Volume 48, Issue 1

Hospital Information Systems have been emerging towards Health Information Systems (HIS) for more than a decade. Systems have spread across institutional borders, and regional health networks are being supported. Furthermore, E-Health is starting to become a reality. In the same time, HIS functionality has significantly improved: systems have become by far more comprehensive, providing essential information and knowledge to health care professionals, supporting quality management, improving patient safety, and providing means to inform patients. Old and new problems, however, remain to be solved, and significant challenges exist. Among them are the need for flexibility, extensibility, seamless integration, and adaptation to work processes. Health Information Systems need to cope with change and with the evolution of medical concepts. Continuous quality improvement of distributed health care processes needs to be supported. The underlying IT infrastructure has to gradually overcome semantic heterogeneity of systems, and to provide support for inter-institutional workflow. In this article, we will present both challenges and architectural approaches for future HIS.

In this paper two major tasks of health telematics are identified: telemedicine to support the physicians and collaborative health information systems additionally incorporating the patient. In the field of telemedicine, exemplary scenarios of teleconsultation/teletherapy but also the creation of joint electronic patient records by several healthcare providers are described in detail and analysed. Those are teleradiology, telepathology, and telesurgery. On the other side, collaborative health information systems provide several means to actively incorporate the empowered patient in the care process. We illustrate the approach of sharing a patient's electronic medical record with the patient and distinguish it from alternative approaches, such as email communications between patients and doctors or patient empowerment through web-based information services. For all such applications, recent trends in research and implementation are analysed and the technological as well as legal requirements are discussed.

Especially in knowledge-rich domains such as medicine perfect access to the literature is essential for professionals. Unfortunately, especially in knowledge-rich domains it is difficult to achieve perfect access: it is too difficult and too time consuming for users to formulate queries that yield the maximum of relevant documents and a minimum of non-relevant ones. The paper first discusses the challenges of information retrieval in medicine and various existing approaches. To address the challenges two completely opposite approaches are presented. The first supports the user by means of metabrowsing: a visual way of depicting the relations between domain concepts and documents. Metabrowsing relieves the user from the formulation of queries, while leaving him in full control. The second approach aims to minimize the interaction with the user. Information needs and queries are autonomously and proactively formulated by a software-agent who remains invisible to the user. The agent uses the electronic patient record of a particular patient and domain knowledge. As a result, the agent provides the doctor with literature that is relevant with respect to the patient at hand.

The term cognitive tool was coined for a means especially designed to improve human cognition. Examples of cognitive tools range from simple mind maps to computer-based assistence systems. Cognitive tools can play a key role in the knowledge management process. This paper describes specific requirements for cognitive tools in a medical context, and presents an implemented framework for enabling medical knowledge management by cognitive tools. The visualization of semantic networks and the users interaction with these graphical metaphors play an important role not only in the process of authoring or knowledge externalization, but in the computer-supported application and internalization of medical knowledge, as well. The paper addresses special methodological aspects, namely: 1) the seamless integration of formal knowledge representation and informal knowledge documentation, 2) the introduction of graphical means for interacting with the medical knowledge, and 3) the mutual support of eLearning and knowledge management. The framework is applied to complementary fields: 1) a learning system for differential diagnosis in paediatrics and 2) a tool, which empowers scientific literature retrieval by a graphical visualization of concept-nets based on the Medical Subject Headings (MeSH). As a result the case studies show that a generic framework, which supports the visualization of conceptual structures and allows an easy interaction with a medical knowledge repository can successfully support very different steps of medical knowledge work and clinical decision support.

Over the last decade, the areas of bioinformatics and genomics have identified, catalogued and characterised, at the molecular level, the components that make up the complex system of a cell. The next step is to describe how the many components interact to create the complex behaviour that underlies development and disease. The following article is to describe some of the research areas and challenges involved.

Zusammenfassung Thema dieses interdisziplinären Forschungsprogramms ist die Analyse und Optimierung des computerbasierten Wissensaustauschs in Lern- und Arbeitskontexten. Kommunikationswerkzeuge für derartige Situationen müssen auf bestimmte Herausforderungen eingehen, die sich aus der Kommunikation in Gruppen, auf Distanz und mit dem Ziel des Wissenserwerbs ergeben. Beispielhaft werden zwei Informatikprojekte vorgestellt, die das computerunterstützte kollaborative Lernen (CSCL) durch die Implementation von annotationsbasierten Lerndiskursen und CSCL-Skripten fördern.

Zusammenfassung Die Integration von Multibandantennen in moderne Mobiltelefone stellt zunehmend eine Herausforderung für den Antennenentwickler dar. Eine platz- und kostenoptimale Lösung folgt daher dem Ansatz, das Gerät selbst als Antenne zu nutzen und mit dem zu integrierendem Antennenmodul nur dessen Ankopplung einzustellen. Obwohl zunächst skeptisch betrachtet, hat sich dieser Ansatz durch seine offensichtlichen Vorteile mittlerweile bei der Entwicklung von Mobiltelefonen durchgesetzt.