Health Telematics (AIM) Final Report


	Updated: Feb 1, 97
MILORD

Multimedia Interaction with Large Object-oriented Radiological and Clinical Databases

Project Code: A2024

Project value: 4397 KECU

EC contribution: 2420 KECU

No of partners: 9

No of countries: 5

Duration: 36 months

Contact:
Prof. Alessandro d'Atri
Univ. Dell' Aquila
Dip. Ingegneria Elettrica
Poggio di Roio
I-67100 l'Aquila, Italy
Tel.: +39-862-43.25.57
Fax: +39-862-43.25.43
E-mail: datri@vaxaq.infn.it

Overview

The MILORD project concerns the storage, communication, and processing of large multimedia clinical information in an integrated environment. Advanced information technologies are exploited: new knowledge representation languages and tools, friendly human-computer interaction, 3D graphical processing and displaying of medical images, high performance parallel architecture's, large-scale distributed data storage, federated environments for clinical co-operation.

Purpose and objectives

The main objective of the project stems from the observation that the spreading of diagnostic and therapeutic procedures and the increasing number of specialists involved in the care of patients lead to a large amount of multimedia data that need to be shared among health care professionals. The goal of the MILORD project is therefore to facilitate the effective interaction of physicians with all relevant data and with other participants in the clinical process, through the use of advanced information technology. To this end, the project aims to develop an integrated tool kit environment that provides powerful services in several areas that are relevant to the problem domain.

The MILORD environment is a federation of autonomous MILORD systems, each system is composed by at least one database server, a number of client multimedia workstations, and standard interfaces to external information sources. MILORD users in the federation can share the same patient data in a real time co-operative work mode supported by teleconference facilities. More specifically, the MILORD system supports: a flexible object oriented medical information model that provides an intuitive framework for the representation of medical data and background knowledge; an advanced human-computer interaction paradigms that can be tailored according to the user's functional needs; an efficient parallelized multimedia data storage and retrieval for very large multimedia medical databases; a multimedia data handling and processing (e.g. 2D and 3D graphics); the sharing and co-operative processing of information among users through a teleconference facility; the sharing of information among heterogeneous systems (e.g. Hospital Information Systems, other MILORD sites, etc.).

MILORD was intended to design, implement and evaluate a system able to handle in an effective and homogeneous way multimedia medical records. MILORD offers an environment through which the medical staff can manage directly all the information involved in the department as well as access the information provided by external sources. The medical applications market, rapidly growing from today's 3653 MECU during 92/93 period to 15264 MECU in the year 2000, witnesses the importance of this field. The MILORD features deal with all the new technologies that will be soon available to every professional in the medical field.

Results

The MILORD project covered the following topics: data modelling, user interaction, local, national and international healthcare networks, advanced 3D graphic. In order to unify the above aspects, a Medical Application Development System was designed and several testing applications were implemented obeying to the physicians requirements. During the MILORD project course, a strong research and development effort, linked with the continuos monitoring and assessment in the partner's clinical site, was devoted to the creation of a concrete base for the future commercial systems. Remarkably, the participation of one of the MILORD's partners in the in-progress project EUREKA n.1187 for the development of a multimedia medical workstation has to be seen in this context.

The exploitation of MILORD experience, design and technologies, combined with new emerging tools and technologies (Internet, HDTV, virtual reality) and integrated end-users distributed environments (Windows NT) could represent an high-tech / low-cost solution to the increasing demand of effective applications in the medical field. At the moment the dissemination of MILORD results is done towards several main directions. MILORD brochures have been produced and disseminated to many health-care organisations interested in the project outcomes. The consortium participated in European and international conferences, workshops and industrial exhibitions to present the work of the project and to demonstrate the prototype system. Several publications appear in conference proceedings, scientific magazines, etc. During its three-year activity MILORD produced a high number of deliverables (this information is mostly public domain, available for researchers interested in the various technical aspects addressed by the project).

