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1
Content available remote Problemy rozwoju telemedycyny w Polsce
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PL
Rozwój telemedycyny jest wielką szansą dla znajdującej się obecnie w stanie zapaści służby zdrowia w Polsce. Jednak postępy we wdrażaniu tej formy świadczeń medycznych są wciąż dalekie od oczekiwań. Można stwierdzić, iż Polska nie jest przygotowana do praktycznej realizacji usług telemedycznych. Biorąc pod uwagę znaczące korzyści wynikające z telemedycyny, trzeba podjąć działania, które w perspektywie kilku najbliższych lat zmienią ten stan rzeczy. W artykule omówiono finansowe, infrastrukturalne, organizacyjne i prawne bariery rozwoju telemedycyny w Polsce. Następnie zaproponowano działania mające na celu upowszechnienie świadczeń telemedycznych w polskiej służbie zdrowia.
EN
Development of telemedicine is a great chance for the polish health care, which is nowadays in bad condition. However, the progress of development of this form of services is still far from expectations. One can assume that Poland is not prepared to realize telemedical services. Taking into account the possible benefits of telemedicine, it is necessary to undertake actions, that will change the existing situation in a few years. The article discusses the financial, infrastructural, organizational and legal barriers of telemedicine development in Poland. Subsequently some actions are proposed to widespread the telemedical services in the polish health care.
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This paper describes design of the Wavelength Division Multiplexing (WDM) transmission system using Alien Wavelength channels for medical data exchange. Main purpose of such system is to develop variety of services for medical cases diagnostics in order to comply with modern standards in telemedicine. Those standards refer to photo or video data transmission produced by diagnostic devices used in radiological centers together with text data concerning medical case analysis and patient data. These features are delivered by Picture Archiving and Communication System (PACS). PACS describes intra-hospital network organization, which applies to constructing system data from raw graphical data and text information according to Digital Imaging and Communica tions in Medicine (DICOM) version 3.0 standard. This standard is used by authors to evaluate necessary bit rate con- cerning all types of services delivered by PACS and cumulative throughput of link connections between hospitals and databases. Organization of this connections in metropolitan WDM system using advantages of Alien Wavelength technique is this article the main goal. Difference between configurable and non-configurable 10 Gigabit Small Form Factor Pluggable (XFP) end devices for AlienWavelength channels are analyzed and compared with the standard approach using transponder cards.
PL
Telemedicine is very promising way of delivering medical services. At this moment telecardiology gives many possibilities of improving outcome of patient and very often it also decreases the costs, which makes it cost-effective solution. Unfortunately actually in Poland there are many difficulties in delivering telemedicine. There is no central refunding of procedures; hospitals are not ready with IT solutions etc. The article describes those problems in different fields of telecardiology.
EN
The processes of globalization and integration, as well as technologies and computerization, occurring in public life cause significant changes in all its spheres, especially in medicine. Nowadays, computerization of healthcare facilities has become the norm of their development. However, rapid technological change requires the modernization of medical education system, revising the approaches to the training of competitive medical professionals who will able to adapt quickly to changes in the field of health care. The research issue concerns the processes of future medical professionals’ training. The importance of telemedicine in health-care systems of Ukraine and Poland is justified. It is suggested that the problem of telemedicine and e-health usage in the process of medical professionals’ training in Ukraine is not studied sufficiently and does not have practical consolidation. The didactic methodology of medical specialties students training for the use of telemedicine technologies in future professional activities is developed.
EN
Interactive medical teleconsultations are an important tool in modern medical practice. Their applications include remote diagnostics, conferences, work- shops, and classes for students. In many cases, standard medium or low-end machines are employed, and the teleconsultation systems must be able to provide a high quality of user experience with very limited resources. Particularly problematic are large datasets consisting of image sequences that need to be accessed fluently. The main issue is insufficient internal memory; therefore, proper compression methods are crucial. However, a scenario where image sequences are kept in a compressed format in the internal memory and decompressed on- the-fly when displayed is difficult to implement due to performance issues. In this paper, we present methods for both lossy and lossless compression of medical image sequences that only require compatibility with the Pixel Shader 2.0 standard, which is present even on relatively old, low-end devices. Based on the evaluation of quality, size reduction, and performance, these methods have been proven to be suitable and beneficial for medical teleconsultation applications
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Content available remote Pacjenci a e-zdrowie
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PL
E-zdrowie jest przełomowym podejściem do zarządzania służbą zdrowia związanym z rewolucją społeczną, jaka łączy się z transformacją pomiędzy społeczeństwem industrialnym a społeczeństwem informacyjnym. Dąży się do tego, by pacjent, mając komputer z kamerą, mikrofonem i głośnikami oraz urządzenia z czujnikami, mógł konsultować swoje objawy z lekarzem i przesyłać wyniki, które archiwizowane byłyby w bazie danych. Lekarz na bieżąco modyfikowałby zalecenia albo wzywał pacjenta na wizytę. Taki jest projekt i założenia e-zdrowia w Polsce. Czy e-zdrowie okaże się niemożliwe do realizacji ze względu na wymaganie wyjątkowo dużych nakładów finansowych, nietrafne programy dotyczące skomputeryzowania służby zdrowia, niemające połączenia ogólnopolskiego i światowego? Co na to lekarze? Co na to pacjenci?
