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Information Technology in Healthcare
Dr Keith Boardman
Director of Computer & Network Services
University Hospitals Coventry & Warwickshire NHS Trust
The NHS as a Business
National Health Service Formed in 1948 Employs 1 million people 500 health authorities Costs £37 billion Treats 8.4 million in-patients a year About 3 million day-cases a year 40 million out-patient attendances 30,000 GPs
UHCW NHS Trust
Acute Trust with 1246 beds11 Regional SpecialitiesMeets 98% of Coventry & Rugby acute
healthcare needsContract Income £200M approx.6000 employees
Urology General Surgery Ear Nose & Throat Ophthalmology Oral Surgery Orthopaedics Rheumatology Dermatology General Medicine GP Maternity Gynaecology Special Care Baby Unit Paediatrics Obstetrics
Cardiac Surgery Thoracic Surgery Cardiology Renal Transplantation Renal Dialysis Neurology Neurosurgery Radiotherapy Bone Marrow Transplantation Haemophilia Services Neonatal Intensive Care
General Specilaties Regional Specialties
In-patient attendances - 90,000 Out-patient attendances - 306,000 Emergency assessments - 27,000 Accident Dept attendances - 103,000 Pathology requests - 865,000 Radiology Examinations - 207,000 MRI & CT Scanning - 13,000 Patient meals - 1,400,000 Staff meals - 744,000
Activity Levels
Computers in HealthcareKey application areas:Information ManagementTreatmentDiagnosis
Information ManagementHospital Administration SystemsCommunity & GP SystemsClinical Information SystemsBusiness Systems
Hospital Information SystemsA HIS meets the real-time operational information needs of health professionals to deliver care to patients, whilst also providing accurate and timely information for management purposes.
HIS Benefits Improved care and delivery of services
provided to patients Reduced administrative work Better information for resource
management
HIS Functional areas(used by 1500 staff)
Patient Administration Admissions, Discharges and Transfers Accident & Emergency Maternity Operating Theatres Professions Allied to Medicine Case Note Tracking Contracting & Billing
HIS Computer System:HP9000/K460 running UNIX•2 G Byte RAM
•100 G Byte disk storage (RAID)
•128 V24 ports
•IEEE 10/100 MHz Ethernet
•Cartridge Magnetic Tape
•DLT Magnetic Tape
Radiology Clinical DocumentationPathology
Clinical Information SystemsClinical Information Systems
Clinical InformationSystem
Intranet &Internet
HIS HP9000
CommunityHP 9000
Breast Scr’HP 9000
PathologyRS6000
PharmacyRS6000
RadiologySun
RenalHP 9000
MIS General E-Mail
Computer Systems Overview
PC ClientAccess
Local Area Network (with ATM backbone)
HIS
Pathology System Radiology
InterfaceEngine
Clinical System(Data Warehouse)
Local Area Network (with ATM backbone)
PC ClientAccess
DATA INTEGRATION
SecureGateway
NHSnet Intranet
Internet
Wide Area NHS Communications
Information for Health
An Information Strategy for the Modern NHS 1998-2005
Top level commitment
“The challenge for the NHS is to harness the information revolution and use it to
benefit patients”.
Rt. Hon. Tony BlairAll Our Tomorrows Conference 2 July 1998
Purpose of the strategy
. . . . to put in place over the next seven years the people, the resources, the
culture and the processes necessary to ensure NHS clinicians and managers
have the information needed to support the core purpose of the NHS. And to ensure the public and patients have a range of quality information easily accessible about health and
health services.
Treatment and care
Primary careEHR
PublicPatientsHealthcare professionalsManagers
Knowledge for
Public healthClinical GovernanceHealth Improvement ProgrammePerformance management
Analysis
Socialcare
records
NHSTrustEPR
Defining electronic records Electronic Patient Record - a record of
periodic care provided by one institution, typically an acute hospital
Electronic Health Record - the concept of a longitudinal record of a patient’s health and healthcare to combine information from primary healthcare with periodic care from other institutions
4 Key Pieces of the Strategy
Better Practice Systems +Electronic Health Record
( EHR )
Better Hospital Systems +Electronic Patient Record
( EPR )
National ElectronicLibrary of Health
( NELH )
INFRASTRUCTURE(wires,security,standards)
CRRS: Logins Per Week
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Week Ending
Co
un
t
Computers in Healthcare
Key application areas:
Information Management
Treatment
Diagnosis
Computers used in TreatmentRadiotherapyIntensive CarePatient Communication AidsProtheses
Computers in Healthcare
Key application areas:
Information Management
Treatment
Diagnosis
Computers used in DiagnosisComputerised TomographyMagnetic Resonance ImagingUltrasonicsRadioisotope Imaging
MedicalImaging
Computerised Tomography
Intracranialhaematoma
Renaltumour
Magnetic Resonance ImagingProtons in a magnetic field have a microscopic magnetization and act like tiny toy tops that wobble as they spin. The rate of the wobbling or precession is the resonantor Larmor frequency. In the magnetic field of an MRI scanner there is approximately the same number of proton nuclei aligned with the main magneticfield as counter-aligned.On a macroscopic level, exposure of an object or personto RF radiation at the Larmor frequency, causes the net magnetization to spiral away from the static field.Relaxation is the process whereby nuclear magnetization returns to its resting state following a perturbation, such as by an RF pulse.
An MRI Scanner
Magnetic Resonance Imaging
Lumbar Spine
KneeAnatomy
Baker’sCyst
Ultrasound Imaging
Ultrasound Imaging System
Pregnancy
Triplets
Liver carcinoma
Nuclear Medicine Imaging
ConventionalRadiography
Gamma Camera:Pulmonary Embolism
THE END