An Approach to Integrate Distributed Systems of Medical Devices in High Acuity Environments

This paper presents a comprehensive solution to build a distributed system of medical devices in high acuity environments. It is based on the concept of a Service Oriented Medical Device Architecture. It uses the Devices Profile for Web Services as a transport layer protocol and enhances it to the Medical Devices Profile for Web Service (MDPWS) to meet medical requirements. By applying the ISO/IEEE 11073 Domain Information Model, device data can be semantically described and exchanged by means of a generic service interface. Data model and service interface are subsumed under the Basic Integrated Clinical Environment Specification (BICEPS). MDPWS and BICEPS are implemented as part of the publically available openSDC stack. Performance measurements and a real world setup prove that openSDC is feasible to be deployed in distributed systems of medical devices

Business intelligence and nosocomial infection decision making

Nosocomial infection prevention in healthcare units it is very important to improve patient’s well-being and safety. This prevention can be done by manipulating and analysing real data to identify critical processes and areas inside the healthcare unit, and monitoring indicators generated from data. The main goal of this paper is to evaluate the applicability of the Business Intelligence tools and concepts to healthcare and their performance as a Clinical Decision Support System, analyzing the evolution of nosocomial infection in the Centro Hospitalar do Porto, by defining a set of indicators that can help the nosocomial infection management and inducing Data Mining models to predict the occurrence of nosocomial infections (sensitivity of 91%). A Business Intelligence system composed by the presentation of a set of indicators and a Data Mining part capable of predict the occurrence of infection can provide important information to support healthcare professionals in their decisions.(undefined

On Line Service Composition in the Integrated Clinical Environment for eHealth and Medical Systems

Medical and eHealth systems are progressively realized in the context of standardized architectures that support safety and ease the integration of the heterogeneous (and often proprietary) medical devices and sensors. The Integrated Clinical Environment (ICE) architecture appeared recently with the goal of becoming a common framework for defining the structure of the medical applications as concerns the safe integration of medical devices and sensors.This research was partly supported by iLand (EU ARTEMIS-1-00026) granted by the ARTEMIS JUand the Spanish Ministry of Industry, Commerce and Tourism. It has also been partly funded by the REM4VSS (TIN2011-28339) project grant of the Spanish Ministry of Economy and Competitiveness and by Universidad Carlos III de Madrid. The authors would also like to mention the large development team of the iLand reference implementation that performed an outstanding role to achieve a software proven also on commercial applications, and they thank them for their valuable efforts and work.Publicad

Essential Elements for Assessment of Persons with Severe Neurological Impairments for Computer Access Using Assistive Technology Devices: A Delphi Study

This study was undertaken with the intention of determining potential elements for inclusion in an assessment of persons with disabilities for access to computers utilizing assistive technology (AT). There is currently a lack of guidelines regarding areas that constitute a comprehensive and valid measure of a person’s need for AT devices to enable computer access, resulting in substandard services. A list of criteria for elements that should be incorporated into an instrument for determining AT for computer access was compiled from a literature review in the areas of neuroscience, rehabilitation, and education; and a Delphi study using an electronic survey form that was e-mailed to a panel of experts in the field of AT. The initial Delphi survey contained 22 categories (54 subcategories) and elicited 33 responses. The second round of the survey completed the Delphi process resulting in a consensus by the panel of experts for inclusion of 39 subcategories or elements that could be utilized in an assessment instrument. Only those areas rated as essential to the assessment process (very important or important by 80% of the respondents) were chosen as important criteria for an assessment instrument. Many of the non-selected elements were near significance, were studied in the literature, or were given favorable comments by the expert panelists. Other areas may be redundant or could be subsumed under another category. There are inherent obstacles to prescribing the proper AT device to assist disabled persons with computer access due to the complexity of their conditions. There are numerous technological devices to aid persons in accomplishing diverse tasks. This study reveals the complexity of the assessment process, especially in persons with severe disabilities associated with neurological conditions. An assessment instrument should be broad ranging considering the multidimensional nature of AT prescription for computer access. Both intrinsic and extrinsic factors affect the provision of AT

An informatics model for guiding assembly of telemicrobiology workstations for malaria collaborative diagnostics using commodity products and open-source software

