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Showing papers in "Journal of Medical Systems in 2006"


Journal ArticleDOI
TL;DR: A microscopic study compared two GIS-based measures of accessibility in a case study of dialysis service centers in Chicago and found a significant mismatch of the accessibility ratios between the two methods.
Abstract: The inequitable geographic distribution of health care resources has long been recognized as a problem in the United States. Traditional measures, such as a simple ratio of supply to demand in an area or distance to the closest provider, are easy measures for spatial accessibility. However the former one does not consider interactions between patients and providers across administrative borders and the latter does not account for the demand side, that is, the competition for the supply. With advancements in GIS, however, better measures of geographic accessibility, variants of a gravity model, have been applied. Among them are (1) a two-step floating catchment area (2SFCA) method and (2) a kernel density (KD) method. This microscopic study compared these two GIS-based measures of accessibility in our case study of dialysis service centers in Chicago. Our comparison study found a significant mismatch of the accessibility ratios between the two methods. Overall, the 2SFCA method produced better accessibility ratios. There is room for further improvement of the 2SFCA method--varying the radius of service area according to the type of provider or the type of neighborhood and determining the appropriate weight equation form--still warrant further study.

248 citations


Journal ArticleDOI
TL;DR: Differences in health information seeking between Hispanics and Whites existed in both 2000 and 2002, and data highlight the persistence of “Digitally Underserved Groups,” despite recent Divide reduction strategies.
Abstract: Policy initiatives of the late 1990s were believed to have largely eliminated the information "Digital Divide." For healthcare consumers, access to information is an essential part of the consumer-centric framework outlined in the recently proposed national health information initiative. This study sought to examine how racial/ethnic characteristics are associated with Internet use and online health information. Using a cross-sectional nationwide study of reported Internet use and information search in 2000 and 2002, we studied a stratified sample of computer users from the Pew Internet & American Life Project surveys. Adjusted estimates of race/ethnicity and income effects on Internet use and search behaviors were derived from generalized estimating equations. Results show wide gaps in the use of computers between Hispanics and Whites (OR = 0.593 [0.440, 0.798]) and between African-Americans and Whites (OR = 0.554 [0.427, 0.720]) in 2000 significantly narrowed in 2002 (OR of Hispanic to white = 1.250 [0.874, 1.789]; OR of African-American to Whites = (0.793 [0.551, 1.141]). Gaps in access to the Internet, however, remained consistent between 2000---2002. Differences in health information seeking between Hispanics and Whites existed in both 2000 and 2002. 56% of White Internet users at some time searched for online health information, whereas 42% of Hispanic Internet users did so in 2000. By 2002, these percentages had increased to 13.4 and 15.8%, respectively. Data highlight the persistence of "Digitally Underserved Groups," despite recent Divide reduction strategies.

175 citations


Journal ArticleDOI
TL;DR: The challenges in measuring return on investment (ROI) are described and published ROI studies on health IT studies are reviewed to suggest the early stage of this knowledge base is needed.
Abstract: In the current paper, we describe the challenges in measuring return on investment (ROI) and review published ROI studies on health IT. In addition, given the absence of a robust ROI literature base, we review the general benefits and potential costs of various health IT applications including electronic health records (EHRs), computerized physicians order entry (CPOE) systems, and clinical decision support systems (CDSS). We conclude that articles examining these benefits are much more common than studies examining ROI itself. This trend suggests the early stage of this knowledge base. Additional research utilizing broader perspectives and multidisciplinary techniques will be needed before a better understanding of ROI from health IT is achieved.

135 citations


Journal ArticleDOI
TL;DR: The storing and transmission of sensitive patient data in the modern health care system and current security practices that health care providers institute to comply with HIPAA Security Rule regulations are discussed.
Abstract: This paper discusses the challenges associated with privacy in health care in the electronic information age based on the Health Insurance Portability and Accountability Act (HIPAA) and the Security Rules. We examine the storing and transmission of sensitive patient data in the modern health care system and discuss current security practices that health care providers institute to comply with HIPAA Security Rule regulations. Based on our research results, we address current outstanding issues that act as impediments to the successful implementation of security measures and conclude the discussion and offer possible avenues of future research.

