August 1998

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Surgeons align hips more accurately with HipNav
At the Shadyside Hospital's Centre for Orthopaedic Research in Pittsburgh, a great deal of energy, devotion and grant funding is being invested in computer assisted orthopaedic surgery. In collaboration with the Centre for Medical Robotics and Computer Assisted Surgery and the Harvard Medical School, researchers have succeeded in designing a Hip Navigation system, referred to as HipNav, to assist surgeons before and during Total Hip Replacement (THR) operations, which are known to be extremely delicate. HipNav allows accurate and patient-specific placement of the acetabular implant in the pelvis with much less danger for dislocation or impingement of the implant's femoral neck or ball joint with the acetabular rim or socket afterwards.

E-mail between health care facilities improves communication
Recently, the Dutch Flevo Hospital in Almere has switched from traditional to electronic mailing services. The new approach has a lot of advantages in store for the patient. The results from the laboratory or the radiology department are more quickly available, the scheduling of patient appointments with specialists takes far less time and the overall risk for committing mistakes in the data exchange has been considerably reduced. Various projects have been launched to optimize the workflow management in the hospital, as reported by the Flevo Hospital Periodical .

European surgeons to experiment with minimally invasive procedures
During the months of May and June, 18 cardiac and digestive surgeries were performed by three teams of Belgian, French and German surgeons, using the the Intuitive system. This new computer-enhanced minimally invasive surgery system incorporates advanced robotics, electronic instrumentation, and innovative visualization techniques. The surgeon executes the intervention, seated at a console, while he is viewing a high-resolution 3D video image of the surgical field and remotely monitoring the computerised mechanical arm and wrists. Manufacturer of the system is the California based company, Intuitive Surgical, which has been founded in 1995.

Health Card System maps Arab citizens medical history
In the foreseeable future, hospitals and clinics within the United Arab Emirates (UAE) will have immediate access to a patient's medical record from no matter what location. ICL, a supplier of information technology (IT) systems and services, has implemented a sophisticated health card registration and issuing system, which likely will pay useful services in a country with a population of 2.4 million people, living in a area of 32.000 square miles, and often moving from one health district to another.

Image Overlay guides physician through complex surgical procedures
Accurate organ or tumour localization and precise guidance within the patient's body can help the surgeon during delicate interventions in the operating theatre. Researchers from the Centre for Orthopaedic Research at the Shadyside Hospital in Pittsburgh have worked out a prototype system for 3D image overlay, allowing the physician to view medical images or computer enhanced graphics overlaid on the patient and simultaneously registered with his body. This technique can even be applied for teleguidance of medical staff, situated at remote sites.

Germans aim for uniform visual enabling concept for brain surgery
A team from the German National Research Centre for Information Technology (GMD) began in May 1997 with the project Visual Enabling for Precision Surgery (VEP). The ultimate goal is to integrate various existing visualization and registration techniques into one single computer-based three-dimensional image guidance system for neurosurgical procedures. The research is specifically focused on the rather complex laser-induced interstitial thermotherapy (LITT) for brain tumour coagulation. The partners are trying to set up a configuration for pre-operative diagnosis and planning, as well as intra-operative therapy and control, with incorporation of an open magnetic resonance imaging (MRI) system. In this VEP project, research people, industry and hospitals are striving to achieve a perfect interaction between the human medical specialist and the computer.

Telehomecare changes infusion pump business trends
The international marketing and consulting company Frost & Sullivan specializes in market trends, measurements and strategies for the health care industry. Recently, this market research firm issued a study on the current infusion pump market scene in the United States, to investigate the impact of both the overall cost reduction tendencies in health care and the introduction of innovative technologies and alternate care environments, on the increasing success of infusion pumps' sales. Telemedical practices nowadays enable patients to enjoy the unequalled freedom of staying at home or at work without missing the indispensable care they need.

Virtual pelvis and hips sockets show surgeons where to screw
At the Second Annual Meeting of Computer Assisted Orthopaedic Surgery, which took place in Pittsburgh from June 18th till 20th latest, Dr. David Kahler, surgeon and associate professor from the University of Virginia Health Sciences Centre, demonstrated a new computer guided surgical technique which treats pelvic and hip socket fractures in a more efficient way. A virtual computer model of the patient's pelvis serves as a guide for the accurate introduction of surgical instruments and screws at the exact location of the fracture. In contrast with conventional surgery, the method only requires minimal invasion and allows the patient to leave the hospital far more quickly.


