Erik Borälv

Mobile teleradiology: all images everywhere

This paper describes the ongoing work on mobile teleradiology systems in the EC-funded project MTM. The current development is based on the CHILI software architecture which provides a PACS and tel ...

The German teleradiology system MEDICUS system description and experiences in a German field test

MEDICUS is a teleradiology system which has been developed in a joint project of the German Cancer Research Center (Deutsches Krebsforschungszentrum) and the Transfer Center Medical Informatics (Steinbeis-Transferzentrum Medizinische Informatik) in Heidelberg, Germany. The system is designed to work on ISDN lines as well as in a local area network. Special attention has been given to the design of the user interface and data security, integrity, and authentication. The software is in use in 13 radiology departments in university clinics, small hospitals, private practices, and research institutes. More than 25 thousand images have been processed in 6 months. The system is in use in six different application scenarios. MEDICUS is running under the UNIX operating system. The connection of the modalities could in most cases not be realized with the DICOM protocol as older machines were not equipped with this standard protocol. Clinical experiences show that the MEDICUS system provides a very high degree of functionality. The system has an efficient and user friendly graphical user interface. The result of a comparison with other systems shows that MEDICUS is currently the best known teleradiology system. Cost reductions are already obvious, but additional research has to be performed in this field. An even more powerful commercial successor is currently under construction at the Steinbeis-Transferzentrum Medizinische Informatik in Heidelberg.

Experiences with the German teleradiology system MEDICUS

This paper introduces the teleradiology system, MEDICUS, which has been developed at the Deutsches Krebsforschungszentrum (German Cancer Research Center) in Heidelberg, Germany. The system is designed to work on ISDN lines as well as in a local area network. The global software architecture is explained in the article. Special attention has been given to the design of the user interface and data security, integrity and authentication. The software has been evaluated in a German field test at 13 radiology departments in university clinics, small hospitals, private practices and research institutes. More than 30 thousand images have been transmitted using this system during a 9 month period. Realized application scenarios are: in-house communication, image and report delivery to referring hospitals, remote reporting, radiotherapy treatment planning and research cooperation. Experience has shown that the system is easy to use and saves time. It obviates the need for patient transport and reduces film costs. Experiences of individuals while using the system during the field test helped define the functionality of the second generation teleradiology system which is even more flexible and is also available as a commercial product.

A teleradiology system design case

Have you ever been frustrated with that IT system at work that does not behave the way you expect it to? Or had problems with using the features on your new mobile phone? When systems and appliances do not support us in what we are doing, and do not behave the way we expect them to, then usability is neglected. Poor usability may be frustrating and irritating when trying out your mobile phone, but in a critical work situation poor usability may be disastrous.In this thesis, user-centred systems design (UCSD) is advocated as an approach for facilitating the development of usable interactive systems. Systems that suit their intended use and users do not just “emerge”. They are the result of a UCSD process and a user-centred attitude during the development. This means in short that the real users and their needs, goals, context of use, abilities and limitations, drive the development – in contrast to technology-driven development. We define UCSD as: a process focusing on usability throughout the entire development process and further throughout the system life cycle. I argue that this definition along with a set of key principles do help organisations and individual projects in the process of developing usable interactive systems. The key principles include the necessity of having an explicit focus on users and making sure that users are actively involved in the process.The thesis provides knowledge and insights gained from real-life situations about what UCSD is and how it can be put into practice. The most significant results are: the proposal of a clear definition of UCSD and a set of key principles encompassing UCSD; a process for usability design and the usability designer role. Furthermore, design cases from different domains are provided as examples and illustrations.

Physicians' concept of time usage : A key concern in EPR deployment

This paper is based on an interview study with 19 resident, specialist and senior physicians. The study was initiated by a Swedish Hospital management to investigate physicians’ attitude towards their EPR (Electronic Patient Records) and give recommendations for improvement in organization, development, deployment and training. The management had experienced that the physicians were unwilling to take part in the EPR deployment process and simultaneously complained about the low usability and potential safety risks of the systems. The study shows that the EPR must be considered a shared responsibility within the whole organization and not just a property of the IT department. The physicians must consider, and really experience, EPR as efficient support in their daily work rather than something they are forced to use. This includes considering work with the EPR as an important part of their work with patients.

Internet Based Artificial Neural Networks for the Interpretation of Medical Images

This paper presents a computer-based decision support system for automated interpretation of diagnostic heart images, which is made available via the Internet. The system is based on image processing techniques, artificial neural networks, and large and well validated medical databases. The performance of the neural networks detecting infarct and ischemia in different parts of the heart, measured as areas under the receiver operating characteristic curves, was in the range 0.76-0.92. These results indicate a high potential for the tool as a clinical decision support system. The system is currently evaluated by a group of pilot users in different European countries.