Rafael Andrade

Wireless and PDA: a novel strategy to access DICOM-compliant medical data on mobile devices

The medical procedures at the patient bedside are out of the scope of current HIS/RIS systems, which means that patient record and image data access during the medical visit or the execution, recording and confirmation of the medicine prescriptions, still do not enjoy computerized support. As a consequence, the necessary inclusion of new data to the patient record, still needs to be carried out through notations on paper and later typed, causes delays on the availability of this information (Mobile computing in a hospital: the Ward-In-Hand project. SAC 2000-ACM Symposium on Applied Computing, Março, 2000, Villa Olmo, Como, Italy). This paper presents a software technology where the medical and nursing staff will be equipped with a handheld computer connected by radio to a central server that provides access to the electronic patient records and that will actively inform about tasks pending distribution. The server acts as a database for multimodal electronic patient record information, storing patient data from computerized tomography (CT), ultrasonography (US), magnetic resonance (MRI) images and also medical findings, observations and prescriptions coded as DICOM Structured Reports (Digital Image and Communications in Medicine). The prototype described in this article implements a medical images and structured reports server that makes the search and recovery of data stored in the DICOM standard possible.

Building a National Telemedicine Network

Motivated by the need to reduce the cost of patient transport to health centers, the authors designed a prototype national telemedicine network in Brazil. As a result of this project, we now have an agile, easy-to-use, high-quality telemedicine network that provides greater access to patient data and helps in medical decisions, cutting unnecessary costs to the state and benefiting the population as a whole.

Implementing DICOM structured reporting in a large-scale telemedicine network.

INTRODUCTION Large-scale asynchronous telemedicine networks can offer a unique opportunity for the acquisition of detailed epidemiological information if the data are acquired and handled in an appropriate way. In this work, an approach is presented for the integration of medical reports in the Digital Imaging and Communications in Medicine (DICOM) Structured Reporting standard in telemedicine networks using structured vocabularies. MATERIALS AND METHODS The use of these structured vocabularies is extended beyond radiology, and a case study in telecardiology is presented. The approach was applied in the context of a real-world statewide public telemedicine network; nowadays on average 470 written electrocardiographic structured reports daily are being performed. Cardiologists provided more than 220,000 written structured reports, and these reports are stored into a central database. RESULTS This study was performed during a 12-month period, and it was possible to examine possible associations between a list of co-morbidities and cardiac risk factors with a diagnosis that indicates the presence of cardiac ischemia, cardiac injury, or possible necrosis by using DICOM Structured Reporting. Our application is responsible for coordinating the process of issuance of reports through various technologies and devices. The system works as a library in an HTTP server, which accesses information from studies in DICOM format from the database and from structured vocabularies. CONCLUSIONS Results indicate that traceability of morbidity, diagnoses, and patient clinical information can be achieved, resulting in an efficient data mining-friendly framework. A multidevice application for Web-based and smartphone-based platforms showed that it is a viable solution for applying the DICOM Structured Reporting standard in telemedicine networks.

Asynchronous Data Replication: A National Integration Strategy for Databases on Telemedicine Network

Telemedicine systems currently have increased the volume of information stored in their databases. A centralized telemedicine system project covers datasets that ranges from personal patients information, physicians and institutions to all images of examinations performed. As they store large amounts of examinations, the medical databases can reach several terabytes of volume. This paper presents a contribution characterized by an asynchronous replication model for medical distributed databases. The model, called postgresreplication, is an extension to the relational database postgreSQL. In our experiment, an engine has been created to manage all integration operations and information replication for the medical databases. The early results indicate that the model and its implementation have successfully reached a good performance level and interoperability.

