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IS-H*MED Overview and News

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Presentation on theme: "IS-H*MED Overview and News"— Presentation transcript:

1 IS-H*MED Overview and News
SAP Healthcare Sales Partner Summit Feb 27th, 2002

2 IS-H*MED Modules and Integration Overview

3 Roll-based Concept of Workplace and Authorization
Authorized activity sets for - Managers - Admission and billing - Physicians - Nurses - Medical controlling - Maintenance, procurement - Acountants, Controllers

4 IS-H*MED Standard Modules
Clinical Workprocess Support Out- and Inpatient Departments‘ Workplaces Service Request Workflow Scheduling for Patients and Services Work Organizers Clinical Documentation Patient‘s EMR Structured Medical Documentation Hospital- and department specific Freely defineable

5 IS-H*MED Standard Modules: Recent Developments
Clinical Workplace For outpatients‘ departments For functional units Scheduling Admission scheduling Multiappointment e.g. Preoperative Planning Waiting List Management Patient Organizer Patient‘s history, EMR

6 IS-H*MED Standard Modules - Clinical Workplace
Unified Workplace Look&Feel Shows Service Requests Appointments Visits Freely defineable Displays Set of functions Functionality Outpatients‘ management Service request processing

7 IS-H*MED Standard Modules - Scheduling
Multiappointment Planning Caseless registry of patients for intended operations/treatments Optional admission planning Requesting services for clearing up Coordinated planning of accompanying visits Progress check of e.g. preoperative phase Waiting List Mgmt Based on preregistration In clinical workplace Service Requests, Visits Coordinated Planning

8 IS-H*MED Standard Modules - Patient Organizer
Aspects offer various views on patient‘s clinical history Cases, Movements Requests, Appointments Diagnoses, Documents Services Customer-specifics Quick navigation Personalization Integrated object viewer e.g. Acrobat Reader

9 IS-H*MED Application-specific Modules
Surgery Nursing Radiology Patient Transport Doctor‘s Round Vital Parameters Guidelines Mobile Internet

10 IS-H*MED Selected Modules

11 IS-H*MED Radiology The Situation Increasing DICOM Application Entities
Evolving PACS Implementations Development of DICOM-capable Endoscopes and Ultrasound Devices Increasing need for Telemedicine Applications Report and Image Access (Workplace Solutions) Clinic wide General Practicioners Patients Report and Image Delivery Transaction to other provider (hospital) Delivery to Patient (CD)

12 An integrated solution for radiology must support
IS-H*MED Radiology An integrated solution for radiology must support Radiology workflow Clinical Workflow Business partner´s workflow

13 IS-H*MED Radiology Workflow
Request Scheduling Worklist Management Prefetching Planning Pat. Arrival Single Pat. Preparation Work Organizer ID-Stamping, Labels Execution Ex-Docu Autoroute Perf.Proc.Step Deriving Findings Query/Retrieve Writing Findings Findings Transferring Findings Archiving

14 IS-H*MED Radiology - Clinical Workflow
Clinical Workplace Integrated IS-H/IS-H*MED with ADT-Management Request communication Appointment planning Findings communication Service-Request Appointment Planning Finding

15 IS-H*MED Radiology - Business Partners
General Practitioner Hospital Internet Service Request DOK-BAPI Workplace SAP R3 Findings/ Image Transfer AE XML, PDF Image Connector DICOM Archive Historical Findings Images / Cineframes (CD) ... Other Patient

16 IS-H*MED Radiology Workplace
Patient-based Navigation-Bar (Computerized Medical Record) Service- and Workplace-related Hierarchical Finding-Documentation User- and/or Profession-specific Worklist Technical Navigation-Bar (PACS-Study) Direct Dictation and Speach-Recognition Detailed Image Information concerning selected items of the worklist Application-Controled Viewer Integration

17 IS-H*MED Radiology – Reports and Evaluation
Device and Service Related X-Ray Register Service Statistics Person-Related Experience History, Radiation Dosage Open Studies Scientific Evaluations

18 IS-H*MED Radiology - Technical Features
Worklist-Server Event-based generation of worklist entries in the MSI-Format (Customizing) Patient Management Generation of ADT-information in the MSI-Format, for admissions,, discharges, transfers, etc. in IS-H, IS-H*MED (HCM) Study Management Overview of the entire examination flow PACS-IDs in the Study Document DICOM Study Status in the Examination Document Integrated Radiological Image Findings Work Station Calling the Load Study Servers Including Viewer-Interface Using RIS-Communication Client (RCC) Report Management Transfer of the Report Text and Status to the PACS-Broker in the MSI-Format

