, but not for their composition and structure. In the present study we investigated the gray-level values of chemical substances in concretions. It was established the appropriate X-ray exposure for subsequent image analysis. A method for intracorporal analysis of composition and structure of kidney concretions is proposed.
Use of Statistical Classifiers as Support Tools for the Diagnosis of Iron-Deficiency Anemia in Patients on Chronic Hemodialysis
Authors: Baiardi P.  , Piazza V.  , Montagna G.  , Mazzoleni M.C.
Published: February 2025

Discriminant analysis, logistic regression and neural network models were applied to the diagnosis of iron-deficiency anemia in hemodialyzed patients. The ability of the three quantitative approaches to distinguish between subjects suffering or not from iron-deficiency anemia was compared by re-substitution and cross-validation testing. Methods performance was evaluated by means of sensitivity, specificity and accuracy. All the methods performed globally well (sensitivity and specificity>0.85), revealing that the problem is classifiable. Neural networks showed the highest accuracy, both in the re-substitution (models developed and tested on the complete data set) and 3-way cross-validation (data set randomly splitted into 3 developmental and validation data sets) testing. These preliminary results suggest that the correct classification of iron status in the hemodialytic population can be treated as a pattern classification problem, for which neural networks and traditional statistical modelling can be a valuable aid to the clinical diagnosis of iron-deficiency anemia. A better performance of the neural network model must be confirmed through prospective testing on a larger data set.
Preparing the Next Generation of Clinicians to Manage Information
Authors: Murphy Jeannette  , Errington Rowena  , Achara Shirley  , Simone Richard  , Olaiwon Musa
Published: February 2025

Curriculum development in informatics must be underpinned by knowledge of the information environment new recruits encounter after qualification. A pilot study was carried out to identify the type of information handling tasks newly qualified healthcare professionals are expected to undertake. This data was related to the skills junior staff possess at the point of entry to hospital posts. Data was collected on the opportunities these recently qualified individuals had to acquire IT skills and generic competence in information handling in their prequalification courses. Self-report data was supplemented by direct observation of junior staff on the wards. In addition to investigating the perspective of the junior staff, the study also explored the attitudes and expectations of senior clinicians, educationalists and NHS trust staff. The purpose of the study was to provide guidance to those involved in developing informatics curricula for clinical students at the prequalification stage. This paper reports some of our preliminary findings.
A distributed support system for medical and nursing students
Authors: Crudele Michele  , Serio Angelo
Published: February 2025

The Internet provides resources for physicians, but there isn't yet a comprehensive support system for medical and nursing students. Moreover the knowledge of English language is often scarce in young Italian students, so most of the available resources are not really useful. This project aims at the establishment of a distributed framework of interactive courses and mentoring facilities among a group of Italian Medical and Nursing Schools.
An Example of Usability Measurement in Clinical Software Procedures
Authors: Terazzi Adriana  , Giordano Andrea  , Minuco Giuseppe
Published: February 2025

As a consequence of the dramatic improvements achieved in information technology standards in terms of single hardware and software components, efforts in the evaluation processes have been focused on the assessment of critical human factors, such as work-flow organisation, manmachine interaction and, in general, quality of use, or usability.
Coherent Exchange of Healthcare Knowledge in Open Systems
Authors: Buchan Iain  , Hanka Rudolf
Published: February 2025

This paper outlines design philosophies and methods for healthcare knowledge systems. Clinical priorities for knowledge are discussed in terms of temporal and individual needs. Book centred organisation of healthcare knowledge, which has proven effective in clinical practice, is proposed as the basis of virtual libraries available at the point of care for target groups of healthcare professionals
Patient Care Evaluation Studies: Applying this concept of quality management in oncology
Authors: Hölzer S.  , Dudeck J.
Published: February 2025

Patient Care Evaluation Studies are valid tools of quality management in oncology. With the use of modern methods of medical informatics, epidemiology and biometrics, the acceptance of tumor documentation in the clinical routine will be improved. We will describe the ideas behind the concept of the PCE studies.
From Electronic Medical Record to Personal Health Record
Authors: Iakovidis Ilias
Published: February 2025

In this paper we attempt to provide a definition and purpose for the electronic patient record, point out the benefits of its use and outline the major challenges in wider implementation that are encountered world-wide. Finally, some trends are highlighted that are believed to play an important role in the future development and use of the electronic patient record.
Virtual Reality for Health Care: a survey
Authors: Moline Judi
Published: February 2025