EN
Thanks to eHealth, doctors can access patients' medical records more easily, get immediate access to test results from the laboratory, and deliver prescriptions directly to pharmacists. Patients with heart problems can carry monitors which alert their doctor if their condition changes, yet allow them to continue with their daily business.
PL
Dwie książki, Erica Topola, “The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care “ oraz Jody Ranck, “Connected Health: How Mobile Phones, Cloud and Big Data Will Reinvent Healthcare”, syntetycznie przedstawiają dokonujący się proces głębokiej transformacji współczesnej medycyny, w którym istotną rolę odgrywają nowe media i technologie informacyjne. Tytuł artykułu „Od doktora House do doktora Google” wskazuje na przejście od jedynie oglądania fabularnych obrazów lekarza na ekranie telewizora do metaforycznego lekarza internetowego, nazwanego doktorem Google. Korzysta z tej wyszukiwarki niemal dwie trzecie internautów, często za pomocą smartfonu. To urządzenie zapewnia nie tylko dostęp do lekarskiej diagnostyki, ale także samo staje się poprzez dołączane sensory medycznym diagnostą w telemedycynie.
EN
Two books by Eric Topol, “The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care” and Jody Ranck, “Connected Health: How Mobile Phones, Cloud and Big Data Will Reinvent Healthcare”, synthetically present an ongoing process of profound transformation of modern health care, in which an important role play new media and information technologies. Title of the article “From Dr. House to Dr. Google” indicates the transition from merely watching a fictional doctor on TV screen to metaphorical images online doctor, called Dr. Google. Almost two thirds of internauts use the search engines frequently, often using smartphone. This device not only provides access to the medical diagnosis and tool to be in touch with medical personnel, but through sensors attached it becomes itself a medical diagnostician in telemedicine.
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For contemporary software systems, security is considered to be a key quality factor and the analysis of IT security risk becomes an indispensable stage during software deployment. However, performing risk assessment according to methodologies and standards issued for the public sector or large institutions can be too costly and time consuming. Current business practice tends to circumvent risk assessment by defining sets of standard safeguards and applying them to all developed systems. This leads to a substantial gap: threats are not re-evaluated for particular systems and the selection of security functions is not based on risk models. This paper discusses a new lightweight risk assessment method aimed at filling this gap. In this proposal, Fuzzy Cognitive Maps (FCMs) are used to capture dependencies between assets, and FCM-based reasoning is performed to calculate risks. An application of the method is studied using an example of an e-health system providing remote telemonitoring, data storage and teleconsultation services. Lessons learned indicate that the proposed method is an efficient and low-cost approach, giving instantaneous feedback and enabling reasoning on the effectiveness of the security system.
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Content available remote Teleconsultations - synergy of medicine and IT technology
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EN
The combination of medical sciences with computer networks and computer telematics creates a wide spectrum of new applications called telemedicine. One of telemedical domains is making digitally represented medical data available to medical technicians and professionals from remote locations. It can improve health care and lower its costs. The application discussed it this article is remote access to patients' medical documentation, and DICOM (http://medical.nema.org/) images in particular, for consultation purposes. The paper presents the research done so far by Distributed Systems Research Group (DSRG) in the area of telemedicine. It shows the functional evolution of applications designed and developed by the group. Starting from relatively simple Web-based services through dedicated access and consultation applications, DSRG has created a comprehensive and sophisticated environment called TeleDICOM, allowing participants from the distributed consultation team to diagnose patients in collaboration. Teleconsultation services, demanding as they are, should be designed with deep knowledge and experience in the area of medical data, distributed systems, computer networks and many others. All these issues have been considered in constructing the applications and discussed in the article.
EN
The article presents the concept of hospital telemetric system. The goal of the project is a model of early warning systems for patients outside intensive care wards. Proposed system is based on constant telemetric monitoring using objective physiological parameters. Using low-distance sensor network which covers body of a patient, so-called BAN (Body Area Network) is the main innovation of the project. Some preliminary results of ECG analysis and interpretation modules and units of proposed system will be presented.
