International IT Institutes

8/14/2019 International IT Institutes

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International IT Institutes

IISSAASSRREEPPOORRTT

IsasTitle:IT advances have opened

11/2009

Coordinator : Mrs.Thm

Student: PPhhaann AAnnhh cc NNgguuyynn VVnn HHuuyy NNgguuyynn TThhnnhh TTrruunngg NNgguuyynn TThhnnhh TTrruunngg

Group : 5Batch : MMS0908Quarter : 1


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Isas NIIT ThangLong IT advances have opened

Group 5 MMS0908 Page | 3

CERTIFICATE

This is to certify that this report Multimadia Setup embodies the originalwork done by Group5in partial fulfillment of the course requirement atNIIT.

Coordinator: Mrs.Thm


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AACCKKNNOOWWNNLLEEDDGGEEMMEENNTT

I have benefited a lot of from the feedback and suggestion given to us byMrs.Thm and other faculty members.


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Music

Referred to entertain, first day we think of music. Just as this, music is second can not lack in the livesof anyone in our . from ancient times, music has been present in the lives of each person, it helps

reduce the pressure at work, hard to dispel, allowing each person the spirit back to nature, about thesoul in light of his. Over time, the entertainment became more plentiful, today thanks to the remarkable

development of information technology we have many sources and different entertainment but music isalways the first choice. To meet the needs of the people's music must also constantly developed to suit

each time . as well as many other areas of information technology has helped develop the music andbring it to close to people than ever before.

Previously, the information industry is not the birth of hearing a song by his favorite singer presentsdifficult is even luxury, as well as the scope of influence of singer and abandoned in a narrow

geographical range of specific, health spread of the song and music is limited to very .History, we want

to hear a Song Bac Ninh is one of them to swim to the country's Sunset the "instant he, instant sisters"

to the Lim festival of the fall or wait for the songs they sing sea to enjoy the tone of their lanes clear,

bold nature rustic villageBut as the days that people can only save the Song through my mind, and of course those of their

distant country known to be the Song of the light, simple to store since . Keep all of them or the onlyword of mouth, long and gradual loss of the original lyrics of it, also the vocal enchantment of the heart

can only be remembered in the mind and enjoy the time . It has everything else, we eventually have thetechnology to change perceptions as well as how to enjoy his music. . Since 1965, the common

cassette tape music began selling the market, at first could only play the audio quality mono (singlechannel, single speaker), but since 1966 has cassette tape stereo (multi-channel ) [2].


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MMuussiicc

Started, by having in hand the cassette tape and machines that had been the favorite songs by the

artist expressed his love, the rest we need to do is for the machine you want to listen to the tape andpress machine will play the notes left for us to enjoy all your favorite things before we get , and thus

the music closer to the listener, the singer known more, old songs as well as vocalist gold is storedfor later generations, and from this music really is about how it was connecting time and space.

But industry where it stopped growing and many new improvements to the many cassette machinesequipped with Dolby soy filter system to filter the noise, soy arising from the radio cassette tape. In

1979, Sony built a Sony Walkman, portable cassette player and small thereby helping more commonuse of the information Cassette. course, over time needs to enjoy music more and more people

become so hard over, while the machine cassette revealed several disadvantages if used to happen to

the situation with your home, or your "balance" if the wheels were pressed by the machine path, overagain for convenience when moving must carry with free play and real . Over time technologicaldevelopment rushing other new player, also advanced to continuous life-time development the

development of information technology as other mp3 players. MP3 format appeared in the late 1990shas allowed music fans can gather and listen to hundreds of digital music. But the songs that are still

stored on the computer. Limited capacity of former biggest problem with the MP3 first. Theseproducts often have storage capacity of 32MB or 64MB, hardly enough to store an audio CD fulllength. In 2000, flash memory card was born to meet the needs archive music on mobile devices

dong. 2002, mp3 video display and the first born. 2004, color screen has become popular in the MP3device to create a turning point for the great music of all . course, the player based on flash memory

as the iPod Shuffle is there small size, cheap and no display still more lovers. Player's first touch

screen appeared on the market in 2007.The system is the first iPod Touch 16GB storage and touchscreen 3.5-inch. Samsung also introduced MP3 touch screen devices YP-P2 response capacity 16GBand Bluetooth connectivity. In 2008, the MP3 player is designed with traditional wide screen and the

buttons are easy to use .2009, the MP3 devices today have features such as Wi-Fi, integrated browserWeb, video games, listening stations, applications (about Apple's App Store application work with

iPod Touch) and the ability to play content stored on external devices such as TV or stereo. OtheriPod models that support S-Video to connect to the TV. Zune HD was introduced from September

and a competitor to Apple's iPod Touch. Products with OLED touch screen, storage capacity to32GB, Wi-Fi and the adjustment of HD radio.


