%0 Journal Article %J Bioinformatics %D 2019 %T PatientExploreR: an extensible application for dynamic visualization of patient clinical history from Electronic Health Records in the OMOP Common Data Model Title. %A Glicksberg, Benjamin S %A Oskotsky, Boris %A Thangaraj, Phyllis M %A Giangreco, Nicholas %A Badgeley, Marcus A %A Johnson, Kipp W %A Datta, Debajyoti %A Rudrapatna, Vivek %A Rappoport, Nadav %A Shervey, Mark M %A Miotto, Riccardo %A Goldstein, Theodore C %A Rutenberg, Eugenia %A Frazier, Remi %A Lee, Nelson %A Israni, Sharat %A Larsen, Rick %A Percha, Bethany %A Li, Li %A Dudley, Joel T %A Tatonetti, Nicholas P %A Butte, Atul J %X

MOTIVATION: Electronic Health Records (EHR) are quickly becoming omnipresent in healthcare, but interoperability issues and technical demands limit their use for biomedical and clinical research. Interactive and flexible software that interfaces directly with EHR data structured around a common data model could accelerate more EHR-based research by making the data more accessible to researchers who lack computational expertise and/or domain knowledge.

RESULTS: We present PatientExploreR, an extensible application built on the R/Shiny framework that interfaces with a relational database of EHR data in the Observational Medical Outcomes Partnership Common Data Model (CDM) format. PatientExploreR produces patient-level interactive and dynamic reports and facilitates visualization of clinical data without any programming required. It allows researchers to easily construct and export patient cohorts from the EHR for analysis with other software. This application could enable easier exploration of patient-level data for physicians and researchers. PatientExploreR can incorporate EHR data from any institution that employs the CDM for users with approved access. The software code is free and open-source under the MIT license, enabling institutions to install and users to expand and modify the application for their own purposes.

AVAILABILITY: PatientExploreR can be freely obtained from GitHub: https://github.com/BenGlicksberg/PatientExploreR. We provide instructions for how researchers with approved access to their institutional EHR can use this package. We also release an open sandbox server of synthesized patient data for users without EHR access to explore: http://patientexplorer.ucsf.edu.

SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

%B Bioinformatics %8 2019 Jun 19 %G eng %R 10.1093/bioinformatics/btz409 %0 Journal Article %J J Digit Imaging %D 2018 %T A Platform for Innovation and Standards Evaluation: a Case Study from the OpenMRS Open-Source Radiology Information System. %A Gichoya, Judy W %A Kohli, Marc %A Ivange, Larry %A Schmidt, Teri S %A Purkayastha, Saptarshi %K Diagnostic Imaging %K Humans %K Radiology Information Systems %K Software %K Systems Integration %K Workflow %X

Open-source development can provide a platform for innovation by seeking feedback from community members as well as providing tools and infrastructure to test new standards. Vendors of proprietary systems may delay adoption of new standards until there are sufficient incentives such as legal mandates or financial incentives to encourage/mandate adoption. Moreover, open-source systems in healthcare have been widely adopted in low- and middle-income countries and can be used to bridge gaps that exist in global health radiology. Since 2011, the authors, along with a community of open-source contributors, have worked on developing an open-source radiology information system (RIS) across two communities-OpenMRS and LibreHealth. The main purpose of the RIS is to implement core radiology workflows, on which others can build and test new radiology standards. This work has resulted in three major releases of the system, with current architectural changes driven by changing technology, development of new standards in health and imaging informatics, and changing user needs. At their core, both these communities are focused on building general-purpose EHR systems, but based on user contributions from the fringes, we have been able to create an innovative system that has been used by hospitals and clinics in four different countries. We provide an overview of the history of the LibreHealth RIS, the architecture of the system, overview of standards integration, describe challenges of developing an open-source product, and future directions. Our goal is to attract more participation and involvement to further develop the LibreHealth RIS into an Enterprise Imaging System that can be used in other clinical imaging including pathology and dermatology.

