Developing a web application to transfer image and patient information
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Presented By:


Name : Arif Shaik
Student Number : 0624808
Award : MSc Computer Science
CP4064 MSc Computer Science Dissertation Proposal

University of Wolverhampton
School of Computing and Information Technology
Wulfruna Street, WV1 1SB, United Kingdom




Project Title:


Developing a web application to transfer image and patient information


Aim :


Aim of this application to develop a web based data transfer model that can transfer both image and patient information with applied security features like encryption.

Deliverables:

Following deliverables are derived while evaluating the application

¢ A working web application that can transfer both the image and ordinary data across different countries
¢ A backend database that can store typical data like images and attachments
¢ A rich graphical user interface that can provide easy navigation to transfer the data
¢ A secured data transfer mechanism.





Research question(s) :


1. How to develop a web application that can be able to transfer rich content like images and attachments related to patient information across the country?
2. How to provide both the database level security and document level security in a web based image transfer application with out loosing the quality of the content?

Literature Review:


According to Lead tools medical Web viewer framework, Web-based medical image application enables the programmers to build a high quality images based on the services to maintain high-level stratification. Distributing medical studies to web clients from a server, a bit of knowledge is necessary for web hosting and web development. The main purpose of web development is to view images and patient information from Internet explorer. This extensive design is used for specific data transfer and DICOM images to implement web service application.
To build a medical viewing application a advanced component for building application in medical display is needed. Such as teleradiology solutions, diagnostic workstations, view stations, DICOM viewers which were found in radiology and other medical department. Communication system PACS is used to reduce the complexity and to provide a solid foundation to the project.
http://leadtoolssdk/medical/medical-web-viewer.htm.


According to Yu S Lim e.atl (No year) digitized medical images are used in this system, which are acquitted from CR, CT, MRI and nuclear medicine techniques. Functional images can be powerful tool to examine disease in human body .
To view the medical image necessary steps are used:
¢ MRI, CT, Digital X-Ray, Ultrasound are the colored images and also display in grayscale.
¢ It supports physically and programmatically by altering the screen layout. For example the screen shot below shows an MRI and an XA series displayed side by side, the MRI series is shown as 2X2 images while the XA is shown as 1X1.
¢ Maintain the scale and offset to a single sub-cell automatically and systematically.
¢ Different images with various sizes are supported to the same cell.
¢ It fires a Active Sub-Cell with the changed active sub-cell.
¢ Window Level, Zoom, Position, Rotation can reorganize to sustain.
¢ It also supports the images of the medical observer or pages added and removed.
¢ The images contain information will overlay to display an important feature for any high-level medical viewer. The programmer has full command over the text to be displayed and should be placed and sized within each window. I It also maintain on overlays such as standards of window width and window center, field of view and more.
¢ It also helps to recover, modify or remove tags from a DICOM dataset .
¢ Some of the features of DICOM are shown below.
Rich Client Web Viewer:
o For outsized images Overview (Pan/Zoom) window is necessary.
o Full screen mode.
o Measurement and section processing tools.
o Streaming series with many single frame and multi-frame images. . Multiple display layouts, including stack, cine and series view.
o Cine playback of DICOM image series.
o Supports patient orientation information, localization and reference lines.
o Copy images to clipboard to be pasted into other imaging applications.
o Access to display non-image DICOM dataset tags. http://leadtoolssdk/medical/medical-web-viewer.htm.

WCF( Windows Communication Foundation) Security Guidelines :
o Limit Service access to authorized users.
o Manage to user authentication, groups and roles http://leadtoolssdk/medical/medical-web-viewer.htm.

Universal DICOM Converter:

DICOM means Digital Imaging and Communications in Medicine, TIMS is a worldwide DICOM convertor and some therapeutic agents are CT,X-ray angiography, MRI, fluoroscopy TIMS can trace out video signal with any physical agent using vast technology within the system. Nearly 20 yrs onwards few medical vendors are taking foresight imaging from the companies such as Siemens, HeartLab, GE, and more. TIMS attune any type of video signal that may publish in partial list. TIMS is helpful in department or hospitals in several ways. It is impossible with extra DICOM convertors for the normal video signals.

