Daniel L. Maloney

Integrating medical images into hospital information systems

The effective delivery of health care has become increasingly dependent on a wide range of medical data that includes a variety of images. Manual and computer-based medical records ordinarily do not contain image data, leaving the physician to deal with a fragmented patient record widely scattered throughout the hospital. The Department of Veterans Affairs is currently installing a prototype hospital information system workstation network to demonstrate the feasibility of providing image management and communications functionality as an integral part of an existing hospital information system. The core of this system is a data base management system adapted to handle images as a new data type. A general model for this network-based integration is discussed and various alternative architectures are examined.

Exchange of Veterans Affairs medical data using national and local networks.

Remote data exchange is extremely useful to a number of medical applications. It requires an infrastructure including systems, network and software tools. With such an infrastructure, existing local applications can be extended to serve national needs. There are many approaches to providing remote data exchange. Selection of an approach for an application requires balancing of various factors, including the need for rapid interactive access to data and ad hoc queries, the adequacy of access to predefined data sets, the need for an integrated view of the data, the ability to provide adequate security protection, the amount of data required, and the time frame in which data is required. The applications described here demonstrate new ways that the VA is reaping benefits from its infrastructure and its compatible integrated hospital information systems located at its facilities. The needs that have been met are also needs of private hospitals. However, in many cases the infrastructure to allow data exchange is not present. The VAs experiences may serve to establish the benefits that can be obtained by all hospitals.

Experience with an architecture for integrating images into a hospital information system

An integrated image system to provide high-quality image data from cardiology, pulmonary and gastrointestinal endoscopy, pathology, radiology, hematology, and nuclear medicine for hospital information systems has been developed. Images and associated text data are presented to clinicians throughout the hospital on high-resolution workstations which are interfaced to the main hospital system in a client-server architecture. The systems architecture is described, and experience in the first six months of operation is discussed. Initial use has validated the approach and has indicated a number of unanticipated benefits for patient care and teaching.<<ETX>>

Experiences with a comprehensive hospital information system that incorporates image management capabilities

The Department of Veterans Affairs has undertaken a project to integrate image management functionality within its hospital information system. One of the goals of this integrated image system is to provide high-quality image data from cardiology, pulmonary and gastrointestinal endoscopy, pathology, radiology, hematology, and nuclear medicine to clinicians throughout the hospital. Images are presented to clinicians on high-resolution workstations simultaneously with associated text data. This DHCP Integrated Imaging System is currently being installed and tested at the Washington DC VA Medical Center. Initial use has revealed a number of expected as well as unanticipated benefits for patient care and medical teaching.

Providing image management and communication functionality as an integral part of an existing hospital information system

The effective delivery of health care has become increasingly dependent on a wide range of medical data which includes a variety of images. Manual and computer-based medical records ordinarily do not contain image data, leaving the physician to deal with a fragmented patient record widely scattered throughout the hospital. The Department of Veterans Affairs (VA) is currently installing a prototype hospital information system (HIS) workstation network to demonstrate the feasibility of providing image management and communications (IMAC) functionality as an integral part of an existing hospital information system. The core of this system is a database management system adapted to handle images as a new data type. A general model for this integration is discussed and specifics of the hospital-wide network of image display workstations are given.