In the VMW November issue, we reported on the twenty building blocks of the Euromed framework as a guiding structure to create the telemedical information society. One of the main active components constitutes the navigation around the web to gather the required medical data related to a particular patient. Since these data are kept in several databases over the Internet, a time gaining procedure of methodical search has to be developed to reduce the burden of surfing the web. Responding to this need, Euromed has defined the concept of Virtual Medical Worlds. Basically, this is the electronic health card record for each patient, dispersed over the network but accessible from one initial html page: the Personal Home Page.
Virtual Medical Worlds is built upon three components: medical images in Dicom 3.0 format stored in PACS; reconstructed medical pictures in VRML 2.0 format stored on WWW servers and medical application packages compatible with the X windows protocol. Prime condition for a physician of course is having access to a computer on the Internet. The Personal Home Page (PHP) will be located on a unique WWW 'Virtual Medical Worlds' server. From the PHP, the practitioner can trace all the medical history related to the patient.
The general idea is to divide the patient's html page into four sections. The first attributed to general administrative information; the second containing general personal details; the third presenting historical details with hyperlinks to the diagnosis reports and the Virtual Medical Worlds environment and the fourth showing specific patient information accessible by any web browser. The Virtual Medical Worlds environment is hypergraphical and broken down into whole body templates. Here, annotations can be added to hyperlink to a more detailed model of a specific organ or part of the body. To prevent physicians from following unnecessary links, shortcuts are installed in the PHP linking to respective levels of templates or information. The practitioner could for example directly open the way to the patient's heart.
In order to create a user friendly Virtual Medical Worlds environment for the physician, the following types of general procedures were identified and defined as a Personal Medical Resource (PMR): examination, examination method, specific finding, parameter, diagnosis and therapy. If applicable dynamically, each of these will be embedded as a hyperlink. To track down a PMR in whatever database, every PMR has a corresponding and unique Personal Medical Resource Locator (PMRL). Generally, the PMR is stored in the database of the hospital where it was generated and with the PMRL, the practitioner has the potential to reach the PMR throughout the medical world on Internet.
The patient's PHP is designed to contain all his PMRLs which means that it actually can be defined as a Personal Medical Resource Locator Database. To easily reach the PHP site, the patient's personal identification suffices since it is unique and therefore can serve as the URL to his Personal Home Page. The next step is to generate web pages with mutually related PMRs so physicians could efficiently surf and reach all logically combined PMRs. The expert knowledge of medical doctors is indispensable in this regard. This information finally has to be incorporated in a Personal Medical Resource Description Database (PMRDD). As the representation of expert knowledge through the PMRDD is improved, new versions of these databases can be easily distributed through Internet.
Please consult the Andrew Marsh paper on the global telemedical information society in the section analysis of our magazine to learn more about the Personal Home Page. A summary of Euromed's twenty building blocks is to be found in VMW's November issue . Finally read all about goal and mission of the Euromed project at their special web site.