Design and evaluation of a multimedia electronic patient record "oncoflow" with clinical workflow assistance for head and neck tumor therapy.

OBJECTIVES: The management of patient-specific information is a challenging task for surgeons and physicians because existing clinical information systems are insufficiently integrated into daily clinical routine and contained information entities are distributed across different proprietary databases. Thus, existing information is hardly usable for further electronic processing, workflow support or clinical studies. METHODS: A Web-based clinical information system has been developed that automatically imports patient-specific information from different information systems. The system is tailored to the existing workflow for the treatment of patients with head and neck cancer. In this paper, the clinical assistance functions and a quantitative as well as a qualitative system evaluation are presented. RESULTS: The information system has been deployed at a clinical site and is in use in daily clinical routine. Two evaluation studies show that the information integration, the structured information presentation in the Web browser and the assistance functions improve the physician's workflow. The studies also show that the usage of the new information system does not impair the time physicians need for a process step compared with the usage of the existing information system. CONCLUSIONS: Information integration is crucial for efficient workflow support in the clinic. The central access to information within a modern and structured user interface saves valuable time for the physician. The comprehensive database allows an instant usage of the existing information clinical workflow support or the conduction of trial studies.

A new evaluation and training system for micro-telemanipulation at the middle ear.

In this article, a new surgical model for evaluating telemanipulators used in middle ear surgery is presented. The purpose of this work was to develop an evaluation and training system which imitates a typical surgical task of middle ear surgery and which can easily be repeated in order to get significant result. The abstract task can be performed manually or by means of a microsurgical telemanipulator and guaranties stable experimental conditions between different subjects at any time. As a task the stapedotomy was chosen, due to the high demands in positioning and in applying forces to the delicate structures in the middle ear. The manual and telemanipulated performance of 15 ENT surgeons and 17 medical students was compared using this evaluation and training system.