%B J Digit Imaging %V 31 %P 361-370 %8 2018 06 %G eng %N 3 %R 10.1007/s10278-018-0088-5 %0 Journal Article %J Insights Imaging %D 2016 %T PACS for Bhutan: a cost effective open source architecture for emerging countries. %A Ratib, Osman %A Roduit, Nicolas %A Nidup, Dechen %A De Geer, Gerard %A Rosset, Antoine %A Geissbuhler, Antoine %X

This paper reports the design and implementation of an innovative and cost-effective imaging management infrastructure suitable for radiology centres in emerging countries. It was implemented in the main referring hospital of Bhutan equipped with a CT, an MRI, digital radiology, and a suite of several ultrasound units. They lacked the necessary informatics infrastructure for image archiving and interpretation and needed a system for distribution of images to clinical wards. The solution developed for this project combines several open source software platforms in a robust and versatile archiving and communication system connected to analysis workstations equipped with a FDA-certified version of the highly popular Open-Source software. The whole system was implemented on standard off-the-shelf hardware. The system was installed in three days, and training of the radiologists as well as the technical and IT staff was provided onsite to ensure full ownership of the system by the local team. Radiologists were rapidly capable of reading and interpreting studies on the diagnostic workstations, which had a significant benefit on their workflow and ability to perform diagnostic tasks more efficiently. Furthermore, images were also made available to several clinical units on standard desktop computers through a web-based viewer.

MESSAGES/TEACHING POINTS: • Open source imaging informatics platforms can provide cost-effective alternatives for PACS • Robust and cost-effective open architecture can provide adequate solutions for emerging countries • Imaging informatics is often lacking in hospitals equipped with digital modalities.

%B Insights Imaging %8 2016 Jul 28 %G eng %R 10.1007/s13244-016-0512-7 %0 Journal Article %J Microsc Microanal %D 2016 %T Performing Quantitative Imaging Acquisition, Analysis and Visualization Using the Best of Open Source and Commercial Software Solutions. %A Shenoy, Shailesh M %X

A challenge in any imaging laboratory, especially one that uses modern techniques, is to achieve a sustainable and productive balance between using open source and commercial software to perform quantitative image acquisition, analysis and visualization. In addition to considering the expense of software licensing, one must consider factors such as the quality and usefulness of the software's support, training and documentation. Also, one must consider the reproducibility with which multiple people generate results using the same software to perform the same analysis, how one may distribute their methods to the community using the software and the potential for achieving automation to improve productivity.

%B Microsc Microanal %V 22 %P 2064-2065 %8 2016 Jul %G eng %N Suppl 3 %0 Journal Article %J American Journal of Infection Control %D 2016 %T Process control charts in infection prevention: {Make} it simple to make it happen %A Wiemken, Timothy L. %A Furmanek, Stephen P. %A Carrico, Ruth M. %A Mattingly, William A. %A Persaud, Annuradha K. %A Guinn, Brian E. %A Kelley, Robert R. %A Ramirez, Julio A. %K Health care-associated infection %K Quality Improvement %K Surveillance %X BACKGROUND: Quality improvement is central to Infection Prevention and Control (IPC) programs. Challenges may occur when applying quality improvement methodologies like process control charts, often due to the limited exposure of typical IPs. Because of this, our team created an open-source database with a process control chart generator for IPC programs. The objectives of this report are to outline the development of the application and demonstrate application using simulated data. METHODS: We used Research Electronic Data Capture (REDCap Consortium, Vanderbilt University, Nashville, TN), R (R Foundation for Statistical Computing, Vienna, Austria), and R Studio Shiny (R Foundation for Statistical Computing) to create an open source data collection system with automated process control chart generation. We used simulated data to test and visualize both in-control and out-of-control processes for commonly used metrics in IPC programs. RESULTS: The R code for implementing the control charts and Shiny application can be found on our Web site (https://github.com/ul-research-support/spcapp). Screen captures of the workflow and simulated data indicating both common cause and special cause variation are provided. CONCLUSIONS: Process control charts can be easily developed based on individual facility needs using freely available software. Through providing our work free to all interested parties, we hope that others will be able to harness the power and ease of use of the application for improving the quality of care and patient safety in their facilities. %B American Journal of Infection Control %G eng %R 10.1016/j.ajic.2016.09.021 %0 Journal Article %J Stud Health Technol Inform %D 2015 %T Patient Access to Their Health Record Using Open Source EHR. %A Chelsom, John %A Dogar, Naveed %X

In both Europe and North America, patients are beginning to gain access to their health records in electronic form. Using the open source cityEHR as an example, we have focussed on the needs of clinical users to gather requirements for patient access and have implemented these requirements in a new application called cityEHR-PA. The development of a separate application for patient access was necessary to address requirements for security and ease of use. The use of open standards throughout the design of the EHR allows the possibility of third parties to develop applications for patient access, consuming the individual patient record extracted from the full EHR.

