DIOGENE 2, a distributed Hospital Information System with an emphasis on its Medical Information Content

Jean-Raoul Scherrer; Christian Lovis; François Borst

doi:10.1055/s-0038-1638023

Yearbook of Medical Informatics, Inhaltsverzeichnis

Yearb Med Inform 1995; 04(01): 86-97
DOI: 10.1055/s-0038-1638023

Review Paper

Georg Thieme Verlag KG Stuttgart

DIOGENE 2, a distributed Hospital Information System with an emphasis on its Medical Information Content

Jean-Raoul Scherrer

¹Hospital Informatics Centre; Geneva Canton University Hospital, Geneva, Switzerland

,

Christian Lovis

¹Hospital Informatics Centre; Geneva Canton University Hospital, Geneva, Switzerland

,

François Borst

¹Hospital Informatics Centre; Geneva Canton University Hospital, Geneva, Switzerland

› Institutsangaben

Abstract

Abstract:

DIOGENE 1 has been a mainframe-based centralised HIS with a star network of communication operating on a daily basis with 120 nursing ward units since 1978. Together the limited and costly growth capabilities of such a system with its extreme difficulty in cooperating jointly with other heterogeneous medical systems, with the need for faster networking expansions, led to the new design of a distributed architecture called DIOGENE 2. In 1989, a migration process between DIOGENE 1 and DIOGENE 2 was initiated and is now on the verge of being achieved. During the time of this new expansion of the HIS, it has been easy to cooperate with the decentralisation process of the new hospital organisation as well facilitating the integration of new functionalities like i.e. new WIS architectture, medical office patient histories, integration based upon PCs with UNIX based client/server platforms. That approach combines the handling of paragraphs structured patient records with the use of medical natural language processing and semi-automatic encoding as well. Amongst these new functionalities the P ACS are associated with image manipulation platforms called OSIRIS for X-Ray images as well as other tools devoted to molecula biology and genetics up to the ExPASy server on Internet using WWW Mosaic which is accessible from all over the world. The distributed architectture appears well suited not only for the integration of these new functionalities but to keep them growing as smoothly as possible.

Keywords:

Hospital Information Systems (HIS) - distributed architecture computer-based patient record - PACS - image manipulation - WWW /Mosai

