Implementation of multi-vendor DICOM standard image transfer in hospital wide ATM network.

At Hamamatsu University Hospital, an ATM + FDDI network was installed in January 1995, when the hospital information system was upgraded. With its unique 'wheel' shape configuration, FDDI automatically backs up in case of an ATM switch failure. The authors implemented a DICOM image database server and DICOM viewer in the Hamamatsu University Hospital ATM + FDDI network. The DICOM standard worked well between different vendor products. In sending 512 x 512, 2 byte CT images, 40% of the transfer time was spent for the network data transfer, which is 70% of the theoretical value of 10 Mb peripheral transfer rate. Meanwhile, ATM load factor increased less than 0.5%. As we have a very fast data transfer network, we must check display speed, hard disc access time, PC bus speed, and display software, in order to enjoy the high speed network transfer fully. The sequence of image transmission within a study is not stated in the DICOM document and is depending on the server. Therefore, there should be an agreement between server and clients, still more than DICOM, in order to make better PACS.

[Decision support of clinical laboratory test by object-oriented data base].

We have constructed an object-oriented database system, using prescription, lab test result, and disease registry data, transmitted from the order entry system of Hamamatsu University Medical School Hospital. It serves not only numeric data but also semantics of laboratory results. The database system has a feature to categorize each data into structured hierarchies of attributes. By this, the user can retrieve abstract level descriptions such as "prescriptions of anti-inflammation medicines, suppository only", "any kind of gastric ulcer", etc., which is expected to be useful for researchers and students. In transferring order entry data from HIS, HL7-ASTM E1238 standard data formats using the Japan Association of Clinical Pathology lab test item code are utilized, proving this system's transferability to other hospitals. This is the first real use implementation of an object-oriented data base in a clinical setting, and results are promising in terms of providing an intelligent clinical database. Also discussed are future trends of clinical master files, hospital administrative tools, and multi vendor configurations of HIS.

Image-oriented rule generating tool for medical knowledge base.

This paper describes an automatic programming tool for the end users in the medical knowledge representation. When end users work with the rule generating tool (RGT) that we have designed, they can represent an idea using an Image-oriented interface such as a picture, movie, audio reference or two dimensional bar code. Such representations can be valuable tools for medical study, diagnosis, decision making and treatment monitoring to supplement the expertise of medical personnel. The RGT will automatically generate rules in the logic programming language Prolog and then add them to the knowledge base.