%B Stud Health Technol Inform %V 208 %P 104-8 %8 2015 %G eng %0 Journal Article %J Stud Health Technol Inform %D 2014 %T Plug-and-play Integration of dual-model based Knowledge Artefacts into an Open Source Ehr System. %A Krexner, Rabea %A Duftschmid, Georg %X

In this paper we present our experiences with extending an existing approach for an archetype-compliant collection and export of data according to the openEHR specifications within the open source EHR system OpenMRS. It allows an automatic generation of forms from templates, which were introduced by openEHR as an extension of the dual-model approach. Data entered in these forms can be exported in form of standardized EHR extracts. The use of templates allowed us to solve problems reported for the original archetype-based version of the approach, which were caused by the high optionality within archetypes.

%B Stud Health Technol Inform %V 205 %P 101-5 %8 2014 %G eng %0 Journal Article %J Methods Inf Med %D 2014 %T Possible combinations of electronic data capture and randomization systems. principles and the realization with RANDI2 and OpenClinica. %A Schrimpf, D %A Haag, M %A Pilz, L R %K Automatic Data Processing %K Computer Communication Networks %K Humans %K Medical Informatics Computing %K Medical Records Systems, Computerized %K Random Allocation %K Randomized Controlled Trials as Topic %K Software Design %X

BACKGROUND: Clinical trials (CT) are in a wider sense experiments to prove and establish clinical benefit of treatments. Nowadays electronic data capture systems (EDCS) are used more often bringing a better data management and higher data quality into clinical practice. Also electronic systems for the randomization are used to assign the patients to the treatments.

OBJECTIVES: If the mentioned randomization system (RS) and EDCS are used, possibly identical data are collected in both, especially by stratified randomization. This separated data storage may lead to data inconsistency and in general data samples have to be aligned. The article discusses solutions to combine RS and EDCS. In detail one approach is realized and introduced.

METHODS: Different possible settings of combination of EDCS and RS are determined and the pros and cons for each solution are worked out. For the combination of two independent applications the necessary interfaces for the communication are defined. Thereby, existing standards are considered. An example realization is implemented with the help of open-source applications and state-of-the-art software development procedures.

RESULTS: Three possibilities of separate usage or combination of EDCS and RS are presented and assessed: i) the complete independent usage of both systems; ii) realization of one system with both functions; and iii) two separate systems, which communicate via defined interfaces. In addition a realization of our preferred approach, the combination of both systems, is introduced using the open source tools RANDI2 and OpenClinica.

CONCLUSION: The advantage of a flexible independent development of EDCS and RS is shown based on the fact that these tool are very different featured. In our opinion the combination of both systems via defined interfaces fulfills the requirements of randomization and electronic data capture and is feasible in practice. In addition, the use of such a setting can reduce the training costs and the error-prone duplicated data entry.

%B Methods Inf Med %V 53 %P 202-7 %8 2014 %G eng %N 3 %R 10.3414/ME13-01-0074 %0 Journal Article %J J Clin Pathol %D 2013 %T Physiological states and functional relation between thyrotropin and free thyroxine in thyroid health and disease: in vivo and in silico data suggest a hierarchical model. %A Midgley, John E M %A Hoermann, Rudolf %A Larisch, Rolf %A Dietrich, Johannes W %K Adolescent %K Adult %K Aged %K Aged, 80 and over %K Autoantibodies %K Autoantigens %K Biological Markers %K Computer Simulation %K Feedback, Physiological %K Humans %K Hyperthyroidism %K Hypothyroidism %K Iodide Peroxidase %K Iron-Binding Proteins %K Linear Models %K Middle Aged %K Models, Biological %K Multivariate Analysis %K Nonlinear Dynamics %K Predictive Value of Tests %K Retrospective Studies %K Thyroid Diseases %K Thyroid Function Tests %K Thyroid Gland %K Thyrotropin %K Thyroxine %K Young Adult %X

AIMS: Understanding the exact relationship between serum thyrotropin/thyroid stimulating hormone (TSH) and free thyroxine (FT(4)) is a prerequisite for improving diagnostic reliability and clinical decision making.

METHODS: We (1) retrospectively studied the relationship between TSH and FT(4) in a large unselected clinical sample (n=6641) of primary hypothyroid, euthyroid and hyperthyroid subjects, and (2) applied a mathematical model of thyroid hormone feedback control to assess the relation between structural parameters and TSH levels in the different functional states.

