1. “Victor Babes” UNIVERSITY OF MEDICINE AND PHARMACY TIMISOARA DEPARTMENT OF MEDICAL INFORMATICS AND BIOPHYSICS Medical Informatics Division www.medinfo.umft.ro/dim 2007 / 2008

2. HEALTH INFORMATICS MEDICAL INFORMATION SYSTEMS (II) COURSE 14

3. 3. CLINICAL INFORMATION SYSTEMS 3.1 STRUCTURE OF CLINICAL SPECIALISED HEALTHCARE:3.1 STRUCTURE OF CLINICAL SPECIALISED HEALTHCARE: –CLINICAL DEPARTAMENTS : INTERNAL MEDICINE (… … …)INTERNAL MEDICINE (… … …) SURGERY (… … …)SURGERY (… … …) PEDIATRICS (…)PEDIATRICS (…) MONITORING (…)MONITORING (…) PSYCHIATRYPSYCHIATRY NEUROLOGYNEUROLOGY … … …… … …

4. –PARACLINICAL DEPARTAMENTS AND SERVICES RADIOLOGY AND IMAGING (…)RADIOLOGY AND IMAGING (…) NUCLEAR MEDICINENUCLEAR MEDICINE FUNCTIONAL INVESTIGATIONS (…)FUNCTIONAL INVESTIGATIONS (…) CLINICAL LABORATORYCLINICAL LABORATORY ENDOSCOPYENDOSCOPY PATHOLOGYPATHOLOGY THERAPY (…)THERAPY (…) PHARMACYPHARMACY

5. 3.2. GENERAL OBJECTIVES a. MANAGERIAL - ADMINISTRATIVEa. MANAGERIAL - ADMINISTRATIVE –healthcare and interventions planning b. PATIENT DATA b. PATIENT DATA –data acquisition, storing and retrieval (anamnesis, laboratory, images, biosignals) –data verification and coding –data processing –integrated (multimedia) presentation

6. c) DECISIONc) DECISION –diagnosis and therapy assistance –intervention simulation on models –advice for patients d) MONITORINGd) MONITORING –therapy follow-up –intensive care monitoring

7. e) REPORTSe) REPORTS –data centralization –statistical analysis –report generating f) ASSESSMENT f) ASSESSMENT –disease evolution follow-up (chronic, congenital etc) (chronic, congenital etc) –healthcare quality assessment (for planning, research etc) (for planning, research etc)

8. 3.3. SPECIFIC OBJECTIVES IN CLINICAL AND PARACLINICAL DEPARTAMENTS a) INTERNAL MEDICINEa) INTERNAL MEDICINE –CARDIOLOGY (accurate investigations, num. data) –METABOLICAL DISEASES (follow-up, patient education, diabcard) –HAEMATOLOGY (haemophilia registers) –NEPHROLOGY (transplant planning, dialysis monitoring) –GASTROENTEROLOGY –ENDOCRINOLOGY

9. Health Card - “smart card” – chip 32 k - magnetic card - laser card = combined identity and health card Health Card - “smart card” – chip 32 k - magnetic card - laser card = combined identity and health card

10. b) SURGERYb) SURGERY –OPERATION PLANNING –SURGICAL INTERVENTIONS PREPARETION AND CONTROL –SIMULATIONS (virtual reality) –MONITORING, ANESTESY c) PEDIATRICSc) PEDIATRICS –PREMATURES FOLLOW-UP –CONGENITAL DISEASES –OTHER: similar to internal medicine and surgery

11. VIRTUAL REALITYVIRTUAL REALITY –Imersion –Interactivity TELEMEDICINETELEMEDICINE –Tele-consultation Video presentationVideo presentation Medical consultationMedical consultation –Tele-surgery Surgical robotsSurgical robots

13. d) OBSTETRICSd) OBSTETRICS –PREGNANCY FOLLOW-UP –PATIENT EDUCATION e) PSYCHIATRYe) PSYCHIATRY –LARGE VARIABILITY IN DIAGNOSIS f) MONITORINGf) MONITORING –CORONARY UNITS –INTENSIVE CARE, REANIMATION –PRE/POSTOPERATORY MONITORING –PERINATAL NURSING –ORGAN BANKS, TRANSPLANT