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MMuussiicc

In addition to the portable player's development of information technology music lovers also enjoy

the music style you want with specialized equipment dung.1 how to listen now that people love islisten to music online on how to listen website. Day is very active, just type the name of listeners

want to hear songs that had been his favorite song to suffering but to find a CD or tape collectionthat song .

Now, thanks to information technology that the music has evolved over the .Music to listen to thepeople closest to the various ways that this by actively listening to all of your music listening style.

Future development direction

Many experts believe that about 11 years, we could use up to 50th

generation iPod and can see 3D

video.Industry of online music will develop me. Will change the style of many people listen to musicAfter about a decade to appear on the market, MP3 devices are starting to not purchase items in the

list of users. Not because the device is not useful today, people tend to download music and listendirectly on the phone rather than carrying two devices to simultaneously. As in the case of Apple,although the iPod is still "the golden egg," iPhone sales are considered "the bitter sweet" to them for

each iPhone sold usually mean customers will not buy iPod anymore.The appearance of memory card, DVD and music industry are making online sales of CDs decline.

When lower bandwidth charges and faster Internet connections, CD will be difficult to place


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Cinema

Historical film is the process of the birth and development of cinema from the late 19th century untilnow. After more than 100 years of establishment and rapid development, the film from a new form

of entertainment merely become a tool of art and media, entertainment and most important of modernsociety .

According to the Guinness record for film recording motion pictures first known today as the moviewas filmed Roundhay Garden Scene with the speed of 12 frames per second in Leeds, England in

1888.

Film quickly became a minor novelty entertainment department became a film projection boothindispensable in large fairs. Where it is often a slideshow of the one-minute short film, depicting

scenes of daily living or sports activities. Although the film has never been editing, attention to theback corner or simply do not know how a director, the film is still popular and create conditions for

developing a strong film in the next century that.Until the late 1920s, almost all Hollywood films are already free. Sound quickly to help the film

become attractive and appealing than the audience, also put the movie studios to small spot to beclosed because not enough capital cost to the system recorded for the film. Sound is one reason

American film through the Great Depression and entered the heyday (The Golden Age ofHollywood) with a series of great films come out, it comes with a series of super - I like Greta

Garbo, Clark Gable, Katharine Hepburn or Humphrey Bogart.Sound has made the process of film production must change fundamentally, the voice of the

screenplay is more elaborate, the actors must also be familiar with both the acting could have readthe phone, The birth of music and noise can lead to the formation of a new genre, typically with the

musical film The Broadway Melody (1929) or the American film Le Million (1931) directed by the

French school of super - to Ren Clair. Following the sound, big step Monday technical film is thefilm color . 1965, with the introduction of universal type super 8 camera by Kodak production,cinema of the amateur artist was born. Step latest film at the end of the 20th century is applied to

digital cinema, from the use of digital camera to the Digital Magic staged film and sound on yourcomputer.


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Cinema

Many famous films, attracting audiences than content, also resort to technical tricks film, such asTitanic, dinosaur park, Pearl Harbor, Egyptian Mummy, The Hung ... What Digital Magic film used

to do?A simple method most countries cinema development was ever used. If a scene needs a high-rise

buildings caught fire, people will create a model exactly like real buildings, and use camera anglesand lighting to the model was shot in flames. Since the early cinema, which has a constantly opens

with the camera to surprise the audience, that Georges Mlis - names are considered the "father ofgenre fiction" . The film A Trip To The Moon was born in 1902 as an example. Combination of real

footage with animation, the paint and wallpaper samples shrink, Georges Mlis just opens justcreative. Techniques such as filming fell on each other (double exposure), divide the screen (split

screen), the stop-animation (stop-motion animation) ... he used became lessons for the beginner to

technical tricks later.