Fakespace holds great promise for medical visualisation
On June 2nd latest, Electrohome Ltd, an Ontario-based manufacturer of large screen video, data, and graphics projection systems, established a new Visualization business group, and has made an equity investment in Fakespace, Inc., which is an expert supplier of spatially immersive display systems, in order to optimize the realistic visualization of three-dimensional, computer-generated images in virtual environments.

Comprehensive healthcare backup for 2800 hospitals around the US
Excellent backup and recovery capacities constitute essential features in a hospital information systems (HIS) network. The Atlanta-based HIS provider, HBOC, covers nearly 2800 hospitals all over the country with high standard applications systems software. The company has now selected the 3466 Network Storage Manager (NSM), as developed by IBM, to monitor the complex backup and recovery activities within the entire, integrated health care network of HBOC customers.

Tele-echo demonstrated live at Echocardiography Conference
If physicians want to use moving pictures of the heart for remote consultation, they have to compress the images for real time transmission and tolerate a certain percentage of quality loss and sharpness. Hewlett Packard's Medical Products Group has now designed an integrated tele-echo solution which is able to reconstruct the images in their original clarity. The method is based on the store-and-forward principle by means of a digital image archive and retrieval function. The new tool proved its excellence in a live demonstration at the American Society of Echocardiography Conference, held in San Francisco, last June.

New low power converter offers higher medical image quality
Cost-effective but high performance signal conversion is of capital importance in the world of medical imaging systems. The Burr-Brown Corporation, an Arizona based manufacturer of data conversion and mixed signal integrated circuits, has just issued the ADS807 analog-to-digital converter. This 12-bit device with a sampling rate of 53 Mhz operates at surprisingly low power but offers a superior image quality, because of its high signal-to-noise ratio.

Orbix merges patient information into single record
The Baptist Health System of South Florida (BHSSF) provides medical services to approximately two million patients and members. This multifacility health care enterprise is working together with 3M Health Information Systems (HIS) to install the Master Member Index, a unified patient identification directory, to tie together the demographic and clinical records of every patient residing at one of the BHSSF medical sites. In turn, the 3M HIS Division, based in Salt Lake City, has selected IONA Technologies to supply the specialized software infrastructure Orbix, in order to integrate all the heterogeneous database systems into this one Master Member Index.

Digital commerce for health care markets
The trade of goods and services over the Internet constitutes a rapidly expanding phenomenon. InterTrust Technologies Corporation, a digital commerce and information security company based in California, has developed the Commerce 1.0 system to turn commerce on the Internet and on the various other digital media into an efficient process through delivery of persistent protection, easy business modelling, usage auditing and automatic payment procedures. The system has been launched in July 1998. It also includes several neat applications for health care providers, such as telemedical services.

Medical experts can benefit from iCBR
Since 1983, Optivision Inc. specializes in products for high quality MPEG video creation and network distribution. Recently, the company's new appointed President and Chief Executive Officer Michael Liccardo spoke about the enhancement of the VSTOR 100 series MPEG video encoders and mpegStudio Pro software. Freshly added tools for superior video image output, imply intelligent Constant Bit Rate (iCBR), VideoSpool technology for cost effective network transport and optimized software management for user friendly purposes. Medical experts and specialists who are frequently using medical video imaging processing techniques, can make good use these innovative features.


Workshop analyses Fifth Framework Health Programme
Within the European Research Consortium for Informatics and Mathematics (ERCIM), the Working Group Health and Information Technology (HIT) has organized its first workshop at the GMD offices in Germany last May. As a representative from the European Commission, Directorate-General XIII, Mister Peter Fatelnig offered a brief survey of the preparatory activities for the Fifth Framework Programme. The participating ERCIM members afterwards exchanged ideas about possible co-operation for future project proposals.

Hypermedata exchanges multimedia patient records between hospitals
The need for a universally accessible patient record increases, as people are getting more mobile than ever in both their professional career and their leisure time. If they are hospitalized, they are often moved from one health care facility to another, which turns the electronic medical record into an indispensable tool for accurate information exchange between the hospitals. Every medical information system is different, so the health care record has to be compatible with any imaginable local computer system. Since the patient record consists of complex data, including text, images, tables, formulae, graphics, and maybe even sounds, the challenge seems enormous. At the ERCIM Health and Information Technology Workshop last May, Professor Keith Jeffery presented the Hypermedata project, a truly promising solution for the smooth exchange of multimedia patient data.

