Development of an HL7 interface engine, based on tree structure and streaming algorithm, for large-size messages which include image data Original Research
Computer Methods and Programs in Biomedicine
A basic assumption of Health Level Seven (HL7) protocol is ‘No limitation of message length’. However, most existing commercial HL7 interface engines do limit message length because they use the string array method, which is run in the main memory for the HL7 message parsing process. Specifically, messages with image and multi-media data create a long string array and thus cause the computer system to raise critical and fatal problem. Consequently, HL7 messages cannot handle the image and multi-media data necessary in modern medical records.
This study aims to solve this problem with the ‘streaming algorithm’ method. This new method for HL7
message parsing applies the character-stream object which process character by character between the main memory and hard disk device with the consequence that the processing load on main memory could be alleviated. The main functions of this new engine are generating, parsing, validating, browsing, sending, and receiving HL7 messages. Also, the engine can parse and generate XML-formatted HL7 messages.
This new HL7 engine successfully exchanged HL7 messages with 10 megabyte size images and discharge summary information between two university hospitals.
1. Introduction and background
2. Design considerations
2.1. Developing environment
2.2. Algorithm and concept designs
2.2.1. Tree structure
2.2.2. Streaming parsing algorithm
2.2.3. Binary data transforming for inserting into an HL7 message
2.2.4. Validating algorithm
188.8.131.52. Syntax check on segment level 184.108.40.206. Syntax checking for required fields 220.127.116.11. Validating for data value of each node 18.104.22.168. Process for errors or exceptions 2.2.5. Addressing method for pointing out each node 3. System description
3.1. System design
3.1.1. Class flow diagram
3.1.2. Class block diagram
3.1.3. ElementNode class
3.1.4. HL7MessageTree class
22.214.171.124. Problem solution of variable data type 126.96.36.199. Automatic data transforming 3.2. Implementation
3.4. Experimental application for performance evaluation
4. Status report
4.1. Performance evaluation
4.1.1. Message sending and receiving 4.1.2. Message parsing
4.1.3. Message generating
4.1.4. Message validating
4.1.5. Menage browsing
4.1.6. Encoding and decoding function for image data 5. Lessons learned and future plans 5.1. ED or RP data type as a method of multimedia data transferring
5.2. Future plans
Multi-path selection for multiple description video streaming over overlay networks Original Research Article
Signal Processing: Image Communication
Real-time media distribution over the Internet poses several challenging problems due to its stringent delay/loss requirements and complex network dynamics. A promising approach to alleviate the severe impacts of these dynamics is to transmit the media over diverse paths. For such an environment, multiple description (MD) coding has been previously proposed to produce multiple independently decodable streams that are routed over partially link–disjoint (non-shared) paths for combatting bursty packet losses and error propagation. However, selecting these paths appropriately is fundamental to the success of MD streaming and path diversity. Hence, in this paper we develop models for MD streaming over multiple paths and based on these models we propose a multi-path selection method that chooses a set of paths maximizing the overall quality at the client under various constraints. The simulation results with MPEG-2 show that sizeable average peak signal-to-noise ratio (PSNR) improvements (ranging from 0.73 to 6.07 dB) can be achieved when the source video is streamed over intelligently selected multiple paths as opposed to over the shortest path or maximally link–disjoint paths. In addition to the PSNR improvement,
end-users experience a more continual, i.e., uninterrupted, streaming quality. Our work also considers the architecture and mechanisms by which multi-path streaming can be accomplished over a conventional IP network.
2. Background on multiple description coding
3. Envisioned network model
3.1. Overlay model
3.3. Link parameters
4. Multi-path selection
4.1. Bandwidth-distortion relation
4.2. Computation of success probabilities
4.2.1. Arrival probability
188.8.131.52. Path segregation
184.108.40.206. Link aggregation
4.2.2. On-time delivery probability
4.3. End-to-end multi-path model
5. Simulation results
5.2. Single-hop topology
5.3. Internet topology
Video streaming: Implementation and evaluation in an undergraduate nursing program Original Research Article
Nurse Education Today
Video streaming technology enables video content, held on the web sites, to be streamed via the web. We report the implementation and evaluation of video streaming in an undergraduate nursing program in a metropolitan university in Australia. Students (n = 703) were emailed a survey with a 15% response rate. We found that 91% (n = 74) of respondents stated that video streaming assisted their learning. Forty-six percent(n = 50) of students had difficulty accessing video streaming (particularly at the beginning of the study period). Over a 97-day period there were 8440 “hits” to the site from 1039 different internet protocol (IP) addresses. There were 4475 video streaming sessions undertaken by users. Video streaming was used for reviewing previously attended lectures (52%, n = 56), examination preparation
(34%, n = 37), viewing missed lectures (27%, n = 29) and class preparation (9%, n = 10). Our experience
with the introduction of video streaming has met with general enthusiasm from both students and teaching staff. Video streaming has particular relevance for rural students.
Web site usage
Adopting electronic medical records in primary care: Lessons learned from health information systems implementation experience in seven countries Original
International Journal of Medical Informatics
The adoption of health information systems is seen world wide as one method to mitigate the widening health care demand and supply gap. The purpose of this review was to identify the current state of knowledge about health information systems adoption in primary care. The goal was to understand factors and influencers affecting implementation outcomes from previous health information systems implementations experiences. A comprehensive systematic literature review of peer reviewed and grey literature was undertaken to identify the current state of knowledge regarding the implementation of health information systems. A total of 6 databases, 27 journal websites, 20 websites from grey sources, 9 websites from medical colleges and professional associations as well as 22 government/commission websites were searched. The searches returned almost 3700 article titles. Eighty-six articles met our inclusion and exclusion criteria.
