Presentation on the topic of computer analysis of medical data. Medical information systems. Presentation on the topic: Medical information systems

27.04.2020

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Presentation on the topic: Medical Information Systems

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The classification of medical information systems is based on a hierarchical principle and corresponds to the multilevel structure of healthcare. There are: 1. Basic level medical information systems. The main goal is computer support for the work of doctors of various specialties.

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According to the tasks to be solved, there are: information and reference systems (designed for searching and issuing medical information on request) consultative and diagnostic systems (for diagnosing pathological conditions, including prognosis and making recommendations on treatment methods) instrument-computer systems (for information support and / or automation of the diagnostic and treatment process carried out in direct contact with the patient's body) automated workstations (AWP) of specialists (to automate everything technological process a doctor of the relevant specialty and providing information support in making diagnostic and tactical medical decisions)

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2. Medical information systems at the level of medical institutions. They are represented by the following main groups: information systems of advisory centers (information support for doctors during consultations) information banks of medical services (contain summary data on the qualitative and quantitative composition of employees of the institution, attached population) personalized registers (containing information on the attached or observed contingent) screening systems (for conducting pre-medical preventive examination of the population) information systems of a medical institution (combining all information flows into a single system and automation of the institution) information systems of research institutes and medical universities

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3. Medical information systems of the territorial level. Presented: IP of the territorial health authority; IS for solving medical and technological problems, providing information support for activities medical workers specialized medical services; computer telecommunication medical networks that ensure the creation of a single information space at the regional level

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Medical instrument-computer systems An important type of specialized medical information systems are medical instrument-computer systems (MPCS). The use of a computer in combination with measuring and control equipment in medical practice has made it possible to create new effective tools to ensure the automated collection of information about the patient's condition, its processing in real time and the management of its condition. MPCS belong to the medical information systems of the basic level. The main difference between systems of this class is the work in conditions of direct contact with the object of study and in real time.

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Typical representatives of the MPCS are medical systems monitoring the condition of patients: during complex operations; systems for computer analysis of tomography data, ultrasound diagnostics, radiography; systems for automated data analysis of microbiological and virological studies, analysis of human cells and tissues.

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medical support includes methods for implementing a selected range of medical tasks that are solved in accordance with the capabilities of the hardware and software parts of the system. Medical support includes sets of methods used, measured physiological parameters and methods for their measurement, determination of methods and permissible limits of the system's impact on the patient.

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Medical diagnostics The task of diagnostics in the field of medicine can be posed as finding the relationship between symptoms and diagnosis. To implement an effective organizational and technical diagnostic system, it is necessary to use artificial intelligence methods. The expediency of this approach is confirmed by the analysis of the data used in medical diagnostics, which shows that they have a number of features, such as the qualitative nature of the information, the presence of data omissions. The interpretation of medical data obtained as a result of diagnosis and treatment is becoming one of the serious areas of neural networks.

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Systems for monitoring The task of rapid assessment of the patient's condition arises in a number of very important practical areas in medicine, and primarily in the continuous monitoring of patients in intensive care units, operating rooms and postoperative departments. In this case, it is required, on the basis of a long and continuous analysis of a large amount of data characterizing the state of the physiological systems of the body, to ensure not only the prompt diagnosis of complications during treatment, but also the prediction of the patient's condition, as well as to determine the optimal correction of emerging disorders.

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Among the most commonly used parameters in monitoring are: electrocardiogram, blood pressure at various points, respiratory rate, temperature curve, blood gases, minute volume of blood circulation, gas content in exhaled air. An important feature of monitoring systems is the availability of tools for express analysis and visualization of their results in real time. This allows you to display on the monitor screen also the dynamics of various derivatives of controlled values.

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Treatment process management systems These include automated intensive care systems, as well as prostheses and artificial organs created on the basis of microprocessor technology. In treatment process control systems, the following tasks come to the fore: accurate dosing of quantitative parameters of work, stable retention of their set values in conditions of variability of the physiological characteristics of the patient's body. Automated intensive care systems are understood as systems designed to control the state of the body for therapeutic purposes, as well as to normalize it, restore the natural functions of the organs of a sick person, and maintain them within the normal range.