This report surveys the state of the art in applications of virtual environments and related technologies for health care. Applications of these technologies are being developed for health care in the following areas: surgical procedures (remote surgery or telepresence, augmented or enhanced surgery, and planning and simulation of procedures before surgery); medical therapy; preventive medicine and patient education; medical education and training; visualization of massive medical databases; skill enhancement and rehabilitation; and architectural design for health-care facilities. To date, such applications have improved the quality of health care, and in the future they will result in substantial cost savings. Tools that respond to the needs of present virtual environment systems are being refined or developed. However, additional large-scale research is necessary in the following areas: user studies, use of robots for telepresence procedures, enhanced system reality, and improved system functionality.
Experiences with DCE: The pro7 Communication Server Based on OSF-DCE Functionality
Authors: Schulte Michael  , Lordieck Wolfgang
Published: February 2025

The pro7-communication server is a new approach to manage communication between different applications on different hardware platforms in a hospital environment. The most important features are the use of OSF/DCE for realising remote procedure calls between different platforms, the use of an SQL-92 compatible relational database and the design of a new software development tool (called protocol definition language compiler) for describing the interface of a new application, which is to integrate in a hospital environment.
Save Medical Personnel's Time by Improved User Interfaces
Authors: Kindler Hauke
Published: February 2025

Common objectives in the industrial countries are the improvement of quality of care, clinical effectiveness, and cost control. Cost control, in particular, has been addressed through the introduction of case mix systems for reimbursement by social-security institutions.
The Information Age: The Status of Technology in Nursing Education Programs in the United States
Authors: Carty B.  , Rosenfeld P.
Published: February 2025

The purpose of this research was to determine the status of technology in nursing education in the United States. The research design was a comparative descriptive survey of a stratified random sample of National League for Nursing accredited diploma, associate, baccalaureate and master programs. The instrument for data collection was developed by a panel of six experts in the area of educational technology. The survey, mailed to 347 randomly selected schools, identified four primary areas of investigation: 1) technology inventory, 2) technology applications and content, including education and clinical areas, 3) implementation plan, and 4) decision making including funding and staffing resources. Findings indicated there was a significant difference in available electronic resources among baccalaureate, associate and diploma programs. A majority of schools utilize computer applications to enhance teaching, but a very small percentage of schools addressed informatics in the curriculum. The project was funded by a grant from the Helene Fuld Health Trust Fund.
‘Shared Care’ and Computer Assistance in Glaucoma Management
Authors: Martin L.
Published: February 2025

Primary open angle glaucoma afflicts 1-2% of people over 50 years of age. The diagnosis relies on a number of examinations, many of them performed by ophthalmic nurses, and the care of glaucoma patients has become one of their main tasks. A knowledge-based system for decision support in glaucoma management has been developed and validated.
Monitoring and Evaluating Benefits of an Automated Patient Care
Authors: Welychka P.
Published: February 2025

“Information Management”, is key to the successful reengineering of our health care delivery system. There is a need to change the hospital system, in order to contain costs and find ways to constantly evaluate and improve the services that we provide to our customers. Information systems that support complete, integrated multidisciplinary care management, seem to be the tool that will support decision making in regards to future changes needed in the health care industry. The task of justifying information systems and information technology expenditures is an extremely complex process. At the Welland Hospital, we embarked on a formal benefits realization process with the assistance of an independent consultant company prior to the purchase and acquisition of CareVISION, an integrated electronic patient care record.
Conquering Technophobia: Preparing Faculty for Today
Authors: Richard P.L.
Published: February 2025

The constantly changing world of technology creates excitement and an obligation for faculty of schools of nursing to address computer literacy in the curricula at all levels. The initial step in the process of meeting the goals was to assist the faculty in becoming computer literate so that they could foster and encourage the same in the students. The implementation of The Cure for Technophobia included basic and advanced computer skills designed to assist the faculty in becoming comfortable and competent computer users. The applications addressed included: introduction to windows, electronic mail, word processing, presentation and database applications, library on-line searches of literature databases, introduction to internet browsers and a computerized testing program. Efforts were made to overcome barriers to computer literacy and promote the learning process. Familiar, competent, computer literate individuals were used to conduct the classes to accomplish this goal.
Development of a Computerized Database for a Nursing Quality Management Program
Authors: Welton J.M.
Published: February 2025

There has been little study on how nurse managers collect, store, process and retrieve quality management data, yet nearly every nursing department has an existing program to provide these functions. We investigated our current paper-based system and found several deficiencies. Guided by structured interviews, task analysis, and focus groups we developed a networked computerized quality management database to provide more timely data reporting and consistency of analysis. This paper describes the development and implementation of the system with discussion on how it will be evaluated in the future.
The (Dutch) patient views on confidentiality and security
Authors: Beun J.G.
Published: February 2025