To the 1920s and 1930s, Digital Magic film stock accumulated from the birth of legendary films,

notably The Thief Of Bagdad (1924). Works with the Arab context is mysterious "right to" the hand

of director Raoul Walsh. He used innovative techniques to the time that created the dragon sprayingfire scene, spiders are under water, horse fly in the sky and petals to the brave heroes of the Armydust blind. Many film began using blue screen techniques (blue screen), it is still used until now:

actors acting before blue background, at up to then, the fonts will be replaced by frame other scenes.Race of information technology in the 1970s helped the Magic to Digital Cinema achieved many

significant achievements. Star Wars (1977), product of George Lucas and the technical staffmembers, is evidence for the achievements gained from the development of techniques available to a

system of special tools for filmmakers to fiction. Many critics have estimated that, the spacecraftmodel, firearms and the Star Wars robot shown so very hard to find fault. Most advanced technology

that era - computer - also used to control the camera.


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Cinema

Today's computer technology growing, creating efficient models and movies with more modern,more realistic. But required, who do this have good technical and computer graphics programs

3D.lllllCan see the image special effect of outstanding 3D film compared to the 2D film. Clearly known

three-dimensional space, the audience feel the emotional impact is stronger. Genre action, adventurefilm adventure, horror films and animation will be most appropriate for 3D. However, if a bit narrow

screen, the 3D film can not maximize the effectiveness of it.Mr Brian Hall - Chairman of the Management Company Megastar - for idea of 3D films already

exists from more than 100 this year and his first film was released as "The power of love" in the U.S.in 1922.

But four years ago it started a new strong identity with the giant screen at IMAX theaters in America.

3D films are considered revolutionary in the film industry, progress from silent to sound films arefrom black and white to color, from 2D to 3D is 3D animation and feature films.In Hanoi and Ho Chi Minh, Mega has a 3D movie projection room with about 8 billion investment

per room. Megastar's first 3D film to the public Vietnamese as "Avatar" will be released in late 2009."Avatar" by Original Fox is a mix of many genres: Science Fiction, adventurer, action ... produced infour years with funding of 200 million USD, Will become the largest 3D film of all time. Thus, clear

effects on the film carefully and in particular the development of information technology in generalis always accompanied with the development of cinema, when audiences are always eager to enjoy

new things. Technology will continue to grow and a certainty that audiences see the film will be the"witches" of Digital Magic moments to meet with one label.


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Film industry to wait more than 40 years appear first film is free. The other game, no need to 40years that the only integrity 10 years have witnessed so much change the world is colorful

entertainment

Game is a gadget-electronic technology to serve the computing needs of human entertainment. It issoftware built by a certain content, allowing the participants control a "character" as you want and

follow the rules of the game is installed. Through a screen of data coding is given in the form ofimages, for players to observe the evolutions of the game. This is the key to be the appeal of the

game. Accompanied by a sound system installed to play audio in the control of the usersimultaneously with the image on the screen. As a compelling film that players can change as you

wish. Attractive in pictures and sound stimulation victory tastes and instincts of the humanimagination, forcing them to conquer the game. Game by the development of information

technology, divided into several categories: the content, in the form of ...Game was born and developed by the development of computing. The history of video games began

when electronic computers to generation step 2, the electronic devices are still bulky, slow then thedevelopment of electronic computers to 3. The companies innovative game development and peace

was born on his entertainment industry. Who pioneered the games are very popular names in the

game as the author village game "Pong" game ever to be mistaken as first written in 1972 by AlanAlcorn, engineer of the software companies Atari (U.S.).

Game


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Benefits:

. The first game is known comes from recreation needs, is a form of development based on games,films, literary works and get ideas from everyday life takes place. The game now no longer merely so

that it became a media broadcast, the number of participants is raised hundreds of millions of peoplearound the world. It can promote the culture of countries included in the ads for the issuer and build

the game. Besides game can now apply for the service industries of the society. From the healthsector, education

ornational defense security.

Skills useful in life that you will learn if the game play properly.