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According to the structural configuration implemented in them, intensive care systems are divided into: program control closed control systems Program control systems include systems for the implementation of therapeutic effects. For example, various physiotherapy equipment equipped with computer technology, devices for infusing drugs, equipment for artificial lung ventilation and inhalation anesthesia, heart-lung machines. Closed intensive care systems combine the tasks of monitoring, assessing the patient's condition and developing control therapeutic effects. Therefore, in practice, closed intensive care systems are created only for very particular, strictly fixed tasks.

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Ways of development of medical information technologies: 1. It is necessary to widely introduce into clinical practice proven means and methods of informational influence that meet such requirements as safety and ease of use, high therapeutic efficacy. 2. Stimulate and encourage the development and creation of new means and methods of influencing the human body. 3. One of the main ways to solve a number of medical, social and economic problems is currently the informatization of the work of medical personnel. These problems include the search for effective tools that can provide an increase in three key indicators healthcare: the quality of treatment, the level of patient safety, economic efficiency medical care.

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Presentation on the topic "Medical information systems of the level structural unit medical institution"(Grade 11) can be downloaded absolutely free on our website. Project subject: Informatics. Colorful slides and illustrations will help you interest your classmates or the audience. Use the player to view the content, or if you want to download the report, click on the appropriate text under the player. The presentation contains 4 slide(s).

Presentation slides

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Medical information systems at the level of a structural unit of a medical institution. Food service information systems. Examples of some food service information systems. Food service automation subsystem "Interin PROMIS"

Completed by: student of group 254 Lomova K.V. Checked by: Dynkina G.B.

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automated workplace(AWP) - a program for automating a single task (function), for example, AWP for extracting DLO, AWP statistics, AWP fluorotheca, etc. Medical Information Systems (MIS) – software for automation certain types activities in medical facilities Laboratory information systems (LIS) - a type of HIS designed to solve laboratory automation problems Radiological information systems (RIS) - a type of HIS designed to automate the work of diagnostic departments using radiation diagnostic methods (X-ray, tomography, ultrasound) Hospital or Complex MIS (KIIS) - systems that integrate all the main areas of automation in health care facilities and allow solving the problem of automation at the level of health care facilities by means of one system Simple Complex

Emergence of networks in healthcare facilities (Netware) File-server solutions Transition to MS Windows Interest in mobile technologies Real increase in competition Interest in Open Source 1980s Client-server architecture Implementation of industry standards Demand for integrated solutions First PCs in healthcare facilities (statistics, accounting) Single-user ARMs MS DOS, FoxPro, Clipper

Separate workstations Integrated system Miscellaneous programs for individual tasks A complex of related programs with a single database Each program uses its own separate database, the data is not integrated and duplicated A common database leads to time savings and truly objective information Patchwork automation allows you to temporarily solve burning problems, but then become a dead end for further development

5 Registry Patient Attending physician Ultrasound laboratory Tomography Medical treatment Surgical treatment Discharge from a medical facility Blood transfusion Outpatient voucher Card of a patient who left the hospital Compulsory medical insurance bills Prescriptions for DLO Examination protocol Operation protocol

6 Registry Patient Attending physician Ultrasound laboratory Tomography Medical treatment Surgical treatment Discharge from health facility Blood transfusion Examination protocol Operation protocol Outpatient coupon Outpatient card Accounts for compulsory medical insurance Recipes for DLO

Administrative and economic approach oriented approach The main thing is to take into account the interests of the head doctor as an administrator, automate the formation of statistical reporting and accounting paid services Beginning: registration and referral of the patient, medical examinations, examination and operation protocols Then: they try to make a “clinical” out of the statistical HIS, supplementing the forms for entering information about services with fields for medical records Then: from any medical document, you can freely “extract” statistical and financial It is fundamentally very difficult to achieve the administrative-statistical effect without any problems 7

