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Internet patient records: new techniques.

Brelstaff G, Moehrs S, Anedda P, Tuveri M, Zanetti G - J. Med. Internet Res. (2001 Jan-Mar)

Bottom Line: Indeed, second-generation Internet technologies such as the ones described in this article--XML (eXtensible Markup Language), XSL (eXtensible Style Language), DOM (Document Object Model), CSS (Cascading Style Sheet), JavaScript, and JavaBeans--may significantly reduce the complexity of the development of distributed healthcare systems.Early indications are that the rapid prototyping of reports afforded by our EPR system can assist communication between clinical specialists and our system developers.We are now experimenting with new technologies that may provide services to the kind of XML EPR client described here.

View Article: PubMed Central - HTML - PubMed

Affiliation: CRS4, BioMedical Area, Sardinia, Uta, 09010, Cagliari, Italy. gjb@crs4.it

ABSTRACT

Background: The ease by which the Internet is able to distribute information to geographically-distant users on a wide variety of computers makes it an obvious candidate for a technological solution for electronic patient record systems. Indeed, second-generation Internet technologies such as the ones described in this article--XML (eXtensible Markup Language), XSL (eXtensible Style Language), DOM (Document Object Model), CSS (Cascading Style Sheet), JavaScript, and JavaBeans--may significantly reduce the complexity of the development of distributed healthcare systems.

Objective: The demonstration of an experimental Electronic Patient Record (EPR) system built from those technologies that can support viewing of medical imaging exams and graphically-rich clinical reporting tools, while conforming to the newly emerging XML standard for digital documents. In particular, we aim to promote rapid prototyping of new reports by clinical specialists.

Methods: We have built a prototype EPR client, InfoDOM, that runs in both the popular web browsers. In this second version it receives each EPR as an XML record served via the secure SSL (Secure Socket Layer) protocol. JavaBean software components manipulate the XML to store it and then to transform it into a variety of useful clinical views. First a web page summary for the patient is produced. From that web page other JavaBeans can be launched. In particular, we have developed a medical imaging exam Viewer and a clinical Reporter bean parameterized appropriately for the particular patient and exam in question. Both present particular views of the XML data. The Viewer reads image sequences from a patient-specified network URL on a PACS (Picture Archiving and Communications System) server and presents them in a user-controllable animated sequence, while the Reporter provides a configurable anatomical map of the site of the pathology, from which individual "reportlets" can be launched. The specification of these reportlets is achieved using standard HTML forms and thus may conceivably be authored by clinical specialists. A generic JavaScript library has been written that allows the seamless incorporation of such contributions into the InfoDOM client. In conjunction with another JavaBean, that library renders graphically-enhanced reporting tools that read and write content to and from the XML data-structure, ready for resubmission to the EPR server.

Results: We demonstrate the InfoDOM experimental EPR system that is currently being adapted for test-bed use in three hospitals in Cagliari, Italy. For this we are working with specialists in neurology, radiology, and epilepsy.

Conclusions: Early indications are that the rapid prototyping of reports afforded by our EPR system can assist communication between clinical specialists and our system developers. We are now experimenting with new technologies that may provide services to the kind of XML EPR client described here.

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Related in: MedlinePlus

The Reporter Bean (top-left) is launched from the EPR Browser. Each report is configured to the particular exam in question, here the left coronary artery. The user clicks on the resultant image map (SVG encoded) to initiate a reportlet page from a menu of context-sensitive reportlets. Here, the user chose to report on Arteriosclerosis for the vessel labeled IVA II. A reportlet (bottom) for Arteriosclerosis then appears and allows the medics to graphically specify the clinical signs appropriate for their patient. As is shown, the interface is constructed from sliders, pull-down text menus and pop-up image menus; there is no way to hand type information. The colored part of the menu-bar is a decision support aid that dynamically indicates the type of lesion, based on the evidence accumulated in the report. In this case the simple voting heuristic implemented indicates that a type B lesion is the most likely interpretation. The next figure illustrates the mechanism underlying each reportlet
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figure4: The Reporter Bean (top-left) is launched from the EPR Browser. Each report is configured to the particular exam in question, here the left coronary artery. The user clicks on the resultant image map (SVG encoded) to initiate a reportlet page from a menu of context-sensitive reportlets. Here, the user chose to report on Arteriosclerosis for the vessel labeled IVA II. A reportlet (bottom) for Arteriosclerosis then appears and allows the medics to graphically specify the clinical signs appropriate for their patient. As is shown, the interface is constructed from sliders, pull-down text menus and pop-up image menus; there is no way to hand type information. The colored part of the menu-bar is a decision support aid that dynamically indicates the type of lesion, based on the evidence accumulated in the report. In this case the simple voting heuristic implemented indicates that a type B lesion is the most likely interpretation. The next figure illustrates the mechanism underlying each reportlet

Mentions: Clicking on the [Edit] link in theEPR Browser launches a context-specific Reporter tool. Figure 4 (top) illustrates the configuration for reporting on coronary arteries. The design follows an anatomical image map paradigm. The image map structure is read as SVG and its context-sensitive pop-up menu is specified in XML. For example the figure shows the IVA-II artery and a pop-up menu that can launch three different types of report: Arteriosclerosis, Bypass, or Myocardial Bridge. Selecting a menu item launches a pop-up reportlet window; the Arteriosclerosis reportlet window is illustrated in Figure 4 (bottom).


Internet patient records: new techniques.