RESULTS: When separately analysing total sample and untreated subjects, the correlation slope for logTSH versus FT(4) for hypothyroid subjects was significantly different from that of the euthyroid panel and hyperthyroid subjects (the latter being compromised by reaching the TSH assay's lower detection limit). As trends between functional states changed, each functional segment appeared to become differently regulated. Theoretical modelling and sensitivity analysis revealed that the influence of various structural parameters on TSH levels also depends on the overall function of the feedback loop.

CONCLUSIONS: Our data suggest that the states of hypothyroidism, euthyroidism and hyperthyroidism can be regarded as differently regulated entities. The apparent complexity could be replicated by mathematical modelling suggesting a hierarchical type of feedback regulation involving patterns of operative mechanisms unique to each condition. For clinical purposes and assay evaluation, neither the standard model relating logTSH with FT(4), nor an alternative model based on non-competitive inhibition can be reliably represented by a single correlation comparing all samples for both hormones in one all-inclusive group.

%B J Clin Pathol %V 66 %P 335-42 %8 2013 Apr %G eng %N 4 %R 10.1136/jclinpath-2012-201213 %0 Journal Article %J Eur J Endocrinol %D 2013 %T Is pituitary TSH an adequate measure of thyroid hormone-controlled homoeostasis during thyroxine treatment? %A Hoermann, Rudolf %A Midgley, John E M %A Larisch, Rolf %A Dietrich, Johannes W %K Adult %K Female %K Homeostasis %K Humans %K Hypothyroidism %K Male %K Pituitary Gland %K Retrospective Studies %K Thyrotropin %K Thyroxine %K Triiodothyronine %X

OBJECTIVE: In recognition of its primary role in pituitary-thyroid feedback, TSH determination has become a key parameter for clinical decision-making. This study examines the value of TSH as a measure of thyroid hormone homoeostasis under thyroxine (T(4)) therapy.

DESIGN AND METHODS: We have examined the interrelationships between free triiodothyronine (FT(3)), free T(4) (FT(4)) and pituitary TSH by means of i) a retrospective analysis of a large clinical sample comprising 1994 patients either untreated or on varying doses of l-T(4) and ii) independent mathematical simulation applying a model of thyroid homoeostasis, together with a sensitivity analysis.

RESULTS: Over a euthyroid to mildly hyperthyroid functional range, we found markedly different correlation slopes of log TSH vs FT(3) and FT(4) between untreated patients and l-T(4) groups. Total deiodinase activity (G(D)) was positively correlated with TSH in untreated subjects. However, G(D) was significantly altered and the correlation was lost under increasing l-T(4) doses. Ninety-five per cent confidence intervals for FT(3) and FT(4), when assessed in defined TSH concentration bands, differed significantly for l-T(4)-treated compared with untreated patients. Higher doses were often needed to restore FT(3) levels within its reference range. Sensitivity analysis revealed the influence of various structural parameters on pituitary TSH secretion including an important role of pituitary deiodinase type 2.

CONCLUSION: The data reveal disjoints between FT(4)-TSH feedback and T(3) production that persist even when sufficient T(4) apparently restores euthyroidism. T(4) treatment displays a compensatory adaptation but does not completely re-enact normal euthyroid physiology. This invites a study of the clinical consequences of this disparity.

%B Eur J Endocrinol %V 168 %P 271-80 %8 2013 Feb %G eng %N 2 %R 10.1530/EJE-12-0819 %0 Journal Article %J J Biomed Inform %D 2011 %T A partnership approach for Electronic Data Capture in small-scale clinical trials. %A Franklin, Joshua D %A Guidry, Alicia %A Brinkley, James F %K Clinical Trials as Topic %K Data Collection %K Humans %K Internet %K Medical Informatics %X

Amid researchers' growing need for study data management, the CTSA-funded Institute for Translational Health Sciences developed an approach to combine technical and scientific resources with small-scale clinical trials researchers in order to make Electronic Data Capture more efficient. In a 2-year qualitative evaluation we found that the importance of ease of use and training materials outweighed number of features and functionality. EDC systems we evaluated were Catalyst Web Tools, OpenClinica and REDCap. We also found that two other systems, Caisis and LabKey, did not meet the specific user needs of the study group.