19 IS-H*MED Radiology Summary
Institution-wide Image & Cineframe Access Access of Findings and their related Images Standard Programming Architecture (BAPI) allows easy transfer of findings via Internet-technology (PDF, XML). New applications as the mySAP Enterprise Portals allow direct access to findings and related pictures for GPs or even patients. The media integration in IS-H*MED concludes the efforts for a multimedial patient record

20 IS-H*MED Current Developments
Doctor‘s Round Vital Parameters

21 IS-H*MED Doctor‘s Round
Objective Support of doctor‘s round via online-connected mobile device All needed patient-related information at his fingertip Vital parameters Blood pressure, temperature, pulse, ... 1st step to doctor‘s round support Presentation in grid or graphics Entry for one or more patients Integrated in clinical workplaces for in- and outpatient departments

22 IS-H*MED Doctor‘s Round
Vital Parameters: integrated in clinical workplace Clinical Workplace Grid Graphics Tick patient(s)

23 IS-H*MED Doctor‘s Round
Medication Support the Workflows relating to Drug Therapy Documentation of Prescribed and Administered Medications Medication & Vital Parameters Clinical Workplace Clinical Workplace

24 IS-H*MED Current Developments

25 IS-H*MED Guidelines What are guidelines? Using Guidelines
Systematically developed conclusions aimed at supporting physician and patient’s decisions concerning appropriate health care for specific clinical situations. Reproduce the status of the knowledge and the methodology comprehensively although simply for a detailed problem Using Guidelines Improves the quality of medical and non-medical services. Improves the quality of the execution and results of clinical research. Fundamentally better acceptance and therefore also a permanent behavioral change. Cost savings due to reduction in unprofitable diagnostic and therapeutic processes. Medium-term improvement of knowledge

26 IS-H*MED Guidelines Example chest trauma
clinically instable clinically instable cardiopulmonary findings chest deformation CT scan 4 chest xray pa if n/a 4 chest xray pa 4 rib xray ao/po 4 accurate visualization of morphology ? cardiac tamponade spine xray studies CT scan 4 MRI 3 pericardiocentesis 4 CT scan 4 Suitability of diagnostic test: 1 indicated, rare additional findings 3 indicated, usually conclusive 2 indicated, often additional findings 4 absolutely indicated

27 Implementation of 4.63 B Informative (Can be implemented immediately)
Case-related, linked information, here in user-defined textual format or via external applications. Simple Rules (Project Solution) Simple, parametrizable service rules that check the time reference of services and their relations to diagnoses. Rule Interpreter (more as Application) Layout of an interpreter that checks the rules of a certain syntax using two-valued logic. Dedicated Application (Concept) Interface for creating and managing processes with link to each of the relevant objects in IS-H*MED

28 IS-H*MED Guidelines: Informative
Clinical Work Station (CWS) Patient Organizer (PO) Internet Intranet (i.e. Concern-Wide Guidelines) ...

29 IS-H*MED Guidelines: Dedicated Application
Miller, Max * Back Guideline: Myocardial Infarction Level: 1 Day: 3 / 5 TOP Change ^ On/Off Text Time Diagnostic Therapy Nursing Procedures Other Lab non invas invasiv conservative operative Activity Diet Procedure Pat.-Info Consultation Misc. Day 1 CK EKG check weight bedrest low K+ sit up CH worker CK-MB EKG Heparin PTT EKG ß-Blocker Day 2 PTT EKG check weight sit in bed Check BP Dietician Aspirin ß-Blocker Day 3 Aspirin walk 20m ß-Blocker Day 4 Aspirin walk 100m cont. NOK ß-Blocker Letter

30 IS-H*MED Guidelines: Dedicated Application
Back Miller, Max * TOP Guideline: Myocardial Infarction Level: 1 Day: 3 / 5 Change ^ On/Off Text Time Diagnostic Therapy Nursing Procedures Other Lab non invas invasiv conservative operative Activity Diet Procedure Pat.-Info Consultation Misc. Day 1 CK EKG check weight bedrest low K+ sit up CH worker CK-MB EKG Heparin PTT EKG ß-Blocker Work Organizer Nursing Documentation / Charts Charts Service Request Lab Request

31 IS-H*MED Guidelines: Relevance
Demand for approx. 10 guidelines per year as provided for in SGB V §137 (German Social Insurance Code). Existing discussions concerning financial incentives in remuneration system if guidelines are used. Current discussion concerning financing for the development of guidelines by self-governing partners. Important basis for labor and process controlling in the new, completely consolidated pay system.

