Introduction : In recent time medical image processing and analysis become an essential component in clinical practice. Medical images have a huge data to process due to increased image resolution. These tasks are inherently parallel in nature, so will fit to naturally to parallel processors like Central Processing Unit (CPU) and Graphics Processing Unit (GPU). Methods : In this work several common used image processing algorithms for 2D and 3D were evaluated regarding the computation performance increase using the GPUs and CPUs on a Personal Computer (PC). Results : For tested algorithms GPU leads to decreasing running times from 1.1 to 422 times.

Health professionals are able to make right decision in right time only if they posses prompt, accurate and up to date information about health status of patients and general population. They also need knowledge and tools, computer and information technologies, for successful management of huge amount of information. Efficient management of information is of crucial importance for health policy and decision-making process, and to produce high quality results in public health and healthcare delivery. The book consists of 6 chapters: Connections between Computer Sciences and Medical Informatics; Development of Information and Communication Technologies (ICT); Development of Internet and Social Networks; Development of Classification Systems in Biomedicine; Development of Artificial Intelligence, Expert Systems and Biocomputers; The Role of IMIA and EFMI in Development of Medical Informatics. The book presents an original effort to summarize the basic knowledge about the history of medical informatics and informatics education in Europe and broader, development stages and influence of computer sciences on development of medical informatics. In addition, history and development of medical informatics in former Yugoslav countries is also presented, as well as some basic facts about the establishment, importance and activities of the two key international associations IMIA and EFMI. A broad history of establishing and activities of all Working Groups of IMIA and EFMI is included, as the most influential scientists and doyens in development of medical informatics worldwide. The author of the book pay special tribute to most important events and persons who were included in the development of Medical informatics during last 50 years, especially for establishing and developing of International Association of Medical Informatics (IMIA) and European Federation for Medical Informatics (EFMI) and MIE and MEDINFO Congresses organized from 1974 in Stockholm till 2014 organized in Istanbul. The book is fulfilling an important gap revealing the history and emphasizing the importance of medical informatics as a new scientific discipline with very fast development and implementation in health care sector. Health informatics is contributing remarkably in everyday practice of medical and public health professionals, in efficient management of huge and increasing amount of health information and general and specific medical knowledge toward improved quality of health care, as well as to professional and scientific competitiveness in Europe and broader. The knowledge of information technology is now part of general literacy. The 212 pages are distributed in 6 chapters with references and consulted references added to each chapter. The book is directed toward medical and other professionals in biomedicine, especially the young doctors. The book can be used by students at all levels, from undergraduate to postgraduate master and doctoral studies, and professionals in various clinical disciplines and public health. The book can also be useful as a guideline for all medical and other professionals in biomedicine in conducting everyday activities and promoting of their professional and research work.

Purpose: To analyze organization of ophthalmology health care in Tuzla canton and use of information technologies(IT). Introduction: IT in ophthalmology is the technology required for the data processing and other information important for patient and essential for building an electronic health record(EHR). IT in ophthalmology should include the study, science, and solution sets for all aspects of data, information and knowledge management in health information processing. Material and methods: We have analyzed organization of ophthalmology health care in Tuzla canton. Data relevant for this research were acquired from annual reports of Tuzla Canton health ministry. All institutions and ambulances were visited and all health care professionals interviewed. A questionnaire was made which included questions for health care professionals about knowledge and use of computers, internet and information technology. Results: Ophthalmology health care in Tuzla canton has paper based medical record. There is no information system with any possibility to exchange data electronically. None of the medical devices is directly connected to the Internet and all data are typed, printed and delivered directly to the patient. All interviewed health care professionals agree that implementation of IT and EHR would contribute and improve work quality. Conclusion: Computer use and easy information access will make a qualitative difference in eye-care delivery in Tuzla canton. Implementation phase will be difficult because it will likely impact present style of practice. Strategy for implementation of IT in medicine in general must be made at the country level.