List of Deliverables

Year 1

Preliminary specification of the medical requirements (2/R/I)
Preliminary description of the system (2/R/I)
Modelling of medical data: a state of the art (2/R/P)
Multimedia medical interaction environments: a state of the art (2/R/P)
Graphical systems and parallel architecture: a state of the art (2/R/P)
Interoperability for medical information systems: state of the art (2/R/P)
Multimedia object management and parallel systems: a state of the art (3/R/P)
Preliminary description of the MILORD user interaction environment (4/R/I)
Preliminary description of the MILORD data representation language (4/R/I)
Requirements analysis of graphical functions and I/O (4/R/I)
Preliminary description of the MILORD co-operative processing model (4/R/I)
Revised description of the system (4/R/P)
Specification of the medical requirements (6/R/P)
Evaluation QC improvements deriving from department information system (6/R/P)
Report H1.1 - 6 month periodic progress report (6/R/I)
QC: The basic situation before the introduction of MILORD (6/R/I)
Detailed specification of the graphics subsystem (8/R/I)
Specification of the architecture of the multisource coop. module (8/R/I)
Demo of the device support in the MILORD server (9/P/I)
The device layer of MILORD (9/R/P)
Design of the user interface Kernel (9/R/I)
Design of the Loco+multimedia medical knowledge represent. (9/R/I)
Report H.IR.1 - First interim report for technical auditing (10/R/I)
Report H1.2 - 6 month periodic progress report (12/R/I)
Report H.AR.1 - Annual edited periodic progress report (12/R/P)
Demonstration of the Kernel graphical subsystem (12/P/I)
Description of the main functionality of the graphical subsystem (12/R/P)
Report F2.1 - 6 month review of the HCI aspects (12/R/I)
Report F.AR.1 - Annual report on the overall evaluation of MILORD (12/R/P)
Demonstration of the KERNEL multisource cooperation module (12/P/I)
Description of Kernel multisource cooperation module (12/R/P)

Year 2

Demo of the storage hierarchy support (3/P/I)
Storage hierarchy support in MILORD (3/R/P)
Report on the integration of graphical Kernel in the hosp. environ. (3/R/P)
Demonstration of the user interface Kernel (3/P/I)
Description of the main functionality of the MILORD UI Kernel (3/R/P)
Demonstration of the Loco+language (3/P/I)
Description of the main functionalities of Loco+ (3/R/P)
Report F3.1 - 6 month review of data/funct. completeness/correctness (3/R/I)
DEMO G5 - Integration of the prototype in the hospital environment (3/P/I)
Demo of the first prototype of the MSCM (6/P/I)
Description of facilities for teleconferencing and data sharing (6/R/P)
Evaluation of Loco+ in large object-oriented radiological databases (6/R/P)
Demo of the first integrated server prototype (6/P/I)
Report on the first integrated server prototype (6/R/P)
Report H1.3 - 6 month Periodic progress report (6/R/I)
Report F2.2 - 6 month review of the HCI aspects (6/R/I)
Demo of the graphical module revised according to the evaluation (6/P/I)
Report on the 1st experience during the clinical evaluation (6/R/P)
Report F4.1 - 6 month review on cooperation/communication (6/R/I)
Design of the multimedia user interaction environment (8/R/I)
Design of the multiprocessor server (9/R/I)
Report F3.2 - 6 month review of data/funct. completeness/correctness (9/R/I)
Report F5.1 - 6 month review of time performances (9/R/I)
Report H.IR.2 - Second interim report for technical auditing (10/R/I)
Demo of the scheduling support for three level storage (12/P/I)
Report on the scheduling support for three level storage (12/R/P)
Description of functions/interfaces to integrate medical (12/P/I)
Demo of functions for the integration of medical information (12/P/I)
Demo of extended conferencing facilities in MILORD (12/P/I)
Report on the facilities for teleconferencing in MILORD (12/R/P)
Report F4.2 - 6 month review of cooperation/communication (12/R/I)
Demo of the multimedia user interaction environment (MUIE) (12/P/I)
Description of the multimedia user interaction environment (12/R/P)
Revised design documentation of the Loco+ language (12/R/I)
The loco+ reference manual (12/R/P)
Report H1.4 - 6 month Periodic progress report (12/R/I)
Report H.AR.2 - Annual edited periodic progress report (12/R/P)
Report F2.3 - 6 month review of the HCI aspects (12/R/I)
Report F.AR.2 - Annual report on the overall evaluation of MILORD (12/R/P)
Demo of the first version of the 3D Shell medical workstation (12/P/I)
Report on the functionality of the 1st shell medical workstation (12/R/P)