This paper deals with the way patients view and experience the security and reliability of chipcards. After an introduction of the way patients are organised in The Netherlands, the lessons from past experiments are discussed. The importance of guarantees for complete and permanent protection of the privacy is stated.
The Prospects of Health Cards in Asia
Authors: Takahashi T.
Published: February 2025

Card Systems have been in use world-wide as well as in most of the Asian countries for more than 30 years. In Asia these systems have been used with great success in different fields such as transportation, posts, telecommunications, banking, and education. Recently, card systems have also started to play an important role in health care.
The New Health Insurance Card System in Slovenia
Authors: Sušelj M.  , Debold P.
Published: February 2025

In recent years Slovenia has intensively modernised the information technology support of the national health care services. The standardised and well kept data bases, the presence of IT equipment in all doctor's practices and the familiarity of health care professionals with computerised operations represent a sound base for the next step - introduction of a health insurance card system. This system will upgrade the virtual network among the actors in the health care arena: patients, health care service providers, insurance providers, payers of insurance contributions, etc. This paper outlines the system and its salient social, organisational, economic and technical aspects
Security Functions of a Health Professional Card (HPC)
Authors: Struif B.
Published: February 2025

In the TrustHealth project, sponsored by the European Commission (first project phase is finished, second will start soon), the main goals are
Interactive services with chipcards in the health care sector
Authors: Frankhuizen J.
Published: February 2025

A whole new telecommunications environment is now developing, based on such concepts as ISDN, Internet, Intranet and smart card technology. The developments that are taking place are of interest to the health care sector because they enable introduction of interactive services that will raise efficiency and quality.
Planning and Simulation of Medical Robot Tasks
Authors: Raczkowsky Jörg  , Bohner Petra  , Burghart Catherina  , Grabowski Hartwig
Published: February 2025

Complex techniques for planning and performing surgery revolutionize medical interventions. In former times preoperative planning of interventions usually took place in the surgeons mind. Today's new computer techniques allow the surgeon to discuss various operation methods for a patient and to visualize them three-dimensionally. The use of computer assisted surgical planning helps to get better results of a treatment and supports the surgeon before and during the surgical intervention. In this paper we are presenting our planning and simulation system for operations in maxillo-facial surgery. All phases of a surgical intervention are supported. Chapter 1 gives a description of the medical motivation for our planning system and its environment. In Chapter 2 the basic components are presented. The planning system is depicted in Chapter 3 and a simulation of a robot assisted surgery can be found in Chapter 4. Chapter 5 concludes the paper and gives a survey about our future work.
MOTION FEEDBACK AS A NAVIGATION AID IN ROBOT ASSISTED NEUROSURGERY
Authors: Wapler Matthias  , Stallkamp Jan  , Weisener Thomas  , Urban Volker
Published: February 2025

This paper describes a test prototype for precision robot-assisted surgery using a hexapod operating robot and a movable operating cockpit. The objective of the work described is twofold: 1) To evaluate the use of hexapod robots for precisely manipulating endoscopes and surgical instruments in sub-millimeter surgery. 2) To test a new user interface concept based on motion feedback. This paper gives an overview of the system components and the user interface concept, and reports results from initial tests. Finally, the paper investigates potential applications and areas for further development.
3D-Brain 2.0 - Narrowing the gap between personal computers and high end workstations
Authors: Kling-Petersen Torben  , Pascher Ragnar  , Rydmark Martin
Published: February 2025

Recent advances in personal computer hardware and software have pushed the graphic capacity of these easier to use and, more importantly, cheaper computers to a level approximating the current standard of high end workstations. The interactivity and graphic complexity of a modern PC is rapidly approaching the current standard on Silicon Graphics (although with respect to texture mapping, the SGI is still ahead of the PCs). The modern medical student laboring under increasingly higher demands with respect to versatility, not only in basic science and traditional medical knowledge, is also faced with the requirement to learn and understand modern scientific visualization and analytical instruments. Furthermore, basic knowledge of information technowlogy and computer literacy is expected of the next generation medical professionals. These demands forces medical schools to increasingly invest in computers and information technology for educational purposes. Due to common class sizes, these computers are most commonly Windows PCs or Apple Macintoshes. For distance education, telematics or studies at home, personal computer versions of the workstation graphics are a necessity.
3D Visual Presentation of Shoulder Joint Motion
Authors: Totterman Saara  , Tamez-Pena Jose  , Kwok Edmund  , Strang John  , Smith Jason  , Rubens Deborah  , Parker Kevin
Published: February 2025