Brelstaff G, Moehrs S, Anedda P, Tuveri M, Zanetti G - J. Med. Internet Res. (2001 Jan-Mar)

The Reporter Bean (top-left) is launched from the EPR Browser. Each report is configured to the particular exam in question, here the left coronary artery. The user clicks on the resultant image map (SVG encoded) to initiate a reportlet page from a menu of context-sensitive reportlets. Here, the user chose to report on Arteriosclerosis for the vessel labeled IVA II. A reportlet (bottom) for Arteriosclerosis then appears and allows the medics to graphically specify the clinical signs appropriate for their patient. As is shown, the interface is constructed from sliders, pull-down text menus and pop-up image menus; there is no way to hand type information. The colored part of the menu-bar is a decision support aid that dynamically indicates the type of lesion, based on the evidence accumulated in the report. In this case the simple voting heuristic implemented indicates that a type B lesion is the most likely interpretation. The next figure illustrates the mechanism underlying each reportlet
© Copyright Policy
Related In: Results  -  Collection

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figure4: The Reporter Bean (top-left) is launched from the EPR Browser. Each report is configured to the particular exam in question, here the left coronary artery. The user clicks on the resultant image map (SVG encoded) to initiate a reportlet page from a menu of context-sensitive reportlets. Here, the user chose to report on Arteriosclerosis for the vessel labeled IVA II. A reportlet (bottom) for Arteriosclerosis then appears and allows the medics to graphically specify the clinical signs appropriate for their patient. As is shown, the interface is constructed from sliders, pull-down text menus and pop-up image menus; there is no way to hand type information. The colored part of the menu-bar is a decision support aid that dynamically indicates the type of lesion, based on the evidence accumulated in the report. In this case the simple voting heuristic implemented indicates that a type B lesion is the most likely interpretation. The next figure illustrates the mechanism underlying each reportlet
Mentions: Clicking on the [Edit] link in theEPR Browser launches a context-specific Reporter tool. Figure 4 (top) illustrates the configuration for reporting on coronary arteries. The design follows an anatomical image map paradigm. The image map structure is read as SVG and its context-sensitive pop-up menu is specified in XML. For example the figure shows the IVA-II artery and a pop-up menu that can launch three different types of report: Arteriosclerosis, Bypass, or Myocardial Bridge. Selecting a menu item launches a pop-up reportlet window; the Arteriosclerosis reportlet window is illustrated in Figure 4 (bottom).

Bottom Line: Indeed, second-generation Internet technologies such as the ones described in this article--XML (eXtensible Markup Language), XSL (eXtensible Style Language), DOM (Document Object Model), CSS (Cascading Style Sheet), JavaScript, and JavaBeans--may significantly reduce the complexity of the development of distributed healthcare systems.Early indications are that the rapid prototyping of reports afforded by our EPR system can assist communication between clinical specialists and our system developers.We are now experimenting with new technologies that may provide services to the kind of XML EPR client described here.

View Article: PubMed Central - HTML - PubMed

Affiliation: CRS4, BioMedical Area, Sardinia, Uta, 09010, Cagliari, Italy. gjb@crs4.it

ABSTRACT

Background: The ease by which the Internet is able to distribute information to geographically-distant users on a wide variety of computers makes it an obvious candidate for a technological solution for electronic patient record systems. Indeed, second-generation Internet technologies such as the ones described in this article--XML (eXtensible Markup Language), XSL (eXtensible Style Language), DOM (Document Object Model), CSS (Cascading Style Sheet), JavaScript, and JavaBeans--may significantly reduce the complexity of the development of distributed healthcare systems.

Objective: The demonstration of an experimental Electronic Patient Record (EPR) system built from those technologies that can support viewing of medical imaging exams and graphically-rich clinical reporting tools, while conforming to the newly emerging XML standard for digital documents. In particular, we aim to promote rapid prototyping of new reports by clinical specialists.

Methods: We have built a prototype EPR client, InfoDOM, that runs in both the popular web browsers. In this second version it receives each EPR as an XML record served via the secure SSL (Secure Socket Layer) protocol. JavaBean software components manipulate the XML to store it and then to transform it into a variety of useful clinical views. First a web page summary for the patient is produced. From that web page other JavaBeans can be launched. In particular, we have developed a medical imaging exam Viewer and a clinical Reporter bean parameterized appropriately for the particular patient and exam in question. Both present particular views of the XML data. The Viewer reads image sequences from a patient-specified network URL on a PACS (Picture Archiving and Communications System) server and presents them in a user-controllable animated sequence, while the Reporter provides a configurable anatomical map of the site of the pathology, from which individual "reportlets" can be launched. The specification of these reportlets is achieved using standard HTML forms and thus may conceivably be authored by clinical specialists. A generic JavaScript library has been written that allows the seamless incorporation of such contributions into the InfoDOM client. In conjunction with another JavaBean, that library renders graphically-enhanced reporting tools that read and write content to and from the XML data-structure, ready for resubmission to the EPR server.

Results: We demonstrate the InfoDOM experimental EPR system that is currently being adapted for test-bed use in three hospitals in Cagliari, Italy. For this we are working with specialists in neurology, radiology, and epilepsy.

Conclusions: Early indications are that the rapid prototyping of reports afforded by our EPR system can assist communication between clinical specialists and our system developers. We are now experimenting with new technologies that may provide services to the kind of XML EPR client described here.

Show MeSH
Related in: MedlinePlus