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IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 1. IS-H*MED Overview and News SAP Healthcare Sales Partner Summit.

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Presentation on theme: "IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 1. IS-H*MED Overview and News SAP Healthcare Sales Partner Summit."— Presentation transcript:

1 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 1. IS-H*MED Overview and News SAP Healthcare Sales Partner Summit Feb 27 th, 2002

2 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 2. IS-H*MED Modules and Integration Overview

3 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 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 Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 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 Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 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 Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 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 Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 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, VisitsCoordinated Planning

8 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 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 Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 9. IS-H*MED Application-specific Modules Surgery Nursing Radiology Patient Transport Doctor‘s Round Vital Parameters Guidelines InternetMobile

10 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 10. IS-H*MED Selected Modules Radiology

11 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 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 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 12. IS-H*MED Radiology An integrated solution for radiology must support Radiology workflow Clinical Workflow Business partner´s workflow

13 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 13. IS-H*MED Radiology Workflow Request Scheduling Planning Pat. Arrival Preparation Execution Deriving Findings Writing Findings Transferring FindingsArchiving Prefetching FindingsEx-Docu Work Organizer ID-Stamping, Labels Single Pat. Worklist Management Perf.Proc.Step Query/Retrieve Autoroute

14 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 14. IS-H*MED Radiology - Clinical Workflow Integrated IS-H/IS-H*MED with ADT-Management Request communication Appointment planning Findings communication Clinical Workplace Service-Request Appointment Planning Finding

15 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 15. IS-H*MED Radiology - Business Partners Image Connector DOK-BAPI AE Internet Service Request SAP R3 General Practitioner Patient Hospital Archive Other Findings/ Image Transfer XML, PDF DICOM mySAP.com Workplace Historical Findings Images / Cineframes (CD)...

16 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 16. IS-H*MED Radiology Workplace User- and/or Profession- specific Worklist Patient-based Navigation-Bar (Computerized Medical Record) Service- and Workplace-related Hierarchical Finding-Documentation Detailed Image Information concerning selected items of the worklist Technical Navigation- Bar (PACS- Study) Application-Controled Viewer Integration Direct Dictation and Speach-Recognition

17 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 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 Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 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 Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 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 Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 20. IS-H*MED Current Developments Doctor‘s Round Vital Parameters

21 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 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 Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 22. IS-H*MED Doctor‘s Round Clinical Workplace Vital Parameters: integrated in clinical workplace Tick patient(s) Grid Graphics

23 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 23. IS-H*MED Doctor‘s Round Medication –Support the Workflows relating to Drug Therapy –Documentation of Prescribed and Administered Medications Clinical Workplace Medication & Vital Parameters

24 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 24. IS-H*MED Current Developments Guidelines

25 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 25. IS-H*MED Guidelines What are 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 Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 26. IS-H*MED Guidelines Example chest trauma 2 indicated, often additional findings 1 indicated, rare additional findings Suitability of diagnostic test: clinically instable chest deformation cardiopulmonary findings spine xray studies ? cardiac tamponade chest xray pa 4 CT scan 4 MRI 3 CT scan 4 rib xray ao/po 4 pericardiocentesis 4 CT scan 4 chest xray pa if n/a 4 accurate visualization of morphology 4 absolutely indicated 3 indicated, usually conclusive

27 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 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 Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 28. IS-H*MED Guidelines: Informative Clinical Work Station (CWS) Patient Organizer (PO)  Internet  Intranet (i.e. Concern-Wide Guidelines) ...

29 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 29. IS-H*MED Guidelines: Dedicated Application Miller, Max * Guideline: Myocardial Infarction Level: 1Day: 3 / 5 Time Diagnostic Labnon invasinvasiv Therapy conservativeoperative Nursing Procedures ActivityDietProcedure Day 1 EKGcheck weight Other Heparin ß-Blocker Pat.-Info CK CK-MB PTT Consultation low K + CH worker Day 2 bedrest sit in bed TOP ^ Text EKG check weight Aspirin DieticianCheck BP Back Day 3 Day 4 Change On/Off sit up cont. NOK walk 20m walk 100m Aspirin ß-Blocker Letter Misc. PTT

30 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 30. IS-H*MED Guidelines: Dedicated Application Miller, Max * Guideline: Myocardial Infarction Level: 1Day: 3 / 5 Time Diagnostic Labnon invasinvasiv Therapy conservativeoperative Nursing Procedures ActivityDietProcedure Day 1 EKGcheck weight Heparin ß-Blocker CK CK-MB PTT low K + CH workerbedrest TOP ^ Text EKG BackChange On/Off sit up Lab Request Service Request Charts Nursing Documentation / Charts Work Organizer Other Pat.-InfoConsultationMisc.

