Intelligent image management in a distributed PACS and telemedicineenvironment

Advances in information technology in the past decade have resulted in a proliferation of clinical information systems dedicated to individual user groups and clinical functional areas. This, in turn, has led to the need for hospital-wide management and integration of information, and has triggered major efforts towards the development of integrated hospital information systems. A framework for developing an integrated regional health telematics system is presented, based on the functional and data integration of federated autonomous information systems. The concept of the patient meta-record is introduced as a central element in achieving integration in terms of content, structure, and access to information resources. Intelligent image management at the level of either a single health care provider (hospital) or a regional health telematics network is addressed and is achieved through event and model-driven strategies enabled by a distributed hierarchical storage management system. Intelligence, in this context, refers to methods of efficient and effective real-time resource management in the timely delivery of health care     

Biomedical Engineering in Health Care?Potential Versus Reality

Although we have heard a great deal about the potential of biomedical engineering in health care, utilization of engineering and technology in the health care field has not progressed as expected. Reasons for this situation are presented and they include the points of view in industry, engineering and the medical community. Expanded and successful use of clinical engineers in health care institutions, the development of relevant educational curricula and a continuum of medical engineering education, as well as early involvement of biomedical engineering in the planning of health care delivery at Federal, State and district levels, could expedite the engineering medical interaction.     

The Biomedical Engineering Quandary

As of this date, biomedical engineering has become a recognized profession. The full impact of its efforts in the health related fields is just becoming visible to the leaders of the health delivery systems. As a profession it differs markedly from traditional engineering disciplines; however, that is the reason it has come into being. The demand for individuals well trained in the biomedical engineering sciences appears to be insatiable. This is due to the belated recognition by many members of the health delivery system hierarchy of the true role and contribution of the well-trained biomedical engineer. This article discusses the sociological and technological factors that have been influencial in the establishment of the science of biomedical engineering.     

Telerehabilitation: Expanding access to rehabilitation expertise

The potential of modern telecommunications and computing technologies as tools in the delivery and evaluation of assistive technology (AT) has been discussed and has been termed telerehabilitation. The problems of providing AT in rural areas parallels the delivery of health care to rural areas where the proportion of people with chronic illnesses is higher and the means to pay for them is reduced. Large distances mean long travel times, increasing costs associated with any service delivery, and consuming valuable time skilled professionals could be using to provide services elsewhere. The technology available for practising telerehabilitation is significant and expanding at a rapid rate. Currently, plain old telephone systems (POTS) and broad-band videoconferencing equipment, Internet and World Wide Web, and embedded processor systems are most widely available. These technologies continue to evolve as well as emerging technologies such as wearable sensors that will have telehabilitation applications. Issues of payment, safety liability, and licensure need to be resolved, as legislation lags the development of new technologies     

The Role of Clinical Engineering in Health-Care Delivery

Modern health-care delivery is becoming increasingly dependent on the contributions of engineering science and technology. The important and often critical need for such technological support has resulted in the establishment of a clinical engineering role at a number of hospitals. The literature quotes numerous examples of the contributions such a capability can make to the delivery of quality patient care.     

电子产品系统维修性管理及可靠性的关系之探讨

电子产品（设备）的可靠性工作是一个复杂的系统工程，而电子产品的维修性管理工作，不但是这个系统工程中的一个重要构成部分，而且通过维修性管理所获得的反馈信息可为改进可靠性设计提供依据。本文论述了电子产品维修性管理的内函、数量特征、流程及方法，提出了提高电子产品维修性与可靠性的设计措施。     

The application of telepresence in medicine

Telemedicine is a wide ranging subject which encompasses teleconsultation, electronic patient records, continuing medical education and public health information systems. Telemedicine will impact every aspect of health care delivery from remote clinical analysis and consultation between experts based in specialist hospitals, to teleconsultation as a substitute for physical referral between the GP and a hospital, and ultimately the remote delivery of medical monitoring and care into the h ome. Telepresence, where remote human expertise is transported by communications networks to a remote location, has its own unique place within the spectrum of telemedicine applications. This paper describes some of those applications of medical telepresence into which BT have been researching with various clinical partners.     