Pharmacy inventory management (PIM) comprises business activities which are connected with the size and placement of stocked drugs. To manage minimal and maximal drugs stock, orders dynamics etc., pharmacies must track expiration dates of each drug in stock. Outdated drugs can’t be counted as stock and produce lot of costs, especially for their disposal. The most number of pharmacies in Bosnia use European Article Numbering (EAN13) barcode by which is impossible to define drug expiration dates. Radio Frequency Identification (RFID) enables full automatization of PIM, but it is still not in use, mostly because of high costs of implementation of this system. In our research we have observed 52 Bosnian pharmacies and presented another approach to barcode technology which can be used in automatization of PIM. As the base we have used existing EAN13 code, adding 6 digits for expiration dates. We have successfully created and tested program for extraction of EAN13 and expiration dates from that barcode using separate files in database to keep inputs, outputs and stocks of each item by expiration dates.

INTRODUCTION Laboratory diagnosis of medical biochemistry activity plays a significant role in the Primary Health Care Center (PHCC), dominated by Family medicine and diagnostic services. Medical biochemical diagnosis has a visible place at all levels of health care, which shows the number of requests for laboratory diagnosis, number and type of required laboratory tests. MATERIALS AND METHODS The study included 1000 requests for laboratory tests at the PHCC in Gracanica in primary health care units. We made an analysis of the most common laboratory tests in the requests by doctors from primary health care based on requests for laboratory diagnosis. RESULTS The requests of primary health care units in PHCC laboratory tests are required at all levels of service: urine, WBC, SE, glucose, total bilirubin, ALT, AST, AF, CK, cholesterol, HDL cholesterol, triglycerides, creatinine, urea, uric acid, CRP, fibrinogen, calcium and phosphorus. The following requirements are the most common laboratory tests with 94% representation: urine, WBC, glucose, cholesterol, triglycerides, aminotransferases, creatinine, and urea. In 1000 requires was required total of 5333 laboratory tests. Test requirements of a general practice make 44, 1%; FM doctors account for 40% and the requirements of other specialists (pediatricians, gynecologists and specialists of occupational medicine) are 15, 3%. The doctors in family practice most often required: glucose, urine, WBC, SE, TGL., Chol., ALT, AST, creatinine and urea. General practitioners are demanding more cholesterol and triglycerides, a family medicine doctors are demanding lower cholesterol and triglycerides and higher CRP, fibrinogen, total bilirubin, ALT, AST, and other specialists the most demanded urine and WBC. DISCUSSION Laboratory diagnosis is a common diagnosis, which shows the representation of required number and type of laboratory tests. In requirements of PHC units in PHCC laboratory tests are required at all levels of service: urine, WBC, SE, glucose, bilirubin, ALT, AST, AF, CK, cholesterol, HDLchol., triglycerides, creatinine, urea, uric acid, CRP, fibrinogen, calcium and phosphorus. The following requirements are the most common laboratory tests at the primary level: urine, WBC, glucose, cholesterol, urea, and found the secondary level of triglycerides, index levels and did not clear the number of searches required by the standards and norms of PHC.

Problem: Laboratory medicine, medical-biochemical diagnosis in primary health care is much represented. By organization of family medicine medical-biochemical diagnosis is defined as a branch of diagnostic services in primary health care. For these actions is necessary in the morning prior to admission of users and their demands that all jobs are properly prepared. On previous day should be provided and prepared: accessories, reagents and machines. Morning daily routine work of preceding control and calibration equipment, methods and process quality control of work in the laboratory. Only after the fulfillment of the procedures followed overview of search control of samples. After validating the results of daily quality control and after they met the criteria can be analytically examined samples from users. These procedures are not sufficiently familiar to users and doctors, for that are very often necessary the direct telephone communication between them. To make the results of laboratory tests needed are huge material resources. This is evident in the economic analysis where laboratory tests are valued with a score of: search by type and material resources expended for analytical examination. These technical and financial performances of laboratory medicine are not appropriately classified as blatant as that in other industries, technology and other primary health care (PHC) and family medicine (FM). Goal: The overall objective of the research is to define a model of efficiency (or effectiveness) of medical-biochemical diagnosis for users with the requirements of units of family medicine (FM), in a representative sample of patients in the unit for the laboratory diagnosis of the Primary Health Care Center Gracanica. Confirm what is the usefulness of the application of laboratory diagnosis in family medicine. Determine the frequency of the need for laboratory tests in the therapeutic treatment of major diseases. Evaluate the need for using laboratory diagnostics to try to prevent major diseases. Material and methods: The study included a total of 1000 respondents. All subjects were users of primary health care in Primary Health Care Center Gracanica (Tuzla Canton) in primary health care units have received requests for laboratory diagnosis. This paper is an analysis of the representation requirements for the laboratory diagnosis by doctors in primary health care and the most frequent diseases in primary care. An analysis is made of laboratory test results, based on requests for laboratory diagnosis by doctors and illnesses in primary care. Made is analysis of the presence of normal and pathological laboratory test results from the request for the laboratory diagnosis by doctors in primary health care. Made is an analysis of the most common laboratory tests requests, and based on requests for laboratory diagnosis by doctors in primary health care and the most frequent diseases in primary health care. Incorporated is the economic analysis of labor

