1. Information Systems in Medicine
Lections №3

2. Main Questions Information Systems Basics.
Medicine-Related Information Systems

3. 1. Information Systems Basics
Information systems definition
Applications of IS
Areas of IS work
Information technology (IT)

4. 1.1. Information system definition
An Information System (IS) is the system of persons, data records and activities that process the data and information in a given organization, including manual processes or automated processes;
The computer-based information systems is only the Information technologies component of an Information System;
The computer-based information systems are the field of study for Information technologies (IT)

5. 1.2. Applications of IS
Information systems deal with the development, use and management of an organization's IT infrastructure;
The biggest asset of companies today, is their information, represented in people, experience, know-how, innovations (patents, copyrights, trade secrets), and for a market operator to be able to compete, he/she must have a strong information infrastructure.

6. 1.3. Areas of IS work
Information Systems has a number of different areas of work:
Information Systems Strategy
Information Systems Management
Information Systems Development
Each of which branches out into a number of sub-disciplines

7. 1.4. Information technology (IT)
Information technology (IT) is the study, design, development, implementation, support or management of computer-based information systems, particularly software applications and computer hardware.
Information Technology Association of America (ITAA).
IT deals with the use of electronic computers and computer software to convert, store, protect, process, transmit and retrieve information, securely.

8. 1.4. Information technology (IT)
Today, the term IT has ballooned to encompass many aspects of computing and technology, and the term is more recognizable than ever before.
IT professionals perform a variety of duties that range from installing applications to designing complex computer networks and information databases.
A few of the duties that IT professionals perform may include data management, networking, engineering computer hardware, database and software design, as well as the management and administration of entire systems.

9. 2. Medicine-Related Information Systems
Hospital Information System
Radiology Information System
Laboratory information system
Laboratory information management system
Dentistry information systems
Picture archiving and communication system

10. 2.1. Hospital Information System
A hospital information system (HIS), variously also called clinical information system (CIS) is a comprehensive, integrated IS designed to manage the administrative, financial and clinical aspects of a hospital.
This encompasses paper-based information processing as well as data processing machines.

11. 2.1. Hospital Information System
The aim of an HIS is to achieve the best possible support of patient care and administration by electronic data processing:
more efficient use of the restricted resources available for patient care;
qualitative improvement of the service to the patient;
support of research;
support of teaching;

12. 2.1. Hospital Information System
CISs are sometimes separated from HISs in that the former concentrate on patient-related and clinical-state-related data (electronic patient record) whereas the latter keeps track of administrative issues.
The distinction is not always clear and there is contradictory evidence against a consistent use of both terms.

13. 2.1. Hospital Information System
As an area of medical informatics the aim of an HIS is to achieve the best possible support of patient care and administration by electronic data processing.
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 (e.g. Laboratory Information System, Radiology Information System).

14. 2.1. Hospital Information System
Computers in clinical departments are generally used for the following tasks:
Administrative support - the administrative and logistic planning of patient care and interventions.
Patient data collection - the acquisition, storage, and retrieval of patient data, examinations, biosignals, and images; the real-time reduction and verification and the coding and processing of patient data; and the integration of all patient data into one comprehensive presentation.
Decisions. Simulation of interventions by using models, the support of diagnostic and therapeutic decision making.
Monitoring. The monitoring and assessment of therapy (drug therapy).
Reporting. Generation of reports, for example, after the discharge of the patient from the hospital or when referring patients to other clinicians.
Assessment. Evaluation of the effect of the care that was provided on patient outcome.

15. 2.1. Hospital Information System
Bellow shown general stages in the HIS evolution:
Isolated Applications
Monolithic Systems
Evolutionary Systems
Composable Systems

16. 2.1. Hospital Information System
There are three types of integration can be distinguished:
Data integration - means that data registered in one application are available to another application, if necessary and provided that it is not conflicting with confidentiality. This prevents repeated recording of the same data and reduces the risk of mistakes .
Presentation integration implies that data from various applications are presented to the user in an adequate and consistent way. Especially for dynamically changing data, this is not self-evident.
Functional integration means that functions of different applications are available to the qualified user within one user environment

17. 2.1. Hospital Information System

18. 2.1. Hospital Information System

19. 2.2. Radiology IS
A Radiology Information System (RIS) is used by radiology departments to store, manipulate and distribute patient radiological data and imagery.
Basic Features of RIS:
Patient Registration;
Patient Scanning;
Result(s) Entry;
Reporting;
Result(s) Delivery including faxing and ing of clinical reports;
Patient Tracking;

20. 2.2. Radiology IS

21. 2.3. Laboratory information system
A lab information system (LIS), is a class of software which handles receiving, processing and storing information generated by medical laboratory processes.
These systems often must interface with instruments and other information systems such as hospital information systems (HIS).