Healthbench focus on clinical and epidemiological analysis
The University of Cardiff and the Central Laboratory for the Research Councils (CLRC) are searching for partners to try to raise funding for Healthbench. This project proposal is based on the ongoing work for the creation of a statistical workbench at the Velindre Oncology Hospital and the Hypermedata efforts to produce a toolset for the exchange of heterogeneous, distributed patient information. If these two initiatives could be combined, this could lead to the establishment of an integrated workbench for health care workers, to perform extensive epidemiological and occupational health studies. During the recent ERCIM Health and Information Technology (HIT) Workshop, Professor Keith Jeffery explained the project's aims and special issues, which need to be tackled.

Europe thinks it's smarter than US for academic networking
In the European countries, academic and research (A&R) network services have always been organized on a national basis, and were kept separate from the general purpose Internet. Former head of CERN's Computing and Networks division in Geneva, David O. Williams, regards this natural development as a major advantage in comparison with the traumatic privatization experience in the United States. At the Mannheim Supercomputer Seminar '98, he insisted on sustaining these valuable national research networks. The European problem is situated at the level of pan-European and transcontinental interconnectivity. We are beaten by the USA if it comes to extensive bandwidth capacities. American projects, such as Internet2 and the Next Generation Internet constitute more than promising initiatives to solve overall network congestion. The European answer consists in the upcoming QUANTUM or TEN-155 project. How should we actually deal with insufficient Internet performance?

Exploring a beating heart from every angle
The GMD National Research Centre for Information Technology in Germany is actively involved in the creation of interactive 3D graphics and animation of the human heart for a project, referred to as SCENE. A set of prototype demonstrators has been developed, in order to integrate the 3D imaging material into a simulation system, equipped with virtual reality input devices. At the recent occasion of the ERCIM Health and Information Technology (HIT) Workshop, hosted by GMD, Dr. Gernoth Grunst presented three training modules, especially designed by the SCENE researchers for ultrasonographic heart examination. The overall purpose is to optimize both medical diagnosis and learning facilities.

New ultrasound techniques provide a window on the womb
The ultrasound research group at the University of North Carolina will provide the physician with computer-augmented vision, allowing him to directly see inside the patient's body in a non-invasive manner. At ASCI'98, the annual conference of the Advanced School for Computing and Imaging, which took place at the Vossemeren in Lommel, last June, Dr. Henri Fuchs presented the first preliminary and encouraging results of his team, as well as the challenges the researchers are currently facing to implement augmented reality in real time 3D medical visualization for surgical procedures.

Finnish HL7 stimulates system integration
The technological approach of health care is rapidly evolving towards an ever increasing need for system integration. At the recently organized ERCIM Health and Information Technology (HIT) Workshop, Dr. Vesa Pakarinen outlined the growing importance of health care networking in Finland during the past two decades. It seems that the implementation of the Health Level Seven (HL7) standard has become indispensable to optimize communication between heterogeneous hospital information systems.


UK funds seventeen HPC projects valued at GBP 16 million
Seventeen higher-education science and technology research projects - including Professor Steven Hawking's study of the 'origin and structure of the universe' at the University of Cambridge - are set to benefit from high performance systems from Silicon Graphics following the allocation of GBP 16 million of joint funding under the Higher Education Funding Council for England's (HEFCE) Joint Research Equipment Initiative (JREI).

US Government cuts down on telemedecine services
The use of telemedicine constitutes a growing success in the United States, especially in underserved regions. Yearly summaries show a facilitated access to the services of medical specialists by rural populations. Tertiary care hospitals witness more frequent referrals of rural patients, in search for specific medical treatment. Yet data from two reports issued by Feedback Research Services indicate that for 1998, no big expenditures are likely to be made for telemedicine services by the government.

Stethoscope detects remote heart murmurs in children
Researchers at the University of Virginia have designed a stethoscope solution for tele-auscultation. Paediatric cardiologists will use the system to diagnose the heart murmurs of children in distant locations. Cardiac specialists have assessed the telemedicine stethoscope and judged the results to be very positive.

