SOLUTION AVANCÉE POUR LE MARCHÉ MÉDICAL INTRA-HÔPITAL EUROPÉEN

Résultats exploitables

CLINWORKS was conceptualized, implemented and validated, as an integrated departmental system for neuromedicine. It provides a system for neuromedicine, to support patient data management, teleconsultation and diagnostic tools for diseases of the brain. CLINWORKS comprises three modules: BrainWorks, a diagnostic workstation for 2-dimensional and 3-dimensional display and editing of images of the brain from various sources(principally computerized tomography, CT, and magnetic resonance imaging, MRI), and incorporating atlases and tools for matching the atlases with modality images. 3-dimensional visualization and 3 dimensional editing are new features. The atlases are enhanced with brain stem objects and textual information on brain objects; InfoWorks, the departmental multimedia electronic patient folder for documentation and archiving of medical patient data; TeleWorks, for remote consultation and sharing of diagnostic expertise using co-operative work on radiological images. TeleWorks is particularly designed for narrow bandwidth (integrated services digital network, ISDN) communication. The validation and demonstration of CLINWORKS took place at the four hospitals. Common to all software components is the support of personal computer (PC) hardware under Windows NT 4.0. It therefore opens diagnostic imaging, teleconsultation and multimedia document handling to a wide community of clinical users. This was clearly appreciated by the clinical test sites. Using CLINWORKS has: increased the availability of distributed medical information from different sources, human expertise via TeleWorks, external knowledge via Brainwork (atlases and case collection) and databases and the modalities via InfoWorks; decreased time needed to access the distributed medical information; made diagnostic findings more reproducible and objective via the BrainWorks reference data (ie the Atlases and Case Collection and quantitative measurements of the brain with the BrainWorks 3-dimensional Editor; increased ease of analysis and processing of diagnostic information of a patient, such as 3-dimensional visualization in BrainWorks.

Teleworks is a CSCW application which supports cooperative work on modality generated diagnostic images for remote diagnosis support and teleconsultation. The system has the capability to pretransmit diagnostic images from one station to the other and then to permit remote discussion of the diagnostic findings. This discussion is supported by a telepointing service, a ROI telemarking service, a voice or V/C channel and a service allowing the remote initiation of image processing algorithms. The telepointing service is based on real time transmission and displaying of mouse coordinates on each station. Each user manipulates the local pointer, while following, at the same time, the movement of the remote pointer. ROI telemarking is the capability of markup of rectangular and circular regions of the shared images. A voice channel is used for voice conference between users as a low cost solution. Teleworks includes a security subsystem that allows the encryption and decryption of the transmitted confidential medical data. The security subsystem, uses RSA for public-key cryptography, DES or IDEA for bulk encryption and MD5 as message digest. The key-exchange protocol used is based partly on SSL (Secure Socket Layer), while key generation, storing and management is derived from PGP (Pretty Good Privacy). Asymmetric keys of the system are stored on a diskette in PGP format. Existing public and private key-rings can be used for communication using Teleworks, otherwise they must be generated using PGP. The private keys are stored encrypted using IDEA and a pass phrase is required to unlock them. Teleworks was used during trials performed in the framework of the Health TELEMATICS project SAMMIE2 (HC1044) and TEN-IBC project HIM3 (B3014).

Résultats exploitables

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