22. 2.3. Laboratory information system
An LIS is a highly configurable application which is customized to facilitate a wide variety of laboratory workflow models.
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.

23. 2.3. Laboratory information system
Basic features of the LIS:
Laboratory Information Systems commonly support the following features:
Patient Check In
Order Entry
Specimen Processing
Result(s) Entry
Reporting
Patient Demographics
Physician Demographics .

24. 2.4. Laboratory information management system
A "Laboratory Information Management System" (LIMS) is computer software that is used in the laboratory for the management of samples, laboratory users, instruments, standards and other laboratory functions such as invoicing, plate management, and work flow automation.
The difference between LIMS and LIS that primary are generally targeted toward environmental, research or commercial analysis, such as pharmaceutical or petrochemical, and second are targeted toward the clinical market (hospitals and other clinical labs).

25. 2.4. Laboratory information management system
The goal of implementation the LIMS is to create a seamless organization where:
Instruments used are integrated in the lab network; receive instructions and worklists from the LIMS and return finished results including raw data back to a central repository where the LIMS can update relevant information to external systems such as a Manufacturing Execution System or Enterprise Resource Planning application.

26. 2.4. Laboratory information management system
The goal of implementation the LIMS is to create a seamless organization where:
Lab personnel will perform calculations, documentation and review results using online information from connected instruments, reference databases and other resources using electronic lab notebooks (ELN's) connected to the LIMS.

27. 2.4. Laboratory information management system
The goal of implementation the LIMS is to create a seamless organization where:
Management can supervise the lab process, react to bottlenecks in workflow and ensure regulatory demands.
External participants (department, etc.) can place work requests and follow up on progress, review results and print out analysis certificates and other documentation.

28. 2.5. Dentistry information systems

29. 2.5. Dentistry information systems

30. 2.6. Picture archiving and communication system
In medical imaging, picture archiving and communication systems (PACS) are computers or networks dedicated to the storage, retrieval, distribution and presentation of images.
The medical images are stored in an independent format.
The most common format for image storage is DICOM (Digital Imaging and Communications in Medicine).

31. 2.6. Picture archiving and communication system
Sample patient record view from an image-based electronic health record (VistA).

32. 2.6. Picture archiving and communication system
A PACS allows to store volumic exams and to reconstruct 3D images

33. 2.6. Picture archiving and communication system
PACS replaces hard-copy based means of managing medical images, such as film archives.
It expands on the possibilities of such conventional systems by providing capabilities of off-site viewing and reporting (distance education, telemedical uses).
Additionally, it enables practitioners at various physical locations to access the same information simultaneously (telemedical uses).

34. 2.6. Picture archiving and communication system
The most difficult area for PACS is interpreting the DICOM image format.
A feature common to most PACS is to read the metadata from all the images into a central database.
This allows the PACS user to retrieve all images with a common feature no matter the originating instrument.
The differences between vendors' DICOM implementations make this a difficult task.

35. 2.6. Picture archiving and communication system

36. 2.6. Picture archiving and communication system
A full PACS should provide a single point of access for images and their associated data (i.e. it should support multiple modalities).
It should also interface with existing hospital information systems: Hospital information system (HIS) and Radiology Information System (RIS).

37. 2.6. Picture archiving and communication system
Interfacing between multiple systems provides a more consistent and more reliable dataset:
Less risk of entering an incorrect patient ID for a study – modalities that support DICOM worklists can retrieve identifying patient information (patient name, patient number, accession number) for upcoming cases and present that to the technologist, preventing data entry errors during acquisition.

38. 2.6. Picture archiving and communication system
Interfacing between multiple systems provides a more consistent and more reliable dataset:
Data saved in the PACS can be tagged with unique patient identifiers (such as a social security number or NHS number) obtained from HIS. Providing a robust method of merging datasets from multiple hospitals, even where the different centers use different ID systems internally.

39. 2.6. Picture archiving and communication system
An PACS interface can also improve workflow patterns:
When a study has been reported by a radiologist the PACS can mark it as read. This avoids needless double-reading. The report can be attached to the images and be viewable via a single interface.
Improved use of online storage and nearline storage in the image archive. The PACS can obtain lists of appointments and admissions in advance, allowing images to be pre-fetched from nearline storage (for example, tape libraries) onto online disk storage (RAID array).

40. Conclusion In this lecture was described next questions:
Information Systems Basics.
Medicine-Related Information Systems

41. Literature Electronic documentation on to the TDMU server: