Telemedicine services use a large amount of data, most of which are diagnostic images in Digital Imaging and Communications in Medicine (DICOM) and Health Level Seven (HL7) formats. Metadata is generated from each related image to support their identification. This study presents the use of decision trees for the optimization of information search processes for diagnostic images, hosted on the cloud server. To analyze the performance in the server, the following quality of service (QoS) metrics are evaluated: delay, bandwidth, jitter, latency and throughput in five test scenarios for a total of 26 experiments during the loading and downloading of DICOM images, hosted by the telemedicine group server of the Universidad Militar Nueva Granada, Bogotá, Colombia. By applying decision trees as a data mining technique and comparing it with the sequential search, it was possible to evaluate the search times of diagnostic images in the server. The results show that by using the metadata in decision trees, the search times are substantially improved, the computational resources are optimized and the request management of the telemedicine image service is improved. Based on the experiments carried out, search efficiency increased by 45% in relation to the sequential search, given that, when downloading a diagnostic image, false positives are avoided in management and acquisition processes of said information. It is concluded that, for the diagnostic images services in telemedicine, the technique of decision trees guarantees the accessibility and robustness in the acquisition and manipulation of medical images, in improvement of the diagnoses and medical procedures in patients.
The American Health Level Seven (HL7) Reference Information Model (RIM) consists of six back-bone classes that have different specialized attributes. Furthermore, for the purpose of enforcing the semantic expression, there are some specific mandatory vocabulary domains have been defined for representing the content values of some attributes. In the light of the fact that it is a duplicated effort on spending a lot of time and human cost to develop and modify Clinical Information Systems (CIS) for most hospitals due to the variety of workflows. This study attempts to design and develop sharing RIM-based components of the CIS for the different business processes. Therefore, the CIS contains data of a consistent format and type. The programmers can do transactions with the RIM-based clinical repository by the sharing RIM-based components. And when developing functions of the CIS, the sharing components also can be adopted in the system. These components not only satisfy physicians- needs in using a CIS but also reduce the time of developing new components of a system. All in all, this study provides a new viewpoint that integrating the data and functions with the business processes, it is an easy and flexible approach to build a new CIS.
This paper describes Clinical Document Architecture Release Two (CDA R2) standard and a client application for messaging with SAĞLIK-NET project developed by The Ministry of Health of Turkey. CDA R2 , developed by Health Level 7 (HL7) organization and approved by American National Standards Institute (ANSI) in 2004, to standardize medical information to be able to share semantically and syntactically. In this study, a client application compatible with HL7 V3 for a project named SAĞLIKNET, aimed to build a National Health Information System by Turkey. Moreover, CDA conformance of this application will also be evaluated.