Introduction to Information TechnologyYour Digital World

Parts of Information SystemsHardwareSoftwareDataCommunicationsPolices and ProceduresUsers

Information Systems HardwareInputProcessingStorage

PrimarySecondary

OutputCommunications

Input & OutputInput hardware - devices that translate data into a form the computer can process.

Output hardware - devices that translate information processed by the computer into a form that humans can understand.

Input Hardware – Keyboard

Keyboard - a device that converts letters, numbers, and other characters into electrical signals that can be read by the computer’s processor.

Types of Keyboards

Traditional computer keyboards

Specialty keyboards and terminals

Dumb terminals Intelligent terminals (e. g. ATMs) Internet terminals

Input Hardware – Pointing DevicesPointing devices - control the position of the cursor or pointer on the screen.

Mouse Trackball Pointing Stick Touchscreen TouchpadPen/stylus inputDigitizing tablet

Mouse

Trackball

Pointing Stick

Touchpad

Touchscreen

Pen/Stylus input

Digitizing Tablet

Input Hardware – Scanning and Reading Devices

Source data-entry devices – create machine-readable data.

Scanners - use light-sensing equipment to translate images of text, drawings, photos, and the like into digital form.

Input Hardware – Scanning and Reading DevicesBar-code readers:

Bar codes - photoelectric scanners that translate the symbols in the bar code into digital code.

Input Hardware – Scanning and Reading Devices Mark-recognition and character-

recognition devices – sense marks or characters

Types MICR - character recognition system that

uses magnetic ink and special characters OMR - uses a device that reads bubble marks

and converts them into computer-usable form. OCR - converts scanned text from images to

an editable text format that can be imported into a word-processing application and manipulated

Input Hardware – Scanning and Reading DevicesFax machine – scans an image and sends it as electronic signals over telephone lines to areceiving fax machine.

Types of fax machines:

Dedicated fax machine Fax modem

Dedicated fax machine

Fax modem circuit board

Input Hardware – Audio-Input DevicesAudio-input device - records analog sound and translates it for digital storage and processing.

Digitizing an audio signal:

sound board

MIDI board

Input Hardware – Webcams and Video-Input CardsWebcam – a video camera attached to a computer to record moving images that can be posted on a website in real time.

Input Hardware – Digital CamerasDigital camera - uses a light-sensitive processor chip to capture photographic images in digital form and store them on a small diskette.Smartphone – most smartphones include a digital camera, as does the iPad

Digital cameraattached to a computer

Input Hardware – Speech-Recognition Systems

Speech-recognition system - converts a person’s speech into digital signals.

Input Hardware – Sensors Sensor – an input device that collects specific data directly from the environment and transmits it to a computer.

Input Hardware – Radio-Frequency Identification Tags

RFID tags – based on an identifying tag bearing a microchip that contains specific code numbers.

A tollbooth with RFID readers

RFID tag in a car for paying toll

Input Hardware – Human-Biology-Input DevicesBiometrics - the science of measuring individual body characteristics.

Screen of face recognition system

Palm print recognition reader

ProcessingTaking the input and converting it to outputRelated definitions

Data – The raw facts and figures that are processed into information

Information – Data that has been summarized or otherwise manipulated for use in decision making

Knowledge – Application of experience, ability, etc. to information

Processing HardwareCentral Processing Unit (CPU) – the “brains”

of the computerControl Unit – directs activityArithmetic/Logic Unit – does math and logical

comparisons

StoragePrimary – main

computer memoryTypes of primary

storageROM (Read Only

Memory) Programmed into chip by manufacturer contains instructions for start-up.

RAM (Random Access Memory) Holds everything open and currently being worked on.

Secondary – permanent storage; “saving” a file

Types of secondary storageUSB driveHard driveCD/DVDCloud

Output HardwareSoftcopy - data that is shown on a display screen or is in audio or voice form.

Hardcopy - printed output.

Hardcopy

Softcopy

Output Hardware – Display ScreensDisplay screens - output devices that show programming instructions and data as they are being input and information after it is processed.

Output Hardware – Display ScreensPixel (picture element) - the smallest unit on the screen that can be turned on and off or made different shades.

