W. van der Velde

Evaluation of a DICOM-3 link between a referring and a university hospital

As catheterization laboratories are switching from cinefilm to digital recorded images, the transportation of the images between hospitals can be realized in digital mode. This paper describes the transportation of angiographic images between a referring and a university hospital. Besides the more technical information about transmission speed, etc., it elucidates on those patient categories that clearly profit from these new possibilities.

Uniform pacemaker and ICD information system in the Netherlands

In the Netherlands the Central Pacemaker Patient Registry (CPPR) collects information of pacemaker and ICD (implantable cardio defibrillator) patients from all 109 Dutch hospitals. Many pacemaker clinics use a computer to store their implant and follow-up data in a database. Because the devices are getting more and more complex more clinical data is needed for optimal use of the device. Since 1989 databases have been developed by several pacemaker industries and some clinics use databases developed themselves. When using these databases you depend on individual persons for support and update of the database. In order to improve the accuracy of received data and to ensure continuity a uniform pacemaker and ICD information system is developed where data is checked, after which it is sent to the central registry by e-mail and where support is guaranteed by the NPRF.

A diagnostic component for the EPD-Car project

This paper describes a diagnostic module which is a part of the EPD-CAR (Electronic Patient Dossier for Cardiology) project of the Interuniversity Cardiology Institute of the Netherlands. It consists of 13 coding trees, each containing between 3 and 20 subitems. The scheme evolved from daily practice where standard coding schemes proved insufficient. It consists of one main diagnosis and up to 10 optional subdiagnoses. Back-end integration is achieved through conversion tables to ICD-9 and ICD-10. The current system is in use now,for over 1.5 years and contains diagnoses of over 11000 patients. The system is written in Visual Foxpro 6.0 and is an ActiveX-component.

Feasibility support for multi-center trials in the Netherlands

Describes a feasibility support module for multi-center clinical trials in the Netherlands. It is a subproject within a large Electronic Patient Record for Cardiology project. The setup is based on the fact that each participating center has its own departmental information system. Therefore conversion tables are designed between these information systems and a central common data model. As time constraints are not crucial E-mail is used to transfer information. The module was tested through prototyping in 3 centers. The results indicate that the module generates feasibility indications that are closer to reality than the numbers produced through educated guesses.

Integration of the Marquette ECG management system into the Department Information System using the European SCP-ECG Standard

In patient care, as well as in research, data from ECGs is essential, even more so in combination with data from other diagnostic and therapeutic procedures. This paper describes the communication between the acquired MUSE 5000 ECG management system and our department information system. The exchange of information between the systems was structured according to the European standard communication protocol for computerised electrocardiography and implemented on the hospital local area network through TCP/IP and (PC-). NFS.

A proposal for a standard communication protocol for pacemaker/ICD programmers

The information generated by pacemakers and ICDs to support the cardiologist and technician for installing the optimal settings for the patient is increasing rapidly. In this paper a proposal is described for electronic data exchange between the pacemaker/ICD programmers and electronic information systems

An enhanced DTC component for the EPD-CAR project

This paper describes a module which is a part of the EPD-CAR (Electronic Patient Dossier for Cardiology) project of the Interuniversity Cardiology Institute of the Netherlands. It uses general guidelines to advise on the functional tests that have to be performed depending on the diagnoses. The model differentiates between the diverse conditions under which the patient enters the medical circuit. The model converts the detailed information into a crude code the is becoming the basis of financial compensation for medical treatment, starting January 1st 2003. The system is written in Visual Foxpro 7.0 and is an ActiveX-component.

Application form based optimization of the echo lab workflow

In 2001, the number of echocardiograms performed at the University Hospital Groningen exceeded 5500. This is an increment of 13.5% compared to two years earlier. This number is expected to increase further, as improvements in the clinical application and structural changes in the organization progressively evolve. Real time reporting and digital storage of the ultrasound images had a major beneficial impact on optimization of the total process. Currently, clinical supervision by experienced operators is possible through the implementation of Apple Macintosh machines, connected to a local network. This connection is subsequently able to provide the entire hospital area network following the conversion of the Apple platform into Microsoft Windows variants. Although a significant improvement in the efficiency of clinical supervision was achieved, further research is being implemented to continue the update process.

Cardiac pacing in the next millenium: a problem?

Like in other fields in medicine, the unpredictable behaviour of computer systems, known as the millennium problem is finally gaining interest in cardiology. In general two major categories of problems can be predicted. Firstly the large computer programs where the use of a real time clock representation should be considered in many thousands of lines of software. Secondly a class of problems is formed by devices were software is embedded in hardware and cannot be reprogrammed other than by replacing EPROM. In cardiology an additional problem is formed by those devices that have been implanted and cannot be reprogrammed, like pacemakers and defibrillators. To investigate the potential risk of malfunctioning of implantable cardiac devices, the Netherlands Pacemaker Registry Foundation has performed a survey on all traceable pacemaker and defibrillator companies active in The Netherlands.

A low cost DICOM review station for cardiac surgery

A low-cost PC based DICOM multi modality review station for cardiac surgery has been developed for use during minimally invasive Coronary Surgery. This system is a Windows 95 networked PC for review of DICOM coronary catheterization, ultrasound and MRI cines stored at a departmental image server. For fast review a specific one-heartbeat sequence out of a coronary catheterization selected by an application departmental image server. The Ultrasound studies, acquired by Vingmed System 5 and stored in an Echopac archive, are exported as DICOM files to the same server. The MRI studies are pushed as DICOM messages from an Agfa Picture Archiving and Communication System (PACS) to this image file server and automatically converted to DICOM file format. The RuboMed v 1.00 DICOM PC DICOM viewer is used to review the multi-modal cines and the patient data. The review station does not require expensive hardware and software to provide for easy, direct and transparent review of multi-modal DICOM cines stored at a central departmental image file server.