A medical digital library to support scenario and user-tailored information retrieval

Contextualized access to electronical health records in cardiology

In this paper, we propose a new approach for accessing the electronical health records (EHR), and we apply it to the cardiology medical specialty. Though the use of EHR improves the storage and access to the information in it regarding the previous health records in papers, it entails the risk of having the same problems of huge size and of becoming inoperative and really difficult to handle, especially if the user is looking for a specific data item. Our proposal is based on the contextualization of the access, providing the user with the most important information for the assistance act in which he/she is involved. To do this, we define the set of possible contexts and consider different aspects of the pertinence of the documents to each context. We do it by using fuzzy logic and pay special attention to the efficiency, due to the huge size of the involved databases. Our proposal does not limit the access to the EHR, but establishes a prioritization based on the access needs, which provides the system with an additional advantage, easily enabling the use of new terminals and devices like tablet PCs and PDAs, which have great limitations in the interfaces.

TM-provider: a new communicatory model for telemedicine services support

In this paper a new model for telemedicine service providers denoted as TM-Provider is presented. The TM-Provider establishes two multilevel controllers for the fully administration of telemedicine sessions conduct. The communication between the controllers' levels is based on an advanced request-respond protocol that addresses the traffic of the messages and applies sophisticated security mechanisms for access and data protection issues. The proposed architecture and message-flow protocol synthesize a 'tool' for the designers and developers of telemedicine applications and provide them with an integrated architectural solution, independent of the various or advanced technologies and platforms that they intent to use.

Selective automated indexing of findings and diagnoses in radiology reports

The recent improvements in capabilities of desktop computers and communications networks give impetus for the development of clinical image repositories that can be used for patient care and medical education. A challenge in the use of these systems is the accurate indexing of images for retrieval performance acceptable to users. This paper describes a series of experiments aiming to adapt the SAPHIRE system, which matches text to concepts in the UMLS Metathesaurus, for the automated indexing of image reports. A series of enhancements to the baseline system resulted in a recall of 63% but a precision of only 30% in detecting concepts. At this level of performance, such a system might be problematic for users in a purely automated indexing environment. However, if the ability to retrieve images in repositories based on content in their reports is desired by clinical users, and no other current systems offer this functionality, then follow-up research questions include whether these imperfect results would be useful in a completely or partially automated indexing environment and/or whether other approaches can improve upon them.