1. Calm and request resources2. Computer team3. Typing skills

4. Thinking physics5. Reflex hand - eye

6. Computing skillsBesides game offers a huge source of revenue. Contribute to budget state budget is not smal

Impact:However, everything has two faces and not harm the game is, if you regularly play violent games

will be adverse health and especially the treatment . many accidents occur as all everyone .2008added more case horrified . only took the game to make it fall on the players status addictive, but

most gamers are young people .Time for learning have been the "appropriation" by the game .. The"fan game" giddy excluding day, selling energy and money into the game "invisible added. Game

pretty much hands the blood "hegemony" did not hesitate to put real money to buy virtual weapons,

armor virtual ... not even put the money to hire a gamer is "plowed" help yourself

Game


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Game

Where this amount if you do not lie parent or theft, shoplifting, robbery and even the people.Especially when the fight over the virtual world into real battle of life outside the game is really fun

to become a risk to social .Game it really is almost identical tothat drug. It has a very intense the attraction. What was going offline last known, not only young

children but also adults that have blocks invisible students, engineers, BA, director of companyinvolved and barbecue ,.... do not know how much money, the wealth and most importantly, time.

And death:- Waste of money to load the card, buy black market outside.

- Two health product image sitting for too long regardless of day and night.- Lost confidence when entering the real world.

- Time for family, friends, work.

- Time passed, the character of their heavy exercise is increasingly lose value, they are gong tocontinue to pursue the things an invisible virtual exhaustion.Corollary:

- Many students of the school's reputation as Polytechnic University, Humanities ,.... had to drop outof school, test ban, expulsion.- A lot of engineering bachelor's no attention to the work, neglect their studies to improve their lot as

the project was lax, talent is key ,......- The fathers, mothers were not interested in children, families ,......

Future development direction

-The development of information technology to directly influence the development of the gaming

industry. The future of information technology will be developed rushing, the world would be asocial information network Internet has made distance the world is becoming small. Knowledge andinformation will not border any activities beyond national and into activity of the whole is

indispensable .Game also developed continuously.-We are entering a new era - the era of 3D MMORPG game. And in another few years only graphics

will play an extremely important role in the decision to choose . Game features the use of human,true simulation of movement brought an area new look for the game industry World. Now that really

is difficult to distinguish between a person with flesh and bone with a character created by thecomputer.

-Between interactive gaming and game will be improved upGames for education, health, security and defense will be focused and developed


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Education

yy EEdduuccaattiioonnaall tteecchhnnoollooggyy ((aallssoo ccaalllleedd lleeaarrnniinngg tteecchhnnoollooggyy)) iiss tthhee ssttuuddyy aannddeetthhiiccaall pprraaccttiiccee ooffffaacciilliittaattiinngg lleeaarrnniinngg aanndd iimmpprroovviinngg ppeerrffoorrmmaannccee bbyy ccrreeaattiinngg,,uussiinngg aanndd mmaannaaggiinngg aapppprroopprriiaattee tteecchhnnoollooggiiccaall pprroocceesssseess aanndd rreessoouurrcceess.. TThheetteerrmm eedduuccaattiioonnaall tteecchhnnoollooggyy iiss oofftteenn aassssoocciiaatteedd wwiitthh,, aanndd eennccoommppaasssseess,,iinnssttrruuccttiioonnaall tthheeoorryy aanndd lleeaarrnniinngg tthheeoorryy..WWhhiillee iinnssttrruuccttiioonnaall tteecchhnnoollooggyy ccoovveerrsstthhee pprroocceesssseess aanndd ssyysstteemmss ooff lleeaarrnniinngg aanndd iinnssttrruuccttiioonn,, eedduuccaattiioonnaalltteecchhnnoollooggyy iinncclluuddeess ootthheerrssyysstteemmss uusseedd iinn tthhee pprroocceessss ooffddeevveellooppiinngg hhuummaannccaappaabbiilliittyy..

y For several decades, vendors of equipment such as laptop computers andinteractive white boards have been claiming that their technologies wouldtransform classrooms and learning in many positive ways, but there has beenlittle evidence provided to substantiate these claims.