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Content available remote Achieving high dependability of an endoscopy recommender system (ERS)
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EN
The paper presents a strategy for achieving high dependability of a computer-based system devoted to endoscopic examination (ERS). Two levels of replication are used: hardware (3 computers) and database (redundant copies). Archivisation of documents describing patient examinations and films made during such examinations is described. The influence of the used techniques on performance and dependability of the replicated system is estimated.
EN
Information technology applications in medicine are rapidly expanding, and new methods and solutions are evolving since they are considered pivotal in the success of preventive medicine. In this paper two different concepts will be presented, the PANACEIA-iTV and the e-Vital concept. PANACEIA-iTV is a home care service provision system based on interactive TV technology and supported by the IST programme of the European Commission. The e-Vital service, supported by the eTEN programme of the European Commission, regards an integrated home care and telemonitoring service chain aimed at large sensitive parts of the European population, the "at-risk" citizens, who are usually patients with a stable medical condition that allow a near normal life but may suddenly deteriorate and put life at risk.
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Content available remote Program e-Zdrowie wspomagający świadczenie usług medycznych - telemedycyna
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PL
Komunikat Komisji Europejskiej (kwiecień 2004) dotyczący e-Zdrowia wymusza na krajach członkowskich podjęcie działań zmierzających do poprawy stanu wykorzystania IKT Informatyczno-Komunikacyjnych Technologii (ang. ICT- Information Communication Technology) w ochronie zdrowia. Wszystkie państwa opracowują własne plany krajowe oraz regionalne, których podstawą jest dopasowanie procedur, mentalności i kompetencji w ochronie zdrowia do nowych warunków. Technologia informacyjna wprowadza możliwości technologiczne, ale technologia sama w sobie nie jest nastawiona na żadną dziedzinę. Szpitale i inne jednostki ochrony zdrowia będą musiały przejść proces transformacji. Regionalny program e-Zdrowie ma propagować i dostarczać usługi informatyczne poprzez zintegrowany system Informatyczny wspomagający działalność administracji oraz świadczenie usług medycznych I telediagnostykę. Jest wspólną inicjatywą Marszałka Dolnego Śląska, Urzędu Miejskiego, JM Rektora Wrocławskiej Akademii Medycznej, JM Rektora Politechniki Wrocławskiej oraz Dolnośląskiego Centrum Zaawansowanych Technologii (DCZT).
EN
The announcement of European Commission (April 2004) regarding "e-health"expedlted EU member states to undertake measures aimed at Improving use of ITC - Information communication technology In health sector. Member states elaborate on their own regional and national plans based on procedural compatibility, work culture and health protection under the new circumstances. Information technology offers new possibilities, but It is not pre-deslgned to serve any particular sector. Hospitals and health sector institutions will have to undergo transformation process. Regional programme called e-health has to propagate and provide IT services using Integrated Information and communication system supporting both administration and medical services and tele-diagnostics. The programme was announces as a joint initiative of Marshall of Lower Silesia, Municipality Council, Rector of Wroclaw Medical Academy and Rector of Wroclaw Technical University as well as Lower Slleslan Centre for Advanced Technologies (SCAT).
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EN
Telemedicine is one of the most innovative and promising applications of technology in contemporary medicine. Telemedical systems, a sort of distributed measurement systems, are used for continuous or periodic monitoring of human vital signals in the environment of living. This approach has several advantages in comparison to traditional medical care: e.g. patients experience fewer hospitalizations, emergency room visits, lost time from work, the costs of treatment are reduced, and the quality of life is improved. Currently, chronic respiratory diseases comprise one of the most serious public health problems. Simultaneously patients suffering from these diseases are well suitable for home monitoring. This paper describes the design and technical realization of a telemedical system that has been developed as a platform suitable for monitoring patients with chronic pulmonary diseases and fitted to Polish conditions. The paper focuses on the system's architecture, included medical tests, adopted hardware and software, and preliminary internal evaluation. The performed tests demonstrated good overall performance of the system. At present further work goes on to put it into practice.
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The article presents a control algorithm of a robotic manipulator used as the main component of a system for a remote noninvasive medical ultrasound examination. This algorithm has been developed within the ReMeDi (Remote Medical Diagnostician) project. At the beginning of the article, the manipulator kiinematics, its mechanical construction and the control system structure as a part of the telemanipulation system is shown. The essential components of the control system are discussed in detail. Then problems and solutions connected with the generation and conversion of the position and orientation of the reference signals are presented. Finally, the results of the evaluations with users are discussed.