32 IS-H*MED Current Developments
Mobile Solutions

33 IS-H*MED Mobile Solutions
The situation in healthcare: Computer workplace is fixed on a desktop Medical stuff has more and more rotative workplaces  Medical data lacks where it is needed Paper documentation is further on widespread Much time for documentation and information retrieval means less time for the patient Conclusion: Healthcare Information Systems have to become mobile

34 IS-H*MED Mobile Solutions
Technology an mobile devices are on-hand Wireless LAN SAP ITS SAP Web Server Laptop Webpads Organizer Handheld WAP-Handy

35 IS-H*MED Mobile Solutions
Palm-PC Personal Digital Assistant Laptop WAP-Handy Web-Pad

36 IS-H*MED Mobile Solutions
Mobile solutions are an extension of the existing system Using IS-H*MED with RFC und BAPI Existing network infrastructure Extending with SAP Portal Wireless LAN Devices

37 IS-H*MED Mobile Solutions

38 IS-H*MED Mobile Solutions
The Laptop as a complete mobile Client with Good mobility Familiar usage of IS-H*MED Optimised for usage of keyboard and mouse Easy implementation

39 IS-H*MED Mobile Solutions

40 IS-H*MED Mobile Solutions
The Handheld or Webpad as a special mobile device with Very good mobility Webbased User Interface of IS-H*MED Optimized for usage of touch-screens Easy to implement und easy to extend

41 IS-H*MED Mobile Solutions
Personal and secure access to IS-H*MED Small Medical Record showing e.g. Worklists Requests Patient Information Findings

42 IS-H*MED Mobile Solutions
Healthcare Information Systems have to become mobile IS-H*MED is mobile! and

43 IS-H*MED Current Developments

44 IS-H*MED @web: Development Initiation
Hospitals have new policies See themselves as “service providers” Want to strengthen the links with general practitioners and patients Give better support to patients and external doctors Aspects Extended processes and patient logistics Increased transmural communication Improved standards and efficiency in communication Needed Tools Portal with services offered by the hospital For patients, for everybody For external doctors @ @

45 IS-H*MED @web: Communication GP  Hospital
Hospital Service Facility, e.g. Radiology @ View Finding @ Book Appointment @ Book Services Leistungsstelle im KH GP‘s Workplace

46 IS-H*MED @web: The Portal
Hospital’s central access point Reachable via internet Offers services for everybody departments, locations, opening hours, .... Offers services for external doctors Register patients Book services Book appointments Access findings for requested Restricted access, agreement necessary Tool: mySAP Enterprise Portals

47 IS-H*MED @web: Requesting Services
Select desired services From one ore more service facilities defined by the hospital On service ranges offered by service facilities Multiple selections possible Book appointments Based on a suggestion Enter additional information Short anamnesis, diagnosis For new patient: Enter patient’s data, only name is mandatory

48 Booking Services@web (1): Select services
Service Units Services provided

49 Booking Services@web (2): Book Appointments
Enter Appointment Preferences (optional) Enter Appointment Preferences (optional) Select and book suitable Appointments

50 Booking Services@web (3): Patient‘s Data & Details
Check Selected Appointments Add Details Add Patient‘s data Confirm

51 Booking Services@web (4): Confirmation
Patient‘s data and details Booked Appointments

52 IS-H*MED@web: Steps for the Hospital
View services in service facility’s work-pool Appointment already assigned patients are listed together with internally booked requests Patient shows up First visit: identify and admit the patient Subsequent visit: register the patient New or existing case is assigned to the booked services Render services Create results report

53 IS-H*MED@web: Access to Findings
Clinicside Encryption of documents Publishing documents for external access Logging the access of external users No physical transfer of findings GP side Access to findings for GP´s patients via hospital’s portal Viewing the document, printing the document Following up the state of the document

54 IS-H*MED@web: Access to Findings
Hospital Service Facility, e.g. Radiology @ Web Browser: booked appointments Web Browser: Book appointments Web Browser: Request services GP‘s Workplace View finding

55 IS-H*MED Application-specific Modules
Surgery Nursing Radiology Patient Transport Doctor‘s Round Vital Parameters Guidelines Mobile Internet

56 IS-H*MED Overview and News
Thank you! Harald Bartl, T-Systems Austria Friedrich König, GSD Berlin

57 Copyright 2002 SAP AG. All Rights Reserved
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