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Information Systems in Medicine
Main QuestionsMain Questions
Information Systems Basics.Medicine-Related Information
Systems
1.1. Information Systems Basics Information Systems Basics
Information systems definitionApplications of ISAreas of IS work Information technology (IT)
1.1.11. . Information system definitionInformation system definitionAn Information System (IS)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 Information technologies componentcomponent of an Information SystemInformation System;
The computer-based information systems are the field of study for Information Information technologies (IT) technologies (IT)
1.1.22. . Applications ofApplications of ISISInformation systemsInformation systems deal with the
development, use and management of an organization's IT infrastructureIT infrastructure;
The biggest asset of companies today, is their information, represented in people, people, experience, know-how, innovationsexperience, know-how, innovations (patents, copyrights, trade secrets), and for a market operator to be able to compete, he/she must have a strong strong information infrastructureinformation infrastructure.
1.1.33.. Areas of IS workAreas of IS work
Information Systems has a number of different areas of work:
Information Systems StrategyInformation Systems Strategy Information Systems ManagementInformation Systems Management Information Systems DevelopmentInformation Systems Development Each of which branches out into a
number of sub-disciplines
1.1.44.. Information technologyInformation technology (IT)(IT)
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).
ITIT deals with the use of electronic electronic computerscomputers and computer softwarecomputer software to convert, store, protect, process, transmit and retrieve information, securely.
1.1.44.. Information technologyInformation technology (IT)(IT) Today, the term ITIT has ballooned to encompass
many aspectsmany aspects of computing and technology, and the term is more recognizable than ever before.
IT professionalsIT 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 managementdata management, , networkingnetworking, , engineeringengineering computer hardware computer hardware, database and database and software designsoftware design, as well as the managementmanagement and and administrationadministration of entire systems of entire systems.
2. 2. Medicine-Related Medicine-Related Information SystemsInformation Systems
Hospital Information System Radiology Information System Laboratory information system Laboratory information management system Dentistry information systems Picture archiving and communication system
22..1. 1. Hospital Information SystemHospital Information SystemA hospital information system (HIS),hospital information system (HIS),
variously also called clinical information clinical information system (CIS)system (CIS) is a comprehensive, integratedintegrated IS designed to manage manage the administrative, financial and clinical aspects of a hospital.
This encompasses paper-based paper-based information processing as well as data processing machines.
22..1. 1. Hospital Information SystemHospital Information System
22..1. 1. Hospital Information SystemHospital Information SystemThere are tthree types of integrationhree types of integration can be distinguished: Data integrationData 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 integrationPresentation 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 integrationFunctional integration means that functions of different applications are available to the qualified user within one user environment
22..1. 1. Hospital Information SystemHospital Information System
The aim of an HIS is to achieve the best possible support of patient care and administration by electronic data electronic data processingprocessing:
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;
22..1. 1. Hospital Information SystemHospital Information SystemCISsCISs are sometimes separated from HISs HISs
in that the former concentrate on patient-patient-relatedrelated and clinical-state-related data clinical-state-related data ((electronic patient recordelectronic patient record)) whereas the latter keeps track of administrative administrative issuesissues.
The distinction is not always clear and there is contradictory evidence against a consistent use of both terms.
22..1. 1. Hospital Information SystemHospital Information SystemAs an area of medical informatics the aim of
an HISHIS is to achieve the best possible support of patient carepatient care and administration administration by by electronic data processingelectronic data processing.
It can be composed of one or a few software componentssoftware components with specialty-specific extensions as well as of a large variety of sub-systems in medical specialties (e.g. Laboratory Information SystemLaboratory Information System, Radiology Information SystemRadiology Information System).
22..1. 1. Hospital Information SystemHospital Information SystemComputers in clinical departments are generally used for the following
tasks: Administrative supportAdministrative support - the administrative and logistic planning of
patient care and interventions. Patient data collectionPatient 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.
DecisionsDecisions.. Simulation of interventions by using models, the support of diagnostic and therapeutic decision making.
MonitoringMonitoring.. The monitoring and assessment of therapy (drug therapy).
ReportingReporting.. Generation of reports, for example, after the discharge of the patient from the hospital or when referring patients to other clinicians.
AssessmentAssessment.. Evaluation of the effect of the care that was provided on patient outcome.
22..1. 1. Hospital Information SystemHospital Information SystemBellow shown general stages in the HIS evolution: Isolated ApplicationsIsolated Applications Monolithic SystemsMonolithic Systems Evolutionary SystemsEvolutionary Systems Composable SystemsComposable Systems
22..1. 1. Hospital Information SystemHospital Information System
22.2.2.. Radiology Radiology ISISA Radiology Information System (RIS)A Radiology Information System (RIS) is used by
radiology departments to store, manipulate and distribute patient radiological data and imagery.
Basic Features Basic Features of RIS:of RIS: Patient Registration; Patient Scanning; Result(s) Entry; Reporting; Result(s) Delivery including faxing and e-mailing of
clinical reports; Patient Tracking;
22.2.2.. Radiology Radiology ISIS
22.3.3. . Laboratory information systemLaboratory information systemA lab information system (LIS),lab information system (LIS), is a
class of software which handles receiving, processing and storing information generated by medical medical laboratorylaboratory processes processes.
These systems often must interface interface with with instrumentsinstruments and other information systems such as hospital information hospital information systemssystems (HIS). (HIS).
22.3.3. . Laboratory information systemLaboratory information systemAn LISLIS is a highly configurable highly configurable
applicationapplication which is customized to facilitate a wide variety of laboratory workflow models.
