Computers in hospitals

4 Computers in hospitals

The Advantages of Computerisation

Eliminates Repetitive Tasks	• Repetitive form-filling not required • Once a patient’s name has been entered, it should not have to be re-entered
Eliminates Paper Handling and Filing	Elimination of hardcopies of:

• Request forms

• Reports

• