Mario Ciampi

Controller-free exploration of medical image data: Experiencing the Kinect

In this paper, an open-source system for a controller-free, highly interactive exploration of medical images is presented. By using a Microsoft Xbox Kinect™ as the only input device, the systems user interface allows users to interact at a distance through hand and arm gestures. The paper also details the interaction techniques we have designed specifically for the deviceless exploration of medical imaging data. Since the user interface is touch-free and does not require complex calibration steps, it is suitable for use in operating rooms, where non-sterilizable devices cannot be used.

Smoothed Pointing: A User-Friendly Technique for Precision Enhanced Remote Pointing

This paper presents Smoothed Pointing, a velocity-based precision enhancing technique for remote pointing by means of absolute devices. After discussing the most recent related work concerning the problem of accuracy in remote pointing by handheld input devices, we introduce the distinctive features of the control-to-display ratio adaptation technique we have designed to: i) reduce the effect of both noise in input device signals and of hand tremors on the cursor stability; and ii) increase the accuracy of pointing when performed on large, high resolution displays. Moreover, we describe a 10 second calibration procedure to determine the filtering parameters, so as to free the user from a manual set up.

An event-based notification approach for the delivery of patient medical information

Data sharing is pivotal in current medical practice so as to better treat patients by taking the best medical decisions, and to optimize healthcare costs by reducing the need to repeat unnecessary medical tests and by better managing healthcare structures. To improve the delivery of treatment outcomes and test results, the request-triggered retrieval of clinical documents provided by current Health Information Systems is not sufficient. The addition of a notification solution is necessary to inform users as soon as their clinical documents of interest have been produced so that they can retrieve them by means of the traditional Health Information Systems. In addition, this notification solution also has to implement the event-based information exchange patterns, which characterize the current attempts at integrating heterogeneous Health Information Systems in a seamless manner. This paper proposes an architecture for an effective asynchronous notification of clinical documents. Our intention is to bridge the gap between primary and secondary care, and between the clinical personnel and the administrators. The proposed solution is based on a publish/subscribe service, properly extended to allow us to jointly notify collections of correlated documents. Moreover, it has been implemented by means of a web service-based platform in accordance with the Web Service Notification specification so as to obtain a solution easy to integrate and manage. A systematic analysis has been carried out to assess the suitability of the implemented solution to satisfy the requirements for notifying medical documents, and to evaluate the notification latency in different use conditions.

An access control model to minimize the data exchange in the information retrieval

In healthcare the fast retrieval of clinical information on a patient can be vital, for example in an emergency, and allows anyway, in normal situations, an improvement in the service of care and a consequent significant reduction in costs (for example, eliminating the need to repeat medical examinations). Health information systems, and in particular Electronic Health Record Systems, enable clinical information to be found quickly and in a distributed environment. The information should be available only to authorized users, because much of it is sensitive. For this reason, it is necessary to use a mechanism that realizes access control, the main goal of which is to guarantee the confidentiality and integrity of the data, and to allow the definition of security rules which reflect the need for the privacy of the patients. In this work, we show the designed GUIs, which use the innovative access control system defined. GUIs allow patients to define in a detailed and clear manner the access rules concerning their clinical information, both in document and data form. The main innovation of this work is to provide the ability to protect the resources (documents and clinical data) of the system by presenting only the content of the information needed depending on the type of request made directly by the patients, the content being extrapolated from the resource request. This feature allows the definition of an access control model that increases the patients trust in the EHR system.

Medical image fusion for color visualization via 3D RDWT

This paper presents a novel 3D multimodality medical image fusion algorithm based on wavelet multiresolution analysis, a powerful tool able to decompose an image into multiple frequency bands that can be independently analyzed and merged. The focus of this work is to merge 3D medical images coming from several modalities (CT, PET, MRI, etc.), organized as series of 2D image slices, while preserving the salient information. The algorithm aims also at enhancing the visualization of fused images by applying a color to source images. A pre-processing stage using rescaling and resampling filters makes the spatial resolution and the image slice number of the input series equal. Images are i) decomposed by 3D RDWT, ii) combined through appropriate fusion rules based on average, variance and energy, and iii) reconstructed by 3D IRDWT. Experimental results validate the superiority of the proposed 3D technique over other existing algorithms on the basis of subjective and objective criteria.

A federated interoperability architecture for health information systems

The last decade has been characterised by the proliferation of several projects for integrating the already-existing health information systems so as to form national or transnational infrastructures for sharing medical data. This evolution is felt as a promising solution for improving the provided healthcare and reducing its costs by avoiding unnecessary examinations. However, such a vision comes with several challenging issues, in terms of interoperability and security. This paper presents an architecture for federating health information systems in a secure manner, and its concrete implementation. The quality of this implementation is assessed by means of several experiments for measuring the time needed for the retrieval and notification of documents.

A patient privacy centric access control model for EHR systems

The EHR systems consist of very sensitive data originated by the interaction of the patients with the healthcare system. In order to control who can do what on the data in the system, it is necessary to use a security mechanism that is the access control (AC). In this paper, an innovative AC model is defined. It meets the main features that have to be satisfied by an EHR. Our proposal is an advanced access control model that combines access control models known in the literature. It adds the characteristics of modularity and easiness in the management of access policies, focusing attention on patients privacy and consent (patient privacy centric). The proposed model presents the following characteristics: attribute-based, multi-level, modular and with a dynamic and temporal management of the users lists. Besides, we have defined support functionalities that allow patients, organisations and physicians to take advantage of the AC potential.

Secure healthcare data sharing among federated health information systems

The current trend in designing health information systems is to apply federated architectures to integrate existing systems. This exacerbates the security guarantees that such systems are required to satisfy and demands the introduction of advanced methods to deal with security. This paper aims at describing how federated health information systems can offer security properties by adopting proper mechanisms to protect the exchanged data and the provided functionalities from malicious manipulations. We have experimentally evaluated the costs in terms of performance penalty related to the introduction of security mechanisms within the proposed solution.

An asynchronous communication system for pervasive grids

Event-driven paradigms have become the leading model for large classes of applications and environments. In particular, pervasive, ubiquitous and grid computing, in which services dynamically plug in and get out, rely on middleware services that use communication channels and events to integrate and coordinate application-level services. This paper presents an advanced asynchronous communication service, which is a core component of Middleware for Pervasive Grids (MiPeG), a middleware platform for pervasive grid environments. This service handles hierarchies of classes of events. In particular, events are grouped into classes, which can be related in hierarchies. Producers and consumers can subscribe to the communication service for one or more classes; i.e., a consumer that subscribes to a class receives all the events of that class and of any hierarchically higher class.

A novel system for the automatic extraction of a patient problem summary

Clinical summarization means the collection and synthesis of a patients significant data, undertaken in order to support health-care providers in the process of patient care. Considering that medical information comes from multiple sources, a system for the automatic generation of problem lists could prove to be very effective in terms of saving time in the analysis of large amounts of medical data. In this paper, we propose a system able to acquire and present relevant references to medical disorders from a patients history, producing a subject-oriented summary. The implemented system relies on an NLP pipeline, for the extraction of relevant medical entities contained in narrative health records, and on several queries, necessary for the scanning of structured documents. The tool aggregates any medical problems, performed procedures, and prescribed medications, providing the healthcare practitioner with a visual summary of the patients data.