Medical Blog

3. large AXES OF HIS DEVELOPMENT.

The expansion plans and development of SIH present and future are already dominated by six major axes:

3.1 The telecommunication

Telecommunication resources to work more and with greater speed and wide bandwidth, that is to say capable of taking into account in addition to alphanumeric data, sounds and images.
The interconnection of local networks between them leads to the so-called open systems architecture, that is to say Federation of UNIX machines defined relational DBMS like SQL distributed more or less strongly or distributed.

3.2 The emergence of new micro-computers "minis" and "supermini"

The emergence of new micro-computers "minis" and "supermini" with large local resources in main memory, mass storage of at least 500 megabytes, availability of a range of compilers and software tools leads to more specifically focus our attention on facilities offered by a variety of them, the various workstations in UNIX, MAC-2 and following, etc. ... On the availability of a joint bit-map screen 1000 x 1000 with mouse and powerful multi-window system, the a laser printer service type postscript station also having an affair over a network Quick with other hospital services.

3.3 The new "software engineering"

The new "software engineering" of new software environments on workstation-based systems approaches focus objects whereas one or several objects simultaneously, or on hypermedia as already on MAC (MAC and 2) not only "HyperCard" but also "supercard" already allow software developments at least ten times faster than on other environments such as those of the usual personal computers and other legacy environments to "hand frames. The strategy here allows rapid prototyping by the enduser or otherwise with its close collaboration.
Naturally, it is reasonable to mention here the share of fourth generation languages and break a lance for those so-called fifth-generation.

3.4 The "knowledge engineering"

"Knowledge engineering" deserves to be considered here because it takes up strategies
Established knowledge base in expert systems by trying to anticipate how learning system in a given field of knowledge, whether in local mode or dependent one or more network servers. It is clear that a workstation should care unit given have its own environmental knowledge.

3.5 The natural language processing medical

About medical natural language processing, it is worthwhile to mention here the first applications Experimental "Linguistics String Project''automatic analysis of medical texts in natural language, developed in collaboration with N. Sager et al. the Courant Institute of Mathematics of New York University. Indeed some of these applications are able to interface a relational database such as "INGRES "integrated himself into the HIS DIOGENE from the free text medical discharge summaries from the department of Surgery and digestive system seized by word processing on microcomputers Personal connected to the network. The product of linguistic analysis is automatically inserted in the DBMS in terms of medical knowledge. This mode of analysis is also adopted for the consideration of radiology reports such as clinical specialist consultants.

3.6 The lmages

Already in 1986, during a retrospective study of six years of operating an information system radiology, integrated itself into the system SIH DIOGENE 1 it has been clearly demonstrated than 100 000 examinations annually producing 500 000 images in 32 radiology rooms, 49 percent of they are immediately though no fingerprints representative at only 10 percent of the examinations.
Calculations have shown that around 1990, all imaging techniques produce in our all hospital alone, about 0.5 terabytes, or every two years litigant without archiving mode possible (PACS = picture archiving and Communications Systems) of a new additional local Tape storage, dusted off, and humidity-controlled with a program rewriting periodic bands! We can not dodge the county and from the PACS PACS integrated into the HIS. It is true that from the outset the development of workstations for PACS have been oriented notion of comfortable tools for the rapid display of images with the best possible resolution. Moreover, we can not forget that in many clinical applications, increasing needs appear, reporting requirements of quantitative analysis of images.
Accordingly, the project is emerging to design and evaluate a workstation care unit and / or Radiology able to accommodate a large number of image analysis methods (in fact a real laboratory image analysis). Particular attention is already given to the design of the interface user to allow clinicians to use a variety of complex analytical tools images with little or no computer manipulation of virtuosity in the strict sense from the user. A another prototype development was done as an evaluation by 0. Ratib et al. on Macintosh station for the sake of convenience of its "human interface".
Anyway the new features of images, "knowledge engineering" and treatment of sub-natural medical language, must be considered inseparable! Indeed, how to enter the analysis an image at the clinical level without a narrative and conclusions of an expert in radiology! How do not want to look at an image that was just read the related report of the radiologist. Thus one in goes directly to suggestions such as those of the Uppsala group of W. Schneider have on two displays bit map of 1000 x 1000 contiguous to each other, displaying images and related reports corresponding with the additional clinical history of the patient and some digital data performance or organs that are the subject of the image.
Besides, one should not underestimate the 5 to 10 years, the growing need to assign images in clinical investigation!