%B J Biomed Inform %V 44 Suppl 1 %P S103-8 %8 2011 Dec %G eng %R 10.1016/j.jbi.2011.05.008 %0 Journal Article %J J AHIMA %D 2011 %T PopHealth primer. ONC funds open-source software to streamline clinical quality measures reporting for meaningful use program. %A Cottington, Sarah %K Benchmarking %K Financing, Government %K Government Agencies %K Mandatory Reporting %K Organizational Case Studies %K Quality Assurance, Health Care %K Reimbursement, Incentive %K Software %K United States %K User-Computer Interface %B J AHIMA %V 82 %P 48-50 %8 2011 Sep %G eng %N 9 %0 Conference Paper %B Proceedings of the 1st International Workshop on Open Source in European Health Care: The Time is Ripe, OSEHC 2009 In Conjunction with BIOSTEC 2009 and the EFMI LIFOSS WG %D 2009 %T PESCA: Developing an open source platform to bring eHealth to latin america and the caribbean %A Orcero, D.S.a %E López, D.L.b %Y Sanchez, C.L.c %? Alcazar, F.J.c %? Ruiz, S.d %? Rubia, M.J.e %? Romero-Cuevas, M.e %? García-Fortea, P.e %? Aranda, G.e %? Lorca, J.e %X Nowadays the society needs to communicate and the technologies are revolutionizing the information systems, especially for the health; where an effective use of the technologies is used to favor the needs of the persons. These technologies can contribute to the development of the local economies. Open source software (OSS) can be an useful strategy to bring information and communication technologies to developing countries. However, specially in Latin America and the Caribbean, there are some barriers in adopting OSS for health: the need for open standards, heterogeneous OSS developed without normalization and metrics, English predominance as top OSS language, lack of initiatives to evaluate existing health OSS and needs for quality control and functional validation. The Open Source Platform for eHealth (PESCA) has been designed as a set of interoperable modules that can solve either: simple problems on health management and communication in primary care or complex problems in healthcare systems, including telehealth communications between heterogeneous institutions. %B Proceedings of the 1st International Workshop on Open Source in European Health Care: The Time is Ripe, OSEHC 2009 In Conjunction with BIOSTEC 2009 and the EFMI LIFOSS WG %G eng %U http://www.scopus.com/inward/record.url?eid=2-s2.0-67650527704&partnerID=40&md5=cb5a91f3ccf525ed19857b1e3354a61d %0 Journal Article %J Neuroinformatics %D 2009 %T PyMVPA: A python toolbox for multivariate pattern analysis of fMRI data. %A Hanke, Michael %A Halchenko, Yaroslav O %A Sederberg, Per B %A Hanson, Stephen José %A Haxby, James V %A Pollmann, Stefan %X Decoding patterns of neural activity onto cognitive states is one of the central goals of functional brain imaging. Standard univariate fMRI analysis methods, which correlate cognitive and perceptual function with the blood oxygenation-level dependent (BOLD) signal, have proven successful in identifying anatomical regions based on signal increases during cognitive and perceptual tasks. Recently, researchers have begun to explore new multivariate techniques that have proven to be more flexible, more reliable, and more sensitive than standard univariate analysis. Drawing on the field of statistical learning theory, these new classifier-based analysis techniques possess explanatory power that could provide new insights into the functional properties of the brain. However, unlike the wealth of software packages for univariate analyses, there are few packages that facilitate multivariate pattern classification analyses of fMRI data. Here we introduce a Python-based, cross-platform, and open-source software toolbox, called PyMVPA, for the application of classifier-based analysis techniques to fMRI datasets. PyMVPA makes use of Python's ability to access libraries written in a large variety of programming languages and computing environments to interface with the wealth of existing machine learning packages. We present the framework in this paper and provide illustrative examples on its usage, features, and programmability. %B Neuroinformatics %V 7 %P 37-53 %8 2009 Spring %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/19184561?dopt=Abstract %0 Journal Article %J Frontiers in neuroinformatics %D 2009 %T PyMVPA: A Unifying Approach to the Analysis of Neuroscientific Data. %A Hanke, Michael %A Halchenko, Yaroslav O %A Sederberg, Per B %A Olivetti, Emanuele %A Fründ, Ingo %A Rieger, Jochem W %A Herrmann, Christoph S %A Haxby, James V %A Hanson, Stephen José %A Pollmann, Stefan %X The Python programming language is steadily increasing in popularity as the language of choice for scientific computing. The ability of this scripting environment to access a huge code base in various languages, combined with its syntactical simplicity, make it the ideal tool for implementing and sharing ideas among scientists from numerous fields and with heterogeneous methodological backgrounds. The recent rise of reciprocal interest between the machine learning (ML) and neuroscience communities is an example of the desire for an inter-disciplinary transfer of computational methods