Year 3

Report F3.3 - 6 month review of data/funct. completeness/correctness (3/R/I)
Report F5.2. - 6 month review of time performances (3/R/I)
Demo of the diagnostic 3D Shell medical workstation (4/P/I)
Description of the implemented 3D application S/W for diagnosis (4/R/P)
Report F4.3 - 6 month review on cooperation/communication (6/R/I)
Demo of the multiprocessor server (6/P/I)
Report on the multiprocessor server (6/R/P)
Demo of the integrated multisource cooperation module (6/P/I)
Report on the integrated multisource cooperation module (6/R/P)
Demo of the radiological and surgical customisations of MUIE (6/P/I)
Report on the radiological and surgical customisations of MUIE (6/R/P)
Demo of the revised multimedia user interaction environment (6/P/I)
Report on the revised multimedia user interaction environment (6/R/P)
Demo of the Loco+ language revised according to the evaluation (6/P/I)
Report on the Loco+ language revised according to the evaluation (6/R/P)
Report H1.5 - 6 month Periodic progress report (6/R/I)
Report F2.4 - 6 month Review of the HCI aspects (6/R/I)
Demo of the therapeutic 3D Shell medical workstation (8/P/I)
Description of the implemented 3D application S/W for therapy (8/R/P)
Report F3.4 - 6 month review of data/funct. completeness/correctness (9/R/I)
Report F5.3 - 6 month Review on time performances (9/R/I)
Report H.IR.3 - Third interim report for technical auditing (10/R/I)
The Loco+ Language tutorial and user manual (12/R/P)
Final demo of MILORD: Revised version of the multiprocessor server (12/P/P)
Final report on the performance of the server (12/R/P)
Final demo of MILORD: The multisource cooperation module (12/P/P)
Final report on support for interoperability in MILORD (12/R/P)
Report H1.6 - 6 month periodic progress report (12/R/I)
Report H.AR.3 - Annual edited periodic progress report (12/R/P)
Report F.AR.3 - Annual report of the overall evaluation of MILORD (12/R/P)
Final demo of MILORD: The final revised 3D medical workstation (12/P/P)
Final report on achievement and experiences in work package G (12/R/P)
Final demo of MILORD: The multimedia user interaction environment (12/P/P)
Final report on achievement and experiences in the work package C (12/R/P)
Final demo of the MILORD: Loco+ (12/P/P)
Final report on achievement and experiences in work package B (12/R/P)
Final report on MILORD (as requested i article 6.1 of the contract) (12/R/P)

List of Participants

Prof. Roberto Passariello Policlinico Umberto I Dip. Radiologia - 2a Cattedra Viale del Policlinico 155 I-00161 Roma, Italy Tel.: +39-6-49.02.43 Fax: +39-6-49.02.43	Mr. Francesco Adolfo Danza Itaca srl Via della Giuliana 73 I-00195 Roma, Italy Tel.: +39-6-325.25.50 Fax: +39-6-325.19.83
Prof. Janis Jr. Bubenko Swedish Inst. Systems Development Isafjordsgatan 26 Electrum Building PO Box 1250 S-16428 Kista, Sweden Tel.: +46-8-752.16.08 Fax: +46-8-752.68.00	Prof. Heinz Ulrich Lemke Technische Univ. Berlin Computer Graphics Fachgruppe CG. - Sekr. Fr. 3-3 Franklinstrasse 28-29 D-1000 Berlin 10, Germany Tel.: +49-30-31.47.31.00 Fax: +49-30-31.42.11.03
Prof. Stavros Christodoulakis Multimedia Systems Inst. Crete Foundation Of Research And Technology - Forth PO Box 133 GR-73100 Chania-Crete, Greece Tel.: +30-821-648.46 / 648.03 Fax: +30-821-648.46 E-mail: stavros@csi.forth.gr	Prof. Dr. Dirk Vermeir Universitaire Instelling Antwerpen Wiskunde en Informatica Universiteitsplein 1 B-2610 Wilrijk, Belgium Tel.: +32-3-820.24.04 Fax: +32-3-820.22.44 E-mail: vermeir@ccu.via.ac.be
Dr. Lambis Tassakos Parsytec GmbH Intl. Sales & Projects Julicher Strasse 338 D-5100 Aachen, Germany Tel.: +49-241-88.89.90 Fax: +49-241-88.89.50 E-mail: tas@parsytec.de



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