8 Tasks of HIS from the side of the administration of the function of HIS for a doctor Example: the task of collecting and monitoring services provided in a health facility is the goal of introducing a HIS. But this is not the function of a doctor, which means that working with MIS should not require the performance of this work. MIS should give an effect first of all to the doctor - and transform the results of this work into solving problems of the administrative level. Therefore, the task of introducing MIS is not the task of its user. In practice, the development and implementation of MIS is exactly what is done. Objective: accounting for services provided in healthcare facilities and evaluating effectiveness Solution: implementing software for accounting for services and generating reports Result: MIS is a tool for “hardening” statistics. Gives nothing to the doctor. Task: accounting for services provided in healthcare facilities and evaluating effectiveness Solution: we introduce electronic information security, first we eliminate the problems of doctors Result: MIS is really needed by doctors, but gives the administration the necessary “cuts”

Today, among all medical software, the largest growth is in the sector of complex MIS. Therefore, it is complex MISs that are increasingly being introduced in recent years and it is they who will dominate in the near future. The stage of “patchwork automation” has passed - more and more customers have gained experience in using individual solutions and in practice have become convinced of the need to use industrial systems. Recently, more and more often we are talking about clinically oriented solutions. KIIS, “grown” from statistical and accounting systems, are gradually losing out in competition. In the Russian Federation, there are plans to strengthen the role of IIAs at the federal level, and they will probably develop further. This means that the fate of MIS is in integration with the federal system.

Bicycle Car Low price Simple repair No running costs Just teach There is no money for that either…. 1 car = 200 bicycles Who will serve? Need consumables, etc. Who will teach? No more money... THE MAIN REASON is the lack of up-to-date information on this topic. A lot of "stereotypes" The price of the issue - managers do not know (and it can be more accessible) How to implement - the employees of the ACS department do not know (and there is already a lot of experience) How to use - doctors do not know (and there are a lot of examples)

Free software Commercial software Zero cost for the right to install and start using the software High cost of purchasing licenses, but can be considered different schemes payment, incl. leasing Indistinct technical support: from the side of an incomprehensible OpenSource community, in a critical situation it is completely unclear who to make claims and with whom to negotiate Guaranteed technical support, including work of technical support by phone, consultations by mail, a clearly clear solution provider and the ability to work directly Unclear quality assurance: if the supplier of the MIS does not earn on licenses, he will earn on implementation and customization services. And the more they need, the higher his earnings. Is it necessary for LPU? A clear incentive to ensure quality: the supplier must ensure the quality and uninterrupted operation of the MIS, otherwise he incurs the costs of its constant refinement and customization at the client. " free cheese only exists in a mousetrap.

The choice of MIS is at least professional domestic solutions. Define clearly the tasks of the IIA - and see how they will be solved. Just the presence of certain functions is not enough. The difference between the systems lies not in the list of functions, but in the effectiveness of their implementation and use in practice. Statistics and accounting for services is the end result of the MIS, not the initial one. Pay attention to development trends electronic document management! is the best that hospital systems can achieve today. 13

Indicator * Average number of implementations of one KIIS 4.3 5, % 7, % 17, % 23, % 28, % , % 982.6 -2.6% Average number of workstations per 1 implementation 118.1 148.2 +25.5% 264.6 +78.5% 46.2 -82.6% 195.3 +323% 102 ,91 -47.3% Total implementation of KIIS (10.6% of health facilities) 53.9 thousand jobs automated (2.2% of the total number of healthcare workers) Complete automation projects are extremely rare: most often several functions are implemented

What is the “implementation of an integrated IIA”? Some developers report about 250 KIIS implementations and 500 workstations per year??!!! There has been a division of developers into 2 groups: those specializing in “large projects” and those making “a lot of installations”: “Large” solutions before installations at workplaces for 1 implementation “Mass” solutions are installations of KIIS at workplaces

Fear of the computer and complete ignorance of the elementary foundations of informatics - up to 80% Computers at home (for children) - up to% functional responsibilities“All this is a whim of the authorities and extra labor costs” “And so there is no money, but they still buy computers” ... In fact, the main problem in implementation is not computer illiteracy, but unwillingness or fear of mastering new technologies. Start: interest in HIS, learning and use - isolated cases - only among progressive employees In the process: less than 5% of employees quit or give up HIS for a long time, most often understandable at the very beginning. Shortly after: few people imagine how you can do without MIS

Choice of KIIS in HCIs, introduction of primary information (EIB and EAK), gradual readiness for transfer of electronic data to the regional level Automation from below Automation from above