that can benefit from a Python-based framework. For many years, a large fraction of both research communities have addressed, almost independently, very high-dimensional problems with almost completely non-overlapping methods. However, a number of recently published studies that applied ML methods to neuroscience research questions attracted a lot of attention from researchers from both fields, as well as the general public, and showed that this approach can provide novel and fruitful insights into the functioning of the brain. In this article we show how PyMVPA, a specialized Python framework for machine learning based data analysis, can help to facilitate this inter-disciplinary technology transfer by providing a single interface to a wide array of machine learning libraries and neural data-processing methods. We demonstrate the general applicability and power of PyMVPA via analyses of a number of neural data modalities, including fMRI, EEG, MEG, and extracellular recordings. %B Frontiers in neuroinformatics %V 3 %P 3 %8 2009 %1 http://www.ncbi.nlm.nih.gov/pubmed/19212459?dopt=Abstract %0 Journal Article %J Journal of neuroscience methods %D 2007 %T PsychoPy--Psychophysics software in Python. %A Peirce, Jonathan W %X The vast majority of studies into visual processing are conducted using computer display technology. The current paper describes a new free suite of software tools designed to make this task easier, using the latest advances in hardware and software. PsychoPy is a platform-independent experimental control system written in the Python interpreted language using entirely free libraries. PsychoPy scripts are designed to be extremely easy to read and write, while retaining complete power for the user to customize the stimuli and environment. Tools are provided within the package to allow everything from stimulus presentation and response collection (from a wide range of devices) to simple data analysis such as psychometric function fitting. Most importantly, PsychoPy is highly extensible and the whole system can evolve via user contributions. If a user wants to add support for a particular stimulus, analysis or hardware device they can look at the code for existing examples, modify them and submit the modifications back into the package so that the whole community benefits. %B Journal of neuroscience methods %V 162 %P 8-13 %8 2007 May 15 %N 1-2 %1 http://www.ncbi.nlm.nih.gov/pubmed/17254636?dopt=Abstract %0 Journal Article %J Behavior research methods %D 2007 %T PyEPL: a cross-platform experiment-programming library. %A Geller, Aaron S %A Schlefer, Ian K %A Sederberg, Per B %A Jacobs, Joshua %A Kahana, Michael J %X PyEPL (the Python Experiment-Programming Library) is a Python library which allows cross-platform and object-oriented coding of behavioral experiments. It provides functions for displaying text and images onscreen, as well as playing and recording sound, and is capable of rendering 3-D virtual environments forspatial-navigation tasks. It is currently tested for Mac OS X and Linux. It interfaces with Activewire USB cards (on Mac OS X) and the parallel port (on Linux) for synchronization of experimental events with physiological recordings. In this article, we first present two sample programs which illustrate core PyEPL features. The examples demonstrate visual stimulus presentation, keyboard input, and simulation and exploration of a simple 3-D environment. We then describe the components and strategies used in implementing PyEPL. %B Behavior research methods %V 39 %P 950-8 %8 2007 Nov %N 4 %1 http://www.ncbi.nlm.nih.gov/pubmed/18183912?dopt=Abstract %0 Journal Article %J Energy %D 2005 %T ParaView : An End-User Tool for Large Data Visualization %A Ahrens, James %A Geveci, Berk %A Law, Charles %E Hansen, C R %E Johnson, C DEditors %B Energy %V 836 %P 717–732 %G eng %U http://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:ParaView:+An+end-user+tool+for+large+data+visualization#0 %0 Journal Article %J International journal of medical informatics %D 2003 %T PropeR: a multi disciplinary EPR system. %A van der Linden, Helma %A Boers, Gerrit %A Tange, Huibert %A Talmon, Jan %A Hasman, Arie %K Computer Systems %K Delivery of Health Care, Integrated %K Humans %K Interprofessional Relations %K Medical Records Systems, Computerized %K Stroke %X This article describes the architecture of an EPR system developed for the PropeR project. This EPR system not only aims at supporting home care of stroke patients, but is also designed in such a way that it can be ported to other medical services without much effort. We will briefly describe the Stroke Service and the related PropeR project. Starting from a list of requirements to construct a generic EPR system we will outline the architecture and describe the standards and methods used. Subsequently we describe the implementation and the problems encountered. In the discussion, we will go into the advantages and disadvantages of the tools and techniques we have used. %B International journal of medical informatics %V 70 %P 149-60 %8 2003 Jul %G eng %N 2-3 %1 http://www.ncbi.nlm.nih.gov/pubmed/12909166?dopt=Abstract