Information Systems
In Hospitals
What does “System” mean?
• A system is a group of
interrelated components
working together toward a
common goal by accepting
inputs and producing
outputs in an organized
transformation process.
An information system :
Is a collection of people, procedures, software, hardware,
and data .They all work together to provide information
essential to running an organization.
(as we discussed in chapter 1).
An information system, that combines a computer-based
patient record with other modules that support clinical
workflow is called a hospital information system (HIS).
Software
Input
People
Control
Hardware
Procedure
Memory
Output
Data
A Hospital Information System (HIS):
-Is a comprehensive, integrated
information system designed to meet all
the information needs within a hospital.
-It can be composed of one or a few
software components with specialtyspecific extensions as well as of a large
variety of sub-systems in medical
specialties.
Applications:
A hospital information system has many different
aspects incorporated within itself.
Technology allows for the information within these
systems to flow more easily and more accurately.
Some of these systems include:
1- Laboratory Information System (LIS)
2- Nursing Information System (NIS)
3-Picture Archiving Communication System (PACS)
4-Radiology Information System (RIS)
5-Pharamacy Information System (PIS)
6-Adminstration Information System.
7-Financial Information System (FIS)
Common Features:-
* Patient Registration and scheduling.
* Patient List Management .
* Interface with different modalities.
* Department workflow management.
* Requesting.
* Result(s) Entry.
* Reporting and printout.
* Patient Tracking .
* Modality and Material management.
* Information storage and backup.
Advantages of HIS include:
1-Improved quality of patient care.
2-Improved communications within the hospital.
3-Increased productivity.
4-Reduced chances of errors.
5-Reduced costs.
-Medical record, health record, or
medical chart:
-Is a systematic documentation of a
patient's medical history and care.
-Traditionally, medical records have
been written on paper and kept in
folders.
-An electronic health record (EHR)
refers to an individual patient's
medical record in digital format.
-Medical record, health record, or medical chart:
-Electronic health record systems co-ordinate the storage and
retrieval of individual records with the aid of computers.
-EHRs are usually accessed on a computer, often over a network.
-It may be made up of electronic medical records (EMRs) from
many locations and/or sources.
-Among the many forms of data often included in EMRs are patient
demographics, medical history, laboratory test results, radiology
images, billing records and advanced directives.
Advantages of EHRs over paper-based records:
Complete patient data displayed in an integrated fashion
that facilitates medical decision making.
Access from any workstation in the hospital.
Ability to enter orders, notes, data at same workstation.
No double entry of information.
Immediate availability of results.
Simultaneous users can access same medical record.
Access from on site or remote locations.
No loss of patient information.
Nursing Information System:
-Information system that supports the use and documentation
of nursing processes and provides tools for managing the
delivery of nursing care.
-It collects, stores, processes, retrieves, display, and
communicate timely information needed in nursing practice,
education, administration, and research.
Patient Charting:
A patient’s vital signs, admission and nursing assessments,
care plan and nursing notes can be entered into the
system either as structured or free text. These are the
stored in a central repository and retrieved when needed.
Clinical Data Integration:
Here clinical information from all the disciplines can be
retrieved, viewed and analyzed by nursing staff and then
integrated into a patient’s care plan.
Decision Support:
They provide prompts and reminders, along with guides to
disease linkages between signs/symptoms,
etiologies/related factors and patient populations.
Staff Schedules:
Nurse can self schedule their shifts using scheduling rules
provided in shift modules.
Radiology Information System (RIS):
-The RIS is a computerized system used by radiology
departments to store, manipulate and distribute patient
radiological data and imagery.
-A modern Radiology Information System (RIS) is a prerequisite for the efficient management of a department of
Radiology.
-The system generally consists of patient tracking and
scheduling, result reporting and image tracking capabilities.
-Used to support both administrative and clinical operations.
-RIS complements HIS (Hospital Information Systems) and are
critical to efficient workflow to radiology practices.
Simple Workflow within RIS:
-A clinician orders a radiographic exam using the Hospital
Information System (HIS).
-Within minutes, the order subsequently appears at the modality
in a
list of patients requiring radiographs that day.
-The radiology technicians select the appropriate patient from
the list and conducts the study.
-Once the images are generated, they are sent to a central local
server and the exam is automatically completed and charged in
the HIS.
-By simply clicking the ‘‘view images’’ button under the
images tab in the HIS the images appear in an easy to use
browser- based medical image viewer, or on a Digital
Imaging and Communications in Medicine (DICOM)
workstation program on the local computer.
-In addition, the images and reports are accessible from
anywhere inside the local area network (LAN) and also
potentially available outside the clinic network via the
world wide web.
DICOM Images:
-DICOM stands for Digital Imaging and Communications in Medicine.
-It’s a standard protocol for the transferring, displaying, and storing of
medical images data.
-Most modern imaging machines are capable of producing DICOM images.
DICOM Viewer:
-Is a specialized application software enables
you to open, process, and interpret DICOM
images.
-There are a lot of DICOM Viewer
applications available.
-MicroDicom (Free).
-RadiAnt.
The Basic requirements of a DICOM workstation are as
follows:
-The ability to query and send image files to multiple
DICOM devices, including other workstations;
-The capability to manipulate images (window/level,
magnification, measurements, annotation, stack scroll,
Invert, rotate, etc.);
-A HIS/Radiology Information System (RIS) interface to link
reports to the images;
-The ability to import/export other image types, such as
jpeg, and convert them to DICOM;
-The functionality to allow dual monitor viewing;
-The ability to print DICOM images.
Picture Archiving and Communication System PACS:
What is PACS?
-PACS refers to the host of technologies that contribute
to the creation, distribution, and archiving of digital
images.
-Data workflow within PACS:
Acquiring
data from
modalities
Storing
data in an
achiever
Viewing it
in a
workstation
-Typical PACS components include:
1- A digital imaging modality or device
2- A network.
3-An archive device.
4-diagnostic workstations.
5-Archive/routing software, and
6-Some interplay with the hospital or radiology
information system.
Potential Benefits of PACS:
a.Increased connectivity and integration between facilities and
departments.
b.Productivity improvements (less time spent looking for
misplaced radiographs or ultrasound images, less time spent
hanging/removing films, less time distributing films).
c.Simultaneous viewing of the same images in multiple locations.
d.Better image quality than analog film or thermal prints.
e.Provides an avenue for rapid consultation with specialists.
Laboratory Information system LIS:
- A lab information system ("LIS") is a class of software that
receives, processes, and stores information generated by
medical laboratory processes.
-These systems often must interface with instruments and other
information systems such as hospital information systems (HIS).
-Disciplines of laboratory science supported by LIS' include
hematology, chemistry, immunology, blood bank (Donor and
Transfusion Management), surgical pathology, anatomical
pathology, flow cytometry and microbiology.
In summery, the Uses of computer in the hospital can
be categorized into:
1- Handling and processing Medical Data.
2- Decision support.
3-Medical education.
4-Medical searches.
5- Monitoring.