98 citations


Journal ArticleDOI
TL;DR: The objective of this study is to analyze the security protection of personal health record systems and propose some security mechanisms to tackle these problems.
Abstract: The objective of this study is to analyze the security protection of personal health record systems. To achieve this we have investigated different personal health record systems, their security functions, and security issues. We have noted that current security mechanisms are not adequate and we have proposed some security mechanisms to tackle these problems.

95 citations


Journal ArticleDOI
TL;DR: This exploratory technology assessment study seeks to differentiate and delineate specific behaviors, or lack of desired behaviors, across targeted health care subgroups, to allow the design of more effective strategies to promote the use of the Web as a health education and health promotion tool.
Abstract: The growing diversity of the online health information community is increasingly cited as a limiting factor related to the potential of the Internet as an effective health communication channel and information resource. Public-access Internet portals and decreasing costs of personal computers have created a consensus that unequal access to information, or a "Digital Divide," presents a like problem specific to health care consumers. Access to information, however, is an essential part of the consumer-centric framework outlined in the recently proposed U.S. National Health Information Infrastructure (NHII) and Health Architecture initiatives. To date little research has been done to differentiate the types of health information sought on the Web by different subgroups, linking user characteristics and health-seeking behaviors. Data from a study of consumer Web search activity in a post-intervention era serves as a natural experiment, and can identify whether a "digitally underserved group" persists in the United States. Such an environment would serve to exclude traditionally underserved groups from the benefits of the planned national heath information infrastructure. This exploratory technology assessment study seeks to differentiate and delineate specific behaviors, or lack of desired behaviors, across targeted health care subgroups. Doing so allows the design of more effective strategies to promote the use of the Web as a health education and health promotion tool, under the envisioned shared decision-making, consumer-centric health information model.

94 citations


Journal ArticleDOI
TL;DR: The software presented in this paper enables schedulers to instantaneously view the impact of, e.g., an exchange of two block assignments in the master surgery schedule on the expected resource consumption pattern.
Abstract: This paper presents a software system that visualizes the impact of the master surgery schedule on the demand for various resources throughout the rest of the hospital. The master surgery schedule can be seen as the engine that drives the hospital. Therefore, it is very important for decision makers to have a clear image on how the demand for resources is linked to the surgery schedule. The software presented in this paper enables schedulers to instantaneously view the impact of, e.g., an exchange of two block assignments in the master surgery schedule on the expected resource consumption pattern. A case study entailing a large Belgian surgery unit illustrates how the software can be used to assist in building better surgery schedules.

76 citations


Journal ArticleDOI
TL;DR: The results demonstrate consistently superior performance of the covariance methods over Yule–Walker AR and Welch methods.
Abstract: Brain is one of the most critical organs of the body. Synchronous neuronal discharges generate rhythmic potential fluctuations, which can be recorded from the scalp through electroencephalography. The electroencephalogram (EEG) can be roughly defined as the mean electrical activity measured at different sites of the head. EEG patterns correlated with normal functions and diseases of the central nervous system. In this study, EEG signals were analyzed by using autoregressive (parametric) and Welch (non-parametric) spectral estimation methods. The parameters of autoregressive (AR) method were estimated by using Yule---Walker, covariance and modified covariance methods. EEG spectra were then used to compare the applied estimation methods in terms of their frequency resolution and the effects in determination of spectral components. The variations in the shape of the EEG power spectra were examined in order to epileptic seizures detection. Performance of the proposed methods was evaluated by means of power spectral densities (PSDs). Graphical results comparing the performance of the proposed methods with that of Welch technique were given. The results demonstrate consistently superior performance of the covariance methods over Yule---Walker AR and Welch methods.

61 citations


Journal ArticleDOI
TL;DR: Experimental results indicates that the proposed filter is improvable with increased fuzzy rules to reduce more noise corrupted images and to remove salt and pepper noise in a more effective way than what AMF filter does.
Abstract: A new rule based fuzzy filter for removal of highly impulse noise, called Rule Based Fuzzy Adaptive Median (RBFAM) Filter, is aimed to be discussed in this paper. The RBFAM filter is an improved version of Adaptive Median Filter (AMF) and is presented in the aim of noise reduction of images corrupted with additive impulse noise. The filter has three stages. Two of those stages are fuzzy rule based and last stage is based on standard median and adaptive median filter. The proposed filter can preserve image details better then AMF while suppressing additive salt&pepper or impulse type noise. In this paper, we placed our preference on bell-shaped membership function instead of triangular membership function in order to observe better results. Experimental results indicates that the proposed filter is improvable with increased fuzzy rules to reduce more noise corrupted images and to remove salt and pepper noise in a more effective way than what AMF filter does.