The 3D visual presentation of biodynamic events of human joints is a challenging task. Although the 3D reconstruction of high contrast structures from CT data has been widely explored, then there is much less experience in reconstructing the small low contrast soft tissue structures from inhomogeneous and sometimes noisy MR data. Further, there are no algorithms for tracking the motion of moving anatomic structures through MR data. We represent a comprehensive approach to 3D musculoskeletal imagery that addresses these challenges. Specific imaging protocols, segmentation algorithms and rendering techniques are developed and applied to render complex 3D musculoskeletal systems for their 4D visual presentation. Applications of our approach include analysis of rotational motion of the shoulder, the knee flexion, and other colplex musculoskeletal motions, and the development of interative virtual human joints.
Force Interactions in Laparoscopic Simulations: Haptic Rendering of Soft Tissues
Authors: Basdogan Cagatay  , Ho Chih-Hao  , Srinivasan Mandayam A.  , Small Stephen D.  , Dawson Steven L.
Published: February 2025

Research in the area of computer assisted surgery and surgical simulation has mainly focused on developing 3D geometrical models of the human body from 2D medical images, visualization of internal structures for educational and preoperative surgical planning purposes, and graphical display of soft tissue behavior in real time. Conveying to the surgeon the touch and force sensations with the use of haptic interfaces has not been investigated in detail. We have developed a set of haptic rendering algorithms for simulating “surgical instrument - soft tissue” interactions. Although the focus of the study is the development of algorithms for simulation of laparoscopic procedures, the developed techniques are also useful in simulating other medical procedures involving touch and feel of soft tissues. The proposed forcereflecting soft tissue models are in various fidelities and have been developed to simulate the behavior of elastically deformable objects in virtual environments. The developed algorithms deal directly with geometry of anatomical organs, surface and compliance characteristics of tissues, and the estimation of appropriate reaction forces to convey to the user a feeling of touch and force sensations.
An Immersive Environment for the Direct Visualization and Segmentation of Volumetric Data Sets
Authors: Senger Steven
Published: February 2025

This paper describes a software environment for visualizing and segmenting volumetric data sets such as CT, MRI and the Visible Human data set. The goal is to produce an intuitive environment where the expert knowledge of the end user can be employed to directly guide visualization and segmentation of the data. The environment is built around the Fakespace Immersive Workbench (TM), which provides the user with the illusion that the data set volume resides in the space directly above the workbench surface. Using a position/orientation-tracked probe the user is able to interact with the visualization algorithm and segment the data set to expose features of interest. Segmentation can be performed in either the ray space of the volume rendering algorithm or the coordinate space of the data volume itself. The segmentation results can be saved and used for other purposes including the construction of polygonal models.
Telepresence Interface with Applications to Microsurgery and Surgical Simulation
Authors: Hill John W.  , Holst Peter A.  , Jensen Joel F.  , Goldman Jonathan  , Ploeger Dale W.
Published: February 2025

To address the needs for performing microsurgical procedures, the SRI telepresence surgery workstation has been combined with a pair of micromanipulator arms. The prototype microsurgery system has been tested with ex-vivo tasks similar to those required for surgical procedures, such as cutting, grasping, suturing, and knot tying. Initial animal testing has been done on a rat model in which end-to-end anastomosis of the femoral artery (approximately 1 millimeter in diameter) was completed with ten rats, and 100% patency was obtained.
Application of a 3D Display System for Biplane Cerebral Angiography
Authors: Ooe Yosuke  , Ishihara Ken  , Otsuka Hiroki  , Yamada Kenji  , Inoue Michitoshi
Published: February 2025

To improve the total safety for the biplane cerebral angiographic examination, we have developed a new three dimensional (3D) display system. By applying this system, shortening the examination time and reducing the risk of infection and embolization were achieved.
A Global Intranet for an International Scientific Society
Authors: Kleinoeder Thomas  , Rienhoff Otto
Published: February 2025

The International Medical Informatics Association (IMIA) has built up a world-wide infrastructure which is using the Internet as a backbone for a global Intranet. The work has been supported by cost analysis and user acceptance monitoring. As one of the first international scientific societies, IMIA is offering professional electronic communication services to its members. This step has been taken to advance international cooperation and to support the dissemination and exchange of information on the Health Informatics Sector.
Intelligent Agent for Collaborative Diagnosis
Authors: Mulvihill Conn  , Patel Ahmed  , O'Meara Tadhg
Published: February 2025