Volltext

Referenzen

References
1 Scherrer JR, Baud RH, Hochstrasser D, Ratib O. An integrated hospital information system in Geneva . MD Computing 1990; 7 (02) 81-89.
2 McDonald CJ, Murray R, Jeris D, Bhargava B, Seeger J, Blevins L. A computer-based record and clinical monitoring system for ambulatory care. Ami Public Health 1977; 67: 240-5.
3 Pryor TA, Gardner RM, Clayton PD, Warner HR. The HELP System . J Med Syst 1983; 7: 87-102.
4 Simborg DW, Chadwick M, Whiting O’Keefe QU, Tolchin SG, Kahn SA, Bergan ES. Local area networks and the hospital . Comput Biomed Res 1983; 16: 247-59.
5 Stead WW, Hammond WE. Computerized medical records: a new resource for clinical decision making . J Med Syst 1983; 7: 213-20.
6 Bakker AR. The development of an integrated and co-operative hospital information system . Med Inf 1984; 9: 135-42.
7 Bleich HL, Beckley RF, Horowitz GL. et al. Clinical computing in a teaching hospital . N Engl J Med 1985; 312: 756-64.
8 Whiting O’Keefe QE, Whiting A, Henke J. The STOR clinical information system. MD Comput 1988; 5 (05) 8-21.
9 Scherrer JR, Baud R, Brisebarre A. et al. A hospital information system in continuous operation and expansion . In : Orthner HF, Blum BI. eds. Implementing health care information systems. New York: Springer-Verlag.; 1989: 100-22.
10 Rouge A, Baud RH, Scherrer JR. An integrated network of telexprinters within DIOGENE hospital information system . In: van Bemmel JH, Ball MJ, Wigertz O. eds. MEDINFO 83 : Proceedings of the Fourth Conference on Medical Informatics. Amsterdam: North-Holland.; 1983: 1159-62.
11 Rouge A, Baud RH, Brisebarre A, de Roulet D, Scherrer JR. DIOGENE 2: A federated Hospital Information System for the 90’s . In: Barber B, Cao D, Qin D, Wagner G. eds. MEDINFO 89 : Proceedings of the Sixth Conference on Medical Informatics. Amsterdam: North -Holland.; 1989: 326-9.
12 Tolchin SG. Overview of an architecturalapproach to the development of the Johns Hopkins Hospital distributed clinical information system . J Med Syst 1986; 10 (04) 321-38.
13 European Union. Industrial Working Groups for the Fourth Framework Programme – Software Technologies : Distributed Systems Technology and Practice. Draft Report (version 4.1), 17-18 February 1994: 8-9. March 1994
14 Commission of the European Communities: Growth, Competitiveness, Employment : the challenges and ways forward into the 21st Century (White Paper). Brussels 5 December 1993
15 Lindberg DAB. Global information infrastructure . Int J Bio-Med Comp 1994; 34: 13-19.
16 Ferrara FM. The Role of Methodologies and conceptual models in the standardization of Medical Information . Timmers T., Blum BI. eds. Software engineering in medical informatics: Proceedings of the IMIA working conference in Amsterdam. 1991. Elsevier Science Publishers B.V.; (North-Holland).: 255-266.
17 Weinhall TD, Raveh YA. Managing growing organizations. A new approach . John Wiley & Sons, Chichester; New York, Brisbane, Toronto, Singapore: 1983: 172-94.
18 Safran C, Porter D, Lightfoot J, Rury CD, Underhill LH, Bleich HL, Slack WV. ClinQuery a system for on-line searching of data in a teaching hospital . Ann Intern Med 1989; 111: 751-6.
19 Baud RH, Scherrer JR, Coignard J, Lucas L, Degoulet P, Jean FC, Jaulent MC, Springub A, Engelmann U, Meinzer HP. The concept of a Ward Information System . In: Adlassnig KP, Grabner G, Bengtsson S, Hansen R. eds. Medical Informatics Europe 1991: Proceedings of the European conference on Medical Informatics, Lecture Notes in Medical Informatics. Springer Verlag, Berlin, Heidelberg; New York: 1991: 81-5.
20 Degoulet P, Coignard J, Jean FC, Jaulent MC, Lucas L, Ben Saïd M, Meinzer HP, Engelmann U, Springub A, Baud R, Scherrer JR. The HELIOS European project on Software Engineering. In : Software Engineering in Medical Informatics . Timmers T, Blum BI. eds. Elsevier Science Publishers B. V.; (North-Holland) Amsterdam: 1991: 125-137.