31 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 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 Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 32. IS-H*MED Current Developments Mobile Solutions

33 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 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 Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 34. Wireless LAN SAP ITS SAP Web Server Laptop Webpads Organizer Handheld WAP-Handy Technology an mobile devices are on-hand IS-H*MED Mobile Solutions

35 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 35. Personal Digital Assistant Laptop WAP-Handy Web-Pad Palm-PC IS-H*MED Mobile Solutions

36 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 36. 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 IS-H*MED Mobile Solutions

37 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 37. IS-H*MED Mobile Solutions

38 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 38. 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 IS-H*MED Mobile Solutions

39 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 39. IS-H*MED Mobile Solutions

40 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 40. 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 IS-H*MED Mobile Solutions

41 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 41. Personal and secure access to IS-H*MED Small Medical Record showing e.g. Worklists Requests Patient Information Findings IS-H*MED Mobile Solutions

42 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 42. Healthcare Information Systems have to become mobile and IS-H*MED Mobile Solutions IS-H*MED is mobile!

43 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 43. IS-H*MED Current Developments

44 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 44. 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 Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 45. GP‘s Workplace Leistungsstelle im Book Book Appointment Hospital Service Facility, e.g. View Finding Communication GP  Hospital

46 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 46.  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 The Portal

47 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 47.  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 Requesting Services

48 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 48. Booking (1): Select services Service Units Services provided

49 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 49. Booking (2): Book Appointments Enter Appointment Preferences (optional) Select and book suitable Appointments Enter Appointment Preferences (optional)

50 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 50. Booking (3): Patient‘s Data & Details Check Selected Appointments Add Details Add Patient‘s data Confirm

51 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 51. Booking (4): Confirmation Patient‘s data and details Booked Appointments

52 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 52.  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 Steps for the Hospital

53 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 53. 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 Access to Findings

54 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 54. GP‘s Workplace Web Browser: Book Web Browser: booked appointments View finding Web Browser: Request services Hospital Service Facility, e.g. Radiology Access to Findings

55 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 55. IS-H*MED Application-specific Modules Surgery Nursing Radiology Patient Transport Doctor‘s Round Vital Parameters Guidelines InternetMobile

56 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 56. IS-H*MED Overview and News Thank you! Harald Bartl, T-Systems Austria Friedrich König, GSD Berlin

57 IS-H*MED Overview and News H. Bartl, T-Systems; F. König, GSD, Feb 27 th, 2002; Page 57. Some software products marketed by SAP AG and its distributors contain proprietary software components of other software vendors. Microsoft ®, WINDOWS ®, NT ®, EXCEL ®, Word ®, PowerPoint ® and SQL Server ® are registered trademarks of Microsoft Corporation. IBM ®, DB2 ®, OS/2 ®, DB2/6000 ®, Parallel Sysplex ®, MVS/ESA ®, RS/6000 ®, AIX ®, S/390 ®, AS/400 ®, OS/390 ®, and OS/400 ® are registered trademarks of IBM Corporation. ORACLE ® is a registered trademark of ORACLE Corporation. INFORMIX ® -OnLine for SAP and Informix ® Dynamic Server TM are registered trademarks of IBM Corporation. UNIX ®, X/Open ®, OSF/1 ®, and Motif ® are registered trademarks of the Open Group. Citrix ®, the Citrix logo, ICA ®, Program Neighborhood ®, MetaFrame ®, WinFrame ®, VideoFrame ®, MultiWin ® and other Citrix product names referenced herein are trademarks of Citrix Systems, Inc. HTML, DHTML, XML, XHTML are trademarks or registered trademarks of W3C ®, World Wide Web Consortium, Massachusetts Institute of Technology. JAVA ® is a registered trademark of Sun Microsystems, Inc. JAVASCRIPT ® is a registered trademark of Sun Microsystems, Inc., used under license for technology invented and implemented by Netscape. SAP, SAP Logo, R/2, RIVA, R/3, SAP ArchiveLink, SAP Business Workflow, WebFlow, SAP EarlyWatch, BAPI, SAPPHIRE, Management Cockpit, mySAP, mySAP.com, and other SAP products and services mentioned herein as well as their respective logos are trademarks or registered trademarks of SAP AG in Germany and in several other countries all over the world. MarketSet and Enterprise Buyer are jointly owned trademarks of SAP Markets and Commerce One. All other product and service names mentioned are the trademarks of their respective owners. Copyright 2002 SAP AG. All Rights Reserved


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