ERCIM News No.29 - April 1997

Information Technology in Medicine

by Thomas Berlage

Information and communication technologies are about to make a massive move into medical practice, not only in selected areas of 'high-tech' medicine, but throughout the field. Research in information technologies is needed in the areas of medical imaging, telecooperation, education and training

Medical images are produced in such a number and richness of detail that they can only be analyzed with the help of the computer. Computers not only improve the quality of the images, but also help in reconstructing structures, detecting anomalies and measuring. In particular, computers help with an appropriate visualization to make the image contents understandable to the clinician. Three-dimensional images are used more and more. They have the inherent problem that it is extremely difficult to visualize images consisting of a cloud of material in different shades of grey. Mechanisms have to be found that render the interesting detail and hide other structures that are not relevant for a particular situation. The selection and composition of algorithms depend on the medical goals of a particular analysis and thus can only be determined together with medical experts.

Images are needed to plan and control microinvasive surgical procedures. It is therefore necessary to design systems that support the physician with appropriate visualizations throughout the whole process from image acquisition, diagnosis, treatment planning, surgery to final control.

As medical professionals become more specialized, diagnosis and treatment occur in cooperation between different physicians that may be distributed. They have to use computers to exchange their medical data, in particular images. However, data transfer alone is not sufficient. they must also be able to communicate about their patients, to talk freely about medical data and refer to that data during their discussion. Merging these two communication channels (verbal and data communication) is a challenge that needs to be addressed before teleconsultation can be reasonably efficient. And finally, medical knowledge increases at an amazing pace. Physicians are required to keep up with new knowledge for their whole life. To ensure the quality of diagnosis and treatment, special emphasis on continuous education is needed. Computer-based techniques can help with this task, in particular if they provide training on the job, assisting in the analysis of images and teleconsultation.

All these problems can be solved only in interdisciplinary teams. One needs physicians that are open-minded to think about new computer-based approaches. Computer scientists have to listen for the problems of their medical partners. Psychologists have to look at human-human and human-computer interaction. Engineers and administrators have to make things work. A single profession can no longer deal with all aspects of the complex problems. Furthermore, new systems have to be designed iteratively, with the user in mind. Systems must be addressed to real user problems. However, it is not possible to completely assess the value of a new development before it is taken into daily practice with real users. Developers must be ready to radically change their systems until these really meet the user needs. Users must be involved, but not in a naive fashion ("tell me what you need"). A constructive dialog between users and developers, involving a sequence of prototype systems, is needed to acquire the real user needs.

The following examples show that ERCIM members work together with medical partners on all these aspects. These interdisciplinary activities are needed to broaden the influence of computer science research in our society throughout Europe.

Please contact:
Thomas Berlage - GMD
Tel: +49 2241 2141

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