54 citations


Journal ArticleDOI
TL;DR: The results showed that patient-specific demographic characteristics were insignificant in explaining satisfaction level with food services, but the variables of taste and appearance of the food were statistically significant and important determinants of patient satisfaction with the foods served at the hospital.
Abstract: Objective: To determine the factors affecting general satisfaction level of patients with the food services in a military hospital in Turkey. Study design: The study was carried out in a military hospital providing tertiary health care services with the capacity of 1000 hospital bed. A questionnaire was used as data collection tool on measuring satisfaction of the patients with the food services. Results: The results showed that of 374 patients 51.3% evaluated food service quality adequate, 32.4% said that the food quality was inadequate, and 16.3% stated that they were uncertain. A logistic regression model was estimated in determining the most important and statistically significant factors affecting patient satisfaction with hospital foods and food services. The results showed that patient-specific demographic characteristics were insignificant in explaining satisfaction level with food services, but the variables of taste (OR = 9.853, p = 0.000) and appearance (OR = 2.687, p = 0.014) of the food were statistically significant and important determinants of patient satisfaction with the foods served at the hospital. Conclusions: The results of this study would be helpful in making decision on increasing the level of satisfaction of patients with the food services for hospital managers and the food (nutrition) departments. On the other hand, the results can also be used in benchmarking the hospital's food services quality with other hospitals, and in monitoring improvements in food services quality in the future.

51 citations


Journal ArticleDOI
TL;DR: Healthcare informatics research is a scientific endeavor that applies information science, computer technology, and statistical modeling techniques to develop decision support systems for improving both health service organizations' performance and patient care outcomes.
Abstract: Healthcare informatics research is a scientific endeavor that applies information science, computer technology, and statistical modeling techniques to develop decision support systems for improving both health service organizations' performance and patient care outcomes. The analytical strategies include (1) the formulation of a data warehouse for exploration, (2) data mining, (3) the application of confirmatory statistical analysis, (4) simulation via an interface with computer and information system technologies, and (5) translational research. Healthcare informatics research will help to direct evidence-based strategic management.

Journal ArticleDOI
TL;DR: A survey of major works in computational prediction of protein–protein interactions, explaining their assumptions, main ideas, and limitations is presented.
Abstract: Discovery of the protein interactions that take place within a cell can provide a starting point for understanding biological regulatory pathways. Global interaction patterns among proteins, for example, can suggest new drug targets and aid the design of new drugs by providing a clearer picture of the biological pathways in the neighborhoods of the drug targets. High-throughput experimental screens have been developed to detect protein---protein interactions, however, they show high rates of errors in terms of false positives and false negatives. Many computational approaches have been proposed to tackle the problem of protein---protein interaction prediction. They range from comparative genomics based methods to data integration based approaches. Challenging properties of protein---protein interaction data have to be addressed appropriately before a higher quality interaction map with better coverage can be achieved. This paper presents a survey of major works in computational prediction of protein---protein interactions, explaining their assumptions, main ideas, and limitations.

Journal ArticleDOI
TL;DR: Comparison of CIS within one state’s urban and rural hospitals sheds light on variation in clinical support applications, decision support, and electronic medical record “readiness” in these settings.
Abstract: Clinical information systems (CIS) capture clinical data to support more efficient and effective decision making and clinical care delivery. Only a few estimates of CIS availability and use in hospitals are available nationally. The purpose of the current research is to examine differences in CIS availability and use between urban and rural hospitals. A survey addressing this purpose was completed by 74 (63.7%) of Iowa hospitals. Rural hospitals lag behind urban hospitals in terms of many CIS applications. More than 80% of the urban hospitals, but only between 30 and 40% of the rural hospitals, reported using computers to collect basic clinical information for potential use in an electronic medical record (EMR) and computerized provider order entry (CPOE) system. Comparison of CIS within one state's urban and rural hospitals sheds light on variation in clinical support applications, decision support, and electronic medical record "readiness" in these settings.

