What does “System” mean? A system is a group of interrelated components working together toward a common goal by accepting inputs and producing outputs in an organized transformation process.

An information system : Is a collection of people, procedures, software, hardware, and data.They all work together to provide information essential to running an organization. (as we discussed in chapter 1). An information system, that combines a computer-based patient record with other modules that support clinical workflow is called a hospital information system (HIS).

InputOutput Memory Control Hardware Software PeopleData Procedure

A Hospital Information System (HIS): -Is a comprehensive, integrated information system designed to meet all the information needs within a hospital. -It can be composed of one or a few software components with specialty- specific extensions as well as of a large variety of sub-systems in medical specialties.

Applications: A hospital information system has many different aspects incorporated within itself. Technology allows for the information within these systems to flow more easily and more accurately. Some of these systems include: 1- Laboratory Information System (LIS) 2- Nursing Information System (NIS) 3-Picture Archiving Communication System (PACS) 4-Radiology Information System (RIS) 5-Pharamacy Information System (PIS) 6-Adminstration Information System. 7-Financial Information System (FIS)

Common Features:- * Patient Registration and scheduling. * Patient List Management. * Interface with different modalities. * Department workflow management. * Requesting. * Result(s) Entry. * Reporting and printout. * Patient Tracking. * Modality and Material management. * Information storage and backup.

Advantages of HIS include: 1-Improved quality of patient care. 2-Improved communications within the hospital. 3-Increased productivity. 4-Reduced chances of errors. 5-Reduced costs.

-Medical record, health record, or medical chart: -Is a systematic documentation of a patient's medical history and care. -Traditionally, medical records have been written on paper and kept in folders. -An electronic health record (EHR) refers to an individual patient's medical record in digital format.

-Medical record, health record, or medical chart: -Electronic health record systems co-ordinate the storage and retrieval of individual records with the aid of computers. -EHRs are usually accessed on a computer, often over a network. -It may be made up of electronic medical records (EMRs) from many locations and/or sources. -Among the many forms of data often included in EMRs are patient demographics, medical history, laboratory test results, radiology images, billing records and advanced directives.

Advantages of EHRs over paper-based records: Complete patient data displayed in an integrated fashion that facilitates medical decision making. Access from any workstation in the hospital. Ability to enter orders, notes, data at same workstation. No double entry of information. Immediate availability of results. Simultaneous users can access same medical record. Access from on site or remote locations. No loss of patient information.

Nursing Information System: -Information system that supports the use and documentation of nursing processes and provides tools for managing the delivery of nursing care. -It collects, stores, processes, retrieves, display, and communicate timely information needed in nursing practice, education, administration, and research.

Patient Charting: A patient’s vital signs, admission and nursing assessments, care plan and nursing notes can be entered into the system either as structured or free text. These are the stored in a central repository and retrieved when needed. Clinical Data Integration: Here clinical information from all the disciplines can be retrieved, viewed and analyzed by nursing staff and then integrated into a patient’s care plan. Decision Support: They provide prompts and reminders, along with guides to disease linkages between signs/symptoms, etiologies/related factors and patient populations. Staff Schedules: Nurse can self schedule their shifts using scheduling rules provided in shift modules.

Radiology Information System (RIS): -The RIS is a computerized system used by radiology departments to store, manipulate and distribute patient radiological data and imagery. -A modern Radiology Information System (RIS) is a pre- requisite for the efficient management of a department of Radiology.

-The system generally consists of patient tracking and scheduling, result reporting and image tracking capabilities. -Used to support both administrative and clinical operations. -RIS complements HIS (Hospital Information Systems) and are critical to efficient workflow to radiology practices.

Simple Workflow within RIS: -A clinician orders a radiographic exam using the Hospital Information System (HIS). -Within minutes, the order subsequently appears at the modality in a list of patients requiring radiographs that day. -The radiology technicians select the appropriate patient from the list and conducts the study. -Once the images are generated, they are sent to a central local server and the exam is automatically completed and charged in the HIS.

-By simply clicking the ‘‘view images’’ button under the images tab in the HIS the images appear in an easy to use browser- based medical image viewer, or on a Digital Imaging and Communications in Medicine (DICOM) workstation program on the local computer. -In addition, the images and reports are accessible from anywhere inside the local area network (LAN) and also potentially available outside the clinic network via the world wide web.

DICOM Images: -DICOM stands for Digital Imaging and Communications in Medicine. -It’s a standard protocol for the transferring, displaying, and storing of medical images data. -Most modern imaging machines are capable of producing DICOM images.

DICOM Viewer: -Is a specialized application software enables you to open, process, and interpret DICOM images. -There are a lot of DICOM Viewer applications available. -MicroDicom (Free). -RadiAnt.

The Basic requirements of a DICOM workstation are as follows: -The ability to query and send image files to multiple DICOM devices, including other workstations; -The capability to manipulate images (window/level, magnification, measurements, annotation, stack scroll, Invert, rotate, etc.); -A HIS/Radiology Information System (RIS) interface to link reports to the images; -The ability to import/export other image types, such as jpeg, and convert them to DICOM; -The functionality to allow dual monitor viewing; -The ability to print DICOM images.

Picture Archiving and Communication System PACS: What is PACS? -PACS refers to the host of technologies that contribute to the creation, distribution, and archiving of digital images. -Data workflow within PACS: Acquiring data from modalities Storing data in an achiever Viewing it in a workstation

-Typical PACS components include: 1- A digital imaging modality or device 2- A network. 3-An archive device. 4-diagnostic workstations. 5-Archive/routing software, and 6-Some interplay with the hospital or radiology information system.

Potential Benefits of PACS: a. Increased connectivity and integration between facilities and departments. b. Productivity improvements (less time spent looking for misplaced radiographs or ultrasound images, less time spent hanging/removing films, less time distributing films). c. Simultaneous viewing of the same images in multiple locations. d. Better image quality than analog film or thermal prints. e. Provides an avenue for rapid consultation with specialists.

Laboratory Information system LIS: - A lab information system ("LIS") is a class of software that receives, processes, and stores information generated by medical laboratory processes. -These systems often must interface with instruments and other information systems such as hospital information systems (HIS). -Disciplines of laboratory science supported by LIS' include hematology, chemistry, immunology, blood bank (Donor and Transfusion Management), surgical pathology, anatomical pathology, flow cytometry and microbiology.

In summery, the Uses of computer in the hospital can be categorized into: 1- Handling and processing Medical Data. 2- Decision support. 3-Medical education. 4-Medical searches. 5- Monitoring.