21 Foy JL. Integrating non-proprietary work stations into proprietary systems . Int J Bio-Med Comp 1994; 34: 277-283.
22 Jean FC, Lavril M, Lemaitre D, Sauquet D, Degoulet P. A software engineering approach for medical workstation development . Int J Bio-Med Comp 1994; 34: 249-260.
23 Collen MF. Implementing Hospital Computer Systems, General Requirements. In: Hospital Computer Systems. New York: Wiley &.Sons; 1974: 3-23.
24 Bakker AR, Ball MJ, Scherrer JR, Willems JL. Towards New Hospital In-formation Systems. In: IFIP-IMIA Working Group 10 Nijmegen Conference North-Holland: 1988
25 Bergeron BP, Greenes RA. Intelligent Visual Input : A graphical Method for rapid entry of patient-specific data . In : Proceedings of the eleventh annual Symposium on Computer Applications in Medical Care, November 1-4. 1987. Washington D.C.: W.W. Steadeds. IEEE Computer Society Press; 281-286.
26 Cimino JJ, Barnett GO. The physician’s workstation : Recording a physical examination using a controlled vocabulary . In : Proceedings of the eleventh annual Symposium on Computer Applications in Medical Care, November 1-4. 1987. Washington D.C.: Stead WW. eds. IEEE Computer Society Press; 287-291.
27 Degoulet P, Devries C, Sauquet D. Data and knowledge integration in hospital information systems . In: Towards new hospital information systems. Bakker AR, Ball MJ, Scherrer JR, Willems JL. eds. Amsterdam: North-Holland.; 1988: 151-156.
28 Pryor T A. The help medical record sys. tem . Clinical Computing 1988; 5 (05) 22-33.
29 McDonald CJ, Blevins L, Tierney WM, Martin DK. The Regenstrief medical records. Clinical Computing. 1988; 5 (05) 34-47.
30 Stead WW, Hammond WE. Computer-based medical records : the centerpiece of TMR . Clinical Computing 1988; 5 (05) 48-61.
31 Tournade MF, Assicot M, Clement G, Piquet JC, Lion F, DaSilva JL, Rajaona J, Reversat JP, Hugon D, Auffret G, Aamant E. L’expérience IGR en matière de gestion des dossiers médicaux . Informatique et Sante. Springer-Verlag eds 1989; 1: 110-116.
32 Scherrer JR, Revillard C, Borst F, Berthoud M, Lovis C. Medical office automation integrated into the distributed architecture of a Hospital Information System . Meth Inf Med 1994; 33: 174-9.
33 Langer RD. TALMRS ; Time-Affinity Linked Medical Record System: In: Proceedings of the eleventh annual symposium on Computer Applications in Medical Care. November 1-4. 1987. Washington D.C., Stead WW. eds.: IEEE Computer Society Press; 271-274.
34 Ogura H., Yamamoto K, Furutani H, Kitazoe Y, Hirakawa M, Sagara E. On line prescription order and prescription support in an integrated hospital information system . In : Medical Informatics, An international journal of information processing in health care 1985; 10 (04) 287-299.
35 Morel-Guillemaz AM, Baud R, Scherrer JR. Le problème de 1’ analyse temporelle dans les dossiers médicaux. In : Intelligence Artificielle et thérapeutique, Informatique et cancer, Informatique et “économie” hospitalières. Journées francophones d’informatique méedical de Montpellier, 14-16 mars 1989, ENS Collection ACTES. 1989: 256-363.
36 Scherrer JR. Developments in medical care and nursing care . In: Bakker AR, Ehlers CT, Bryant JR, Hammond WE. eds. Hospital Information system Scope-Design-Architecture. Amsterdama North-Holland Publ Comp: 1992: 3-9.
37 O’Desky RI, Ball MJ, Ball EE. Computers in health care for the 21st century . Meth Inform Med 1990; 29: 158-61.
38 Baud RH, Rassinoux AM, Scherrer JR. Natural language processing ana semantical representation of medical texts . Meth Inform Med 1992; 31: 117-25.
39 Sager N, Lyman M, Nhan NT, Tick U, Borst F, Scherrer JR. Clinical knowledge bases from natural language patient documents . In: Lun KC, Degoulet Piemme TE, Rienhoff O. eds MEDINFO 92. Amsterdam: North-Holland Publ Comp; 1992: 1375-81.