<p>Abstract</p> <p>Background</p> <p>Deficits in clinical microbiology infrastructure exacerbate global infectious disease burdens. This paper examines how commodity computation, communication, and measurement products combined with open-source analysis and communication applications can be incorporated into laboratory medicine microbiology protocols. Those commodity components are all now sourceable globally. An informatics model is presented for guiding the use of low-cost commodity components and free software in the assembly of clinically useful and usable telemicrobiology workstations.</p> <p>Methods</p> <p>The model incorporates two general principles: 1) collaborative diagnostics, where free and open communication and networking applications are used to link distributed collaborators for reciprocal assistance in organizing and interpreting digital diagnostic data; and 2) commodity engineering, which leverages globally available consumer electronics and open-source informatics applications, to build generic open systems that measure needed information in ways substantially equivalent to more complex proprietary systems. Routine microscopic examination of Giemsa and fluorescently stained blood smears for diagnosing malaria is used as an example to validate the model.</p> <p>Results</p> <p>The model is used as a constraint-based guide for the design, assembly, and testing of a functioning, open, and commoditized telemicroscopy system that supports distributed acquisition, exploration, analysis, interpretation, and reporting of digital microscopy images of stained malarial blood smears while also supporting remote diagnostic tracking, quality assessment and diagnostic process development.</p> <p>Conclusion</p> <p>The open telemicroscopy workstation design and use-process described here can address clinical microbiology infrastructure deficits in an economically sound and sustainable manner. It can boost capacity to deal with comprehensive measurement of disease and care outcomes in individuals and groups in a distributed and collaborative fashion. The workstation enables local control over the creation and use of diagnostic data, while allowing for remote collaborative support of diagnostic data interpretation and tracking. It can enable global pooling of malaria disease information and the development of open, participatory, and adaptable laboratory medicine practices. The informatic model highlights how the larger issue of access to generic commoditized measurement, information processing, and communication technology in both high- and low-income countries can enable diagnostic services that are much less expensive, but substantially equivalent to those currently in use in high-income countries.</p

Egocentric Computer Vision and Machine Learning for Simulated Prosthetic Vision

Las prótesis visuales actuales son capaces de proporcionar percepción visual a personas con cierta ceguera. Sin pasar por la parte dañada del camino visual, la estimulación eléctrica en la retina o en el sistema nervioso provoca percepciones puntuales conocidas como “fosfenos”. Debido a limitaciones fisiológicas y tecnológicas, la información que reciben los pacientes tiene una resolución muy baja y un campo de visión y rango dinámico reducido afectando seriamente la capacidad de la persona para reconocer y navegar en entornos desconocidos. En este contexto, la inclusión de nuevas técnicas de visión por computador es un tema clave activo y abierto. En esta tesis nos centramos especialmente en el problema de desarrollar técnicas para potenciar la información visual que recibe el paciente implantado y proponemos diferentes sistemas de visión protésica simulada para la experimentación.Primero, hemos combinado la salida de dos redes neuronales convolucionales para detectar bordes informativos estructurales y siluetas de objetos. Demostramos cómo se pueden reconocer rápidamente diferentes escenas y objetos incluso en las condiciones restringidas de la visión protésica. Nuestro método es muy adecuado para la comprensión de escenas de interiores comparado con los métodos tradicionales de procesamiento de imágenes utilizados en prótesis visuales.Segundo, presentamos un nuevo sistema de realidad virtual para entornos de visión protésica simulada más realistas usando escenas panorámicas, lo que nos permite estudiar sistemáticamente el rendimiento de la búsqueda y reconocimiento de objetos. Las escenas panorámicas permiten que los sujetos se sientan inmersos en la escena al percibir la escena completa (360 grados).En la tercera contribución demostramos cómo un sistema de navegación de realidad aumentada para visión protésica ayuda al rendimiento de la navegación al reducir el tiempo y la distancia para alcanzar los objetivos, incluso reduciendo significativamente el número de colisiones de obstáculos. Mediante el uso de un algoritmo de planificación de ruta, el sistema encamina al sujeto a través de una ruta más corta y sin obstáculos. Este trabajo está actualmente bajo revisión.En la cuarta contribución, evaluamos la agudeza visual midiendo la influencia del campo de visión con respecto a la resolución espacial en prótesis visuales a través de una pantalla montada en la cabeza. Para ello, usamos la visión protésica simulada en un entorno de realidad virtual para simular la experiencia de la vida real al usar una prótesis de retina. Este trabajo está actualmente bajo revisión.Finalmente, proponemos un modelo de Spiking Neural Network (SNN) que se basa en mecanismos biológicamente plausibles y utiliza un esquema de aprendizaje no supervisado para obtener mejores algoritmos computacionales y mejorar el rendimiento de las prótesis visuales actuales. El modelo SNN propuesto puede hacer uso de la señal de muestreo descendente de la unidad de procesamiento de información de las prótesis retinianas sin pasar por el análisis de imágenes retinianas, proporcionando información útil a los ciegos. Esté trabajo está actualmente en preparación.<br /