It is generally accepted that early and specialized pre-hospital patient treatment improves outcome in terms of mortality and morbidity, in emergency cases. The focus of this paper is to present the implementation and the evaluation of an ambulance located telemedicine system for pre-hospital patient treatment The primary emphasis is on the vital sign transmission from the accident site or the moving ambulance to the consultation site, using the GSM mobile telephony network. There, the experts evaluate the patient data, decides about the treatment protocol and provide directions to the ambulance's medical staff concerning on the patient handling until the arrival to the hospital.
The innovative features of an advanced Radiology Information System (RIS) are presented in this paper. The interoperability of RIS with the other Intra-hospital Information Systems that interacts with, dealing with the compatibility and open architecture issues, are accomplished by two novel mechanisms [1]. The first one is the particular message handling system that is applied for the exchange of information, according to the Health Level Seven (HL7) protocol's specifications and serves the transfer of medical and administrative data among the RIS applications and data store unit. The same mechanism allows the secure and HL7-compatible interactions with the Hospital Information System (HIS) too. The second one implements the translation of information between the formats that HL7 and Digital Imaging and Communication in Medicine (DICOM) protocols specify, providing the communication between RIS and Picture and Archive Communication System (PACS). The whole structure ensures the automation of the every-day procedures that the ;medical protocol' specifies and provides its services through a friendly and easy to manage graphical user interface.
All users of informatics applications need rapid and reliable access to the kind of information that they are interested in. Web technology provides these capabilities. DICOM standard committees recognized the necessity of a Web medical standard. They specified WADO (Web access to DICOM object) service, so that system interaction takes place through Web, in a standarized way, allowing interoperability and proper information management inside PACS. The advantages of a Web PACS comparatively with a compatible PACS are multiple and they are detected in different fields of functionality. The authors have run a project of a WADO compatible Web PACS development. A Web portal platform with enhanced security has been implemented. Over it, DICOM applications have been developed. JavaServer Pages (JSP) technology is mainly used to satisfy design specifications and dynamic data exchanges. Furthermore, Java applets have been developed and introduced in the whole project to serve specific demands. Evaluation results confirmed our considerations about the improvement of DICOM services, when they are provided through web.
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