Journal ArticleDOI
TL;DR: A Web-based application is presented, which implements a collaborative working environment for physicians by enabling the peer-to-peer exchange of electronic health records by treating technological issues such as Video, Audio and Message Communication, Workspace Management, Distributed Medical Data Management and exchange.
Abstract: 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.

Journal ArticleDOI
TL;DR: Survey research highlights factors that affect physician satisfaction and utilizing of this new technology in a hospital setting and outcome survey data suggests areas for improvement.
Abstract: The Electronic Medical Record (EMR) is a computerized record of clinical, demographic and management information. EMR is an enabling technology that allows physicians to utilize quality improvement processes in the practice of medicine. Oman is one of the Middle Eastern Countries that has implemented an integrated electronic hospital information system at government health care institutions. The system was first applied in primary health care centers and then implemented in hospitals. Survey research highlights factors that affect physician satisfaction and utilizing of this new technology in a hospital setting. Outcome survey data suggests areas for improvement. Specific concerns about patient confidentiality are discussed as well as quality improvement in patient care.

Journal ArticleDOI
TL;DR: Overall, response bias was not detected using established methodologies in this mailed survey of physician EHR use and similar surveys of physicians, even with a lower than expected response rate, may still be valid.
Abstract: Monitoring the diffusion of electronic health records (EHR) into ambulatory clinical practice has important policy implications. However, estimates of EHR use are typically derived from survey data and may be subject to significant response bias. The current study is a retrospective analysis testing for response bias in a large information technology survey of physicians (n=14,921). To detect bias, respondents were compared to nonrespondents on known characteristics. Moreover, early respondents were compared to late respondents with respect to key variables in the survey that are likely to influence participation. The 4203 respondents (28.2% participation rate) did not differ demographically from nonrespondents. Response rates, by specialty, differed slightly. When comparing early and late survey respondents, no differences were detected in EHR use, length of time since EHR installation, practice size, physician age, years since medical school graduation, and years of practice in their current community. Overall, response bias was not detected using established methodologies in this mailed survey of physician EHR use. Similar surveys of physicians, even with a lower than expected response rate, may still be valid.

Journal ArticleDOI
TL;DR: The privately owned health centers were found to be more efficient than public facilities and the public facilities were both allocatively and cost inefficient.
Abstract: This study uses Data Envelopment Analysis (DEA) to estimate the degree of technical, allocative and cost efficiency in individual public and private health centres in Zambia; and to identify the relative inefficiencies in the use of various inputs among individual health centers. About 83% of the 40 health centres were technically inefficient; and 88% of them were both allocatively and cost inefficient. The privately owned health centers were found to be more efficient than public facilities.

Journal ArticleDOI
TL;DR: In this article, the authors analyze a territorial approach to deliver nursing homecare services to a territory public health and conclude that the territorial approach does not sufficiently support fluctuations in population needs for services.
Abstract: We analyze a territorial approach to deliver nursing homecare services to a territory public health. We present the case of the CSSS assigned to Cote-des-Neiges, Metro center and Parc Extension, specifically the case of the Cote-des-Neiges site (CLSC CDN), where a territorial approach is used since 1980. We first give an historical comparison of patient visits delivered in 1998---1999 and in 2002---2003. We follow with an in-depth analysis of the home services delivered in 2002---2003 to determine whether or not the territorial approach can well support the changing needs of the population. We conclude that the territorial approach to deliver homecare nursing services does not sufficiently support fluctuations in population needs for services. Not only is it difficult to predict these fluctuations, but it is difficult to accurately quantify the true needs for services since the availability of nursing services tends to determine the services actually delivered. In sectors of the territory where resources are more scarce (based on previous population needs analyses) or demand for services is greater, the result is work overload for the nursing staff. In addition, this results in service delivery inequities across the entire territory. Therefore, a more dynamic assignment of clients to the nurses based on each nurse's work load and case load rather than based on the geographic location of clients is worth the extra administrative time in case assignment to ensure a more equitable case load attribution between nurses as well as less inequities between clients in terms of service delivery considering their needs.