An agent-based approach to facilitating cooperative medical diagnosis is presented in this paper. Background work in computer supported cooperative work and medical informatics is first discussed. Relevant theory for interaction management is then considered. An agent-based interaction is then shown via a case study to facilitate cooperative diagnosis. This is achieved through monitoring patient record construction and by highlighting relevant diagnostic information.
A Study on Development of a Home Health Care Support Information System
Authors: Inada Hiroshi  , Horio Hiroyuki  , Nakazawa Kazuo  , Ishikawa Kiyomu  , Tashiro Yuhki  , Matsumura Kenji  , Aso Shigeru  , Hosaka Hidehiro
Published: February 2025

As the need for home health care has been increasing with the rising number of the elderly in Japan, the application of medical informatics to home health care delivery is considered to be useful. Therefore, development of a home health care support information system was planned. The system can collect patient's PHD (Personal Health Data) such as data of ECG, complaints, etc. at patient’s home and can send the PHD to medical facilities. We designed and constructed two subsystems on a trial basis. One subsystem has function of gathering, recording and transmitting vital signs of the aged such as ECG, physical activity rate, oxygen saturation rate in arterial blood. Another subsystem can collect and send image data of the old people at their home. Experiments for trial use of the system was conducted and it was recognized that the PHD can be smoothly collected and recorded at home of the elderly and can be sent to the medical facilities with good success by using the system.
A Integrative Molecular Information System
Authors: Hofestädt Ralf
Published: February 2025

Methods of biotechnology allow the isolation, sequencing, and synthesis of molecular structures. Molecular database systems are available, which allow the worldwide data access. Methods and concepts of bioinformatics are important for the analysis of these molecular data, which represent complex regulatory networks. In this paper we present the architecture of our molecular information system.
Preparing for the Third Millennium: the Views of Life Informatics
Authors: Li Zong-Rong  , Tian Ai-Jing  , Yang Yan-Yan
Published: February 2025

The chief aspects of this paper are the condition of the birth of life informatics and its tasks, basic concepts, principles, and structure. There are three phases of combining informatics with medicine: product, technological, and theoretic application of which the goals are respectively the informatization of numerical and word processing, data of medical treatment, and the knowledge of medicine. While reached the third phase we have dealt with two types of biological information, physical and nonphysical, i.e., body information (i.e., the information about body's components and structure), and life information (i.e., the information about life codes-and life programs). Life informatics is a main branch of bioinformatics. It is a new member of the medical informatics family, and as such is younger than health informatics, nursing informatics, and dental informatics. It’s task is to assist biologists and medical doctors to recognize and interfere the human life information procedure just as they are doing well with human body's matter and energy system. Its basic concepts are life information, life information medicine, and life information therapy. Its most important principles are information materialism, general informatics, and information determinism. Its main branches are biomolecule, cellular, organic, individual, and social informatics. In the third millennium, the life informatics will be a leading discipline in biology, medicine and informatics, which will gradually influence modern philosophy and other humanities.
ATRAS: A Decision Support Application Layered on the W3-EMRS Architecture
Authors: Nigrin Daniel J.
Published: February 2025

The creation of portable decision support systems (DSSs) remains an important goal in medical informatics. The Adrenal Test Retrieval and Analysis System (ATRAS) has been developed as an example of a simple yet highly effective decision support application which runs in a system-independent way. It is the first implementation of a decision support application layered on the World Wide Web Electronic Medical Record System (W3-EMRS) architecture, which allows for unified access to remote heterogeneous electronic medical record system (EMRS) databases.
Development of Medical Decision Support System for Leukemia Management
Authors: Chae Young Moon  , Park Kwang Su  , Park Quehn  , Bae Mi Young
Published: February 2025

A leukemia management system was developed in this study which is comprised of four modules: registry, diagnosis, prognosis of treatment, and CAI. The emphasis was on patient management as a whole. Three knowledge models were developed to predict accurate diagnosis and prognosis of treatment: casebased reasoning, neural network, and discriminant analysis, Of these, discriminant analysis model produced the most accurate diagnosis, whereas neural network produced the most accurate prognosis of treatment.
Case Based Diagnosis in Histopathology of Breast Tumours
Authors: Jaulent Marie-Christine  , Le Bozec Christel  , Zapletal Eric  , Degoulet Patrice
Published: February 2025