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EEdduuccaattiioonn

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iieett NNaammeesssseennttiiaall aaccccoommpplliisshhmmeenntt iiss rreeaacchheedd aass ooff iinnccoommiinngg ooffwwaatteerr ffoouunnddaattiioonn ddaayynnooww,, tthhaatt iiss aaccccoommpplliisshhmmeenntt aabboouutt eedduuccaattiioonn.. AAccccoorrddiinngg ttoo MMiinniissttrryy ooffEEdduuccaattiioonn ddeeppuuttyy mmiinniisstteerr-- VViieett NNaamm eedduuccaattiioonn,, tthhee aaccccoommpplliisshhmmeenntt ooff tthheeeedduuccaattiioonn ggrroouunnddVViieettnnaammeesseess tthhaatt iinn5555 yyeeaarrppaassss ooffffiiss pprriiddee tthhee ccoouunnttrryy..

y AAtt pprreesseenntt VViieett NNaamm hhaass 2200 mmiilllliioonn ppeerrssoonnss ttaakkee aawwaayy bbooookkttoo sscchhooooll,, ccaann ssaayy tthhaatt iisseedduuccaattiioonn ggrroouunnddtthheerree iiss llaarrggee--ssccaallee aanndd sseeiizzee uupp ttoo 11// 44 ppooppuullaattiioonn aarree ggoo ttoo sscchhoooolliinngg..

FFrroomm ppllaaccee hhaadd ttoo 9955%% aannaallpphhaabbeettiicc ppooppuullaattiioonnss yyeeaarr 11994455,, ttoo nnooww VViieett NNaamm tthheerree wwaass

9944%% lliitteerraattee ppooppuullaattiioonn

yy At present Viet Nam are advancing vigorously on road spread education highschool is underpinning. For November/ 1999, Hanoi capital becameunderpinning high school popular fiducial consummation firstted metropolitanarea and if those norm to government published become general allegation besurely in this year 2000, Viet Nam will have a series of underpinning highschool popular consummation gently accredited city.

yy PPuuppiill NNuummbbeerriiss qquuiittee jjuurriisspprruuddeenntt iinn aallll ooffggrraaddee lleeaarrnnss aallrreeaaddyy nnuummeerroouussllyy iinnyyeeaarr nneeaarr hheerree.. VViieett NNaamm''ss jjuurriisspprruuddeenntt ppuuppiill ttrroouuppeess aatttteennddss ccoommppeettiittiioonnss

OOLLYYMMPPIICC IInntteerrnnaattiioonnaallllyy ssnnaattcchheedd mmaannyy aaddmmiirriinngg eevveenntt llooffttiinneessss ddeemmoobb ggaaiinnoovveerrss iinn iinntteerrnnaattiioonnaall ffrriieennddss..


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Education

yy CCoouunnttrryy mmooddeerrnnnniizzaattiioonn MMiinniissttrryy ooff EEdduuccaattiioonn lleeaaddeerr-- VViieett NNaammeedduuccaattiioonn ttoolldd::VViieett NNaamm iimmpplleemmeenntt tthhee ccaarreeeerrrriinngg ooffiinndduussttrriiaalliizzaattiioonn-- iinn wwoorrllddbbaacckkggrroouunnddss sstteeppss iinnttoo iinnffoorrmmaattiioonn aaggee,, kknnoowwlleeddggee eeccoonnoommyy,, ccoonnsseeqquueennttllyyVViieett NNaamm eedduuccaattiioonn ggrroouunndd aallssoo mmuusstt hhaavvee nneeww ttuurrnniinngg ppooiinntt..VViieett NNaamm aallssoowwiillll ddeevveelloopp aa nnuummbbeerrooffeedduuccaattiioonn cceenntteerrss tthheerree iiss hhiigghh qquuaalliittyy,, ccoonnttiinnuuaattiioonncchhoooosseedd ccaaddrreess hhaass lleevveelliinngg ggoo oovveerrsseeaa eedduuccaattiioonn,, pprroommoottee ttaalleenntt eedduuccaattiioonn,,iinncchhmmeeaall ccoommee cclloossee wwoorrlldd kknnoowwlleeddggee eeccoonnoommyy..


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y

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resent ever also right taller future. Intellect era's human being is rightnessoccupied future, inexpectant that future come passively fastening rightness arefuture to answerably of idea own.

y Phyla is educational educate human being, man-power resources education foreconomy- society, is Phyla create concept system, is new aware morphologicalconstruction substantive division. Formation not aware that only reflection isobjectively actual that it still is driving force blast, be navigation light gives actual

to move towards. Consequenthy, there isn't what reason that education doesn'tstrive to precede era, make precursive combatant, fugle give desired right track tocountry's ship son go.

y we is determined " education is premier national policy " as soon as manyscandal, its weakness, a look instance deeply about education's importancespecial, about riches position in course build a civilized societies, education still

actual situations are prosperous.NNeeeedd ttoo rreennoovvaattee aaccttiivvee ssttaallwwaarrtt eedduuccaattiioonn tthhoouugghhtt.. IItt bbee uurrggeenntt tthhiinngg,, ttoo ssiiggnniiffyy

ssttrraatteeggiiccaallllyy..


