A new concept toward computer-aided medical diagnosis--a prototype implementation addressing pulmonary diseases.

The original concept that led to the structuring of a computer-based medical decision support system (DSS) that is able to support a physician's diagnosis is introduced in this paper. The concept's implementation modeled a generic DSS, the core of which are an integrated knowledge/information base (KIB) along with the inference properties of a data evaluator. The KIB encapsulates the necessary medical knowledge and experience in the form of rules and constraints, preemptive tasks, and actual patients' clinical data. The data evaluator handles approved medical subjective and objective criteria for assessing the KIB's data. The data evaluator incorporates a medical standard data gathering and decision process, structured upon the principles of the clinical differential diagnosis methodology and has been integrated in the system by means of both algorithmic and artificial intelligence techniques. The novel model and the resulted computer-based package have been extensively tested under the Pulmonary Department, University Regional Hospital Patras, Patras, Greece.

OTE-TS--a new value-added telematics service for telemedicine applications.

A new telemedicine service denoted as the Hellenic Telecommunication Organization Telemedicine Service (OTE-TS), which addresses an open multidisciplinary group of medical care providers (users), is presented in this paper. OTE-TS is supported by the Hellenic Telecommunication Organization (OTE) and is the result of the close collaboration of engineers, medical doctors, and market analysts. Its architecture provides the user with an integrated electronic working domain handling diverse types of conversational audiovisual information and medical records. It includes a stack of functions, protocols, and interfaces for data acquisition, processing, and display, and for the composition of dial-up multiparty cooperation schemes (synchronous or asynchronous), suitable for the coordination and management of high-level consult, report, and review activities. The service provider (i.e., the OTE) performs the central administration and maintenance of the service, as well as the management of medical cases and reports that are exchanged among the users. The service has been extensively tested in real-world conditions.

Telemedicine technology and applications for home hemodialysis.

Home hemodialysis (HD) for the treatment of patients with end-stage renal disease (ESRD) was first put into practice about 30 years ago. In this paper we describe the application of telematics monitoring services (TMS) for supporting patients who need home or satellite HD (SHD). For the clinical trials two modified HD machines were located in the renal unit and a central control station (UNIX workstation with multimedia PC-terminal) was located in another room of the hospital. Bi-directional communication between modified HD machines and central control station was managed via ISDN (Integrated Services Digital Network) links. Using these HD-machines 150 HD sessions were performed in nine patients over a period of five months. This system enabled on-line remote supervision of the HD machine-related functions (air in the blood, leak of blood, low conductivity etc.) and the clinical condition of patients through measurement of blood pressure (BP), pulse rate, PO2 (pulse oxymetry) and electrocardiogram (ECG) from the central control station (CCS). The user checked the type of alarm/warning, its appearance on HD machines and multimedia terminal units (MTU), the action of the protective system and the appearance of consultative messages from CCS on the remote terminal unit RTU. According to the data collected, the disturbances of HD machine function were visible and audible in the CCS and the user messages were always observed on the RTU. No unusual dialysis-associated complications were observed, all data and alarms/warnings were transmitted correctly and patients had adequate HD treatment.