Picture Archiving and Communication Systems (PACS) have been widely deployed in healthcare institutions, and they now constitute a normal commodity for practitioners. However, its installation, maintenance, and utilization are still a burden due to their heavy structures, typically supported by centralized computational solutions. In this paper, we present Dicoogle, a PACS archive supported by a document-based indexing system and by peer-to-peer (P2P) protocols. Replacing the traditional database storage (RDBMS) by a documental organization permits gathering and indexing data from file-based repositories, which allows searching the archive through free text queries. As a direct result of this strategy, more information can be extracted from medical imaging repositories, which clearly increases flexibility when compared with current query and retrieval DICOM services. The inclusion of P2P features allows PACS internetworking without the need for a central management framework. Moreover, Dicoogle is easy to install, manage, and use, and it maintains full interoperability with standard DICOM services.

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Dicoogle - an open source peer-to-peer PACS.

Examining the role of collaboration in studies of health information technologies in biomedical informatics

As the Electronic Health Record (EHR) systems constantly expand to support more clinical activities and their implementations in healthcare organizations become more widespread, several communities have been working intensively for several years to develop open access and open source EHR software, aiming at reducing the costs of EHR deployment and maintenance. In this paper, we describe and evaluate the most popular open source electronic medical records such as openEMR, openMRS and patientOS, providing their technical features and potentials. These systems are considered quite important due to their prevalence. The article presents the key features of each system and outlines the advantages and problems of Open Source Software (OSS) Systems through a review of the literature, in order to demonstrate the possibility of their adoption in modern electronic healthcare systems. Also discussed are the future trends of OS EHRs in the context of the Personal Health Records and mobile computing paradigm.

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Towards the Adoption of Open Source and Open Access Electronic Health Record Systems

The exchange of medical images over the Internet has evoked significant interest over the past few years due to the introduction of web and cloud based medical information systems The protection of sensitive data has always been a key indicator in the performance of such systems In this context, this work presents an algorithm developed for Digital Imaging and Communications in Medicine (DICOM) medical images, which applies secret-sharing steganography methods for ensuring the integrity of sensitive patient data as well as the important parts of the image In the proposed algorithm, images are divided into two parts: the region of interest (ROI) and the region of non interest (RONI) Patient data and integrity hashes are positioned inside the ROI while the information (map) needed to recover the ROI before insertion is positioned in the RONI Security of the extraction process is assured through the use of cryptography The experimental results prove that the original (cover) images and the stego images provide an excellent visual equality result in terms of PSNR Furthermore, they prove that the proposed scheme can be efficiently used as a steganography scheme in DICOM images with limited smooth areas

Sensitive Patient Data Hiding using a ROI Reversible Steganography Scheme for DICOM Images

The present paper studies the prospective and the performance of a forthcoming high-speed third generation (3.5G) networking technology, called enhanced uplink, for delivering mobile health (m-health) applications. The performance of 3.5G networks is a critical factor for successful development of m-health services perceived by end users. In this paper, we propose a methodology for performance assessment based on the joint uplink transmission of voice, real-time video, biological data (such as electrocardiogram, vital signals, and heart sounds), and healthcare records file transfer. Various scenarios were concerned in terms of real-time, nonreal-time, and emergency applications in random locations, where no other system but 3.5G is available. The accomplishment of quality of service (QoS) was explored through a step-by-step improvement of enhanced uplink system's parameters, attributing the network system for the best performance in the context of the desired m-health services.

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Performance Evaluation of an Enhanced Uplink 3.5G System for Mobile Healthcare Applications

Recent developments in networking and computing technologies and the expansion of the electronic health record system have enabled the possibility of online collaboration between geographically distributed medical personnel. In this context, the paper presents a Web-based application, which implements a collaborative working environment for physicians by enabling the peer-to-peer exchange of electronic health records. The paper treats technological issues such as Video, Audio and Message Communication, Workspace Management, Distributed Medical Data Management and exchange, while it emphasizes on the Security issues arisen, due to the sensitive and private nature of the medical information. In the paper, we present initial results from the system in practice and measurements regarding transmission times and bandwidth requirements. A wavelet based image compression scheme is also introduced for reducing network delays. A number of physicians were asked to use the platform for testing purposes and for measuring user acceptance. The system was considered by them to be very useful, as they found that the platform simulated very well the personal contact between them and their colleagues during medical meetings.

Constantinos Delakouridis

Papers

Enabling Collaborative Medical Diagnosis Over the Internet via Peer-to-Peer Distribution of Electronic Health Records