Transcript Information Technology in Healthcare

Information Technology in
Healthcare
Dr Keith Boardman
Director of Computer & Network Services
University Hospitals Coventry & Warwickshire
NHS Trust
The NHS as a Business
National Health Service
 Formed in 1948
 Employs 1 million people
 500 health authorities
 Costs £37 billion
 Treats 8.4 million in-patients a year
 About 3 million day-cases a year
 40 million out-patient attendances
 30,000 GPs
UHCW NHS Trust
Acute Trust with 1246 beds
11 Regional Specialities
Meets 98% of Coventry & Rugby acute
healthcare needs
Contract Income £200M approx.
6000 employees
General Specilaties
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Urology
General Surgery
Ear Nose & Throat
Ophthalmology
Oral Surgery
Orthopaedics
Rheumatology
Dermatology
General Medicine
GP Maternity
Gynaecology
Special Care Baby Unit
Paediatrics
Obstetrics
Regional Specialties
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Cardiac Surgery
Thoracic Surgery
Cardiology
Renal Transplantation
Renal Dialysis
Neurology
Neurosurgery
Radiotherapy
Bone Marrow Transplantation
Haemophilia Services
Neonatal Intensive Care
Activity Levels
In-patient attendances - 90,000
 Out-patient attendances - 306,000
 Emergency assessments - 27,000
 Accident Dept attendances - 103,000
 Pathology requests - 865,000
 Radiology Examinations - 207,000
 MRI & CT Scanning - 13,000
 Patient meals - 1,400,000
 Staff meals - 744,000
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Computers in Healthcare
Key application areas:
 Information
 Treatment
 Diagnosis
Management
Information Management
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Hospital Administration Systems
 Community & GP Systems
 Clinical Information Systems
 Business Systems
Hospital Information Systems
A HIS meets the real-time operational
information needs of health professionals
to deliver care to patients, whilst also
providing accurate and timely
information for management purposes.
HIS Benefits
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Improved care and delivery of services
provided to patients
Reduced administrative work
Better information for resource
management
HIS Functional areas
(used by 1500 staff)
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Patient Administration
Admissions, Discharges and Transfers
Accident & Emergency
Maternity
Operating Theatres
Professions Allied to Medicine
Case Note Tracking
Contracting & Billing
HIS Computer System:
HP9000/K460 running UNIX
•2
G Byte RAM
•100
G Byte disk storage (RAID)
•128
V24 ports
•IEEE
10/100 MHz Ethernet
•Cartridge
•DLT
Magnetic Tape
Magnetic Tape
Clinical Information Systems
Intranet &
Internet
Clinical Information
System
Pathology
Radiology
Clinical
Documentation
Computer Systems Overview
HIS HP9000
Community
HP 9000
MIS
General
E-Mail
Local Area Network (with ATM backbone)
PC Client
Access
Pathology
RS6000
Pharmacy
RS6000
Radiology
Sun
Renal
HP 9000
Breast Scr’
HP 9000
DATA INTEGRATION
Pathology System
Radiology
HIS
Interface
Engine
Clinical System
(Data Warehouse)
PC Client
Access
Local Area Network (with ATM backbone)
Wide Area NHS Communications
Internet
Secure
Gateway
NHSnet Intranet
Information for Health
An Information Strategy for the
Modern NHS 1998-2005
Top level commitment
“The challenge for the NHS is to harness
the information revolution and use it to
benefit patients”.
Rt. Hon. Tony Blair
All Our Tomorrows Conference 2 July 1998
Purpose of the strategy
. . . . to put in place over the next seven
years the people, the resources, the
culture and the processes necessary to
ensure NHS clinicians and managers
have the information needed to
support the core purpose of the NHS.
And to ensure the public and patients
have a range of quality information
easily accessible about health and
health services.
Treatment and care
Primary
care
EHR
NHS
Social
Trust
care
EPR
records
Knowledge for
Analysis
Public
Patients
Healthcare professionals
Managers
Public health
Clinical Governance
Health Improvement Programme
Performance management
Defining electronic records
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Electronic Patient Record - a record of
periodic care provided by one institution,
typically an acute hospital
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Electronic Health Record - the concept of a
longitudinal record of a patient’s health
and healthcare to combine information
from primary healthcare with periodic
care from other institutions
Better Practice Systems +
Electronic Health Record
( EHR )
INFRASTRUCTURE
(wires,security,standards)
Better Hospital Systems +
Electronic Patient Record
( EPR )
National Electronic
Library of Health
( NELH )
4 Key Pieces of the Strategy
Week Ending
02/08/2001
02/07/2001
02/06/2001
02/05/2001
02/04/2001
02/03/2001
02/02/2001
02/01/2001
02/12/2000
02/11/2000
02/10/2000
02/09/2000
02/08/2000
02/07/2000
02/06/2000
02/05/2000
02/04/2000
02/03/2000
02/02/2000
02/01/2000
02/12/1999
Count
CRRS: Logins Per Week
6000
5000
4000
3000
2000
1000
0
Computers in Healthcare
Key application areas:
 Information
 Treatment
 Diagnosis
Management
Computers used in Treatment
Radiotherapy
Intensive
Care
Patient Communication Aids
Protheses
Computers in Healthcare
Key application areas:
 Information
 Treatment
 Diagnosis
Management
Computers used in Diagnosis
Computerised
Tomography
Magnetic Resonance Imaging
Ultrasonics
Radioisotope Imaging
Medical
Imaging
Computerised Tomography
Intracranial
haematoma
Renal
tumour
Magnetic Resonance Imaging
Protons in a magnetic field have a microscopic magnetization and
act like tiny toy tops that wobble as they spin.
The rate of the wobbling or precession is the resonant
or Larmor frequency.
In the magnetic field of an MRI scanner there is approximately
the same number of proton nuclei aligned with the main magnetic
field as counter-aligned.
On a macroscopic level, exposure of an object or person
to RF radiation at the Larmor frequency, causes the net
magnetization to spiral away from the static field.
Relaxation is the process whereby nuclear magnetization returns
to its resting state following a perturbation, such as by an RF
pulse.
An MRI Scanner
Magnetic Resonance Imaging
Lumbar Spine
Knee
Anatomy
Baker’s
Cyst
Ultrasound Imaging
Ultrasound Imaging System
Pregnancy
Triplets
Liver carcinoma
Nuclear Medicine Imaging
Conventional
Radiography
Gamma Camera:
Pulmonary Embolism
THE END