Relevant knowledge and decision making process in histopathology is mostly included in typical pathological cases encountered by the expert. In this article we address the issue of exploiting this knowledge in the diagnosis process. We present the first steps of a Case-Based-Reasoning (CBR) system that uses the previously resolved pathological cases in order to facilitate decision making and diagnosis formulation of a new case. The work has been performed in two phases. Firstly, an object-oriented model of the domain was developed and 35 pathological cases of breast tumours were represented within this model. Secondly, the functional architecture of the CBR system was designed and the main procedure, the selection of similar cases, was achieved. The selection procedure is based on an original similarity measure that takes into account both semantic and structural resemblances and differences between the cases. A first evaluation of the system was performed on several cases of the data base. The interest of the CBR approach in situations where heuristic rules cannot be clearly defined is discussed.
A Comparative Study of Computerised Medical Records Usage Among General Practitioners in Australia and Sweden
Authors: Bomba David
Published: February 2025

This article is based on a major empirical study of the state of adoption of Computerised Medical Records (CMRs) among General Practitioners (GPs) in Australia and Sweden. Responses were gained from a mail out questionnaire to random samples of GPs in both countries (n=600/country). This paper will report on the main findings gained emphasising some of the various similarities and differences between the two sample groups. This comparative study adds to the existing body of CMR literature by way of providing a cross cultural perspective on GP adoption states. As a result, some concluding comments are offered for understanding high and low diffusion rates of CMRs among GPs and the implications for health policy and technology adoption strategies.
Problem Oriented Project Work in a Distance Education Program in Health Informatics
Authors: Bygholm Ann  , Hejlesen Ole  , Nøhr Christian
Published: February 2025

At Aalborg University, an important part ofthe distance education program within Health Informatics is problem oriented project work. Traditionally, distance education has been characterized by one-way communication and self study whereas the problem oriented project study form is based on cooperation and dialogue. In this paper, we describe the way in which we have implemented the problem oriented study form in a program within Health Informatics which is based on distance learning. First, we describe the program with regard to student, structure, aim, and activities. Second, we introduce the problem oriented project study form and present the basic principles behind this approach. Third, we explain important concepts and distinctions within the area of distance education. Finally, we describe the way in which we try to put the ideals of the problem oriented project work into practice. The use of a computer conferencing system is essential but in our experience, it is not in itself sufficient to provide the necessary support for the student project work.
Innovative Informatics Education: Aligning Theory and Practice Through Strategic Partnership
Authors: Miller Karalee  , Pretti Denis  , Wright Irene  , Guerriere Michael
Published: February 2025

The University of Victoria School of Health Information Science (HINF) and The Toronto Hospital (ITH) have formed a strategic partnership to align current information management theory with practical experience. The fourth year undergraduate course in Information Management and Technology was redesigned to include a joint research project with TTH. Staff from TTH were paired with groups of 2-3 students to explore current information management issues. Technology such as electronic mail and conference calls enabled timely communication. Final results were presented via video conference at the end of the term and jointly graded by the professor and hospital staff. Over the three years, a variety of projects have been undertaken and the approach has been refined Each year offered new insight to both students and staff. Findings include several key success factors: senior level support, early planning, timely communication, access to technology, and opportunity for staff and student feedback. This partnership offers strategic advantages to both organizations in innovation, mutual learning, recruiting, and partnership. Next steps include expansion of the project to a regional model and seminars on current information management topics for TTH staff.
Computer-Adjusted Dosage of Anticoagulant Therapy Improves the Quality of Anticoagulation
Authors: Chatellier Gilles  , Colombet Isabelle  , Degoulet Patrice
Published: February 2025

Objective: Risks and benefits of anticoagulant therapy depend directly of the quality of anticoagulation. We performed a meta-analysis of published randomized trials to assess the overall effectiveness of computer-based prescription systems on the quality of anticoagulation.
Professional and Organizational Impact of Using Patient Care Information Systems
Authors: Hebert Marilynne
Published: February 2025

Evaluation of information systems has often been limited to success factors in relation to system implementation (on time and on budget), training and use of the system. Little attention has been paid to the longer-term effect of using these systems and the resulting issues for health care professionals and organizations. This paper reports on a multiple case study of community hospitals, which examined the impact of using Patient Care Information Systems. An analytic framework incorporated Donabedian's 3 aspects of quality care: structure, process and outcome. These were examined at three levels of impact: direct substitution, proceduralization and new capabilities. Many of the anticipated benefits in the study did not occur because changes occurring in structure (generally tasks done by pharmacists and laboratory technologists) did not automatically influence process changes (such as decision making of physicians and nurses) or patient outcomes. Four themes illustrate important professional and organizational issues with implications for worklife of professionals, management and career training. They include the effects of increased efficiency and productivity; “visible” accountability; changing roles and responsibilities; and learning to use new technology versus using new information.
On Stepwise Integrating an Electronic Patient Record based on Digital-optical Archiving and Multi-purpose Health Professional Workstations: Experiences at the Heidelberg University Hospital
Authors: Reinhard Oliver  , Ohr Christian  , Schm¨cker Paul  , Haux Reinhold
Published: February 2025