A reliable approach for applying DICOM structured reporting in a large-scale telemedicine network

The need for procedures and methodologies used in clinical information standardization is continuous, requiring the current telemedicine networks to evolve and adapt by using mature standards and guidelines as the basis for clinical documents transmitted through the network. In this work, we present a different approach for large-scale use of DICOM SR in telemedicine networks using structured vocabularies as its foundation, resulting in a reliable, efficient and data mining ready application applied in a real world telemedicine network. This approach is applied in a large-scale network where 60 physicians report daily an average of 400 reports; resulting in more than 80,000 reports written and stored in the last nine months. We conclude that the use of this approach can reduce eventual syntax or conceptual mistakes by using proper structured vocabularies in addition to DICOM SR.

A Telemedicine Network Using Secure Techniques and Intelligent User Access Control

This paper reports the development and design of the State of Santa Catarinas telemedicine network in Brazil. The resources concentration, like hospitals and clinical staff, in Brazilian large cities have been a problem in public healthcare policies improvement. Telemedicine technology for large scale telediagnostic, processing of routine outpatient examinations, the electronic delivery of examinations results integrated with the decision process of wetter to provide further treatment for a patient, is one strategy to overcome the difficulties imposed by healthcare concentration. The State needs to reduce costs like patient transportation, improve the quality of healthcare service and the origins control of these examinations, motivated the creation of this medical knowledge network. As a result it promoted better patient care, making faster diagnosis, creating a patient information history, reducing the examinations redundancy, maximizing this way, the social welfare and the health technological park on the Santa Catarina State.

Designing an information retrieval system for the STT/SC

The Santa Catarina State Telemedicine and Telehealth System - STT/SC stores well over 2 million examinations and every month about 20 thousand new imaging exams are sent to the system database. As a significant part of the findings associated to these medical data are stored as text documents, the precise extraction of information is a difficult task. In the healthcare domain it is common to find different terms, some of them appearing as composed expressions, used to represent the same concept, whereas the existence of simple modifiers can turn an expression into another, different concept. This work presents an information retrieval architecture developed for the STT/SC. It consists in a module integrated into the STT/SC and was developed in order to support both experienced and inexperienced users to perform queries. Experiments were performed to evaluate the accuracy of the proposed system in real situations. Results show that the search can be performed more much faster and with acceptable precision.

An Architecture for Information Retrieval in a Telemedicine System

This work presents an information retrieval architecture developed for the Santa Catarina State Telemedicine System. This architecture employs DICOM Structured Reporting, controlled vocabularies for data catalogization and a specially developed search engine for data indexing and storing. Results of our case study show that searches can be performed much faster with the proposed search mechanism and that the precision of results is acceptable in most cases. In some searches, irrelevant items within the 15 first results were identified. This occurred partially because search terms found in the additional free text observations inserted into the findings reports were treated with the same relevance as formally diagnostically relevant items of the DICOM SR structure and, partially because the semantics of negations associated to search terms in the findings reports were not taken into consideration.

Ponto de vistaAssinatura digital de laudos médicos: um assunto ainda não resolvidoDigital signature of medical reports: an issue still not resolved☆

Aldo von Wangenheima, Ricardo Felipe Custódiob, Jean Everson Martinab, Isabela de Back Giulianoc e Rafael Andraded,∗ a Instituto Nacional para Convergência Digital (INCoD) da Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brasil b Laboratório de Segurança em Computação (LabSec), da Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brasil c Programa de Pós-graduação em Saúde Coletiva, UFSC, Florianópolis, SC, Brasil d Instituto Federal de Santa Catarina (IFSC), Florianópolis, SC, Brasil

Modelos para jornalismo cidadão e uma análise do cenário brasileiro

“Jornalismo cidadao” e um conceito relativamente novo, representando o tipo de jornalismo executado por nao profissionais. Com a popularizacao da Internet e maior disponibilidade das tecnologias de informacao e comunicacao, o modelo vem se tornando mais praticado em todo o mundo. Alguns casos de sucesso ja podem ser relatados, como o site sul-coreano Ohmynews, que e referencia no assunto. No Brasil, a iniciativa ainda e timida e o modelo parece nao funcionar completamente. Este artigo contextualiza os modelos de jornalismo cidadao e avalia as causas do aparente insucesso no Brasil, apontando as adaptacoes que se fazem necessarias no modelo.