Journal ArticleDOI
TL;DR: This study showed that application of this model could identify CHC patients with clinically significant fibrosis with a high degree of accuracy and may decrease the need for liver biopsy.
Abstract: Although liver biopsy is currently regarded as the gold standard for staging liver fibrosis in chronic hepatitis C, it is a costly invasive procedure and carries a small risk for complication Our aim in this study was to construct a simple model to distinguish between patients with no or mild fibrosis (METAVIR F0---F1) versus those with clinically significant fibrosis (METAVIR F2---F4) We retrospectively studied 204 consecutive CHC patients Thirty-four serum markers with age, gender, duration of infection were assessed to classify fibrosis with a classifier known as the support vector machine (SVM) The method of feature selection known as sequential forward floating selection (SFFS) was introduced before the performance of SVM When four serum markers were extracted with SFFS-SVM, F2---F4 could be predicted accurately in 96% Our study showed that application of this model could identify CHC patients with clinically significant fibrosis with a high degree of accuracy and may decrease the need for liver biopsy

Journal ArticleDOI
TL;DR: In this study, the ECG signal were measured as noiseless with Ag/AgCl electrodes, then converted digital data using pulse code modulation (PCM) technique to monitor and record on the PC of human with chronic heart disease in their living surroundings.
Abstract: In this study, the ECG signal were measured as noiseless with Ag/AgCl electrodes, then converted digital data using pulse code modulation (PCM) technique. The digital data were then sent to receiver where it is in 433 MHz FM/FSK transmitter, which has 10 mW output power and 9.6 Kps transmission speed. At the receiver, the digital data were reconverted to analog signal to monitor and record on the PC with Sonic Foundry Sound Forge 6.0 program. The power spectrum of measured ECG signal was formed using Matlab program. As a result, the medical supporting system is realized for monitoring the ECG signal on PC of human with chronic heart disease in their living surroundings.

Journal ArticleDOI
TL;DR: It is found that the compression efficiency of the neural network based predictive techniques is significantly improved by using the error modeling schemes, and the bits per sample required for EEG compression with error modeling and entropy coding lie in the range of 2.92 to 6.62 which indicates a saving of 0.3 to 0.7 bits.
Abstract: Two-stage lossless data compression methods involving predictors and encoders are well known. This paper discusses the application of context based error modeling techniques for neural network predictors used for the compression of EEG signals. Error modeling improves the performance of a compression algorithm by removing the statistical redundancy that exists among the error signals after the prediction stage. In this paper experiments are carried out by using human EEG signals recorded under various physiological conditions to evaluate the effect of context based error modeling in the EEG compression. It is found that the compression efficiency of the neural network based predictive techniques is significantly improved by using the error modeling schemes. It is shown that the bits per sample required for EEG compression with error modeling and entropy coding lie in the range of 2.92 to 6.62 which indicates a saving of 0.3 to 0.7 bits compared to the compression scheme without error modeling.

Journal ArticleDOI
TL;DR: It is concluded that the economic status, demographic structure, culture, and some other regional and country-specific factors should be taken into account by calculating and especially ranking the countries according to responsiveness level of their health care systems.
Abstract: With this paper it was tried to give a broad perspective about the responsiveness level of Turkish health care system, and how Turkish health care system meets the expectations of its citizens. For achieving the main purpose of this study a sample of hospital managers (n = 172) was selected, and the responsiveness questionnaire developed by WHO was administered. If the responsiveness level of Turkish health care system is measured on the basis of the Turkish hospital managers' views in the sample by using the weights reported in the World Health Report 2000, responsiveness level is calculated as 6.14, and Turkey's place should be 35 rather than 93 among 191 countries. The findings showed that Turkish health care system met confidentiality expectations of Turkish citizens better than other expectations for other aspects of responsiveness. In light of the main results of this study we conclude that the economic status, demographic structure, culture, and some other regional and country-specific factors should be taken into account by calculating and especially ranking the countries according to responsiveness level of their health care systems, and each country should carry out this kind of studies by using the views of their own key informants or preferably citizens, if possible.

Journal ArticleDOI
TL;DR: Practical barriers created by HIPAA regulation are examined and it is found that technically complicated consent forms and privacy protection forms as well as socially-sensitive clinical conditions make patients less willing to participate in research projects and requires more resources and longer time to conduct research.
Abstract: Although many perspectives on the impact of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) on health services research have been wide spread, little empirical evidence has been reported about HIPAA-related barriers during the implementation of research projects. Using three cases of health services research projects, this study examined practical barriers created by HIPAA regulation. During the stage of implementation of the three projects, we experienced some HIPAA-related concerns, previously raised in the field of health services research. We found that technically complicated consent forms and privacy protection forms as well as socially-sensitive clinical conditions make patients less willing to participate in research projects; concerns about safety of patient medical information makes health organizations more hesitant to let researchers have access to the patient's information, especially through electronic transfer; more restrictive IRB processes and challenging patient recruiting processes make health services researchers reluctant to go through the process; and as a result, they may compromise with the scientific soundness of the project. Overall, HIPAA complicates the research process and requires more resources and longer time to conduct research.