Portuguese contribute to European telemedical advances
Digital storage and retrieval of biosignals, multimedia distributed information system design, telecardiology for patients at home, medical tele-imaging, just name it and Dr. Antonio Sousa Pereira will refer to a current project in these areas at INESC or the Istituto de Engenharia de Sistemas e Computadores. This department of the University of Aveiro in Portugal has proven to be an ardent partner at the first ERCIM Workshop of Health and Information Technology (HIT), where several IT health care projects were presented to the participants, at the GMD offices in Sankt Augustin.

ICS presents interregional healthcare scenario
The Centre for Medical Informatics and Health Telematics Applications (CMI/HTA) displays a lot of activity in the field of medical database management, hospital information systems development and co-operative telemedical network setups. During the ERCIM Health and Information Technology (HIT) Workshop in May, Dr. Eleni Kaldoudi presented some of the ongoing projects in the Institute of Computer Science (ICS), belonging to the Foundation for Research and Technology in Hellas (FORTH). The CMI/HTA scientists are also searching their way through the labyrinth of generating an integrated regional telemedicine network with related telematic services on the island of Crete.


SGI takes high performance computing to heart
This year's Supercomputer Seminar in Mannheim had an instructive evening session that closed the first conference day with a touch of philosophy. In the beautiful University Schloss, the senior vice-president of Silicon Graphics Inc., Dr. John F. Vrolyk gave a talk on the strategy of SGI for supercomputer architectures and their scientific applications in the next era. The company is showing a strong will to meet the tremendous challenges of the new millennium with a multiplicity of architectures and high quality software. In San Diego, the Congress of Vascular Surgeons has already received a taste of this huge computational strength.

Telemedicine bridge links the United States and China
President Clinton's visit to China at the end of June offered a beautiful occasion to demonstrate the first telemedical live consultation via the Internet between the Chinese doctors of Xian Medical University and a team of American Stanford University paediatricians, who are practising at Lucile Salter Packard Children's Hospital. A group of senior federal officials and congress members from the United States, together with the Vice Governor of ShaanXi Province and the Mayor of Xian, attended the session and experienced how telemedicine constitutes an ideal instrument for remote diagnosis and treatment of critically ill Chinese children.

Software cure for those obsessive-compulsive disorders
How would it feel to finally get rid of those nasty demons haunting your thoughts and your deeds? Virtual Reality gives you a chance to face the enemy inside and defeat him once and for all. At Clark Atlanta University, special virtual worlds are generated by means of the Meme software package, developed by Immersive Systems, to tackle the specific obsessive-compulsive disorder (OCD) symptoms of each individual patient. In the Atlanta Virtual Reality Technology Laboratory, Dr. Max North integrates the real time three-dimensional Meme universe in his pioneering Virtual Reality Therapy.

Trans-Pacific telemicroscopy joins Japan and the USA
Tiny neurological samples but a big experience for both American and Japanese scientists on Thursday, June 25th, when an ISDN connection between the University of California in San Diego (UCSD) and the University in Osaka was established. At the UCSD site, researchers from the National Centre for Microscopy and Imaging Research (NCMIR), together with their visiting Japanese colleagues, used an advanced computer system, designed by the Osaka Research Centre for Ultra High Voltage Electron Microscopy (UVHEM) and Hitachi Ltd., to remotely control the largest and most performing transmission electron microscope in the world, situated in Osaka. This state-of-the-art device, displaying a capacity of 3 million volt, showed its precious value in the examination of neurological specimens, selected for the research on Alzheimer's and Parkinson's diseases.

South American debate on Telematics in health care
In Santiago, Chile, experts from health care organizations, industrial companies, educational institutions, and telecommunications providers gathered from 10th to 12th June 1998 to debate the subject of Telematics, to explore new ways of co-operation and joint-business between the European Union and the South American countries in the fields of telemedicine, education and training. Organizers of this EuroAmeriTel'98 Conference were Labortel, a support action project of the Fourth Framework Programme, and CTC, one of the major Chilean telephone companies. PictureTel Corporation provided the required videoconferencing technology through its reseller, namely the Coasin Chile S.A.

How to avoid a health care disaster
Computer systems and information technologies are progressively conquering health care facilities. Hospital information systems and electronic patient records allow a higher degree of effectiveness and efficiency with regard to health care procedures but in case of time-sensitive business interruptions, the patient is left at the mercy of failing technology, running considerable risks. SunGard Planning Solutions now has come up with a White Paper covering all possible disaster recovery issues, in order to help health care organizations become aware of the urgent need for redundancy integration into their computer systems. The document has been published under the title of "Healthcare and Disaster Recovery: The Critical Connection".