1. MNIA Introduction to Health Informatics
ABC of Medical Computing
Perry Poulsen/Kieran Savage
Manitoba eHealth

2. Topics Computing Basics What is a computer Applications
terms
networks
connecting it all together (WWW,WAN,LAN)
Applications
local and centralized
Account management
security, authentication and your profile
Discussion of the Clinical system network
architecture, governance model and change management
On the horizon
hand held, radio-frequency identification (RFID) , facial recognition, remote access
MB Health / eHealth and WRHA Services
project management, service desk, work orders, H/W S/W upgrades

3. What do computers have to offer?
The common reason for buying a computer is the need to write simple letters, medical reports, papers - a word processor but they can do much more.
Computers are good at storing and manipulating large amounts of information.
Database programs collect, sort, and analyze and perform repetitive tasks extremely fast and without error.
General practitioners computerize their practices which offer comprehensive recording of medical records, issue repeat prescriptions, and provide call and recall facilities.
Hospitals have many computer systems for Admitting, Scheduling, Lab systems and PAC,s to name a few.
These systems make it possible for us to build the Electronic Health Record (EHR) giving authorized healthcare providers rapid access to patients' complete, up-to-date health information to support clinical decision-making and case management.

4. Computer Basics
Computers are everywhere you look, and even in places you can't see.
Computers check out your groceries, pump your gas, dispense money at the ATM, turn the heat on and off in your home
There are different kinds of computers for different purposes

5. Computer Basics What is a computer?
A computer is an electronic device that executes the instructions in a program.
A computer has four functions:
accepts data as input
processes data
c. produces output
d. stores results - storage

6. Computer Basics Types of Computers
Computers for personal use come in all shapes and sizes
PC (personal computer)
Desktop or referred to as a workstation
Laptop provides mobility
Tablets you use an electronic stylus to write on the screen
PDAs (personal digital assistant)
Black Berry or Palm Pilot

7. Computer Basics Terms Hardware Software Data CD ROMs
the physical parts of the computer
Software 
the programs (instructions) that tell the computer what to do
Data 
individual facts like first name, price, quantity ordered
Information
which has been massaged into a useful form, like a complete mailing address
CD ROMs
(compact disks read only memory) Similar to the audio compact disc, are an excellent way of distributing large amounts of information

8. Computer Basics Terms Network Internet Intranet Firewall
A network is a set of computers which are linked together on a permanent basis. This can mean two computers cabled together on the same desk, or thousands of computers across the world.
Internet
global computer network: a network that links computer networks all over the world by satellite and telephone, connecting users with service networks such as and the World Wide Web
Intranet
computer network within organization: a network of computers, especially one using World Wide Web conventions, accessible only to authorized users such as those within a company
Firewall
similar to firewalls with fire door in building construction. In former case, it is used to prevent network access and intrusion to the private network

9. Computer Basics Terms Server Main Frame Storage
The term server refers to a specific kind of computer.
It handles the sharing of equipment like printers and the communication between computers on the network.
A computer somewhat more capable than a personal computer which requires more power, larger memory & storage capacity with high speed communications
Main Frame
A main frame allows hundreds of people to work at the same time on the same data. It requires a special environment - cold and dry, backup power.
Storage
May be referred to as storage area network ( SAN ) providing data storage on a local disk or a network connected device such as disk arrays , tape libraries.

10. Networks
In the world of computers, networking is the practice of linking two or more computing devices together for the purpose of sharing data.
Networks are built with a mix of computer hardware and computer software.
Networks can be categorized different ways. Usually defined according to the geographic area it spans.
Local area networks (LANs), typically reach across a single home or office
Wide area networks (WANs), reach across cities, states, or even across the world.
The Internet is the world's largest public WAN.

11. Network LAN/WAN
WAN
LAN

12. Application Local and Centralized

13. Account Management security, authentication and your profile
Passwords – the Weakest Link in Healthcare Security
The temptation for users to share passwords is high. Policies such as 90 day auto reset with a rule based on no repeats has been a challenge to adopt
The more complicated the password policy, the more expensive it is to implement and support. Between 25 and 50 percent of calls to help desks are for password resets. Deloitte & Touche estimated that the typical enterprise spends an average of $150 per user, per year to support password resets.

14. Account Management security, authentication and your profile
Why do we need account management?
Security
Trustees must protect personal health information by making reasonable security safeguards to ensure the confidentiality, security, accuracy and integrity of the information
Authentication
Identifies the user
Allows for auditing
Defines privileges
Profile
Categorize types of users based on their job roles within the organization into profiles that can be assigned to multiple users performing the same job.

15. Clinical System Network
Architecture – many systems are designed for a specific purpose, typically the application will define the architecture.
Hardware – systems get old and from time to time need an upgrade
Applications require added functionality or regulatory changes
Governance – How do we manage change to work flow?
Who will participate in the approval as we implement provincial services/applications
How are they implemented – project or a work order / impact assessment
Change Management – How is the change request managed?
Best practices (ITIL) include change, release and incident management processes

16. Clinical System Network

17. On the Horizon Hand Held Devices - The use of these devices to
access medical literature and education, research,
e-prescribing as well as specialty-specific uses for personal digital assistants (PDAs).
Radio Frequency Identification (RFID) is an automatic identification method, relying on storing and remotely retrieving data using devices called RFID tags. It can also be used to locate staff and patients within a facility
A recent survey (BearingPoint) established that RFID technology is being used for a wide variety of applications within health-care organizations, including patient flow management, access control and security, supply chain systems
You are here

18. On the Horizon Biometrics Vendors and Solutions
Fingerprint &Hand
Facial & Iris
Voice & Smart cards
Fingerprint-based identification is the oldest method which has been successfully used in numerous applications. Everyone is known to have unique fingerprint.
Facial recognition - software has come a long way. It can pick someone's face out of a crowd, extract the face from the rest of the scene and compare it to a database of stored images.
Smart Cards defined as pocket-sized card with embedded integrated circuits which can process information. The card is made of plastic, just like any bank card.

19. On the Horizon Remote Access - anywhere any time
Healthcare industry is looking at secure remote access solutions. Growing number of healthcare professionals believe that it will provide improved data accuracy, reduce errors, and result in an overall improvement of patient care.
A team of radiologists deliver a 24-hour on-call service.
Unable to access patient x-rays from their homes and, consequently, spent a lot of time traveling to hospitals.
Secure remote access solution, the radiologists can work from remote locations, reduce travelling time, and deliver urgent reports quickly.
The Manitoba First Nations Remote Access Initiative
Aimed at demonstrating the value of remote, dynamic access to knowledge and health human resources.
Involved 35 First Nations communities, Tribal Councils and their health services organizations;

20. MB Health / eHealth and WRHA Service
Health care initiative are much like any other business. Funding is provided in several ways, treasury board, infoway or grants.
Project management, depending on the initiative may be provided by MB Health, Manitoba eHealth or the WRHA delivering services such as RIS/PACs / Electronic Health Record and Client Registry.
Manitoba eHealth has centralized a service desk as a single point of contact and working with the RHA’s on a shared service model in anticipation of provincial initiatives.
Adoption of new systems and h/w s/w upgrades are becoming a fact of life, some are easy some are very complex.
What makes all of this work, is when we can all work together and better understand the risks and impact and I hope to see more interest in participating together in the future – we will all benefit regardless of roles, service support, care givers and patients alike.

21. Thank for your time
Too much information…