1. ICT in Healthcare
Topic 6

2. WJEC Objectives Medical Databases Expert systems
Scanning, life support, computer controlled equipment
• sensors (analogue and digital), data measured and its use
• scanning devices; MRI (magnetic resonance image); CAT (computerised axial tomography)
• advantages and disadvantages of scanning devices
• backup and recovery procedures
• new and future developments and limitations.
Medical Databases
• electronic patient record keeping (EPR)
• blood bar coding and tracking systems ISBT 128
• use of the Internet, intranets and extranets
• distributed medical databases
• backup and recovery procedures
• new and future developments and limitations.
Expert systems
• Artificial Intelligence
• neural networks and how parallel processors work
• software languages (PROLOG, ASPRIN)
• expert system shells (knowledge base, inference engine, user interface)
• how expert systems work
• medical uses of expert systems e.g. MYCIN,
NEOMYCIN etc.
• advantages and disadvantages of expert systems.

3. Medical Expert Systems
Key word is: Artificial Intelligence
A system based on Rules to reproduce the Role of a Human Expert
Works by using Questions and Answers
(IF-Then rules)

4. Medical Expert Systems
Go on NHS Direct website
Use system to find out what is wrong with you
Other Examples
NEOMYCIN – Used to train doctors
MYCIN – Helps doctors with obscure cases
and patients can be put on correct medication

5. 3 Parts to Expert System LEARN THIS Knowledge Base
A database of all of the facts and knowledge on a subject
Inference Engine
A set of rules to base the decisions on (IF-Then)
Brings the parts of the database together to answer the questions being asked
User Interface
How the questions and answers are presented to the user

6. Exam Question Extensive use is made of Expert Systems.
State the three main components of every expert system and then describe with examples the advantages and disadvantages of using an expert system in medicine. [7]

7. Exam Question Answers

8. Medical Databases (ERP)
Pre-Electronic Database
Storage problems:
Huge number of files
needed
Only one person can access data at the same time
Problems with storing patients records manually (paper based)
Records go missing
Handwritten notes messy
And hard to understand

9. Medical Databases (ERP)
Patients records now stored electronically
Data can be accessed by more than one medical professional at the same time
No need to transport files (speed of data access)
Security
Latest information can be accessed from patients bedside (example: results from blood tests)

10. Blood Bar Coding and Tracking
Tracking of blood across is an essential service the NHS provide
It is also essential that it is accurate
Identify what data is held on the blood and why it is important that it is tracked correctly

11. Intranets and ExtranetsGP
Consultant
Supplier
Surgeon
Nurse

12. Distributed Databases
Radiology
Intensive Care
Laptop
on the
ward
A+E
Plastics
The user uses one database software application to access the information and is likely to be unaware that the data is not stored in one place
Pharmacy
Surgery
Patient data is stored on lots of separate databases

13. Security
Access Levels
Data Encryption
Passwords
Audit Trails

14. Exam Question
Discuss the reasons why databases were introduced for storing patient records and assess the impact they have had upon patient tracking and monitoring. [6]

15. Exam Question Answers

16. Sensors – Analogue to Digital
Analogue Signals
Digital Signal

17. Sensors Used In Hospitals
What is measured using sensors in hospitals?
Temperature
Blood Pressure
Pulse
Blood Sugar
ECG (Heart Rate)
Respiratory Rate
Advantages
No “Human Error” – no missed readings
More Accurate
Real Time Monitoring
Automatically Measure Trends

18. Scanning Devices MRI CAT
Use Radio Waves to build up a picture of the inside of a patient
Used for checking function of organs such as liver, kidney, spleen, blood vessels and heart damage
CAT
Similar x-ray, but multiple x-ray beams are sent out at different angles to produce a more detailed scan
Used to pinpoint tumours

19. Scanning Devices Advantages Disadvantages
Can look at internal organs in 3D
MRI scans are safer than X-Rays
Higher cure rate due to early detection
Reduces the need for exploratory surgery
Faster Diagonosis
Disadvantages
scanning equipment very expensive
Exposure to radiation is dangerous for staff operating scanners
Patients have to be still for about 1 hour in an MRI machine

20. Future Technologies Home Healthcare Diabetes management
Video conference using sensors so that consultation with doctor can be done from home
Diabetes management
Automatic blood glucose measurements are taken and if blood glucose is too low a sensor automatically releases glucose from a reservoir implanted into patient
Japanese Toilets
A Japanese company is developing a toilet that analyses urine and sends a report automatically to the GP if necessary