医疗器械电子设备的维修技术探讨

随着我国社会主义现代化建设的不断发展,我国的医疗卫生水平得到了极大的提升。作为医院日常工作中极为重要的组成部分,医疗器械电子设备的维修与管理直接影响着临床工作的顺利开展,其在医院的诊断与治疗过程中发挥着不可替代的作用,引起了医学界的高度重视。本文将着重对医疗器械电子设备普遍存在的问题进行深入分析,并提出相应的维修技术策略,为医院的医疗器械电子设备的维修提供一个参考与借鉴。     

Microcell design principles

The ways in which microcell systems can help cellular operators face a number of challenges to achieve continued growth, including the need for increased system capacity, enhanced coverage, lower network cost per subscriber, improved performance, delivery of innovative value-added services, and well-planned equipment and service migration strategies, are discussed. It is argued that microcells must work with conventional cellular systems with lower equipment costs per subscriber, and should require only minimal preinstallation RF design and engineering. Keys to cost-effective microcell deployment are high-performance RF component and digital signal processing technology, efficient radio resource management, optimized distributed network design, and effective switch and network integration     

信息化技术在机电设备安装工程中的应用

随着信息化技术的快速发展和广泛应用,各个行业都在积极探索数字化、自动化以及数据分析等技术的应用,以提升效率、降低成本、增加安全性。机电设备安装工程作为基础设施建设的关键领域,也深受信息化技术的影响。文中探讨了信息化技术在机电设备安装工程中的广泛应用及其重要性。信息化技术在该领域中的应用包括自动化控制系统、虚拟设计与仿真技术、数据采集与监测、信息管理系统以及远程监控与维护。这为工程师提供了更智能的工具和资源,推动着工程行业向更高效、智能和可持续的方向发展,引领着工程行业的数字化转型。     

Quantifying the environmental footprint of semiconductor equipment using the environmental value systems analysis (EnV-S)

Many environmental and health impacts from semiconductor processing are tied to the design of the manufacturing equipment. Evaluating solutions to properly treat effluents from semiconductor tools has become an increasingly important part of supply chain management and equipment procurement decisions. Accordingly, understanding the environmental footprint associated with equipment sets is essential for both equipment manufacturers and semiconductor manufacturers seeking to improve their products' environmental and financial performance. Equipment environmental performance must be evaluated within the context of the factory infrastructure and auxiliary equipment sets, with appropriate allocations of impacts from additional steps, both upstream and downstream of the wafer processing tools (chemical precursor delivery as well as byproduct treatment). Several challenges to environmental assessments arise from the nature of semiconductor manufacturing itself, due to short process life cycles, complexity of processes, and the need to track diverse inter-related impacts. Environmental value systems analysis (EnV-S) is an analytical tool to evaluate the environmental performance of semiconductor processing. EnV-S develops environmental assessments through a "bottom-up" analysis approach, assembling equipment environmental models to describe a system. This paper presents the use of EnV-S as a tool to quantify the environmental impact of a product or process by creating an operational signature along multiple dimensions of cost and environmental and health factors. The use of EnV-S is illustrated through a case study comparing systems that abate emissions from dielectric chemical vapor deposition processes.     

Organizational management of telemedicine technology: conqueringtime and space boundaries in health care services

Advanced information technology and improved information infrastructures have made telemedicine an increasingly viable health care service delivery alternative, measured in clinical, technical, and economic terms. Most existing telemedicine programs operate in an investigational setting where filtering or elimination of real-world frictions makes their migration to clinical settings challenging. The ultimate success of telemedicine demands effective technology management which can be systematically analyzed and modified to improve decision making. This paper reports research that identified important decisions that need to be made at each technology-management phase, discusses plausible decision interdependency, and highlights additional management issues that arise when telemedicine involves multiple technologies or extends across organizational boundaries. The authors' analyses of decision interdependency and intertechnology relationships, together with their managerial implications, have contributed to advancing research and practice related to management of suites of complex technologies in organizations participating in the health care service supply chain. Their findings suggest that a paradigmatic shift is needed to surmount the boundaries that have compartmentalized decision making, technology management, and organizations     

Networked multimedia for medical imaging

The development of biomedical imaging has revolutionized medical practice and health care delivery. The next wave of change, however, will come from merging medical imaging with multimedia technology. We discuss the necessary information infrastructure and supporting technology for this evolving field. We describe four types of clinical applications to illustrate the use and versatility of networked multimedia systems for image-assisted medical care     

Telemedicine experience for chronic care in COPD.