DisciplinesDisciplines of laboratory science supported by LIS' includeinclude:: hematology, chemistry, immunology, blood bank (Donor and Transfusion Management), surgical pathology, anatomical pathology, flow cytometry and microbiology.
22.3.3. . Laboratory information systemLaboratory information systemBasic featuresBasic features of the LIS 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 .
22.4.4. . Laboratory information Laboratory information management systemmanagement system A "Laboratory Information Management System" "Laboratory Information Management System"
((LIMSLIMS)) 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 difference between between LIMS LIMS and LISand LIS that primary primary are generally targeted toward environmental, research or commercial analysis, such as pharmaceutical or petrochemical, and secondsecond are targeted toward the clinical market (hospitals and other clinical labs).
22.4.4. . Laboratory information Laboratory information management systemmanagement system The goalgoal of implementation the LIMSLIMS is to
create a seamless organization where:1. 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 Manufacturing Execution SystemSystem or Enterprise Resource PlanningEnterprise Resource Planning application.
22.4.4. . Laboratory information Laboratory information management systemmanagement system The goal goal of implementation the LIMS LIMS is to
create a seamless organization where:2. Lab personnel will perform calculations,
documentation and review results using online information from connected instruments, reference databases and other resources using electronic lab notebooks electronic lab notebooks (ELN's)(ELN's) connected to the LIMS.
22.4.4. . Laboratory information Laboratory information management systemmanagement system The goal goal of implementation the LIMS LIMS is to
create a seamless organization where:3. Management can supervisesupervise the lab
process, react to bottlenecks in workflow and ensure regulatory demands.
4.4. External participantsExternal participants (department, etc.) can place work requests and follow up on progress, review results and print out analysis certificates and other documentation.
2.5. 2.5. Dentistry information systemsDentistry information systems
2.5. 2.5. Dentistry information systemsDentistry information systems
2.5. 2.5. Dentistry information systemsDentistry information systems
2.5. 2.5. Dentistry information systemsDentistry information systems
2.5. 2.5. Dentistry information systemsDentistry information systems
2.5. 2.5. Dentistry information systemsDentistry information systems
2.6. 2.6. Picture archiving and Picture archiving and communication systemcommunication system
In medical imaging, picture archiving andpicture archiving and communication systems (PACS)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.independent format.
The most common format for image storage is DICOM (Digital Imaging and DICOM (Digital Imaging and Communications in Medicine)Communications in Medicine)..
2.6. 2.6. Picture archiving and communication systemPicture archiving and communication system
Sample patient record view from an image-based electronic health record (VistA).
2.6. 2.6. Picture archiving and communication systemPicture archiving and communication system
A PACS allows to store volumic exams and to reconstruct 3D images
2.6. 2.6. Picture archiving and Picture archiving and communication systemcommunication system PACS PACS replaces hard-copyhard-copy based means of
managing medical images, such as film film archivesarchives.
It expands expands on the possibilities of such conventional systems by providing capabilities of off-site viewing and reporting (distance distance educationeducation, , telemedical usestelemedical uses).
Additionally, it enables practitioners at various physical locations to access the same information simultaneously (telemedical usestelemedical uses).
2.6. 2.6. Picture archiving and Picture archiving and communication systemcommunication system
The most difficult area for PACSPACS is interpreting the DICOMDICOM image format image format.
A feature common to most PACS is to read read the metadatametadata from all the images into a central central databasedatabase.
This allows the PACS userPACS user to retrieve all retrieve all imagesimages with a common feature no matter the originating instrument.
The differences differences between vendors' DICOM implementations make this a difficult task.
2.6. 2.6. Picture archiving and communication systemPicture archiving and communication system
2.6. 2.6. Picture archiving and Picture archiving and communication systemcommunication system
A full PACSfull PACS should provide a single point single point of access for imagesof access for images and their associated and their associated datadata (i.e. it should support multiple modalities).
It should also interface interface with existing hospital information systems: hospital information systems: Hospital Hospital information systeminformation system (HIS) and (HIS) and Radiology Radiology Information SystemInformation System (RIS). (RIS).
2.6. 2.6. Picture archiving and Picture archiving and communication systemcommunication system
Interfacing between multiple systems provides a more consistent and more reliable dataset:dataset:
1.1. Less risk of entering an incorrect patient IDLess 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.
2.6. 2.6. Picture archiving and Picture archiving and communication systemcommunication system
Interfacing between multiple systems provides a more consistent and more reliable dataset:dataset:
2. Data saved in the PACS can be tagged with unique patient identifiers (such as a social social security numbersecurity number or NHS numberNHS number) obtained from HISHIS. Providing a robust method of merging datasets from multiple hospitals, even where the different centers use different ID systems internally.
2.6. 2.6. Picture archiving and Picture archiving and communication systemcommunication system An PACS PACS interfaceinterface can also improve workflow improve workflow
patterns:patterns: When a study has been reported by a radiologist
the PACS can mark it as read. This avoids avoids needless double-reading.needless double-reading. The report can be attached to the images and be viewable via a single interface.
Improved use of online storageonline storage and nearline nearline storagestorage in the image archive. The PACS can obtain lists of appointments and admissions in advance, allowing images to be pre-fetchedpre-fetched from nearline storage (for example, tape librariestape libraries) onto online disk storage (RAID arrayRAID array).
ConclusionConclusion
In this lecture was described next questions:
Information Systems Basics.Medicine-Related Information
Systems
LiteratureLiterature
Electronic documentation on to the TDMU server:http://www.tdmu.edu.te.uahttp://www.tdmu.edu.te.ua
