At present, the system of health care intensive implementation of electronic
document circulation and telemedicine development. Information and data circulating in medical networks require new approaches to their processing and analysis –
medical images and records should not only be transmitted, but stored, processed and analyzed at the same time. Providing large-scale streams the information transmitted implies a global rethinking and upgrading of existing medical systems and their architecture. Therefore, the problem of standardizing processes in medical informatics becomes one of the most urgent in the construction of telemedicine networks.
Virtually all standards of medical informatics are one way or another related to the conduct of electronic history of the disease (EIC). Some standards describe the terminology, others – the transfer of medical documents and images in EIC, third – ways to organize data in
ЕІХ, the fourth – providing medical access workers and patients themselves to EICs, etc. In Article only the standards of medical data transfer are considered, which is relevant due to the development of telemedicine and the transmission of medical images and data.
When implementing telemedicine services it is necessary transfer to the consultant and back to the user is different medical information through communication channels. Such a transfer should be carried out according to certain rules and
formats so that they are perceived by any participant in telemedicine consultation.
According to the requirements for the list of documents, which are used in telemedicine consultations, these include medical records, medical imagery and graphic material. In this way, account medical forms are transmitted as a request to telemedicine consultation, outpatient card
patient, epicrisis and statements from medical records, etc.
Medical images include various types of images from electrocardiograms (ECGs) and electroencephalograms to X-ray images, images computer tomography, ultrasound imaging,
imaging of magnetic resonance imaging, etc.
Modern information technology allows you to operate with four main types of images: two-dimensional (planar), layered, three-dimensional
(3D rendering) and four-dimensional (4D rendering).
The latest approaches to visualization are disseminated: virtual endoscopy, multiplanar organ reconstruction, 3D virtual neural echoangiography,
X-ray osteodensitometry, radio-thermography, electro-impedance tomography, digital a posteriori algorithmic treatment of X-rays, etc.
For more convenient storage and transmission of data, several international organizations and industrial companies have adopted a standard
DICOM – Digital Image and Communication in
Medicine (Digital Imaging and Communications in Medicine). It is implemented in modern medical equipment for receiving, processing and transferring images, which facilitates the data exchange between devices.
for visualization of images, post-processing panels and archiving systems. The DICOM standard allows you to solve an open-source integration problem architecture The standard provides multiple images one object with different information in electronic form, which can then be submitted to the computer processing (for example imaging of a magnetic resonance imaging and a computer tomograph). At this ensures image quality is several times higher than that of conventional images. It gives more information about the patient and his condition, which in turn improves the ability to diagnose and further treat it. With the use of this the standard significantly reduces the time of research. Hospitals do not need to store film shots, which reduces costs.
The DICOM message structure allows you to distinguish from the messages of the image without further efforts, which allows the developer to start with the simplest task of receiving and rendering images transmitted from secondary data acquisition devices, for example, X-ray scanners snapshots In this case, a program is used to handle the received messages by other methods of visualization, skipping secondary information.
Thus, DICOM allows you to organize not only data transmission over the network, but also their automatic processing. It significantly reduces the time of preparation and conduct of research, image management and related information. To achieve With the highest efficiency, it supports all stages of diagnosis, reducing cost through reduced service time, film rejection and storage costs, as well as a significant reduction loss of images and results. In general, the use of the DICOM standard appears to be an interesting and important task, the solution of which can bring significant benefits to the end users of medical images – doctors and consultants.
The transfer of research conditions is important for further automated processing of research results. Today’s DICOM standard embedded in the equipment of the largest manufacturers
radiological equipment (PICKER, GE, Siemens, HP, Philips) and most medical imaging systems. It is supported by national ones Standards Organization – CEN TC251 in Europe and
JIRA in Japan.
The HL7 Health Level 7 (Seventh Level) HL7 standard is easily interconnected with other protocols and standards that allows you to use it in quality standard in the devices of many manufacturers of medical equipment. The HL7 organization was founded in
1987 to develop standards for the electronic exchange of clinical, financial and administrative information between various computer medical systems, which include: hospital
information systems, clinical laboratory systems and other. In this way, this standard is used for the exchange of medical records
In addition, the standard HL7 provides an opportunity the only presentation of a medical documentary information without the development of special programs and interfaces, that is, standardizes the exchange of information, and not the systems that transmit these data. As a consequence, there is a variety of methods for applying the HL7 standard in various health care settings. The only scheme is Information technology in medicine 257 receiving data is a valuable asset not only for clinical, but also for statistical research.
The “Level 7” standard is called the “seventh level” by analogy to the seven levels of the Open System Interconnection (OSI) model ISO and represents the processes of the highest level. The OSI communication model is the basic reference model for the interaction of open systems.
To enable the exchange of information between different systems was extremely important
creation of a standard exchange protocol for electrocardiogram (ECG) computerization. The main one the purpose of creating such a protocol is the specification format of data and means of transmission of ECG and conclusions on a straight line of connection from any source recording computer ECG to the central system ECG management. He must also support standardized exchange of digital ECG signals and the results of measurements between different computer systems. As a result, under the auspices of the technical
The Committee of the TC 251 of the European Committee for Standardization (CEN) developed the document ENV1064, which is the official SCP-ECG standard. Standard communication protocol for computerized electrocardiography (Standard communication protocol for computer
Electrocardiography) of the European Union. Standard ENV1064 installs a single (standard) protocol transmission (SCP) of ECG data between a digital electrocardiogram and a computerized system management, and between computer systems of different manufacturers. The SCP-ECG standard does not impose limits on the physical layer of the protocol, but only defines the minimum requirements. It regulates some agreements for the transfer of other data:
patient data, ECG analysis results, conditions for conducting measurements, etc. Within the SCP protocol, the content and format of the ECG signal and results measurements obtained from electrocardiographs of different grades do not necessarily have to be identical.
The following are the possible uses of records ECG signals require special attention: comparison of ECG series of signals and their interpretations; formats of diagrams of ECG signals; bidirectional transmission.