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EXPERT SYSTEMSIn Europe, the development of information technology is used to implement tasks of telemedicine. Most of the laboratory and radiological equipment is computerized, the concept for the integration of information systems, which improves diagnosis and treatment. Data sources for teleradiologičeskih systems are computer tomography, ultrasound, magnetic resonance imaging, digital chest x-ray, computed radiography. Government programmes on tele-health cover database creation (NUCLEUS-a multimedia patient record EMDIS-European information system on donor bone marrow, EPIC-European model of treatment, FEST-a knowledge base for European telemedicine services), telecommunications (ISAAC-integrated telecommunications system, SHINE-strategic health information network Europe), informative programs serving specific groups (the elderly, the disabled, etc.) or situational problems (crashes, etc).Since 1988 in Europe began work on the programme AIM to introduce modern means of Informatics in medicine. The company provided ATL HDI 5000 expert system for image processing speeds of 14 billion. operations per second with 150 DB dynamic range, which enables to observe a clear color image of blood flow. The system is equipped with intelligent adaptive system settings, system optimization, provides a three-dimensional image of the blood vessels.In Russia there are expert systems for orthopedics. Their success is determined by the degree of understanding of the real medical and technical processes. The system is combined with multimedia devices.A number of intelligent systems allow to take into consideration the opinion of a physician (DIAGEN), implement the adjustment mechanism "weights" signs, give the coefficients "confidence", etc. These systems provide solutions: "soft solution", "hard choices", etc.Children's experience of telemedicine advisory system in Russia with the CENTRAL SCIENTIFIC RESEARCH INSTITUTE "Centre" and of Department of Pediatric Surgery of the Russian State Medical University has contributed to the training of Pediatricians in the country. Developed by expert diagnostic system for monitoring babies, medicine, clinical diagnostics, thyroid, etc.In the practice of medicine dynamic model of simulation technology for the diagnosis of èlektrovibrostimulâcii, in particular, the human spinal column.Multimedia technology applied in the creation of information and diagnostic and instructional systems. In ZITO'S the n. N. Priorova, with the participation of STC "new medical technologies" multimedia systems operate with the participation of experts from relevant disciplines. The systems use a Pentium PC, SVGA Monitor, 4 MB RAM, Windows 95.In Russia quite intensively develop local health information systems (MIS) and network. It is now widely used in the practice of medicine, computerized medical records and system of classification terms. An important role is played by the language of communication between databases and terminology.On the agenda is the creation of territorial and then global IIA.The development of information technology and modern communications, the emergence of a large number of clinics and automated monitoring systems, medical devices and computers has led to a new round of interest and to a significant rise in the number of health information systems (MIS) clinics, as in large medical centres with large flows of information, and in a mid-sized medical centers and even in small clinics or clinical departments. Only in the United States costs of clinics in this area account for about 8.5 billion. $. in the year, and estimated cost is expected to increase to 12-14 billion. $. in connection with the proposed replacement or modernization of outdated IIAs.The modern concept of information systems merging electronic records of patients (electronic patient records) with archives of medical images and financial information, monitoring data from medical devices, performance monitoring systems and lab automation, the availability of modern means of communication (electronic mail, Internet-hospital, video conferencing, etc.).According to officials of the American Institute of medical records (Medical Records Institute, USA), actually you can select 5 different levels of computerization to the IIA.The first level of the IIAS are automated medical records. This level is characterized by the fact that only about 50% of patient information is entered into the computer system, and in a different form is issued to users in the form of reports. In other words, such a computer system is an automated environment around the "paper" technology of the patient. Such automated systems generally cover the patient's registration statement, in-hospital transfers, diagnostic information, destination entry, operations, finance, run parallel to the "bumagooborotu" and serve primarily to a different kind of accounting.Second tier IIA is a system of computerized medical records (Computerized Medical Record System). The level of development of the IIA the medical documents that had not previously been in the electronic memory (particularly on information from diagnostic devices, received in the form of various
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