A multimedia electronic patient record (ePR) system for image-assisted minimally invasive spinal surgery.
A multimedia electronic patient record (ePR) system for image-assisted minimally invasive spinal surgery.
复制标题
用于图像辅助微创脊柱手术的多媒体电子病历 (ePR) 系统。
DOI：
10.1007/s11548-009-0387-x
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发表时间：
2010
影响因子：
3
通讯作者：
Huang,HK
中科院分区：
文献类型：
--
作者：
Documet,Jorge;Le,Anh;Liu,Brent;Chiu,John;Huang,HK
目的本文提出了通过开发一站式多媒体电子病历（ePR）系统来弥合诊断图像和图像辅助手术治疗之间的差距的概念，该系统管理和分发实时多模态成像和信息数据，以在手术的所有临床阶段（从计划术中到术后随访）帮助外科医生。我们提出的概念，这种多媒体电子病历手术首先集中在图像辅助微创脊柱手术作为一个临床application.MethodsThree临床阶段的微创脊柱手术工作流程在术前，术中，术后进行了讨论。ePR架构基于三阶段工作流程开发，包括术前、术中和术后模块，以及输入集成单元、容错网关服务器、容错ePR服务器和可视化显示4个组件。建立了一个原型，并部署到微创脊柱外科临床站点，提供用户培训和日常使用支持。总结介绍了一种逐步的方法来开发用于成像辅助微创脊柱外科手术的多媒体电子病历系统，该系统包括图像、临床表格、波形和用于计划手术的文本数据，两种实时成像技术（数字荧光透视，DF）和内窥镜视频图像（Endo），以及手术期间患者的六个以上的实时生命体征。还讨论了临床实施经验和挑战。
PurposeThis paper presents the concept of bridging the gap between diagnostic images and image-assisted surgical treatment through the development of a one-stop multimedia electronic patient record (ePR) system that manages and distributes the real-time multimodality imaging and informatics data that assists the surgeon during all clinical phases of the operation from planning Intra-Op to post-care follow-up. We present the concept of this multimedia ePR for surgery by first focusing on image-assisted minimally invasive spinal surgery as a clinical application.MethodsThree clinical phases of minimally invasive spinal surgery workflow in Pre-Op, Intra-Op, and Post-Op are discussed. The ePR architecture was developed based on the three-phased workflow, which includes the Pre-Op, Intra-Op, and Post-Op modules and four components comprising of the input integration unit, fault-tolerant gateway server, fault-tolerant ePR server, and the visualization and display. A prototype was built and deployed to a minimally invasive spinal surgery clinical site with user training and support for daily use.SummaryA step-by-step approach was introduced to develop a multimedia ePR system for imaging-assisted minimally invasive spinal surgery that includes images, clinical forms, waveforms, and textual data for planning the surgery, two real-time imaging techniques (digital fluoroscopic, DF) and endoscope video images (Endo), and more than half a dozen live vital signs of the patient during surgery. Clinical implementation experiences and challenges were also discussed.