EN
The use of telemedicine had notably been developed in Brazil after the beginning of the public emergency period caused by the pandemic of COVID-19. With the new data protection law in force in Brazil, which is similar to the GDPR, health data are in the spotlight. The purpose of this article is to exam what measures Brazil has adopted to guarantee the data protection for health data in view of this scenario, taking the EU as a perspective for comparison reasons. For the Brazilian analysis, not only the formal legislation was considered, but also the guidance of the Federal Council of Medicine, which is the competent authority to supervise and issue orders on the development of medicine in Brazil, including the telemedicine. The comparison with the EU was chosen due to the similar data protection regulation, since the LGPD presents similar provisions and regulations to those established in the GDPR, and because the European Commission has issued a study on February 11, 2021, assessing the implementation of the GDPR and the domestic regulations for health data in each of the EU countries. This article has found out Brazilian regulation still presents flaws and points for clarification, which are fundamental to guarantee the necessary legal security in operations.
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Content available remote The project of expert system aided decision process in medicine
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EN
The paper deals with a concept of the expert system for family doctor practices. This system will be realized by Division of Systems and Computer Networks Wroclaw University of Technology in co-operation with Medical Academy of Wroclaw. The family doctor loads data (by user interface) to the system, which describes patients state of health. By this way we can obtain, so-called feature vector. Data in feature vector, may be complete by information collecting from different type of diagnosis equipment like electrocardiograph, Rontgen unit, ultrasonic unit and so on. Number of features may be optional, but for investigation goals only 25 features were used. The user can load to the system less then 25 features. It is important in case then we have problems with results of medical examination extraction. On the basis of a patient information, system gives us decisions which aided medical treatment. Information from data base (set of feature vectors) is processed by expert system. It leads to so called “statistical data base” establishment. System consists of three functionally connected parts: 1. data collecting and data processing, 2. decision part, 3. user’s interface. Expert system can give us unlimited number of decision. In the decision expert system, adaptive algorithms are used. It means that in case of some features are not available, expert system starts algorithms which these feature estimates (algorithms take into account whole patients population’s features and typical for individual patient features).
PL
Celem pracy jest przedstawienie opracowywanego w Zakładzie Systemów i Sieci Komputerowych Politechniki Wrocławskiej projektu systemu ekspertowego wspomagającego podejmowanie decyzji lekarskich. W założeniu, system funkcjonuje w oparciu o „statystyczną” bazę wiedzy współpracującą z oryginalnymi algorytmami wnioskowania.
EN
This paper presents an effective solution of packetizing of non-uniform data for the purpose of reporting in telemedical surveillance systems with adaptive interpretation. Unlike the regular systems, where the data continuity is guaranteed by the common reporting interval and unified report content, the adaptive systems must implement a reservation procedure in order to proper data delivery, accordingly to sampling rates set individually for each of the diagnostic parameters. This procedure combines the content of every packet with respect to changes in data flow from particular diagnostic data, caused by time-variable requirements for the update rate of their time series. Our approach postulates appending to the information structure of two auxiliary data attributes, the validity period and the priority. The proposed solution was implemented and tested in a prototype cardiology-oriented monitor using two alternative reporting modes following the monitoring requisites. In immediate mode diagnostic packets are transmitted immediately accordingly to the time requirements, what allows the telediagnostic system to respond in short time in case of emergency. In delayed mode the transmission is deferred until packets are entirely filled with valid data, what limits the usage of data carrier for long-time regular reporting.
PL
Przedstawiono definicje podstawowych pojęć z zakresu telemedycyny i teleradiologii. Przedstawiono scenariusz podstawowych usług teleradiologicznych: telekonsultacji, telediagnostyki, teleoperacji i teledydaktyki. Opisano wymagania stawiane aplikacjom teleradiologicznym. Rozważono zagadnienia dotyczące standardów stosowanych w teleradiologii. Poruszono aspekt prawny przesyłania danych radiologicznych w sieciach telekomunikacyjnych.
EN
This paper is devoted to teleradiology. The definitions of basic terms in telemedicine and teleradiology for teleconsulting, telediagnosis, telesurgery and tele-education, are given. The requirements for teleradiological application are presented. The standards used in teleradiology were considered. The legal aspects of radiological data transmission over telecommunication network were mentioned.
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The electrocardiogram is a digital record of effective action potentials of heart muscle fibres, thus it contains an important information about the heart function. Unfortunately, the signal theory-based description of the ECG contents is not efficient in extracting these data, and the practical interpretation software is mostly based on heuristic statements. This conclusion was a motivation for our research on the expert-like machine reasoning based on ECG perception analysis, physiology-driven feature extraction and fuzzy logic. This paper highlights the aspect of optimal description of an electrocardiogram contents in a digital record.
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