by Gareth Williams, Kevin Doughty and David A Bradley
page 1-9
The systems requirements for an integrated telecare systems are presented by using a modification of the CORE methodology. The resulting system model uses viewpoint analysis to establish the needs and requirements of both the client and the care providers within a system context and discusses the implication for a user-centered technology-based solution referred to as the "CarerNet." The implementation of CarerNet is considered in terms of the enabling technologies required within the local environment of the client and identifies the monitoring, networking requirements, and system intelligence necessary to the provision of a comprehensive telecare service. A hypothetical case study based on patient aftercare following discharge from the hospital is presented to illustrate the points discussed
CarerNet, healthcare networks and informatics, intelligent patient monitoring, smart homes, telecare systems design, telemedicine
by Janice A Replogle, David J Russomanno, Amy L de Jongh and Fritz J Claydon
page 10-19
Three-dimensional (3-D) finite element torso models are widely used to simulate defibrillation field quantities, such as potential, gradient, and current density. These quantities are computed as spatial nodes that comprise the torso model . These spatial nodes typically number between 10**5 and 10**6, which makes the comprehension of torso defibrillation simulation output difficult. Therefore, the objective of this study is to extract a subset of the geometric model of the torso for visualisation in which the nodal information associated with the geometry of the model meets a specified threshold value (e.g. minimum gradient). The data extraction software is implemented in PROLOG, which is used to correlate the coordinate, structural, and nodal data of the torso model. A PROLOG-based environment has been developed and is used to rapidly design and test new methods for sorting, collecting, and optimizing data extractions from defibrillation simulations in a human torso model for subsequent visualization
Computational cardiac electrophysiology, defibrillation simulation, implantable defibrillation device, isovolume extraction, PROLOG, three-dimensional torso model, volume visualization
by Uwe Englemann, Andre Schroter, Ulrike Baur, Oliver Werner, Markus Schwab, Henning Muller and Hans-Peter Meinzer
page 20-25
This paper proceeds from the definition of teleradiology. It identifies three different generations of teleradiology systems and includes those systems that are not regarded as teleradiology by the authors. A list of requirements pertinent to users of first-generation teleradiology systems is introduced. Most of the requirements have been realized in a new generation teleradiology system called CHILI
Biomedical communication, biomedical imaging, collaborative work, computer-assisted radiology, data security, image processing, picture archiving and communication systems, teleconferencing, telemedicine, teleradiology
by E Pelikan, A Ganser, E Kotter, U Schrader and U Timmermann
page 26-29
Legacy local area network (LAN) technologies based on shared media concepts are not adequate for the growth of a large-scale picture archiving and communication system (PACS) in a client-server architecture. First, an asymmetric network load, due to requests of a large number of PACS clients for only a few main servers, should be compensated by communication links to the servers with a higher bandwidth compared to the clients. Secondly, as the number of PACS models increases, the network throughput should not measurably cut production.
These requirements can easily be fulfilled using switching technologies. Here asynchronous transfer mode (ATM) is clearly one of the hottest topics in networking because the ATM architecture provides integrated support for a variety of communication services, and its supports virtual networking. On the other hand, most of the imaging modalities are not yet ready for integration into a native TAM network. For a lot of nodes already joining an Ethernet, a cost-effective and pragmatic way to benefit from the switching concept would be a combined ATM/Ethernet switching environment. This incorporates an incremental migration strategy with the immediate benefits of high-speed, high-capacity ATM (for servers and high-sophisticated display workstations), while preserving elements of the existing network technologies. In addition, Ethernet switching instead of shared media Ethernet improved the performance considerably. The LAN emulation (LANE) specification by the ATM forum defines mechanisms that allow ATM networks to coexist with legacy systems using any data networking protocol.
This paper points out the suitability of this network architecture in accordance with an appropriate system design.
Asynchronous transfer mode (ATM), networking, picture archiving and communication system (PACS), switched ethernet
by Betty A Levine, Kevin Cleary and Seong K Mun
page 3-34
The United States military has been an effective proponent of digital and teleradiology for the past 15 years [1]. A digital imaging network that eliminates the use of x-ray film makes military medicine requirements simpler. X-ray film requirements include storage of new, unexposed films, storage and use of chemicals and water for processing, and disposal of chemicals. In some deployed situations, the chemical discharge needs to be collected and shipped out of the area. Therefore, the ability to implement electronic imaging and eliminate or greatly reduce the dependence on film, chemicals, and water are intrinsically important to military medicine.
In December 1995, the United States government began deployment of 20,000 United States troops in Bosnia-Herzegovina as part of NATO's peacekeeping implementation force (IFOR) operation. A full complement of military medical support facilities was established in Bosnia. An army base in Hungary was the location from which the deployment was staged. The project to deploy telemedicine and teleradiology capabilities to the medical treatment facilities (MTF) in Bosnia and Hungary became known as PrimeTime III [2]. This paper deals with the deployable teleradiology (DEPRAD) system that was installed by the Imaging and Radiology, Georgetown Medical Center, Washington DC, at a number of facilities to implement filmless radiology and teleradiology services in support of PrimeTime III.
by Emmanuele Neri, Jean-Philippe Thiran, Davide Caramella, Claudio Petri, Carlo Bartolozzi, Bruno Piscaglia, Benoit Macq, Thierry Duprez, Guy Consard, Baudouin Maladgue and Johan De Pauw
page 35-38
The European High-Performance Information Infrastructure in Medicine, n0B3014 (HIM3) project of the Trans-European Network - Integrated Broadband Communications (TEN-IBC) program, started on March 1996 and finished on February 1997, aimed to test the medical usability of the European Asynchronous transfer mode (ATM) network in medical image transmission.
The Department of Radiology, University of Pisa, Pisa, Italy, and St-Luc University Hospital, Brussels, Belgium, involved in the project as healthcare partners in the radiological domain, established several connection sessions finalized to test the usability of Digital Imaging and Communication (DICOM) image transmission and interactive telediagnosis tools in the daily radiological practice. The Pisa site was connected to the Italian ATM pilot (Sirius Network) through the Tuscany metropolitan area network (MAN), while St-Luc University Hospital was connected to Belgium ATM network through the Brussels MAN. By means of international connections provided by the European JAMES project, a link between the two sites was established, connecting both national ATM networks. Due to the large variety of hardware present in the medical centers, multiplatformn software tools were used and tested: central test node (CTN) release 2.8 [3], VAT [6], NV-3.3 [7], and IDI (UCL homemade platform teleradiology for interactive visualization and processing of DICOM images).
During the telediagnosis session, led by radiologists in both hospitals, each site submitted neuroradiological clinical cases to the other for remote constellation. The connection, available for a period of two weeks, at 2-Mbit/s bandwidth, allowed the transmission of MR images (256*256*12 bit) and simultaneous multimedia interactive discussion of the cases. Both off-line transmission and review of the images, using the CTN DICON transfer routines, and on-line interactive image discussion, using the IDI telediagnosis software, were tested successfully from the technical and medical point of view.
page 39-40
Transcribed by Angus Nicolson
11 June 1998