Journal ArticleDOI
TL;DR: Insight to productivity in this sector has been obtained, but particular subperiods must be isolated and further investigated, and conclusions could not be generalized for the entire study period due to alternating trends.
Abstract: This study examined total factor productivity of dialysis facilities in Greece over a 12-year period, using nationally representative panel data. Data Envelopment Analysis (DEA) was used to compute Malmquist productivity indices, which were decomposed into technical efficiency change and technological change. The sample consisted of 73 dialysis facilities operating throughout the entire study period (1993---2004), corresponding to 97.3% and 58.9% of all facilities in the first and last study years respectively. Production variables were nursing staff and dialysis machines (inputs) and dialysis sessions (output). The DEA model was input-oriented allowing for constant returns to scale (CRS). Technical efficiency change was decomposed into scale efficiency change and variable returns to scale (VRS) "pure" technical efficiency change. Mean overall efficiency, throughout the study years, ranged from 39.6 to 63.1% with an all-time average of 56.7%, and only 2---4% of the facilities were fully efficient in each study year. Productivity indices indicated year-by-year progress or regress up to 5%, but the efficiency and technological components differed, in some cases, by as much as 30%. Although interesting subperiod effects were observed, conclusions could not be generalized for the entire study period due to alternating trends. We suggest that preliminary insight to productivity in this sector has been obtained, but particular subperiods must be isolated and further investigated.

Journal ArticleDOI
TL;DR: Data Envelopment Analysis was used to measure efficiency of residential mental health facilities and suggest that efficiency improvements are possible with better use of resources but more research employing various data sets is required.
Abstract: Data Envelopment Analysis (DEA) was used to measure efficiency of residential mental health facilities. The sample consisted of 50 half-way houses, 8 nursing homes, and 32 sheltered homes. In total, 68 facilities belonged to the public sector and were 22 supervised by private non-profit organizations. Variables chosen to characterize production were: structure size (m2), staff, salaries and operational costs, and the output measure was patient numbers. An input oriented DEA model, allowing for variable returns to scale, was applied and units were ranked according to a benchmarking approach. Mean efficiency, for the whole sample, was 73.2% and 18 best practice units were found, on average, 33.1% over-efficient. The other 72 were under-performing, with 54 appearing more than 20% inefficient. The mean efficiency scores for public and private non-profit units were 68.8 and 86.6%, respectively, and significantly different (p < 0.001). Results suggest that efficiency improvements are possible with better use of resources but more research employing various data sets is required.

Journal ArticleDOI
TL;DR: Low cost, small size, portable LCD screen ECG device, and phonocardiograph were designed and with designed system, heart sounds that take synchronously with ECG signal are heard as sensitive.
Abstract: Till today, many different ECG devices are made in developing countries. In this study, low cost, small size, portable LCD screen ECG device, and phonocardiograph were designed. With designed system, heart sounds that take synchronously with ECG signal are heard as sensitive. Improved system consist three units; Unit 1, ECG circuit, filter and amplifier structure. Unit 2, heart sound acquisition circuit. Unit 3, microcontroller, graphic LCD and ECG signal sending unit to computer. Our system can be used easily in different departments of the hospital, health institution and clinics, village clinic and also in houses because of its small size structure and other benefits. In this way, it is possible that to see ECG signal and hear heart sounds as synchronously and sensitively. In conclusion, heart sounds are heard on the part of both doctor and patient because sounds are given to environment with a tiny speaker. Thus, the patient knows and hears heart sounds him/herself and is acquainted by doctor about healthy condition.