Information and telecommunication technologies are called to play a major role in the changes that healthcare systems have to face to cope with chronic disease. This paper reports a telemedicine experience for the home care of chronic patients suffering from chronic obstructive pulmonary disease (COPD) and an integrated system designed to carry out this experience. To determine the impact on health, the chronic care telemedicine system was used during one year (2002) with 157 COPD patients in a clinical experiment; endpoints were readmissions and mortality. Patients in the intervention group were followed up at their homes and could contact the care team at any time through the call center. The care team shared a unique electronic chronic patient record (ECPR) accessible through the web-based patient management module or the home visit units. Results suggest that integrated home telemedicine services can support health professionals caring for patients with chronic disease, and improve their health. We have found that simple telemedicine services (ubiquitous access to ECPR, ECPR shared by care team, accessibility to case manager, problem reporting integrated in ECPR) can increase the number of patients that were not readmitted (51% intervention, 33% control), are acceptable to professionals, and involve low installation and exploitation costs. Further research is needed to determine the role of telemonitoring and televisit services for this kind of patients.     

On managing the human factors engineering of hybrid productionsystems

In the transition toward total automation, contemporary manufacturing systems are predominantly composed of production equipment that is neither completely manual or automated. The development of these systems, identified as hybrid production systems, employ and integrate the capacities of human operators with intelligent machines. It is argued that human activities in hybrid automated systems are critical in achieving productivity gains. Given this importance, hybrid systems must be designed to optimize production. Optimal human factors engineering is possible only when engineers and their management are aware of the technical challenges, created by hybrid systems, and the range of options available for meeting these challenges. The authors describe these challenges and their possible solutions, specifically targeted to the management of engineering and technology-based organizations     

Patient monitoring using ad hoc wireless networks: reliability and power management

In the health care domain, a major challenge is how to provide better health care services to an increasing number of people using limited financial and human resources. Wireless patient monitoring has the potential to support these multiple and conflicting requirements. However, the current quality and reliability of patient monitoring have not been very satisfactory due to the unpredictable and spotty coverage of infrastructure-oriented wireless networks. Ad hoc wireless networks can be formed among mobile and wearable patient-monitoring devices for improving the coverage of patient monitoring when infrastructure-oriented networks are not accessible. In this article, we provide support for reliable wireless patient monitoring by presenting several protocols for power management of devices, assisted power control, and sleep strategy. The performance results show that high reliability of message delivery can be obtained while maintaining a level of power conservation.     

铜川广电分前端无人值守机房监控系统建设

随着广电事业的发展,传统的监测系统不能对无人值守机房进行监控,无法提供信号异常报警和分前端机房各类环境信息,已经不能满足新情况新要求,为了保证分前端机房安全及传输安全,提高机房值班效率,必须建设前端机房无人值守监控系统。依托铜川广电现有传输网络和IP网络,借助先进的动力、环境、图像集中监控系统,将机房电源动力运行状态、机房环境参数以及各分前端机房的动力、图像、环境等通过数据和视频的方式传送至铜川市总前端,通过系统的自动报警、记录、显示、远端调测、控制等功能实现无人值守机房的远程监控和远程管理。     

New Mexico's proposed physician-monitored remote areas health program

The State of New Mexico is proposing to combine existing technology in biomedical instrumentation, telemetry, data handling, and communications, developed for aerospace applications, with new techniques in public health screening, prevention, and emergency medical treatment, to establish an integrated system of health care for people living in remote areas. The system proposed consists of a physician-monitored central control facility communicating with remote site facilities staffed by paramedical personnel of limited training. Instrumentation at the remote sites, together with simplified laboratory test materials, provides information on patient condition which is transmitted to central data processing equipment and displayed for the center duty physician. The proposed system will provide for: a) remote conduct of multiphasic medical screening and identification of existing health needs, b) emergency medical treatment, and c) limited routine medical care and instruction. A major goal of the program is the development of a systems package as an area utility service which could be obtained for any area using methods similar to those for procuring or establishing hospitals, rural electrification, or telephone utilities.     

Reliability Engineering and Safety at Sea

This paper surveys the field of reliability as related to marine engineering. The problems in marine systems are characterized by availability and safety. However, the two are different aspects of the same problem, and the discipline of reliability engineering provides solution tools for both. Obviously the reliability and availability of the propulsion, navigation and cargo handling are vitally important to the economic operation of ships. Equally important are safe handling of hazardous cargoes and safe navigation through restricted waters and in areas of high traffic density. Experience in dealing with marine equipment and systems has shown that the available techniques and methods of reliability engineering should be applied with care in marine engineering. Special attention should be paid to failure cause, mechanism, and mode. Some proven methods are discussed. In general, there is a lack of data on mechanical components and systems. This is particularly true for marine equipment because of its size, lack of standardization, low sample size and operational environment. A data collection program, now running successfully, is described. Particularly interesting is the conformity of observed values with the negative exponential distribution of failure for some items. The future aspects of reliability engineering in the marine industry are discussed.