Output Hardware – Display ScreensFactors affecting screen clarity:

Dot pitch (dp) - the amount of space between the centers of adjacent pixels; the closer the dots, the crisper the image.Resolution - the image sharpness of a display screen; the more pixels there are per square inch, the finer the level of detailColor depth - the amount of information, expressed in bits, that is stored in a dotRefresh rate - the number of times per second that the pixels are recharged so that their glow remains bright

Output Hardware – Display ScreensTwo types of monitors:

•CRT - a vacuum tube used as a display screen in a computer or video display terminal.

•Flat-panel display - made up of two plates of glass separated by a layer of a substance in which light is manipulated

CRT vs. Flat-panel

Output Hardware – Display ScreensActive-matrix versus passive-matrix flat-panel displays:

Active-matrix display - each pixel on the screen is controlled by its own transistor

Passive-matrix - a transistor controls a whole row or column of pixels

Output Hardware – Display ScreensColor & resolution standards for monitors:

Output Hardware – Printers Printer - an output device that prints characters, symbols, and perhaps graphics on paper or another hardcopy medium.

Dpi - a measure of the number of rows and columns of dots that are printed in a square inch.

Output Hardware – Printers Impact printer - forms characters or images by striking a mechanism such as a print hammer or wheel against an inked ribbon, leaving an image on paper.

Non-impact printer - forms characters and images without direct physical contact between the printing mechanism and paper.

Traditional Hardcopy Output: PrintersTypes of nonimpact printers:

Laser printer - creates images on a drum which are treated with a magnetically charged toner, and then transferred from drum to paperInk-jet printers - spray small, electrically charged droplets of ink from four nozzles through holes in a matrix at high speedThermal printers - use colored waxes and heat to produce images by burning dots onto special paperMultifunction printer - output device that combines several capabilities, such as printing, scanning, copying, and faxing

Ink-jet printer

Replacing a laser toner cartridge

Multi-function printer

Output Hardware – Sound, Voice, and VideoSound output devices - produce digitized sounds, ranging from beeps and chirps to music

Voice output devices - convert digital data into speech-like sounds

Video output - photographic images which are played at 15-29 frames per second to give the appearance of full motion

CommunicationsCommunications devices- electromagnetic

devices and systems for communicating over long distances

Networks – means of connecting computers and communications devices LAN: Local Area NetworkWAN: Wide Area NetworkWiFi: Wireless NetworkVPN: Virtual Private Network

Communications – NetworksParts of a Network

Nodes or workstationsServer/file serverNetwork interface cards (NIC)Network Operating System (NIS)Communications Media

Cabling Wireless networks Satellites

Communications – NetworksTypes of networks

Client-server – network in which some computers (end-user computers) make requests for data/processing and other computers fulfill these requests Clients – make requests Servers – fulfill requests

Peer-to-peer – network in which computers are able to access each other directly

SoftwareInstruction for the computerTypes

Systems software – allows the computer to perform essential operating tasks and enables the application software to run

Applications software – allows user to perform specific tasks--solve problems, perform work, or entertain yourself

Hospital Information Systems (HIS)Also called clinical information system

(CIS) is a comprehensive, integrated information system designed to manage the administrative, financial and clinical aspects of a hospital.

This encompasses paper-based information processing as well as data processing machines.

Hospital Information Systems (HIS)As an area of medical informatics the aim of

an HIS is to achieve the best possible support of patient care and administration by electronic data processing.

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

Clinical Information Systems (CIS)CISs are sometimes separated from HISs in

that the former concentrate on patient- and clinical state- related data (electronic patient record) whereas the latter keeps track of administrative issues.

The distinction is not always clear and there is contradictory evidence against a consistent use of both terms

Radiologic Information Systems (RIS)used by radiology departments to store,

manipulate and distribute patient radiological data and imagery.

The system generally comprises of patient tracking and scheduling, result reporting and image tracking capabilities.

Basic Features

Laboratory Information Systems commonly support the following features:

Patient Registration Patient Tracking Result(s) Entry Reporting

Additional Features

In addition a RIS often supports the following:

Appointment booking Faxing and emailing of reports Custom report creation HL7 interfaces with a PACS Billing Rule engines

Picture Archiving Communication Systems (PACS)In medical imaging, picture archiving and

communication systems (PACS) are computers or networks dedicated to the storage, retrieval, distribution and presentation of images.

