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

Providers’EnterpriseSystems

• ERP• GDSS

• DSS• CDSS

Physicians

AndSpecialist

s

Patients

Internet

EXTRANETS

INTRANETS

PRM

Src: K.Siau, “Health Care Informatics”, IEEE trans. On Info. Tech. In Biomedicine, 7(1), March, 2003, pp. 1-7

Enterprise Resource Planning

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

Message1 MessageN

Seg1 SegN

Field1 Field1

Comp1 CompN

Terminated by <CR>

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)

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 – 2542PV1|| E | Emergency |||| 0148^Addison^James ||| SUR

An example of HL7 message for patient admission

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

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

Admit/Visit Notification (Contd.)

Digital Imaging Communications in Digital Imaging Communications in MedicineMedicine ((DICOM )DICOM )originally the ACR-NEMA

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

Patient

is subject of

Study

contains

series

contains

creates

Spatially of

Temporally

defines

EquipmentFrame of Reference

Image(Pixels)

Curve

VOILUT

ModalityLUT

Overlay Waveform

1

1,n

1

1

11

1,n1,n 0,n

0,n0,n 0,n 0,n 0,n0,1

DICOM Composite Image IOD Information Model

Patient

is subject of

Study

contains

series

contains

creates

temporally

defines

EquipmentFrame of Reference

1

1,n

1

1

11

1,n1,n 0,n

Waveform

1,n

DICOM Waveform IOD Information Model

Patient

is subjec of

Study

contains

Series

Contains

Waveform

Waveform

contains

MultiplexGroup

contains

Channel

contains

Sample

WaveformAttribute

Time of AcquisitionAcquisition ContextAnnotation

Multiplex GroupAttributes

Number of ChannelsSampling FrequencyTiming

Channel DefinitionAttributes

Channel SourceMetricAnatomic Location(s)FunctionTechnique

Channel SensitivityBaselineSkewFilter Characteristics

1

1,n

1

1,n

1

1,n

1

1

1

1,n

1,n

1,n

DICOM Waveform Information Model

Preamble (128 bytes)

DICM (4 bytes)

DE1

DEn

DICOM File Structure

Data Element……………D EData Element

Data Element

VFVLVRTag Explicit VR

< 4 bytes > < 2 bytes > < 2 bytes >

VFVLTag

< 4 bytes >

Implicit VR

DICOM Data formatDicom Information Structure

An Example of Data Element

Sridhar Raja000CPN0010 0010

Sridhar Raja0000 000C0010 0010

Patient Informatio

n

Patient

Name

VR VL VF

Explicit VR

Implicit VR

Some vital tags for rendering images in DICOM Standard

Tag Description Hex Encoding (Group, Element)

Transfer Syntax TagSamples per pixel

Numbers of FramesNumber of Rows

Number of ColumnsNumber of Bits Allocated

Number of Bits StoredPixel Data

(0x0002, 0x0010)(0x0028, 0x0002)(0x0028, 0x0008)(0x0028, 0x0010)(0x0028, 0x0011)(0x0028, 0x0100)(0x0028, 0x0101)(0x7FE0, 0x0010)