Impossibility to get input data: register of insured persons, beneficiaries, etc. For example, St. Petersburg - data is transmitted only through "own" software in a closed format = "foreign" MIS cannot receive them. On the contrary: Karelia or Perm - an open protocol for information exchange is adopted at the level of the subject, the tasks of the MIS are only to support the legalized format. The impossibility of issuing the final results: the register for compulsory medical insurance, the register of issued preferential prescriptions. For example, the Volgograd region: refusal (in writing!) by the MHIF to accept registers in their own format, but not from their program. Pskov - refusal of a local company to cooperate in accepting the register, because KIIS is perceived as a threat to their regional monopoly. On the contrary: Karelia - outdoor forms uploading registries (XML / DBF), which means freedom in choosing software for exchanging work results and reporting in MIAC.

The reasons for reluctance are different - just laziness, the desire to hide financial and organizational problems, corruption at the level of management or departments, etc. The result is because the use of IT is not included in the management's area of interest, or even contradicts them, then no "educational" seminars, books or articles, the experience of other colleagues will help. As a rule, the interests of management change only with the management itself. But where does he come from, if not from the same environment? A problem that is always "nearby" is the lack of an explicit indication (permission) for the use of IIAs. The healthcare system traditionally organizes its work on the basis of orders from the Ministry of Health. Only a few can act on the principle of "what is not forbidden is allowed." Example: one of the Central Regional Hospitals in Karelia - MIS was offered free of charge, the infrastructure and specialists are there - but at the management level the question is: "...does anyone else need this?".

Open letter S. Peter Wagemann, executive director US Institute of Medical Records: The US experience in the development and use of IT in medicine is recognized as unsuccessful. He urges US President-elect Barack Obama to seize "...opportunity to correct the mistakes of the past and develop a new strategy for the use of information technology in healthcare" as unsuccessful as similar projects in other countries, especially in the UK" Concludes that for "...more significant progress towards computerization" it is actually important to understand that: "...the medical community does not need rigid leadership, but harmonization their activities” [Doctor and information technologies g. p ]

"Compulsory health insurance" - Citizens Russian Federation. Federal body. Medical services. able-bodied citizens. Lawyers. Intelligence. Protection of personal information. Non-Profit Organizations. The structure of the CHI system. Specialists. A number of practically important methodological documents. Organization. Federal fund. Information accounting.

"Occupational diseases of teachers" - Prevention occupational diseases preschool teachers. Avoid unnecessary competition. Prevention of voice disorders. Be healthy. Brain. Prevention of colds and flu. Psychohygiene. Whisper. Recommendations for the preservation of health. Prevention of fatigue of the organs of vision. Prevention.

"Medicine of Russian Railways" - Features of healthcare of JSC "Russian Railways". A comprehensive solution to health issues. Implemented automated systems. The financing system is on a contractual basis. The system of departmental medicine on the example of Russian Railways. 66 centers are successfully operating in the National Healthcare Institution of Russian Railways. Perspective. The composition of the network of NUZ JSC "Russian Railways".

"Medical statistics" - Areas of application of averages. Non-repetitive selection of units of observation. The main sections of medical statistics. Relationship between parts of a whole. Population health statistics. Sample set. Fundamentals of medical statistics. Medical statistics. The number of deaths per year. health statistics.

"Payment for medical services" - Payment for a retired patient. Per capita financing. Estimated funding. Payment for individual services. Global budget method. Payment based on the spent bed-day. Payment for the patient. global budget. Payment of individual medical services. General requirements. Improving the efficiency of the health care system.

"Consent to medical intervention" - Medical intervention. The procedure for giving informed voluntary consent. Consent to certain types of medical intervention. Citizen. Medical organization. Possible consequences. Informed voluntary consent to medical intervention. Compulsory medical measures.

In total there are 20 presentations in the topic

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According to the tasks to be solved, there are: information and reference systems (designed for searching and issuing medical information on request) consultative and diagnostic systems (for diagnosing pathological conditions, including prognosis and making recommendations on treatment methods) instrument-computer systems (for information support and / or automation of the diagnostic and therapeutic process carried out in direct contact with the patient's body) automated workstations (AWP) of specialists (for automating the entire technological process of a doctor of the relevant specialty and providing information support when making diagnostic and tactical medical decisions)

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3. Medical information systems of the territorial level. Presented: IP of the territorial health authority; IS for solving medical and technological problems, providing information support for the activities of medical workers of specialized medical services; computer telecommunication medical networks that ensure the creation of a single information space at the regional level

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4. Federal level Designed for information support of the state level of the healthcare system.