Some the benefits are by converting any modality. The TIMS DICOM System enables you to go digital right away and eliminate film. This saves your hospital money and eliminates the need to purchase new modalities or expensive DICOM upgrades. This translates into real savings of hundreds of thousands or millions of dollars for your hospital . http://timsconvert-any-modality.htm
Electronic Patient Medical Database:

Electronic Medical Record (EMR) is a system which is based on the technology related with the data collection of the outpatient. Here data is operated by a patient through several ways such as professional conference for shared data, planned dialogues are released via phone, web, interactive voice response (IVR) and some are collected from home like chronic obstructive pulmonary disease (COPAD), congestive heart failure and diabetes any more. This data is collected and placed in central service and permit into secure, EMR is accepted by a FDA.
Physicians send out the data when it is screened and recognized as medical alert. Alerts such as email, phone or pager, when the data of the patient reaches it is verified beside the criteria to operate alerts for emergent action to fill up prescription which may require appointment in office.
The patient is undertaken by Health Insurance Portability Accountability Act (HIPAA) as a compliant on the admission of the data base records where it secures in website. This specialized patient status includes a record with related to history information with latest signs of medical physiological and take the result of previous notes and latest record and subject them in system with question and answer of the patient.

EMR and web interface is secured by Medstar which admit the clinical users as well as patients. Therefore the data collection server such as Medstar gives a relevant data as follows:

- Patients are able to pursue their records.

- By seeing the data and analysis of the patient then only physician admit.
- Forecasting the records of outpatient with medical equipment.
- Warning to physicians and technicians via phone, e-mail and pages when the patient
go beyond the limits.
- Regular session will contact through web based and phone, such are questioned and
answered with patients .
- By this facility patients are reminded for appointment to consult and medicated
- Fax reports are drawn automatically to physician.

The Med Star PC is another program in connection with web-based solution with outpatient care. It permit the patient to accumulate all the physiological data which is stored in personal computer and the data is allowed through internet and storage server.
Here the healthcare department and patients can review the data through a Web portal. Data can be observed in printable and practical reports and it also assesses the users to come over the conference hall for consulting through video or mobile. This may show image of wound care, this facility is in online track and the patients may ask question and answers through this process to check out the welfare of the patient through a web login page with manual alerts. http://cybernetindex.php/medical-and-hea...l-database

Methods for removing Hidden Patient Data from Digital Images in PowerPoint:

Global Conversion:

In this we can view patient information from the digital images by using power point presentation. The unnecessary image pixels are hidden giving masking and cropping methods which are present in innovative images. In this aspect we can not be erased or deleted the pixels before presentation these pixels will be invisible mode and we have permanent solution to rid of the unwanted pixels. Individual images are slider to export by using power point slides. By taking these exported images you can form a new presentation by giving photo album function, now automatically the exported images are placed in power point as in album and these images of each slide is converted from screen shots so the hidden pixels will not longer sustain the objects.
Some drawbacks are there in removing hidden information of patient even though it possess eternal solution. After completing all the slides it does not allow editing, so it will vanish but it is possible to give brightness and contrast to the images through image editing. If the innovative presentation encloses movie clips then you have to reintroduce into new slide. We have one chance to safeguard the original text that is the slides must restore with the original slides after the transmission process by copy and paste the functions which contains the two presentations.
In the department several radiologists locate the text and images which give simple presentations. Some of power point features are like hyperlinks, animations, transitions and objects which are more reliable. The hidden patient information is likely to conserve some objects with features from digital images (Chun-Shan Yam, 2005).
Individual Image Modification:

To protect some digital images and objects the patient data must be isolated and we can avoid patient information from the exported images is by cropping technique. This is used to condense the size of the document by selecting the image from the presentation using the compress pictures function within the picture tool bar. Here in the window the compress pictures are deleted with Crop tool which is placed on the picture then click OK button and then click Apply button to begin the process. Hereby we approach in this state that the images will be removed permanently which is cropped the hidden part of patient information (Chun-Shan Yam, 2005).

Patient Data is covered by other Drawing Objects:

Basing on the power point we have some significant role and as well as it is risk also. Here to eliminate the pixels of unwanted image there is no tool is available to change from the digital images. Instead, radiologists are masking the patient information by applying the rectangular boxes. It is not enough to preserve the patient information. To evade this matter other software are used such as Corel draw, Adobe Photoshop and Microsoft paint to rid of the pixels in unwanted images before placing the images in power point. This is an easy resolution to give clarity to the patient information.

In this case, some steps are followed based on the power point for screen capture, Firstly, select the image and drawing object. Secondly, select the point on the picture and save as with the function. Thirdly, delete the items which are in the power point and insert again in the power point via drag and drop method (Chun-ShanYam, 2005).

Research methodology:

The success of the project depends on the accurate planning even if it is huge or little project. The success and failure depends on the planning. Research is a method of gathering, recording, and analyzing data scientifically and systematically which is important to study. Both the quantitative and qualitative methods are used to evaluate the performance of image transfer system. The behavioral aspects of the patient data and the corresponding images are well studied with the help of qualitative methods. Qualitative Research is engaged with analyzing, understanding and gathering the data by interviews (study the people what they do and say), pictures, videos and objects like a manufactured article. The quality of the image that should be maintained while transferring across the internet can be easily calculated with the help of these qualitative methods. The content that is present in the image related to any particular patient can be best scrutinized with the help of the image processing measures, which in turn a part of the qualitative methods. Statistical results of the patient information and the images are best studied with the help of quantitative methods. All the data that was gathered with respect to a particular patient can be estimated for the database with the help of these quantitative methods.