At the Heidelberg University Hospital the conventional paperbased medical record is currently being replaced by a “unique” electronic patient record (EPR). This paper describes the stepwise integration of an EPR based on digital-optical archiving and multi-purpose health professional workstations. It focuses on the potentials of digital optical archiving as an integral part of hospital information systems. So far, the EPR has been introduced in the central archive of the “head clinic”, the Neurosurgical Clinic and the inpatient archive, the endoscopy and sonography section of the Department of Internal Medicine.
Information System for a Periodic Examination and Health Promotion Center
Authors: Cho Belong  , Yoo Taiwoo  , Huh Bong Yul  , Cho Sungja  , Jeon Hyoyee
Published: February 2025

The periodic examination and health promotion center (PEHPC) in Seoul National University Hospital has developed and adopted an information system supported by computers which use an electronic medical record to improve the quality of patient care, advance the science of medicine, lower health care costs, and enhance the education of health care professionals. This information system adopted the concept of incomplete and evolutionary systems to conduct the pursuit of practicalness and efficacy. It has increased efficiency to save costs and to enhance the quality of the medical service. It has also activated clinical research due to ease of managing data. We are also preparing for telecare. Telecare and WWW-using information system is postponed because the protection of a patients privacy is not established.
Design and Development of a Computer-based Clinical Referral System for use within a Physician Hospital Organization
Authors: Sittig Dean F.  , Franklin Michael  , Turetsky Masha  , Sussman Andrew J.  , Bates David W.  , Komaroff Anthony L.  , Teich Jonathan M.
Published: February 2025

The process of creating a clinical referral for a patient and the transfer of information from the primary care physician to the specialist and back again is a key component in the struggle to deliver less costly and more effective clinical care. We have created a computer-based clinical referral application which facilitates 1) identifying an appropriate specialist; 2) collecting the clinical, demographic, and financial data required to generate a referral; and 3) transferring the information between the specialist and the primary care physician. Preliminary results indicate that the new computer-based process is faster.
THE POTENTIAL RELEVANCE OF ATTACHMENT THEORY IN ASSESSING RELATEDNESS WITH VIRTUAL HUMANS
Authors: Alessi Norman E.  , Huang Milton P.
Published: February 2025

Primary efforts to create virtual humans have been in the production of computer generated ergonomically correct objects that look like humans. Although there has been concern with essential human factors, absent are the metrics of human relatedness, or the ability to assess the degree to which a virtual human elicits human emotions. We discuss the potential application of attachment theory as a context for the development of such an assessment paradigm, and specifically the application of the Ainsworth Strange Situation in the evaluation of a “Virtual Mom”. Virtual relatedness fidelity is discussed as a macrometric to define relatedness that would occur with virtual humans. Potential lessons learned are discussed as they apply to the selection of those to develop the model, and its impact on the introduction of virtual humans into clinical psychiatry and psychology.
USES OF VIRTUAL REALITY IN CLINICAL TRAINING: DEVELOPING THE SPATIAL SKILLS OF CHILDREN WITH MOBILITY IMPAIRMENTS
Authors: Stanton Danaë  , Foreman Nigel  , Wilson Paul N.
Published: February 2025

In this chapter we review some of the ways in which the skills learned in Virtual environments (VEs) transfer to real situations, and in particular how information about the spatial layouts of virtual buildings acquired from the exploration of three-dimensional computer-simulations transfers to their real equivalents. Four experiments are briefly described which examined VR use by disabled children. We conclude that spatial information of the kind required for navigation transfers effectively from virtual to real situations. Spatial skills in disabled children showed progressive improvement with repeated exploration of Virtual environments. The results are discussed in relation to the potential future benefits of VR in special needs education and training.
Effects of Nitric Oxide Synthesis Inhibition on Blood Pressure and Pulse Interval Spectral Powers
Authors: Radaelli Alberto  , Mircoli Luca  , Di Rienzo Marco  , Castiglioni Paolo  , Mori Ileana  , Mancia Giuseppe  , Ferrari Alberto U.
Published: February 2025