Journal ArticleDOI
TL;DR: Results show that under controlled circumstances, lossy image compression can be used to improve the diagnostic quality of the MR images, and that at certain ICR’s, it becomes virtually impossible to distinguish between the original and compressed–decompressed image.
Abstract: This paper attempts to improve the diagnostic quality of magnetic resonance (MR) images through application of lossy compression as a noise-reducing filter. The amount of imaging noise present in MR images is compared with the amount of noise introduced by the compression, with particular attention given to the situation where the compression noise is a fraction of the imaging noise. A popular wavelet-based algorithm with good performance, Set Partitioning in Hierarchical Trees (SPIHT), was employed for the lossy compression. Tests were conducted with a number of MR patient images and corresponding phantom images. Different plausible ratios between imaging noise and compression noise (ICR) were considered, and the achievable compression gain through the controlled lossy compression was evaluated. Preliminary results show that at certain ICR's, it becomes virtually impossible to distinguish between the original and compressed---decompressed image. Radiologists presented with a blind test, in certain cases, showed preference to the compressed image rather than the original uncompressed ones, indicating that under controlled circumstances, lossy image compression can be used to improve the diagnostic quality of the MR images.

Journal ArticleDOI
TL;DR: This special issue addresses a diverse set of topics such as the use of health care informatics to conduct research, clinical information systems used by the U.S. Air Force, electronic medical records and physician satisfaction in Oman, and a point of care documentation system used by hospice care providers.
Abstract: Health care informatics has emerged as a diverse and important new field of study. The field can be very broadly defined as the science that addresses how best to use information to improve health care. The field includes the four areas of bioinformatics, medical informatics, public health informatics, and consumer health informatics. Health care informatics applications can be used to improve the quality of patient care, to increase productivity, and to provide access to knowledge. After providing an overview of the field, the 10 articles contained in this special issue are briefly discussed. The first six articles address a diverse set of topics such as the use of health care informatics to conduct research, clinical information systems used by the U.S. Air Force, electronic medical records and physician satisfaction in Oman, and a point of care documentation system used by hospice care providers. The last four articles discuss the complex issues raised by the implementation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

Journal ArticleDOI
TL;DR: Using computer simulation, this study assessed the efficiency of the new process and recommended the optimal number of healthcare assistants needed for delivery of surgical instruments on ad hoc orders, at which healthcare assistants as well as surgical instruments could be most efficiently utilized.
Abstract: Timely and accurate delivery of surgical instruments to operating rooms is critical for success in surgical operations in hospitals. The National Hospital of Singapore was facing several problems in the process of surgical instrument distribution on ad hoc orders from operating rooms. To solve the problems, the Hospital management considered adopting a new process of surgical instrument distribution on ad hoc orders that involves staffing new healthcare assistants for delivery of surgical instruments to operating rooms. Using computer simulation, this study assessed the efficiency of the new process and recommended the optimal number of healthcare assistants needed for delivery of surgical instruments on ad hoc orders, at which healthcare assistants as well as surgical instruments could be most efficiently utilized. The results show that computer simulation is an effective tool supporting decisions on staffing needs for surgical instrument distribution in hospitals.

Journal ArticleDOI
TL;DR: The results showed that an estimation of the number of incident cases of prostate cancer using both methods of identification would be biased because of the high rate of false positives.
Abstract: Claims data from the "Programme de Medicalisation du Systeme d'Information" (PMSI) have been commonly used for several years to complement cancer registries and describe cancer incidence in France. It is less clear whether or not it is possible to use these data as an independent source of information to assess cancer incidence, in the absence of a regional cancer registry. Following a similar study on breast cancer, we present a study which aimed to evaluate two methods of identifying incident prostate cancer using claims data. These methods were developed using claims data from the Hospices Civils de Lyon (HCL) and their validity was tested against medical records. The first method (M1) identified incident patients as those who had at least one stay with a principal diagnosis of prostate cancer. The second method (M2) had a prostate cancer treatment code in addition to the criteria for the first method. Both methods of identification had similar results, indicating a low rate of false negatives (negative predictive values: M1=100 [CI95: 93.8---100], M2=98.6 [CI95: 90.1---99.6]) and a high rate of false positives (positive predictive values: M1=33.3 [CI95: 23.2---42.1], M2=33.7 [CI95: 24.2---43.2]). The sample size did not allow us to produce consistent estimates of sensitivity and specificity. Our results showed that an estimation of the number of incident cases of prostate cancer using both methods of identification would be biased because of the high rate of false positives. Statistical methods that correct identification errors should be used.