Information Systems in Medicine Associated professor Semenets A.V. [email protected] [email protected] Department of Medical Informatics I.Ya.Horbachevsky

Information Systems in Medicine

Associated professor Semenets A.V.

[email protected] of Medical Informatics

I.Ya.Horbachevsky Ternopil State Medical University

Main QuestionsMain Questions

Information Systems Basics.Medicine-Related Information

Systems

1.1. Information Systems Basics Information Systems Basics

Information systems (IS) definition Information technology (IT) definition IS and Related Disciplines IS types

1.1.11. . Information system definition (A)Information system definition (A)An 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;

(Wikipedia, 2007.)

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)

1.1.11. . Information system definition (B)Information system definition (B)An Information System (IS)Information System (IS) is any combination of

information technologyinformation technology and people's activitiespeople's activities that support operations, managementoperations, management and decision makingdecision making.

In a very broad sense, the term information system is frequently used to refer to the interaction between people, processes, data and technology. In this sense, the term is used to refer not only to the information and communication technologyinformation and communication technology (ICT)(ICT) that an organization uses, but also to the way in which people interact with this technology in support of business processes;

(Wikipedia, 2012.)

1.1.22.. 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 usage of the computers computers hardwarehardware and softwaresoftware to convert, store, protect, process, transmit and retrieve information, securely.

1.1.33. . IS and related disciplinesIS and related disciplinesInformation SystemsInformation Systems is a scientific field of study

that addresses the range of strategic, managerial and operational activities involved in the gathering, processing, storing, distributing and use of information, and its associated technologies, in society and organizations.

An ISIS is not only the technology that an organization uses, but also the way in which the organizations interact with the technology and the way in which the technology works with the organization’s business processes.

1.1.33. . IS and related disciplinesIS and related disciplines

1.1.44.. Types of the Types of the ISIS

A four level pyramid model of different types of Information Systems based on the different levels of

hierarchy in an organization


A TTransaction ransaction PProcessing rocessing SSystemystem ((TPSsTPSs)) is a IS that collect, store, modify, and retrieve the transactions of an organization.

A transactiontransaction is an event that generates or modifies data that is eventually stored in an information system.

The essence of a transaction programessence of a transaction program is that it it manages data that must be left in a consistent manages data that must be left in a consistent statestate, e.g. if an electronic payment is made, the amount must be both withdrawn from one account and added to the other; it cannot complete only one of those steps. Either both must occur, or neither.


A MManagement anagement IInformation nformation SSystem (MIS)ystem (MIS) provides information that is needed to manage organizations efficiently and effectively.

It are not only computer systems - these systems encompass three primary components: technology, peopletechnology, people (individuals, groups, or organizations), and data/information for decision making.

MIS are distinct from other information systems in that they are designed to be used to analyze and facilitate strategic and operational activities in the organization.


A Decision Support System (DSS)Decision Support System (DSS) is a computer-based information system that supports business or organizational supports business or organizational decision-making activitiesdecision-making activities.

DSSs serve the management, operations, and planning levels of an organization and help to make decisions, which may be rapidly changing and not easily specified in advance.

DSS can be either fully computerized, human or a combination of both.


An Executive Information System (EIS)Executive Information System (EIS) is a type of management information system intended to facilitate and support the information and decision-making needs of senior executives by providing easy access to both internal and external information relevant to meeting the strategic goals of the organization.

It is commonly considered as a specialized form of decision support system (DSS).


2. 2. Medicine-Related Medicine-Related Information SystemsInformation Systems

Hospital Information System Radiology Information System Laboratory information system Laboratory information management system 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

One doctor’s clinic…. …one patient’s notes

22..1. 1. Hospital Information SystemHospital Information SystemThe aim of an HIS is to

achieve the best possible support of patient care and administration by electronic electronic data processingdata processing:

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 SystemComputer systems in clinical departments are generally can be 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



HIS can be composed of one or a few software software componentscomponents with specialty-specific extensions as well as of a large variety of sub-systems in medical specialties (e.g. Laboratory Laboratory Information SystemInformation System, Radiology Information Radiology Information SystemSystem).


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



Sample patient record view from an image-based electronic health record (VistA).

22.2.2. Laboratory information system. Laboratory 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).

22.2.2. Laboratory . Laboratory information systeminformation system

Basic Basic common common featuresfeatures of of the LISthe LIS:

Patient Check In Order Entry Specimen Processing Result(s) Entry Reporting Patient Demographics Physician Demographics.

22.2.2 Laboratory information system Laboratory 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.

22.2.2 Laboratory information system Laboratory information system

22.3.3. 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).

22.3.3. Laboratory information management . Laboratory information management systemsystem

22.3.3. 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.

22.3.3. 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.

22.3.3. 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.

22.3.3. Laboratory information management system. Laboratory information management system

22.4.4.. 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;

22.4.4.. Radiology Radiology IS - pathworkIS - pathwork

2.4. 2.4. Radiology Radiology IS - exampleIS - example

2.4. 2.4. Radiology Radiology IS vs. PACSIS vs. PACS

2.5. 2.5. 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)..

2.5. 2.5. Picture archiving and communication systemPicture archiving and communication system

A PACS allows to store volumic exams and to reconstruct 3D images

2.5. 2.5. 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).


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.


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).

2.5. 2.5. Picture archiving and communication systemPicture archiving and communication system

ConclusionConclusion

In this lecture was described next questions:

Information Systems Basics.Medicine-Related Information

Systems

ReferencesReferences

Wikipedia, the free encyclopedia – www.wikipedia.org

Hospital Information Systems (HIS) Information Technology Directory– http://www.health-infosys-dir.com

Healthinformatics:– http://healthinformatics.wikispaces.com/

Documents

Information Systems in Medicine Associated professor Semenets A.V. [email protected] [email protected] Department of Medical Informatics I.Ya.Horbachevsky