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Medical instrument-computer systems

An important type of specialized medical information systems are medical instrument-computer systems (MPCS). The use of a computer in combination with measuring and control equipment in medical practice has made it possible to create new effective tools to ensure the automated collection of information about the patient's condition, its processing in real time and the management of its condition. MPCS belong to the medical information systems of the basic level. The main difference between systems of this class is the work in conditions of direct contact with the object of study and in real time.

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Typical representatives of MPCS are medical systems for monitoring the condition of patients:

during complex operations; systems for computer analysis of tomography data, ultrasound diagnostics, radiography; systems for automated data analysis of microbiological and virological studies, analysis of human cells and tissues.

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There are three main components in the MPCS: medical, hardware software.

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medical support

includes methods for implementing a selected range of medical tasks that are solved in accordance with the capabilities of the hardware and software parts of the system. Medical support includes sets of methods used, measured physiological parameters and methods for their measurement, determination of methods and permissible limits of the system's impact on the patient.

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Hardware

includes methods for implementing the technical part of the system, including means for obtaining medical and biological information, means for implementing therapeutic effects and computer equipment.

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Medical diagnostics

The task of diagnostics in the field of medicine can be posed as finding the relationship between symptoms and diagnosis. To implement an effective organizational and technical diagnostic system, it is necessary to use artificial intelligence methods. The expediency of this approach is confirmed by the analysis of the data used in medical diagnostics, which shows that they have a number of features, such as the qualitative nature of the information, the presence of data omissions. The interpretation of medical data obtained as a result of diagnosis and treatment is becoming one of the serious areas of neural networks.

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Monitoring systems

The task of rapid assessment of the patient's condition arises in a number of very important practical areas in medicine and, first of all, during continuous monitoring of the patient in intensive care units, operating rooms and postoperative departments. In this case, it is required, on the basis of a long and continuous analysis of a large amount of data characterizing the state of the physiological systems of the body, to ensure not only the prompt diagnosis of complications during treatment, but also the prediction of the patient's condition, as well as to determine the optimal correction of emerging disorders.

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The most commonly used monitoring parameters include:

electrocardiogram, blood pressure at various points, respiratory rate, temperature curve, blood gas content, minute volume of blood circulation, gas content in exhaled air. An important feature of monitoring systems is the availability of tools for express analysis and visualization of their results in real time. This allows you to display on the monitor screen also the dynamics of various derivatives of controlled values.

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Treatment management systems

These include automated intensive care systems, as well as prostheses and artificial organs created on the basis of microprocessor technology. In treatment process control systems, the following tasks come to the fore: accurate dosing of quantitative parameters of work, stable retention of their set values in conditions of variability of the physiological characteristics of the patient's body. Automated intensive care systems are understood as systems designed to control the state of the body for therapeutic purposes, as well as to normalize it, restore the natural functions of the organs of a sick person, and maintain them within the normal range.

Slide 17

According to the structural configuration implemented in them, intensive care systems are divided into: program control systems closed control systems Program control systems include systems for the implementation of therapeutic effects. For example, various physiotherapy equipment equipped with computer technology, devices for infusing drugs, equipment for artificial lung ventilation and inhalation anesthesia, heart-lung machines. Closed intensive care systems combine the tasks of monitoring, assessing the patient's condition and developing control therapeutic effects. Therefore, in practice, closed intensive care systems are created only for very particular, strictly fixed tasks.

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Ways of development of medical information technologies:

1. It is necessary to widely introduce into clinical practice proven means and methods of informational influence that meet such requirements as safety and ease of use, high therapeutic efficacy. 2. Stimulate and encourage the development and creation of new means and methods of influencing the human body. 3. One of the main ways to solve a number of medical, social and economic problems is currently the informatization of the work of medical personnel. These problems include the search for effective tools that can improve the three most important indicators of health care: the quality of treatment, the level of patient safety, and the cost-effectiveness of medical care.

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