Evaluation:

All the data collected is with the help of different research methodologies and data should be applied to the application with the proper implementation of evaluation methods. Many attributes are to be considered related to the web application transfer of images and patient information. A separate back end database can be maintained where; it should be capable of processing the different set of patientâ„¢s information and medical data across different parts of the country.
As a MSc Computer science student, I am interested to design a database to store large sets of image related data with out any loss in the image quality. By using intelligent method of categorization of images, patient data can be maintained across the database. A rich user interface will be provided to the database with applied web methods, such that all the patient information can be best implicit to initiate the evaluation process.
A front end database is built with the help of front end tools, where number of forms and customization reports can be generated to evaluate the process. Almost seven levels of security (Manager Access, Editor Access, Author Access, Reader Access, Designer Access, Depositor Access, No Access) can be implemented across the application to enhance the security features of the application.
User can access the database, based on their access level to the database and all the access level information can be maintained with the help of a separate Access Control list.
Database administrators are provided with the manager access to that particular database, where they can handle huge sets of images. The programming logic being developed is capable of handling image transfer both in the way of encryption and decryption methodologies.
Web based technology is used for the data collection of the patient. These web service applications are used for medical viewing and diagnosing the patient and medical images are taken with the help of MRI, CT, Ultrasound and Digital X-ray. Some more softwareâ„¢s are also used such as DICOM and PACS devices which are used by radiology department. This technology explains about the device working which is used for the patient information by taking high-level images and modify them to display in window.
Mostly radiology applications are used by applying the magnifying glass tools and giving multi frame images through DICOM datasets for patient information. Most of the companies are focusing to medical vendors such as Siemens, Heartlab and GE. EMR gives the data collection of congestive heart failure and diabetes. So that the patient status can be recorded comparing with the history information. Relevant data is gathered from the server by web interface.
Currently we are using Medstar, MedstarPC to avail the program which is web-based solution to the outpatient care, so that all the information about the patient is stored in servers and web portals for giving online facility to login. It is an online process between physician and patient to see the update result through videos and pictures. It also enhances the interaction with the patient by knowing answers for questions. Power point is also used to check the data base records with image sliders making image albums, even by masking the unwanted pixel images, so it is convenient to the patient that he could see his own records.



Provisional Schedule:

Gantt Chart:
Gantt chart showing the time line of work will be carried out.












Harvard Reference/Initial Reading list:

Leadtools Medical web Viewer Framework (2009) [online]. U.S.A: Lead Technologies, Inc., [cited 17th October 2009]. Available from the Internet: <http://leadtoolssdk/medical/medical-web-viewer.htm>

Convert any Modality to DICOM- Universal DICOM Converter (2009) [online]. Chicago: TIMS DICOM System, [cited 18th October 2009]. Available from the Internet: < http://timsconvert-any-modality.htm >

Electronic Patient Medical Database (no date) [online]. Ann Arbor: Cybernet, [cited 21st October 2009]. Available from the Internet: <http://cybernetindex.php/medical-and-healthcare-technologies/electronic-patient-medical-database>

Yam, C.S. (2005) American Journal of Roentgenology. Removing Hidden Patient Data from Digital Images in PowerPoint [online]. 185(6), pp. 1659-1662 [cited 21st October 2009]. Available from the Internet: < http://ajronlinecgi/content/full/185/6/1659 >

Lim, Y. S., Feng, D. D. and Cai, T. W. (no date) A Web-based Collaborative System for Medical Image Analysis and Diagnosis [online]. [cited 21st October 2009]. Available from Internet: < http://crpitconfpapers/CRPITV2Lim.pdf >

James, N. (no date) Analysis of Professional Literature [online]. 5 July 2006 [Accessed October 2009]. Available at: http://wilderdomOEcourses/PROFLIT/Class6Qualitative1.htm#Obrien#Obrien > .

Shelly, G.B. and Woods, D.M. (2009) Introductory Concepts and Techniques. 5th ed., Boston: Course Technology.

Collison, S. (2006) Beginning CSS web development: from novice to professional. Berkeley: Apress.

Holdener, A. T. (2008) Ajax: the definitive guide. Sebastopol: O'Reilly .







Hardware/Software Needed: Yes

Software Requirements


Front end design: HTML, CSS and AJAX.

Back end database: Notes Domino

Hardware Requirements


System : Pentium IV2.4GHz
RAM : 256 MB
Hard Disk : 40GB
Monitor : 15 VGA colour
Key board : 110 keys enhanced
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