Articles show that systems’ graphical user interface design quality, feature functionality, project
management, procurement and users’ previous experience affect implementation outcomes.
Implementers had concerns about factors such as privacy, patient safety, provider/patient relations, staff anxiety, time factors, quality of care, finances, efficiency, and liability. The review showed that implementers can insulate the project from such concerns by establishing strong leadership, using project management techniques, establishing standards and training their staff to ensure such risks do not compromise implementation success. The review revealed the concept of socio-technical factors, or “fit” factors, that complicate health information systems deployment. The socio-technical perspective considers how the technical features of a health information system interact with the social features of a health care work environment.
The review showed that quality of care, patient safety and provider/patient relations were not, positively or negatively, affected by systems implementation. The fact that no articles were found reviewing the benefits or drawbacks of health information systems accruing to patients should be concern to adopters, payers and jurisdictions. No studies were found that compared how provider–patient interactions in
interviews are effected when providers used electronic health information systems as opposed to the paper equivalent. Very little information was available about privacy and liability. Article Outline
5. Strengths & weaknesses
Playing for Real: Video Games and Stories for Health-Related Behavior Change Review Article
American Journal of Preventive Medicine
Video games provide extensive player involvement for large numbers of children and adults, and thereby provide a channel for delivering health behavior change experiences and messages in an engaging and entertaining format.
Twenty-seven articles were identified on 25 video games that promoted health-related behavior change through December 2006.
Most of the articles demonstrated positive health-related changes from playing the video games. Variability in what was reported about the games and measures employed precluded systematically relating characteristics of the games to outcomes. Many of these games merged the immersive, attention-maintaining properties of stories and fantasy, the engaging properties of interactivity, and behavior-change technology (e.g., tailored messages, goal setting). Stories in video games allow for modeling, vicarious identifying experiences, and learning a story’s “moral,” among other change
Research is needed on the optimal use of game-based stories, fantasy, interactivity, and behavior change technology in promoting health-related behavior change.
Prevalence of Video Game Use
Games and Behavior Change Methods
Theory-Based Procedures in Behavior-Change Games
Importance of a Story
Video Game Design and Structure Age and Game Play
Health Behavior Change Game Development
Time and Cost
An Agenda for Research on Health Behavior-Change Video Games for Children
Digital image steganography: Survey and analysis of current methods Review
Steganography is the science that involves communicating secret data in an appropriate multimedia carrier, e.g., image, audio, and video files. It comes under the assumption that if the feature is visible, the point of attack is evident, thus the goal here is always to conceal the very existence of the embedded data. Steganography has various useful applications. However, like any other science it can be used for ill intentions. It has been propelled to the forefront of current security techniques by the remarkable growth in computational power, the increase in security awareness by, e.g., individuals, groups, agencies, government and through intellectual pursuit. Steganography's ultimate objectives, which are undetectability, robustness (resistance to various image processing methods and compression) and capacity of the hidden data, are the main factors that separate it from related techniques such as watermarking and cryptography. This paper provides a state-of-the-art review and analysis of the different existing methods of steganography along with some common standards and guidelines drawn from the literature. This paper concludes with some recommendations and advocates for the object-oriented embedding mechanism. Steganalysis, which is the science of attacking steganography, is not the focus of this survey but nonetheless will be briefly discussed.
1.2. Ancient steganography
1.3. The digital era of steganography
2. Steganography applications
3. Steganography methods
3.1. Steganography exploiting the image format
3.2. Steganography in the image spatial domain
3.3. Steganography in the image frequency domain
3.4. Adaptive steganography
4. Analysis and recommendations
6. Conclusions and summary
Web-based interactive 2D/3D medical image processing and visualization
software Original Research Article
Computer Methods and Programs in Biomedicine
There are many medical image processing software tools available for research and diagnosis purposes. However, most of these tools are available only as local applications. This limits the accessibility of the software to a specific machine, and thus the data and processing power of that application are not available to other workstations. Further, there are operating system and processing power limitations which prevent such applications from running on every type of workstation. By developing web-based tools, it is possible for users to access the medical image processing functionalities wherever the internet is available. In this paper, we introduce a pure web-based, interactive, extendable, 2D and 3D medical image processing and visualization application that requires no client installation. Our software uses a four-layered design consisting of an algorithm layer, web-user-interface layer, server communication layer, and wrapper layer. To compete with extendibility of the current local medical image processing software, each layer is highly independent of other layers. A wide range of medical image preprocessing, registration, and segmentation methods are implemented using open source libraries. Desktop-like user interaction is provided by using AJAX technology in the web-user-interface. For the visualization functionality of the software, the VRML standard is used to provide 3D features over the web. Integration of these technologies has allowed implementation of our purely web-based software with high functionality without requiring powerful computational resources in the client side. The user-interface is designed such that the users can select appropriate parameters for practical research and clinical studies.
2. Design constraints and technology choices
2.2. Algorithms engine
2.3. 3D Visualization