Nitric oxidc is continuously released in the circulation where it can quickly modify the hemodynamic conditions and therefore affect blood pressure variability. Nevertheless the effect of nitric oxide on blood pressure variability has not been completely elucidated; moreover it remains unknown whether nitric oxide acts independently, in concert or in opposition with the autonomic nervous system. In order to answer these questions we studied the effects of nitric oxide synthesis inhibition in intact, sympathectomized (Sympx) and sino-aortic denervated (SAD) conscious WKY rats. Mean arterial pressure (MAP) and pulse interval (PI) were continuously recorded for 60 minutes both in absence and in presence of an 1-arginine analogue, 1-NMMA (iv bolus 100 mg.kg-1, followed by a 1.5 mg.kg-1.min-122
Autoregressive Modeling for Assessing Closed-Loop Feedback and Feedforward in the Arterial Baroreflex
Authors: Barbieri Riccardo  , Saul J.Philip
Published: February 2025

Quantification of the arterial baroreflex has been achieved with different evaluation techniques. Some measurements usually involve pharmacological or mechanical stimulation of the baroreflex, and neglect the feedforward effect of R-R interval (RR) on arterial blood pressure (ABP). The autoregressive multivariate techniques described in this study satisfy both the requirements of a non-invasive and a closed-loop evaluation of the interactions between RR and ABP. The closed-loop analysis is also able to calculate some of the indices previously used for baroreflex quantification, allowing for a direct comparison of the different approaches. Application to recordings from both a group of healthy subjects in different physiological conditions, and from a group of subjects with mild hypertension, suggests that failure to consider the feedforward effect could lead to an overestimation of the baroreflex quantification.
ICNP and NMDS: Bridging the Gap
Authors: Sermeus W.  , Goossens L.
Published: February 2025

This paper describes what a Nursing Minimum Data Set is and the conditions which have to be fulfilled to include ICNP in a NMDS. The ICNP-data from the validation site of the University Hospital of Amsterdam are analysed with a clear focus of incorporation into a NMDS. Based on the results of this analysis, recommendations for inclusion are formulated.
Learning and Using ICNP on the web Nursing Phenomena
Authors: Nilsson Gunilla  , Rundgren Lars T
Published: February 2025

A web based environment for learning to navigate within the International Classification for Nursing Practice as well as an interactive tool for nurses in practice, research and nurse students around the world to share their experience of nursing and contributing to the continuing development of a unifying classification. For the time being the application is composed of 4 modules, and limited to Nursing Phenomena, alpha version.
Anatomic VisualizeR: Realizing the Vision of a VR-based Learning Environment
Authors: Hoffman Helene  , Murray Margaret
Published: February 2025

The University of California, San Diego's Anatomic VisualizeR© project has reached another milestone. As the period of DARPA-funded research and development comes to a close, UCSD's VR-based learning environment has matured to the point where curricular implementation is now underway. In this presentation, we will reflect on the process by which lessons in this virtual environment are realized, highlight the results of ongoing 3-D perception studies, and describe examples of how Anatomic VisualizeR© is being used in medical school anatomy and high school biology classes. To conclude, we will outline the future of this project which will include full scale curricular implementation, learning outcomes assessment, and dissemination through industrial and academic partnerships
Gaze Patterns in Laparoscopic Surgery
Authors: Ibbotson J.A.  , MacKenzie C.L.  , Cao C.G.L.  , Lomax A.J.
Published: February 2025

By understanding surgeons’ patterns of gaze, and what visual information is being obtained during a procedure, one can improve the operation via new techniques or instrumentation. Part of a larger project on Remote Manipulation in Endoscopic Surgery, we analyzed eye patterns of surgeons from videotape annotation. Three categories of eye patterns were defined: 1) eyes on (gaze on monitor); 2) eyes down (gaze on external operative space); 3) eyes off (gaze away from monitor/hands). In the context of hierarchical decomposition of procedures we compared eye patterns and sequential dependencies (gaze as a function of previous gaze) by procedure, surgical steps and tasks. Timelines showed transitions in eye patterns during the procedure. We determined what visual information is available and what visual information is needed by the surgeons. By comparing these, we suggest technology that can provide these needs.
TESTS ON RELIABILITY OF A PROSTATE BIOPSY TELEROBOTIC SYSTEM
Authors: Rovetta Alberto
Published: February 2025

This paper deals with the development of a robotic (mechanical-electronic) system that operates in the field of surgery, with new sensors and equipment (“Biopsy Program”). The system permits a rapid analysis of the mechanical needle+needle-holder+mechanism system for penetration and aspiration for surgery, for prostate biopsies. These operations benefit from the use of a SR 8438 Sankyo Scara robot; they are also remote-controlled, i.e. via telerobotics. They require accurate positioning in known points of three-dimensional space with a high degree of precision. The safety of the surgical operations is guaranteed by the most complete observance of regulations under European Union Directives and Decrees 626 and 242 of Italian laws. The system proposed represents a big step for the application of industrial solutions, precisely for industrial companies in the medical and surgical field.