40 Rassinoux AM, Michel PA, Jugee RBaud, Scherrer JR. Natural Language Processing of medical texts with the HELIOS environment . Comp Meth and Programs in Biomed, 45 Suppl. 1994: 579-596.
41 Engelmann U, Jean FC, Degoulet P. eds. Supplement : The HELIOS Software Engineering Environment. Results of the European AIM project HELIOS-2. Comp Meth and Programs in Biomed 1994. suppl 51-52.
42 Lovis C, Michel PA, Baud R, Scherrer JR. Use of a conceptual semi-automatic ICD-9 encoding system in an hospital environment . AIME 95. Artificial Intelligence in Medicine Europe. Accepted
43 Cote RA, Rothwell DJ, Palotay JL, Beckett RS, Broche L. SNOMED international, systematized nomenclature medicine. Introduction . College American Pathologists, Northfield, Illinois, April 1993
44 Chute CG, Atkin GE, Ihrke DM. empirical evaluation of concept capture by clinical classification . In: Proceedings MEDINFO 92. Lun KC, Degoulet P, Piemme TE, Rienhoff O. eds. North-Holland Amsterdam: 1992: 1469-1474.
45 World Health Organization International Classification of Diseases Version Genva: WHO; 1980
46 Hersh WR, Evans DA, Monarch IA, Lefferts RG, Handerson SK, Gorman PN. Indexing Effectiveness of linguistic and non-linguistic Approaches to. automated Indexing . In: Proceedings MEDINFO 92. Lun KC, Degoulet P, Piemme TE, Rienhoff O. eds. North-Holland, Amsterdam: 1992: 1402-1408.
47 Rossi Mori A. Model for representation of semantics in medicine . CEN/TC251/PT003 N34. 1992
48 Rossi Mori A, Bernauer J, Pakarinen V, Rector AL, Robbe P, Ceusters W, Hurlen P, Ogonowski A, Olesen H. Models for Representation of Terminologies and Coding Systems in Medicine . In: Proceedings of Opportunities for European and US cooperation in standardization in health care informatics. 1992. Geneva:
49 Frütiger P. Prospective encoding, transcoding and pragmatic representation of medical language . In: Computerized Natural Medical Language Processing for Knowledge Engineering. Scherrer JR, Cote RA, Mandil SH. eds. Elsevier; Amsterdam: 1989: 83-94.
50 Lovis C, Michel PA, Baud R, Scherrer JR. Word Segmentation Processing: a way to exponentially extend medical dietionaries . To be published: MEDINFO 95.
51 Ratib O, Ligier Y, Scherrer JR. Digital image management and communication in medicine. Computerized Medical Imaging and Graphics. 1994; 18 (02) 73-84.
52 DOQH Conti S, Munoz J, Pillou E, Tacchino M, Ratib O, Trayser G. UNIMAGE, anew RIS for the DIOGENE 2 environment at Geneva Cantonal University Hospital . Med Inform 1993; 18 (02) 143-148.
53 Ratib O, Hoehn H, Girard C, Parisot C. Papyrus 3.0: DICOM-compatible file format. Med Inform. 1994; 19 (02) 171-178.
54 Ligier Y, Ratib O, Logean M, Girard C. Osiris: A medical image-manipulation system . MD Computing 1994; 11 (04) 212-218.
55 Huang HK, Taira RK. Infrastructure de sign of a picture archiving and communication system. AJR 1992; 158: 743-749.
56 Osteaux M. A second generation PACS concept. European Congress of Radiology, Vienna. European Radiology 1991: 1-68.
57 Ratib O, Appel R, Scherrer JR. PAPY RUS: A multimodality Image File Format for PACS and teleradiology . Chicago: RSNA; 1990: 177-320.
58 Pun T, Hochstrasser DF, Appel RD, Funk M, Villars V, Pellegrini C. Computerized classification of two – dimensional gel electrophoretograms by correspondence analysis and ascendant hierarchical clustering . Applied and Theoretical Electrophoresis 1988; 1: 3-9.
59 Hochstrasser DF, Appel RD, Vargas R, Perrier R, Ravier F, Funk M, Pellegrini Ch, Muller AF, Scherrer JR. Clinical Molecular Scanner : The Melanie Project. Hawaii. Jan. 1991; Proc HICSS 24, Hawaii International Conference on System Sciences 626-635.
60 Appel RD, Bairoch A, Hochstrasser DF. A new generation retrieval tools for biologists: the example of the ExPASy WWW Server. Trends in Biochemical Sciences. TIBS 19 1994; 258-260.