Victor Babes UNIVERSITY OF MEDICINE AND PHARMACY TIMISOARA

“Victor Babes” UNIVERSITY OF MEDICINE AND PHARMACY TIMISOARA DEPARTMENT OF MEDICAL INFORMATICS AND BIOPHYSICS Medical Informatics Division www. medinfo. umft. ro/dim 2007 / 2008

COURSE 14 HEALTH INFORMATICS MEDICAL INFORMATION SYSTEMS (II)

3. CLINICAL INFORMATION SYSTEMS • 3. 1 STRUCTURE OF CLINICAL SPECIALISED HEALTHCARE: – CLINICAL DEPARTAMENTS : • • INTERNAL MEDICINE (… … …) SURGERY (… … …) PEDIATRICS (…) MONITORING (…) PSYCHIATRY NEUROLOGY ………

– PARACLINICAL DEPARTAMENTS AND SERVICES • • RADIOLOGY AND IMAGING (…) NUCLEAR MEDICINE FUNCTIONAL INVESTIGATIONS (…) CLINICAL LABORATORY ENDOSCOPY PATHOLOGY THERAPY (…) PHARMACY

3. 2. GENERAL OBJECTIVES • a. MANAGERIAL - ADMINISTRATIVE – healthcare and interventions planning • b. PATIENT DATA – data acquisition, storing and retrieval (anamnesis, laboratory, images, biosignals) – data verification and coding – data processing – integrated (multimedia) presentation

• c) DECISION – diagnosis and therapy assistance – intervention simulation on models – advice for patients • d) MONITORING – therapy follow-up – intensive care monitoring

• e) REPORTS – data centralization – statistical analysis – report generating • f) ASSESSMENT – disease evolution follow-up (chronic, congenital etc) – healthcare quality assessment (for planning, research etc)

3. 3. SPECIFIC OBJECTIVES IN CLINICAL AND PARACLINICAL DEPARTAMENTS • a) INTERNAL MEDICINE – CARDIOLOGY (accurate investigations, num. data) – METABOLICAL DISEASES (follow-up, patient education, diabcard) – HAEMATOLOGY (haemophilia registers) – NEPHROLOGY (transplant planning, dialysis monitoring) – GASTROENTEROLOGY – ENDOCRINOLOGY

Health Card - “smart card” – chip 32 k - magnetic card - laser card = combined identity and health card

• b) SURGERY – OPERATION PLANNING – SURGICAL INTERVENTIONS PREPARETION AND CONTROL – SIMULATIONS (virtual reality) – MONITORING, ANESTESY • c) PEDIATRICS – PREMATURES FOLLOW-UP – CONGENITAL DISEASES – OTHER: similar to internal medicine and surgery

• VIRTUAL REALITY – Imersion – Interactivity • TELEMEDICINE – Tele-consultation • Video presentation • Medical consultation – Tele-surgery • Surgical robots

• d) OBSTETRICS – PREGNANCY FOLLOW-UP – PATIENT EDUCATION • e) PSYCHIATRY – LARGE VARIABILITY IN DIAGNOSIS • f) MONITORING – CORONARY UNITS – INTENSIVE CARE, REANIMATION – PRE/POSTOPERATORY MONITORING – PERINATAL NURSING – ORGAN BANKS, TRANSPLANT

• g) FUNCTIONAL INVESTIGATION – RESPIRATORY TESTS – ECG, EEG, EMG etc – EXERCISE • h) RADIOLOGY – RADIOGRAPHY, RADIOSCOPY – CT (computer-tomography) – NMR (nuclear magnetic resonance), PET – ECHOGRAPHY • i) PATHOLOGY • j) CLINICAL LABORATORY

• PHARMACY – MEDICATION RECORDS – RECEIT VERIFICATION – PROVIDING INFORMATION FOR: • DOCTORS, NURSES • CENTRAL LEVEL – PROVISIONING – STOCK RECORDS, VALIDITY – PREPARATION – SUPPLIERS

4. HOSPITAL INFORMATION SYSTEM (HIS) • 4. 1. DATA TYPES: – PATIENT or HOSPITAL oriented • 4. 2. H. I. S. CONCEPT – a) SCOPE: computer use for information collecting, storing and processing for patient care and management in all hospital activities and for functional requirements. – b) COMPONENTS: • 1. DATA BASE • 2. APPLICATIONS (programs) • 3. COMMUNICATION LAYER • 4. WORKING TERMINALS

• 4. 3. HIS ARCHITECTURE – a) TYPES: • • • MONOLITIC SYSTEMS EVOLUTIVE SYSTEMS DISTRIBUTED SYSTEMS – b) STRUCTURE: • SCHEME 1 • 4. 4. INTEGRATED SYSTEM • SCHEME 2 • 4. 5. Examples of H. I. S. : – HISCOM (The Netherlands) – DIOGENE (Switzerland)

H. I. S. STRUCTURE Para. Clinical Dep. Laboratory PC Radiology Manag. Dept. s. ADM Funct. Investig. Pharmacy Manager ICU Account. Supply. Clinical Dep. - CD Cardiology Nefrology Hospital Network Surgery Obstetrics-Gynecology Pediatrics Psychiatry Gateway PACIENT oriented data HOSPITAL oriented data

INTEGRATED H. I. S. Academic Network Administrator Class rooms Gateway PC ADM. Documentation Server Library Network CD Users Hospital Network Primary Care Network Research Network Family doctors (Gen. Pract. ) Research Laboratories Internet, Email Connections

• 4. 6. ACCESIBILITY AND PROTECTION • 4. 7. MANAGEMENT • 4. 8. RESEARCH • 4. 9. FUTURE DEVELOPMENT TRENDS

5. CENTRAL LEVEL HEALTH INFORMATION SYSTEMS • 5. 1. DEPARTMENTAL HEALTHCARE OFFICES • 5. 2. MINISTERIAL LEVEL – HEALTHCARE MINISTERY – OTHER MINISTERIES, CENTRAL INSTITUTIONS • 5. 3. INTERNATIONAL LEVEL COMPATIBILITY

• 6. STANDARDISATION – standard attributes • 7. DATA PROTECTION – a) CONFIDENTIALITY - limited, leveled accessibility – b) PROTECTION - against accidental deterioration / access / loss – c) SECURITY - intended d/a • 8. RESPONSIBILITIES – ethical and legal aspects in medical informatics

We wish you a successful exam session!

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