14. g) FUNCTIONAL INVESTIGATIONg) FUNCTIONAL INVESTIGATION –RESPIRATORY TESTS –ECG, EEG, EMG etc –EXERCISE h) RADIOLOGYh) RADIOLOGY –RADIOGRAPHY, RADIOSCOPY –CT (computer-tomography) –NMR (nuclear magnetic resonance), PET –ECHOGRAPHY i) PATHOLOGYi) PATHOLOGY j) CLINICAL LABORATORYj) CLINICAL LABORATORY

15. PHARMACYPHARMACY –MEDICATION RECORDS –RECEIT VERIFICATION –PROVIDING INFORMATION FOR: DOCTORS, NURSESDOCTORS, NURSES CENTRAL LEVELCENTRAL LEVEL –PROVISIONING –STOCK RECORDS, VALIDITY –PREPARATION –SUPPLIERS

18. 4. HOSPITAL INFORMATION SYSTEM (HIS) 4.1. DATA TYPES:4.1. DATA TYPES: –PATIENT or HOSPITAL oriented 4.2. H.I.S. CONCEPT4.2. H.I.S. CONCEPT –a) SCOPE: computer use for information collecting, storing and processing for patient care and management in all hospital activities and for functional requirements. –b) COMPONENTS: 1. DATA BASE1. DATA BASE 2. APPLICATIONS (programs)2. APPLICATIONS (programs) 3. COMMUNICATION LAYER3. COMMUNICATION LAYER 4. WORKING TERMINALS4. WORKING TERMINALS

19. 4.3. HIS ARCHITECTURE4.3. HIS ARCHITECTURE –a) TYPES: MONOLITIC SYSTEMSMONOLITIC SYSTEMS EVOLUTIVE SYSTEMSEVOLUTIVE SYSTEMS DISTRIBUTED SYSTEMSDISTRIBUTED SYSTEMS –b) STRUCTURE: SCHEME 1SCHEME 1 4.4. INTEGRATED SYSTEM4.4. INTEGRATED SYSTEM SCHEME 2SCHEME 2 4.5. Examples of H.I.S.:4.5. Examples of H.I.S.: –HISCOM (The Netherlands) –DIOGENE (Switzerland)

20. Hospital Network Gateway Cardiology Nefrology Surgery Obstetrics-Gynecology Pediatrics Psychiatry Laboratory Radiology Funct.Investig. Pharmacy ICUManager Supply.Account. H.I.S. STRUCTURE Clinical Dep. - CD ParaClinical Dep. PC Manag. Dept.s. ADM PACIENT oriented data HOSPITAL oriented data

21. Internet, Email Connections INTEGRATED H.I.S. Academic Network Library Network Primary Care Network Research Network Hospital Network Gateway Family doctors (Gen.Pract.) Class rooms Documentation Server Users Research Laboratories Network Administrator CD PC ADM.

22. 4.6. ACCESIBILITY AND PROTECTION4.6. ACCESIBILITY AND PROTECTION 4.7. MANAGEMENT4.7. MANAGEMENT 4.8. RESEARCH4.8. RESEARCH 4.9. FUTURE DEVELOPMENT TRENDS4.9. FUTURE DEVELOPMENT TRENDS

23. 5. CENTRAL LEVEL HEALTH INFORMATION SYSTEMS 5.1. DEPARTMENTAL HEALTHCARE OFFICES5.1. DEPARTMENTAL HEALTHCARE OFFICES 5.2. MINISTERIAL LEVEL5.2. MINISTERIAL LEVEL –HEALTHCARE MINISTERY –OTHER MINISTERIES, CENTRAL INSTITUTIONS 5.3. INTERNATIONAL LEVEL COMPATIBILITY5.3. INTERNATIONAL LEVEL COMPATIBILITY

24. 6. STANDARDISATION6. STANDARDISATION –standard attributes 7. DATA PROTECTION7. DATA PROTECTION –a) CONFIDENTIALITY - limited, leveled accessibility –b) PROTECTION - against accidental deterioration / access / loss –c) SECURITY - intended d/a 8. RESPONSIBILITIES8. RESPONSIBILITIES –ethical and legal aspects in medical informatics

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