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EdMedicine

Information and communication technologies are about to make a massive move into medical

practice, not only in selected areas of 'high-tech' medicine, but throughout the field. Research

in information technologies is needed in the areas of medical imaging, telecooperation,

education and training

Medical images are produced in such a number and richness of detail that they can only be analyzedwith the help of the computer. Computers not only improve the quality of the images, but also help in

reconstructing structures, detecting anomalies and measuring. In particular, computers help with anappropriate visualization to make the image contents understandable to the clinician. Three-

dimensional images are used more and more. They have the inherent problem that it is extremelydifficult to visualize images consisting of a cloud of material in different shades of grey. Mechanisms

have to be found that render the interesting detail and hide other structures that are not relevant for aparticular situation. The selection and composition of algorithms depend on the medical goals of a

particular analysis and thus can only be determined together with medical experts

Images are needed to plan and control microinvasive surgical procedures. It is therefore necessary to

design systems that support the physician with appropriate visualizations throughout the wholeprocess from image acquisition, diagnosis, treatment planning, surgery to final control.

As medical professionals become more specialized, diagnosis and treatment occur in cooperation

between different physicians that may be distributed. They have to use computers to exchange theirmedical data, in particular images. However, data transfer alone is not sufficient. they must also be

able to communicate about their patients, to talk freely about medical data and refer to that data

during their discussion. Merging these two communication channels (verbal and datacommunication) is a challenge that needs to be addressed before teleconsultation can be reasonablyefficient. And finally, medical knowledge increases at an amazing pace. Physicians are required to

keep up with new knowledge for their whole life. To ensure the quality of diagnosis and treatment,special emphasis on continuous education is needed. Computer-based techniques can help with this

task, in particular if they provide training on the job, assisting in the analysis of images andteleconsultation.

All these problems can be solved only in interdisciplinary teams. One needs physicians that are open-

minded to think about new computer-based approaches. Computer scientists have to listen for theproblems of their medical partners. Psychologists have to look at human-human and human-

computer interaction. Engineers and administrators have to make things work. A single professioncan no longer deal with all aspects of the complex problems. Furthermore, new systems have to be

designed iteratively, with the


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user in mind. Systems must be addressed to real user problems. However, it is not possible tocompletely assess the value of a new development before it is taken into daily practice with real

users. Developers must be ready to radically change their systems until these really meet the userneeds. Users must be involved, but not in a naive fashion ("tell me what you need"). A constructive

dialog between users and developers, involving a sequence of prototype systems, is needed toacquire the real user needs.

The Link Between IT and MedicineDr. Mark Smith's Ability to Design Medical Record Systems Puts His Finger on Pulse for Improving Care in ER and Beyond

Dr. Mark Smith, department chair in emergency medicine at Georgetown University MedicalCenter (GUMC), stands at the crossroads of a number of seemingly unrelated health care initiatives.

An expert in the areas of medical informatics, disaster medicine, simulation training, complexity

theory and systems medicine, Smith melds his more than 30 years of experience as a physician withhis ability to design systems for keeping accurate patient medical records.

In addition to his academic role in the School of Medicine, Smith serves as the chair of MedStar

Emergency Physicians, which provides emergency medicine physician leadership and staffing at fourof the seven MedStar hospitals, including Georgetown University Hospital and Washington Hospital

Center.

One of the reasons I find emergency medicine so interesting is that an emergency department is afractal of a whole hospital, Smith says. People enter the ER, are registered, undergo an initial

evaluation, receive a series of diagnostic tests, are administered treatment and then go through a

discharge process. Its a microcosm of a whole hospital admission process, only compressed intime.

Smiths prowess with emergency medicine alone is a valuable asset for the medical schoolscurriculum, says Dr. Stephen Ray Mitchell, dean for the School of Medicine.

