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Clinical reading centers provide expertise for consistent, centralized analysis of medical data gathered in a distributed context. Accordingly, appropriate software solutions are required for the involved communication and data management processes. In this work, an analysis of general requirements and essential architectural and software design considerations for reading center information systems is provided. The identified patterns have been applied to the implementation of the reading center platform which is currently operated at the Center of Ophthalmology of the University Hospital of Tübingen.
Analysis of multicellular patterns is required to understand tissue organizational processes. By using a multi-scale object oriented image processing method, the spatial information of cells can be extracted automatically. Instead of manual segmentation or indirect measurements, such as general distribution of contrast or flow, the orientation and distribution of individual cells is extracted for quantitative analysis. Relevant objects are identified by feature queries and no low-level knowledge of image processing is required.
The amount of image data has been rising exponentially over the last decades due to numerous trends like social networks, smartphones, automotive, biology, medicine and robotics. Traditionally, file systems are used as storage. Although they are easy to use and can handle large data volumes, they are suboptimal for efficient sequential image processing due to the limitation of data organisation on single images. Database systems and especially column-stores support more stuctured storage and access methods on the raw data level for entiere series.
In this paper we propose definitions of various layouts for an efficient storage of raw image data and metadata in a column store. These schemes are designed to improve the runtime behaviour of image processing operations. We present a tool called column-store Image Processing Toolbox (cIPT) allowing to easily combine the data layouts and operations for different image processing scenarios.
The experimental evaluation of a classification task on a real world image dataset indicates a performance increase of up to 15x on a column store compared to a traditional row-store (PostgreSQL) while the space consumption is reduced 7x. With these results cIPT provides the basis for a future mature database feature.
The implementation of a web based portal QA solution will lead to a high acceptance of the staff as the usage of commonly known standard software (e.g. web browser) allows intuitive handling. In the daily use a significant simplification of the workflow and Performance enhancement can be achieved by easy access to the check documents. As the data is now saved in a database it can easily be processed and long-term trends can be displayed. Therefore possible errors can be detected much easier and earlier. By the usage of time stamps and user authentication procedures and user responsibilities are comprehensibly documented. As the software is browser based, integration into an existing software Environment is not critical. As only technical QA data is processed, no further data security measures are necessary. A certification as a medical product is not required.
In this work, a web-based software architecture and framework for management and diagnosis of large amounts of medical data in an ophthalmologic reading center is proposed. Data management for multi-center studies requires merging of standing data and repeatedly gathered clinical evidence such as vital signs and raw data. If ophthalmologic questions are involved the data acquisition is often provided by non-medical staff at the point of care or a study center, whereas the medical finding is mostly provided by an ophthalmologist in a specialized reading center. The study data such as participants, cohorts and measured values are administrated at a single data center for the entire study. Since a specialized reading center maintains several studies, the medical staff must learn the different data administration for the different data center. With respect to the increasing number and sizes of clinical studies, two aspects must be considered. At first, an efficient software framework is required to support the data management, processing and diagnosis by medical experts at the reading center. In the second place, this software needs a standardized user-interface that has not to be trained/taylore /adapted for each new study. Furthermore different aspects of quality and security controls have to be included. Therefore, the objective of this work is to establish a multi purpose ophthalmologic reading center, which can be connected to different data centers via configurable data interfaces in order to treat various topics simultaneously.
Model-guided Therapy and Surgical Workflow Systems are two interrelated research fields, which have been developed separately in the last years. To make full use of both technologies, it is necessary to integrate them and connect them to Hospital Information Systems. We propose a framework for integration of Model-guided Therapy in Hospital Information Systems based on the Electronic Medical Record, and a taskbased Workflow Management System, which is suitable for clinical end users. Two prototypes - one based on Business Process Modeling Language, one based on the serum-board - are presented. From the experience with these prototypes, we developed a novel personalized visualization system for Surgical Workflows and Model-guided Therapy. Key challenges for further development are automated situation detection and a common communication infrastructure.