CONFLICT OF INTEREST: NONE DECLARED PAPERAIM SUMMARY. The development of the digital Information Communication Technology (ICT) has definitely changed healthcare system in all its areas. The development of standardized electronic medical record (EMR) make possible other forms of E-Health like transmural care, telemedicine etc. In this paper was described Health Information System (HIS) of Tuzla Canton and Brčko DC (whose citizens gravitate toward Tuzla Clinical Center). Tuzla Clinical Center is the only Clinic for tertiary healthcare in this region. To estimate level and types of the HIS, telecommunications and information management we have designed questionnaire. Based on this research we have presented current state of E-Health in Canton and the most important problems in this area. Also, based on this research and our experiences, we have identified the main directions of the HIS development, its standardization and integration as the base for E-Heath in Bosnia.

One of the most common events in Surgical Ward is admission of patients with biliary tract disease. To evaluate such patients, it is necessary to create appropriate database and define attributes that will be analyzed. The patients should be divided in groups for analysis and data processing. There were 219 patients included in the study. All patients were selected on the basis of ICD-10 codes and then divided into categories according to the code. In order to assess selected patients, the database was created with all relevant questions about anamnesis, diagnostic tests and surgical procedures. The data about patients was entered into the database. It is possible to analyze data about the most frequent disorders of biliary tract. The most common entity was chronic cholecystitis with calculus and most common procedure was laparoscopic cholecystectomy. The other important attributes are also assessed. ICD-10 classification can be used as a basis for aggregation of data of the patients with biliary tract disease. Some of the codes are more frequent than others and some are rarely used.

Medical informatics is a specific and interdisciplinary science which involves many participants of the health system like: patients, physicians, nurses, managers, administrators, computer experts, students, with the different level of education and understanding, different approaches and expectations. Education of medical informatics requests organization solutions of high quality and necessary equipment for its realization. Educational programs are also limited by student's basic knowledge of informatics from secondary schools. For assessment of this knowledge we have conducted special designed questionnaire at the first year of undergraduate study which results confirm our thesis that great number of students entered the faculty with the lack of basic knowledge from informatics area. In this paper was presented level of organization and education of medical informatics at the Medical faculty and University Clinical Center of Tuzla, with its characteristics through which this system has been passed since 1990.

AIMS In recent year's percutaneous drainage has been used successfully to treat the hydatid cysts. We performed a controlled trial to present the successful appliance of this method in the treatment of abdominal and retroperitoneal hydatid diseases. METHODS In a prospective study, we have assigned 84 patients (51 women and 33 men, average age 45.7 +/- 16.7 with hydatidosis to treatment with percutaneous drainage. Of these, 72 patients had hepatic cysts, seven had renal hydatid cysts and five patients had hydatid cyst in the spleen. Albendasole (10 mg per kilogram of body weight per day for eight weeks) was administered to the patients. Serial assessments included clinical and biochemical examinations, ultrasonography and serologic tests of echinococcal-antibody titers. RESULTS The mean hospital stay was 5.8 (+/- 3.1) days. Over a mean follow-up period of 24 months, the mean cyst diameter decreased from 81.4 (+/- 32.6) mm to 11.8 (+/- 14.5) mm. After 24 months follow-up period 62 cysts (74 percent) disappeared. After an initial rise, the echinococcal-antibody titers fell progressively and at the last follow-up were negative (< 1:160) in 73 patients (87 percent). There were procedure related complications in 29 patients (four patients had abscessus, six hypotension, seven urticaria, ten fever and two strong abdominal pain in the first hour after intervention). CONCLUSIONS Percutaneous drainage, combined with albendasole therapy, is an effective and safe method for the treatment of the abdominal and retroperitoneal hydatid cysts and requires a shorter hospital stay then surgery treatment.