(He) is really unique in many ways -- kind of a Renaissance man. Hes a big picture guy, he says.

He envisioned the information system at Washington Hospital Center. They actually hired him tomake the emergency department run better, and he had a student walking behind every treating

doctor asking, What is it that you need right now? So when they programmed the system, he wasable to say, At this point we need to pull in the blood test, and here we need to go out and get the X-

ray.


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All fourth-year medical students participate in a four-week experience in emergency medicine atGeorgetown. They receive certification in advanced cardiac life support and clinical emergency

department rotation.

Georgetown was one of the first medical schools to require every single student to do emergencymedicine -- long before ER was on TV, so its been in our fabric, and Mark has made it an

excellent program, Mitchell says.

Smith, who joined Georgetown in 2000, regards emergency medicine as a valuable lens throughwhich to test innovations in health care. If it works in the emergency department, it will probably

work anywhere, he says.

Data-Centric Technology

System design is the process of defining and developing a system to satisfy specified data processing

needs. It is all about managing complexity, and health care is about as complex as it gets, says Smith.His amalgam of expertise provides him with a distinct perspective on health care reform, particularlyexpectations centered on the electronic patient record.

Integrating information from a hodgepodge of disparate clinical data sources offers significantpotential for reducing errors, inefficiencies and costs, he says.

Currently, medical personnel operate in an environment where information that is needed for clinical

decisionmaking may not be immediately available, Smith explains.

An electronic medical record should provide current, accurate, clinically relevant patient information,

in effect making the caregiver aware of everything that is happening to a patient, but designing auniversal network of systems to capture, store and deliver that information has proven elusive.

The electronic medical record is not an end in itself, Smith cautions. The end is bettermanagement of health and illness. For that we need information presented in such a way that it best

informs patient care decisions. The challenge is to integrate all information about a persons health,disease, and episodic illness across the complete continuum of care.

He says information has to be available in a way that its going to make a difference in care.Something I read years ago in an article in the Wall Street Journal has stayed with me -- In the

absence of action, information is overhead.

Smith realized early on the importance of integrating information science with medicine. He receiveda masters degree in computer science from Stanford University before graduating with his medical

degree from Yale University School of Medicine.

I love the intellectual clarity and complexity of mathematics and computer science, but I wanted mylifes work to involve serving people and to have the texture of a human endeavor, he says. That is

why I left computer science to become a physician.


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But he never lost his interest in the display and use of information.

From his years of clinical experience, he knows the practical limitations of a range of theoreticalapproaches and can guide the development of systems that will have true clinical utility for improved

patient care, says Dr. Howard Federoff, executive vice president for health sciences and executivedean of the School of Medicine.

For decades Smith has believed the most potent force for improving medicine was going to be the

application of information technology in the service of hospitals care mission. Optimuminformation systems would enable care that is safer, faster, cheaper, and better. That has been my

driving vision, he says.

And so was born, Azyxxi, an integrated clinical information system currently in use at Georgetown

University Hospital and recently acquired by Microsoft. Smith co-developed the system, whichprovides a real-time, comprehensive picture of a patients health care history.

Physicians and staff providing care for a particular patient have immediate access to current,accurate, critically important information from a multitude of disparate data sources and data types,including laboratory test results, past medical history, X-ray images, full motion angiograms,

ultrasound pictures, electrocardiograms, demographic information, scanned documents and more.

Making DataCount

One of the unique aspects of the Azyxxi information system that Smith designed is that it worksequally well in providing views across groups of patients as it does in diving down into an individual

patient. So it can be used to drive quality improvement and clinical research across an organization.

Smith points out the challenge of designing solutions that can adapt to the unforeseeable needs of arapidly evolving scientific knowledge base. His general philosophy -- learned the hard way after

once discarding a piece of unimportant data that he wound up needing -- is to collect everything.

You never know whats going to turn out to be important. Digital storage is cheap, so as long as youarent delaying treatment in an emergency situation, go ahead and collect it, Smith says.

When it comes to using technology to drive safer care, Smith points out that his 25 plus years of

running emergency departments has taught him that mistakes occur in medicine because some basiclessons taught in the first year of medical school are not heeded. A change in vital signs -- a rising

pulse, a falling blood pressure -- that signals deterioration in the state of a patient is somehow notalways paid attention to by the clinician.


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