Types of PACSFull PACS handle images from various

modalities, such as UltrasonographyMagneticresonance imagingpositron emission tomographycomputed tomographyEndoscopyMammographyradiography (plain X-rays).

Uses of PACS

PACS replaces hard-copy based means of managing medical images, such as film archives.

It expands on the possibilities of such conventional systems by providing capabilities of off-site viewing and reporting (distance education, tele-diagnosis).

Additionally, it enables practitioners at various physical locations to peruse the same information simultaneously, (teleradiology).

With the decreasing price of digital storage, PACS systems provide a growing cost and space advantage over film archives.

PACS is offered by virtually all the major medical imaging equipment manufacturers.

Digital Imaging And Communications In Medicine (DICOM)A comprehensive set of standards (polices and

procedures) for handling, storing, printing, and transmitting information in medical imaging

It includes a file format definition and a network communications protocol

The communication protocol is an application protocol that uses TCP/IP to communicate between systems

DICOM files can be exchanged between two entities that are capable of receiving image and patient data in DICOM format

Digital Imaging And Communications In Medicine (DICOM)

DICOM enables the integration of scanners, servers, workstations, printers, and network hardware from multiple vendors into a picture archiving and communication system.

The different machines, servers, and workstations come with DICOM conformance statements which clearly state the DICOM classes they support.

DICOM has been widely adopted by hospitals and is making inroads in smaller applications like dentists' and doctors' offices

Examples of Modalities supported in DICOM are:

AS = Angioscopy BI = Biomagnetic Imaging CD = Color Flow Doppler CF = Cinefluorography (retired) CP = Culposcopy CR = Computed Radiography CS = Cystoscopy CT = Computed Tomography DD = Duplex Doppler DF = Digital Fluoroscopy (retired)

Examples of Modalities Supported in DICOM (cont.)DG = Diaphanography DM = Digital Microscopy DS = Digital Subtraction Angiography DX = Digital Radiography EC = Echocardiography ES = Endoscopy FA = Fluorescein Angiography FS = Fundoscopy HC = Hard Copy

Examples of Modalities Supported in DICOM (cont.)LP = Laparoscopy LS = Laser Surface Scan MA = Magnetic Resonance Angiography MR = Magnetic Resonance MS = Magnetic Resonance Spectroscopy PT = Positron Emission Tomography (PET) RF = Radio Fluoroscopy RG = Radiographic Imaging (conventional film

screen) RTDOSE = Radiotherapy Dose RTIMAGE = Radiotherapy Image

Examples of Modalities Supported in DICOM (cont.)

RTPLAN = Radiotherapy Plan RTSTRUCT = Radiotherapy Structure Set ST = Single-photon Emission Computed

Tomography TG = Thermography US = Ultrasound VF = Videofluorography (retired) XA = X-Ray Angiography XC = eXternal Camera ECG = Electrocardiograms

Impact of Healthcare Information TechnologyVideo Teleconferencing

Synchronous face to face communication over long distances.

Distance Consultations & DiagnosisAllow patients in remote areas to consult

specialists

Virtual CommunitiesCollaborate and exchange ideas through either

synchronous or asynchronous communication.

Concerns Raised by HITPrivacyAccuracySecurityAccessibility

PrivacyA major concern is adequate confidentiality of the individual

records being managed electronically

According to the LA Times, roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization

600,000 payers, providers and other entities that handle providers' billing data have some access also

Multiple access points over an open network like the internet increases possible patient data interception

In the United States, this class of information is referred to as Personal Healthcare Information (PHI) and its management is addressed under the (HIPAA) as well as many local laws Health Insurance Portability and Accountability Act

AccuracyData is correct and completeAccording to the Institute of Medicine in

1999, between 44,000 and 98,000 deaths occur in hospitals that are preventable; data inaccuracy contributes to this number

SecurityPolicies, procedures,

software, and/or hardware designed to insure that data in information systems are protected against accidental or inappropriate destruction, alterations, or access.

Security controls FirewallsNetwork Intrusion

Detection and Prevention Systems

AuthenticationAuthorizationAudit logsEncryption

AccessibilityInformation is available where and when it is

needed