Transcript picture archiving and communication systems

Introduction to Information Technology
Your Digital World
Parts of Information Systems
 Hardware
 Software
 Data
 Communications
 Polices and Procedures
 Users
Information Systems Hardware
 Input
 Processing
 Storage
 Primary
 Secondary
 Output
 Communications
Input & Output
Input 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
Types of Keyboards
Traditional computer
keyboards
Specialty keyboards and
terminals
Keyboard - a device that converts
letters, numbers, and other
characters into electrical signals
that can be read by the computer’s
processor.
Dumb terminals
 Intelligent terminals (e. g.
ATMs)
 Internet terminals

Input Hardware – Pointing Devices
Pointing devices - control
the position of the cursor or
pointer on the screen.
 Mouse
 Trackball
 Pointing Stick
 Touchscreen
 Touchpad
Pen/stylus input
Digitizing tablet
Mouse
Input Hardware – Pointing Devices
Trackball
Pointing Stick
Touchscreen
Pen/Stylus input
Touchpad
Digitizing Tablet
Input Hardware – Scanning and Reading
Devices
Source data-entry
devices – create
machine-readable data.
Scanners - use lightsensing equipment to
translate images of text,
drawings, photos, and
the like into digital form.
Input Hardware – Scanning and Reading
Devices
Bar-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 wordprocessing application and manipulated
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Input Hardware – Scanning and Reading
Devices
Fax machine – scans an
image and sends it as
electronic signals over
telephone lines to a
receiving fax machine.
Dedicated fax machine
Types of fax machines:
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Dedicated fax machine
Fax modem
Fax modem circuit board
Input Hardware – Audio-Input Devices
Audio-input device - records analog sound
and translates it for digital storage and
processing.
Digitizing an audio signal:
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sound board
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MIDI board
Input Hardware – Webcams and VideoInput Cards
Webcam – a video camera
attached to a computer to
record moving images that can
be posted on a website in real
time.
Input Hardware – Digital Cameras
Digital 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 camera
attached 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.
RFID tag in a car for paying toll
A tollbooth with RFID readers
Input Hardware – Human-Biology-Input
Devices
Biometrics - the science
of measuring individual
body characteristics.
Palm print recognition reader
Screen of face recognition system
Processing
 Taking the input and converting it to output
 Related 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 Hardware
 Central Processing Unit (CPU) – the “brains” of the
computer
 Control Unit – directs activity
 Arithmetic/Logic Unit – does math and logical
comparisons
Storage
 Primary – main computer
 Secondary – permanent
memory
 Types of primary storage
storage; “saving” a file
 Types of secondary storage
 ROM (Read Only
 USB drive
Memory) Programmed
into chip by manufacturer
contains instructions for
start-up.
 RAM (Random Access
Memory) Holds
everything open and
currently being worked
on.
 Hard drive
 CD/DVD
 Cloud
Output Hardware
Softcopy - data that is
shown on a display screen
or is in audio or voice form.
Hard
copy
Hardcopy - printed
output.
Soft
copy
Output Hardware – Display Screens
Display screens - output devices that show
programming instructions and data as they are being
input and information after it is processed.
Output Hardware – Display Screens
Pixel (picture element) - the
smallest unit on the screen
that can be turned on and off
or made different shades.
Output Hardware – Display Screens
Factors 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
detail
Color depth - the amount of
information, expressed in bits, that is
stored in a dot
Refresh rate - the number of times per
second that the pixels are recharged so
that their glow remains bright
Output Hardware – Display Screens
Two 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 Screens
Active-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 Screens
Color & 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: Printers
Types of nonimpact printers:
Laser printer - creates images on a drum which are
treated with a magnetically charged toner, and then
transferred from drum to paper
Ink-jet printers - spray small, electrically charged
droplets of ink from four nozzles through holes in a matrix
at high speed
Thermal printers - use colored waxes and heat to produce
images by burning dots onto special paper
Multifunction printer - output device that combines
several capabilities, such as printing, scanning, copying,
and faxing
Traditional Hardcopy Output: Printers
Replacing a laser toner cartridge
Ink-jet printer
Multi-function printer
Output Hardware – Sound, Voice, and
Video
Sound 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
Communications
 Communications devices- electromagnetic devices and
systems for communicating over long distances
 Networks – means of connecting computers and
communications devices
 LAN: Local Area Network
 WAN: Wide Area Network
 WiFi: Wireless Network
 VPN: Virtual Private Network
Communications – Networks
 Parts of a Network
 Nodes or workstations
 Server/file server
 Network interface cards (NIC)
 Network Operating System (NIS)
 Communications Media
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Cabling
Wireless networks
Satellites
Communications – Networks
 Types of networks
 Client-server – network in which some computers (enduser computers) make requests for data/processing and
other computers fulfill these requests
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Clients – make requests
Servers – fulfill requests
 Peer-to-peer – network in which computers are able to
access each other directly
Software
 Instruction for the computer
 Types
 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 staterelated 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
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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 PACS
 Full PACS handle images from various modalities,
such as
 Ultrasonography
 Magnetic
 resonance imaging
 positron emission tomography
 computed tomography
 Endoscopy
 Mammography
 radiography (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:
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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.)
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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.)
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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
Technology
 Video Teleconferencing
 Synchronous face to face communication over long
distances.
 Distance Consultations & Diagnosis
 Allow patients in remote areas to consult specialists
 Virtual Communities
 Collaborate and exchange ideas through either
synchronous or asynchronous communication.
Concerns Raised by HIT
 Privacy
 Accuracy
 Security
 Accessibility
Privacy
 A 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
Accuracy
 Data is correct and complete
 According 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
Security
 Policies, 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
 Firewalls
 Network Intrusion
Detection and
Prevention Systems
 Authentication
 Authorization
 Audit logs
 Encryption
Accessibility
 Information is available where and when it is needed