KEYWORDS: Relays, Medicine, Picture Archiving and Communication System, Medical imaging, Telecommunications, Network security, Internet, Data communications, Computer security, Diagnostics
Diagnostic tools supported by digital medical images have increasingly become an
essential aid to medical decisions. However, despite its growing importance, Picture Archiving and Communication Systems (PACS) are typically oriented to support a single healthcare
institution, and the sharing of medical data across institutions is still a difficult process. This
paper describes a proposal to publish and control Digital Imaging Communications in Medicine
(DICOM) services in a wide domain composed of several healthcare institutions. The system
creates virtual bridges between intranets enabling the exchange, search and store of the medical data within the wide domain. The service provider publishes the DICOM services following a token-based strategy. The token advertisements are public and known by all system users. However, access to the DICOM service is controlled through a role association between an access key and the service. Furthermore, in medical diagnoses, time is a crucial factor. Therefore, our system is a turnkey solution, capable of exchanging medical data across firewalls and Network Address Translation (NAT), avoiding bureaucratic issues with local network security. Security is also an important concern - in any transmission across different domains, data is encrypted by Transport Layer Security (TLS).
KEYWORDS: Picture Archiving and Communication System, Medical imaging, Teleradiology, Radiology, Legal, Medicine, Data communications, X-rays, Equipment and services, Lead
The asymmetric distribution of PACS equipment and service providers across countries leads typically to the need to
hire third party service professionals outside the institutions where the exams were made. In this paper we present a
brokerage mechanism that puts customers and remote providers together in a seamless way.
The proposed solution, asserted with a case study for the Portuguese national health system, addresses the problems that
now impair the optimal provision of those services, enabling a more agile relationship between buyers and sellers,
optimizing administrative work and complying with clinical and legal requirements under discussion in the European
Union for the free movement of patients and professional health workers.
In this document, the detailed process and technical description of the broker functioning is made, and the main benefits
for the participants are also evaluated from a technical and economical point of view.
Finally, in the discussion chapter, an assessment of the creation of a spot market for imaging studies is made and the
integration with other similar markets is discussed.
The interest in tourism has always been strong, for its important role in economic flows among nations. On this study
we analyze the arrivals of international tourism (edges) over 206 countries and territories (nodes) around the world, on
the year 2004. International tourist arrivals reached a record of 763 million in 2004. We characterize analytically the
topological and weighted properties of the resulting network.
International tourist arrivals are analyzed over in strength and out strength flows, resulting on a highly directed network,
with a very heterogeneity of weights and strengths. The inclusion of edge weights and directions on the analysis of network
architecture allows a more realistic insight on the structure of the networks. Centrality, assortativity and disparity are
measured for the topological and weighted structure. Assortativity measures the tendency of having a high weight edges
connecting two nodes with similar degrees. ITN is disassortative, opposite to social network. Disparity quantifies the how
similar are the flows on a node neighborhood, measuring the heterogeneity of weights for in flows and out flows of tourism.
These results provide an application of the recent methods of weighted and directed networks, showing that weights
are relevant and that in general the modeling of complex networks must go beyond topology. The network structure may
influence how tourism hubs, distribution of flows, and centralization can be explored on countries strategic positioning and
policy making.
KEYWORDS: Picture Archiving and Communication System, Medical imaging, Image compression, Internet, Web services, Diagnostics, Image quality, Medicine, Computer programming, Cardiology
During the last years, the ubiquity of web interfaces have pushed practically all PACS suppliers to develop client
applications in which clinical practitioners can receive and analyze medical images, using conventional personal
computers and Web browsers. However, due to security and performance issues, the utilization of these software
packages has been restricted to Intranets. Paradigmatically, one of the most important advantages of digital image
systems is to simplify the widespread sharing and remote access of medical data between healthcare institutions.
This paper analyses the traditional PACS drawbacks that contribute to their reduced usage in the Internet and describes
a PACS based on Web Services technology that supports a customized DICOM encoding syntax and a specific
compression scheme providing all historical patient data in a unique Web interface.
This paper presents a Cardiology oriented information system that provides permanent availability of all clinical history, including alphanumeric and image data, with time and cost-effective transmission (reduced download time), without loss of image diagnosis quality and based on a Web Multimedia Integrated Access Interface. This implies the integration of HIS and PACS in a unique access interface, providing on-line and fast access to authorized healthcare professionals. The benefits obtained from the HIS-PACS integration and from the availability of all historical patient data are unquestionable to practitioners but also to the patients. Moreover, the system includes a telematic platform capable of establishing cooperative telemedicine sessions where our most impressive utilization is a transcontinental work platform for cardiovascular ultrasound. The key point of our approach starts with the construction of a DICOM private transfer syntax that is prepared to support any video encoder installed on a Windows-based station. With this structure it is possible to select the best encoder to a specific modality and work scenario. Good trade-off between compression ratio and diagnostic quality, low network traffic load, backup facilities and data portability are other achievements of this system.
KEYWORDS: Picture Archiving and Communication System, Cardiology, Data modeling, Video, Asynchronous transfer mode, Local area networks, Visualization, Cardiac imaging, Medical imaging, Telecommunications
This paper describes an integrated system designed to provide efficient means for DICOM compliant cardiac imaging archival, transmission and visualization based on a communications backbone matching recent enabling telematic technologies like Asynchronous Transfer Mode (ATM) and switched Local Area Networks (LANs). Within a distributed client-server framework, the system was conceived on a modality based bottom-up approach, aiming ultrafast access to short term archives and seamless retrieval of cardiac video sequences throughout review stations located at the outpatient referral rooms, intensive and intermediate care units and operating theaters.
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