Medical Informatics
Representation and
Computation on Medical and
Health Care Information
Targetted at Design and
Development of Information
System for



Medical Science and Technology
Health Care Services
Business world invoving health care
Health Care Informatics
Suppliers’
Enterprise Systems
Pharmacies
Medical
suppliers
Insurance
providers
•
•
•
E
X
T
R
A
N
E
T
S
Providers’
Enterprise
Systems
ERP
GDSS
DSS
CDSS
•
•
•
•
I
N
T
R
A
N
E
T
S
Physicians
And
Specialists
P
R
M
Patients
Internet
Src: K.Siau, “Health Care Informatics”, IEEE trans. On
Info. Tech. In Biomedicine, 7(1), March, 2003, pp. 1-7
Enterprise Resource Planning
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


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Full integration of an organization's information
from pay-roll and human resources to
accounting and finance.
Database integration (Information Sharing)
Information logged once and accessed by
different modules maintaining the data
consistency.
Track inventory, order information and
delivery requirements
Determine equipment usage and
maintenance schedule
Decision Support System (DSS)



Conventional DSS: financial and scheduling.
Clinical DSS (CDSS): diagnosis, pharamacy,
emergency and nursing practices.
CDSS used to send alerts and reminders to
patients about preventive care.
Patient Relationship Management
(PRM)



Primary focus on determining and meeting
patients' needs.
Tracking patients information from diet and
exercise data to past diagnosis information from
family history and allergy information.
Send E-mails satisfying queries, informing
newly published health care studies and
reminding about preventive measures.
Standards for exchange and
management of medical
information



To maintain interoperability between systems
across different platforms.
HL7 (Health Level 7): aims to provide
standards for the exchange, management and
integration of data that support clinical patient
care and management, delivery and evaluation of
health care services.
Digital Imaging and Communications in
Medicine (DICOM): Diagnostic images,
waveforms and test reports.
HL7 Message Structure
Event
MessageN
Message1
SegN
Seg1
Field1
Field1
Comp1
Terminated by <CR>
CompN
Separated by '|'
Separated by '^'
Message Encoding





Sequence of segments separated by '|'
Compulsory and optional segments
Segments as sequence of fields
separated by '^'
Compulsory and optional fields
A field is described by a data type (e.g.
AD datatype denoting an Address)
An example of HL7 message for patient
admission
MSH | ^~ \ & | Clinic || Central|Reg ||| ADT^A01
|MSG00005 | P | 2.3
EVN | A01 | 199601051530
PID ||| 2-687005 || Evans^Carolyn || 19620324 | F
|||903 Diane Circle^^Phoenixville^PA^19460||
(610) 555 – 1212 | (610) 555 – 1212 || S | C ||156
– 96 – 2542
PV1|| E | Emergency |||| 0148^Addison^James |||
SUR
Admit/Visit Notification
1. Message Header
(i) From: Clinic
(ii) To : Central
2. Event
(i) Date: 1996-01-05
(ii) Time: 15:30
3. Patient Identification
(i) Internal Patient ID Number: 2-687005
(ii) Family Name: Evans
(iii) Given Name: Carolyn
(iv) Birth Date: 1962-03-24
(v) Sex: F
Admit/Visit Notification (Contd.)
3. Patient Identification (contd.)
(vi) Street Address: 903 Diane Circle
(vii) City: Phoenixville
(viii) State of Province: PA
(ix) Zip or Postal Code: 19460
(x) Phone (Home): (610) 555 – 1212
(xi) Phone (Office): (610) 555-1212
(xii) Marital Status: S
(xiii) Religion: C
(xiv) Social Security Number: 156-96-2542
4. Patient Visit
(i) Patient Class: E
(ii) Point of Care: Emergency
(iii) Attending Doctor's ID: 0148
(iv) Family Name: Addison
(v) Given Name: James
(vi) Hospital Service: SUR
Digital Imaging Communications in
Medicine
(DICOM
) the ACR-NEMA
originally

developed by American College of Radiology (ACR) and
the National Electrical Manufacturer's Association (NEMA)
provides standardised formats for image capture and storage
coupled with a common information model specifying service
definitions and protocols for communication

DICOM Composite Image IOD Information Model
Patient
1
is
subjec
t of
1,n
Study
1
contain
s
Equipment
1,n
1
create
s
Frame of Reference
1,n
series
0,n
1
1
Spatially
of
Temporall
y
defines
contain
s
0,n
Image
(Pixels)
0,n
Curve
0,n
VOI
LUT
0,1
Modality
LUT
0,n
Overlay
0,n
Waveform
DICOM Waveform IOD Information Model
Patient
1
is
subjec
t of
1,n
Study
1
contain
s
Equipment
1
1,n
1
create
s
Frame of Reference
1,n
series
1
contain
s
1,n
Waveform
0,n
temporall
y
defines
DICOM Waveform Information Model
Patient
1
is
subjec
of
1,n
Study
1
contain
s
1,n
Series
1
Contai
ns
Waveform
Waveform
Attribute
Time of Acquisition
Acquisition Context
Annotation
1
contain
s
1,n
Multiplex
Group
1
Multiplex Group
Attributes
Number of Channels
Sampling Frequency
Timing
contain
s
1,n
Channel
1,n
1
Waveform
contain
s
1,n
Sample
Channel Definition
Attributes
Channel Source
Metric
Anatomic Location(s)
Function
Technique
Channel Sensitivity
Baseline
Skew
Filter Characteristics
DICOM File Structure
Preamble (128 bytes)
DICM (4 bytes)
DE1
DEn
Dicom
Information
Structure
DICOM Data
format
Data Element
Tag
< 4 bytes >
Tag
Data Element
DE
VR
VL
< 2 bytes >
……………
Data Element
VF
Explicit VR
VF
Implicit VR
< 2 bytes >
VL
< 4 bytes >
An Example of Data Element
Patient
Information
Patient
Name
0010 0010
0010 0010
VR
VL
VF
PN
000C
Sridhar Raja
Explicit VR
0000 000C
Sridhar Raja
Implicit VR
Some vital tags for rendering images in DICOM Standard
Tag Description
Transfer Syntax Tag
Samples per pixel
Numbers of Frames
Number of Rows
Number of Columns
Number of Bits Allocated
Number of Bits Stored
Pixel Data
Hex Encoding (Group, Element)
(0x0002, 0x0010)
(0x0028, 0x0002)
(0x0028, 0x0008)
(0x0028, 0x0010)
(0x0028, 0x0011)
(0x0028, 0x0100)
(0x0028, 0x0101)
(0x7FE0, 0x0010)