ELECTRONIC PATIENT RECORD system AT THE DEPARTEMENT OF BIOINFORMATICS macedonian academy of sciences and arts Biljana Gjoneska1 and Sofija Pop-Jordanova2 1 Macedonian Academy of Sciences and Arts, Skopje, R . Macedonia 2 South East European University, Skopje, R. Macedonia

department of bioinformatics: The profile Location - Macedonian Academy of Sciences and Arts (MANU) - Research Center for Energy, Informatics and Materials (ICEIM) - Skopje, R. Macedonia Foundation - ICEIM: 1986 - Department of Bioinformatics: 2001 as result of the “Zafir Sarafov” donation Personnel - 2 Academicians, 2 Professors, 4 Researchers Macedonian Academy of Sciences and Arts Department of Bioinformatics

department of bioinformatics: The profile Purpose To perform research activities in the field of fundamental as well as applied neuroscience. Projects Currently, the Department is involved in 6 international and 1 domestic project. Since 2005 the Center has been the residence of the multi-disciplinary EU COST Action “Electrical Neuronal Oscillations and Cognition”, with participation of more then 80 scientific institutions from 27 countries from all continents, being the first such European project managed outside the EU. International Summer School in Health Informatics (ISSHI 2008) 20-24 June 2008 Ohrid, Macedonia

department of bioinformatics: The main research lines Examining the correlation between the brain electric oscillations and the mental state indexes as quantitative indicators of different cognitive and behavioral disorders Exploring the specific role of mental arousal, as a background state of consciousness related to short-range long-time neuronal activations, including application of spectrum-weighted frequency (brain-rate), as arousal indicator and neurofeedback parameter Investigating the mechanism and properties of synchronization in mutually coupled periodic and/or chaotic oscillators within networks with different topologies and forms of clustering and defining the main features that characterize neuronal synchronization

department of bioinformatics: ORGANIZATION OF WORK FUNDAMENTAL RESEARCH ACTIVITIES EXPLORING SCIENTIFIC PHENOMENA OF INTEREST PARTICIPATING IN ONGOING RESEARCH PROJECTS PREPARING SCIENTIFIC PAPERS AND PROJECT PROPOSALS. APPLIED RESEARCH ACTIVITIES WORKING WITH VARIOUS PROFILES OF PEDIATRIC PATIENTS IN COLABORATION WITH PSYCHOPHYSIOLOGY DEPARTMENT - PEDIATRIC CLINIC, SKOPJE, R. MACEDONIA. SUBJECT OF INTEREST AND FURTHER ANALYSIS IN THIS PRESENTATION

INCEPTION APPLIED RESEARCH ACTIVITIES: DECRIPTION Involved Professionals Pediatrician General Practitioners Clinical Psychologist Senior and Junior Research Investigator Medical Nurses Involved Pathologies: Psychosomatic, behavioral, elimination and eating disorders Anxiety/phobic, sleeping and post-traumatic stress disorders Ticks and stuttering Attention deficit hyperactivity disorders

INCEPTION APPLIED RESEARCH ACTIVITIES: DECRIPTION Procedures: Diagnostics: Basic medical investigation (patient history and physical examination), psychological assessment (patient interviews and tests), neurological evaluation (quantitative EEG, evoked potentials and event related potentials). Treatment: Psychotherapy, drug Therapy, Individually adjusted neurofeedback protocols. Equipment: Quantitative electroencephalograph (EEG), electromyograph (EMG), as well as tools for monitoring of blood volume pulse, body surface temperature and skin conductance. Pop-Jordanova S., Gjoneska B., Electronic Patient Record System August, 2008

INCEPTION APPLIED RESEARCH ACTIVITIES: analysis Weaknesses Time-consuming, manual administrative procedures (appointment registration, creation and maintenance of patient record files) Lack of effective interaction between involved professionals Lack of coordination between involved professionals Lack of results integration and integrated approach Result SLOW, INEFFECTIVE, UNPRODUCTIVE AND EXPENSIVE WORK WITH PATIENTS Useful Modifications REPLACEMENT OF MANUAL PROCEDURES WITH AUTOMATED ONES. CREATION OF SYSTEM FOR CREATION AND MAINTENANCE OF PATIENT RECORD

ELABORATION APPLIED RESEARCH ACTIVITIES: OVERVIEW OF USE-CASES              PATIENT MAKES APPOINTMENT FOR INITIAL CHECK Patient Operator Nurse Pediatrician N URSE REGISTERES THE PATIENT Patient Nurse DOCTOR SETS LIST OF FURTHER INVESTIGATIONS AFTER INITIAL Patient Nurse Pediatrician PATIENT MAKES APPOINTMENT AT THE PSYCHOLOGIST Patient Operator Psychologist Nurse

ELABORATION APPLIED RESEARCH ACTIVITIES: OVERVIEW OF USE-CASES             PSYCHOLOGIST SETS DIF. DIAGNOSIS AFTER EXAMINTAION Patient Nurse Psychologist PATIENT MAKES APPOINTMENT WITH THE RESEARCH INVESTIGATORS Patient Operator Senior Res. Investigator Junior Res. Investigator RESEARCH INVESTIGATORS SETS DIF. DIAGNOSIS AFTER EXAMINATION Patient Junior Res. Investigator Senior Res. Investigator DOCTOR SETS FINAL DIAGNOSIS Patient Pediatrician THIS CONCLUSIVE USE CASE IS CHOICE FOR FULL ELABORATION

ELABORATION USE CASE: DOCTOR SETS FINAL DIAGNOSIS Description This use-case presents all actions necessary for conclusion of the final diagnosis by the responsible pediatrician, systematized in chronological order as an event flow. Pre-conditions - Finalizing initial interview as well as physical examination and formulating list of further investigations by various specialists - Finalizing investigations by the specialists, registering obtained results into the system - Registering given differential diagnosis from the specialists into the system Post-condition The responsible pediatrician will set the final diagnosis. Pop-Jordanova S., Gjoneska B., Electronic Patient Record System August, 2008

DESIGN CLASS DIAGRAM: DOCTOR SETS FINAL DIAGNOSIS PEDIATRICIAN ID Name Date of Birth Address PATIENT ID Name Date of Birth Address DOCTOR ID Name Date of Birth Address NURSE ID Name Date of Birth Address 1 1 1 1 * 1 * * GENERAL PRACTICIONER ID Name Date of Birth Address 1 * 1 * 1 * 1 * 1 1 TESTS ID Name Date Duration Investigator RESULTS ID Name Date Investigator APPOINTMENT ID Name Date Duration Investigator OPERATOR ID Name Date of Birth Address RESEARCH INVESTIGATOR ID Name Date of Birth Address

DESIGN SEQUENCE DIAGRAM: DOCTOR SETS FINAL DIAGNOSIS PATIENT RECORD SEARCH FORM LIST WITH PATIENT RECORDS THE PATIENT RECORD RECORD SCREEN PRINTER  GET FILE (X) GET RECORD CREATE GET ANAMNESIS PRINT ANAMNESIS GET RESULTS FROM PHYSICAL EXAMINATION PRINT PHYS. RESUL GET RESULTS FROM PSYCHOLOGICAL TESTING PRINT PSY. RESUL. GET RESULTS FROM EGG INVESTIGATION PRINT EEG RESUL. Pop-Jordanova S., Gjoneska B., Electronic Patient Record System August 2008 SET FINAL DIAGNOSIS