DRG (Diagnosis Related Groups) classification system requests much of medical and financial data from patients record. We also need comprehensive Clinical Information System with computer database to manage such system. In our research we were using HCFA (Health Care Financing Administration) and AN-DRG (Australian National-DRG) methodology for DRG classification. We also used ICD 10-Revision for diagnosis coding. We have chosen ORL Clinic for DRG classification because of two reasons: 1) They treat two basic types of patients medical and surgical and 2) They had pretty good sorted patients' records. Our base for DRG classification was 1997 year. During our research we found many deficiencies in patient records in both its parts: medical and financial. Since all records were processed and stored manually, financial data didn't exist. So we had to use other ways for direct and indirect costs allocation (for Prospective Payment System purpose). In 1998 we processed 680 patient records (treated in 1997), and made DRG classification putting all 680 patients' records into 183 DRG: 47 medical and 136 surgical. This is so called CASE-MIX of the ORL Clinic for year 1997. DRG classification we made at Tuzla ORL Clinic was identical with HCFA DRG classification system in 92%.

Medical Record contains data about use of health care services of every member of certain population, no matter if they come from preventive or curative health care. Quality of Medical Records is very often in direct as well as indirect connection with health care quality. Better health care systems usually have better Medical Records. These are computer processed and stored on some of contemporary computer media, like: disks, microfilms, magnetic tapes and so-called "smart cards". Good Medical Record should have at least next characteristics: 1. Time dimension, which should contain chronological: past, present and future data, relevant to health care consumers. 2. It should be complete in a sense that every Medical Record must contain adequate medical and other relevant data for health care planning, organization and control. From the aspects of our research described here, it is very important that Medical Records contain all financial data. These usually are consequences of consumption of health care services from various resources of different levels. The results of our research about the application of DRG classification in B&H health system, that have been done in Tuzla University-Clinical Center, show that hospital Medical Records have many inadequacies, both in respect of medical as well as non-medical part. Physicians use very little ICD coding system. There is no uniform anamnesis, no detailed evidences about all hospital services, no adequately defined severity of disease and patient status at discharge. Due to manual based information system, there is no evidence about spending of resources per patient with financial data. The development and application of computer based health information system must go towards direction of solving these problems.

Decision Support Systems (DSS) are more and more used and developed, mainly within the management area. It is used at strategic level for global planning and managing the organization; at tactical level for short-term planning, process realization and control. Although many authors state that DSS are used only at global and tactical level, some of them--through practical applications--show that specific DSS can be created in order to support decision in other areas than classical management. Paper describes computer application that efficiently supports organisation of exams at The Department for Medical Informatics of Medical Faculty in Tuzla.

Improvement of the efficiency and effectivity of health care system is a task of high priority for social system because it is one of its crucial components. Health care system spends significantly great part of social budget. That is why its quality--directly or indirectly--influences other segments of social system. After five years of either total or partial destruction of health care capacities, facilities, resources, lack of human resources, as well due to total collapse of the economy in our country, the consequences of the aggression on Bosnia and Herzegovina require radical changes in respect of the organisation and structure of the health care system in Bosnia and Herzegovina. Concerning the fact that hospital system in Bosnia and Herzegovina is one of the most expensive segments of health care system, future reforms in health care system should be implemented primarily in this field. These reforms should consist of establishing of DRG system for control, evaluation, updating, financing and management of health care system to desired direction and way of development. In that regard, it is necessary to: improve actual computer capacities by application of new technologies; develop DRG and CASEMIX classification systems, following experiences of highly developed countries, and adapt it to our health care system; change financing system by following CASEMIX, and adapt CASEMIX step-by-step to implementation i.e.: department by department; hospital by hospital; in the last phase-to connect CASEMIX with network of integral information system of Sarajevo Canton and, later, with network of all other cantons in BiH. to educate medical staff about the implementation and use of DRG and CASEMIX in practice.