Evaluating IT investments

Before you sign on the dotted line, you know where your money is going. But do you understand the impact of IT investments and the scale and complexity of the project--key elements of evaluating an IT proposal?

[Teleconsultation]

Teleconsultation is a consultation between two or more physicians about the diagnostic work-up and therapeutic strategy in the treatment of an individual case by means of modern telematics. Due to more complex therapeutic strategies and legally defined formal requirements, the need for teleconsultation will increase significantly in the future. Rapid technical improvements in telematics will progressively facilitate the practical performance of teleconsultation (based upon an ISDN network in the beginning, later on by the use of a national health network). The medicolegal aspects of teleconsultation have already been defined sufficiently for use in surgery. However, the question of adequate financial compensation for this type of medical service is still unclear.

Cut costly patient transfers, delays with networked monitoring systems

Reengineering patient care as needs arise is becoming easier thanks to wireless monitoring systems. Find out how several health care facilities have put an end to bottlenecks in the ED and ICU and made more efficient use of patient beds--and reaped financial savings as a result.

The Multi Unit Activity analyzer: a Windows based hardware-software system for low cost, high speed analog to digital data conversion, data acquisition and window discrimination

The Multi Unit Activity analyzer is a hardware-software package for multi-purpose, two-channel data acquisition, with a computer dependent maximal digitizing frequency selectable from 1 to 27,000 s(-1) on both channels simultaneously. The hardware is connected to an IBM compatible PC through one of the serial ports (standard RS 232 interface). Software was developed to view digitized signals and record or read them on or from the harddisk. The program can also perform amplitude based window discrimination on the raw signal, on-line or during replay. The system is used for recording and analyzing multi unit activity from neuronal tissue in our electrophysiology lab but it can be applied in a variety of other settings. Basic programming routines are available that allow customized data acquisition.

The art of defining computer system requirements: say what you need and need what you say

The task of defining computer system requirements often involves the consideration of an overwhelming number of complexly related factors. Therefore, before getting started, a project team assigned this task needs to get an overview and develop a clear understanding of the main objectives and the alternative methods it can use in carrying out its responsibilities. This article presents tips and techniques for achieving success in the requirements definition phase of a software selection process.

User-friendly and low-cost computer system for immediate review, analysis, and reconstruction of intracoronary ultrasound images

Rapid review, digital recording, on-line quantification, and three-dimensional reconstruction are all essential in the evaluation of intracoronary ultrasound images during coronary interventions. We describe a low-cost method that offers all these necessary features. The proposed method uses the QuickTime compatible video digitizers of standard multimedia Apple Macintosh or PowerPC desktop computers and the freeware software Object Image 1.60.

Development of interactive patient-based multimedia computer programs in veterinary orthopedic radiology

Three computerized multimedia programs on large and small animal veterinary orthopedic radiology were developed and implemented for the radiology curriculum as an alternative to traditional film-based laboratory learning. Programs utilized "hot words" (colored text words that displayed an overlaid image label that highlighted lesions) and interactive quizzes which responded appropriately to selected answers. "Hot words" helped students develop confidence in accurate lesion detection and the interactive quizzes transformed learning from a passive to an active process. Multiple examples were provided for reinforcement and concepts were incorporated from other clinical disciplines for curriculum integration. Programs were written using a presentation software program, Toolbook for DOS based platform, and contained radiographic images made by laser-scanning digitization. Multiple students could simultaneously access the programs through a network server. These pilot programs were implemented successfully and computerized multimedia presentation proved to be well suited to teaching radiology. Development of the programs required attention to a number of hardware, software, time and cost factors.

[Communication server in the hospital--advantages, expenses and limitations]

The common situation in a hospital with multiple departments is a heterogeneous set of subsystems, one or more for each department. Today, we have a rising number of requests for an information interchange between these independent systems. The exchange of patients data has a technical and a conceptional part. Establishing a connection between more than two subsystems requires links from one system to all the others, each of them with its own code translation, interface and message transfer. A communication server is an important tool for significantly reducing the amount of work for the technical realisation. It reduces the number of interfaces, facilitates the definition, maintenance and documentation of the message structure and translation tables and helps to keep control on the message pipelines. Existing interfaces can be adapted for similar purposes. Anyway, a communication server needs a lot of configuration and it is necessary to know about low-level internetworking on different hard- and software to take advantage of its features. The code for writing files on a remote system and for process communication via TCP/IP sockets or similar techniques has to be written specifically for each communication task. There are first experiences in the university school of medicine in Mainz setting up a communication server to connect different departments. We also made a checklist for the selection of such a product.

A strategy for empowerment: the role of midwives in computer systems implementation

The procurement and implementation of patient administration systems has been done on numerous occasions in the past. The Rotunda project however encompassed major bespoke clinical developments which were going to impact upon large clusters of midwives, and medical staff to a lesser extent. A broad based four level structured methodology was used to implement the project which is significantly ahead of schedule. This methodology together with its strengths and weaknesses is comprehensively discussed. The empowerment of midwives, their roles in systems analysis and design, software testing and organisational re-engineering is described. The importance of undertaking comprehensive computer training is highlighted and a compact 10 h information technology course coupled with ongoing educational and related activities which could be adopted by any organisation is documented. The seven deadly sins of project management are mapped out. An update on benefits realisation is provided. Gender issues are also discussed.

[Digital radiology]

Digital radiology is the integration of established and new digital imaging modalities into a system which enables the filmless communication of radiological information. It is becoming an indispensable tool in daily medical practice, and yields improved, faster medical communication, reduces the patient's dose and saves 307 307 archivation costs. Some knowledge of the inherent features of digital images and some open-mindedness for a change in viewing and workflow habits is necessary to make full profit of these possibilities. This paper describes digital radiography and the aspects of radiological networking based on 5 years experience with one of the very first filmless radiology departments worldwide.

The dawn of a new hardware technology

Proponents say network computers offer lower costs and easier maintenance. But skeptics are not yet convinced these benefits are real.

[Commercial teleradiology systems in Germany]

Teleradiologysystems can differ considerably in their features. The most important differences lie in the mode of image data acquisition, data transfer, data safety aspects and the possibilities of interaction between separate teleradiology units. A selection of commercially available teleradiologysystems is presented and compared.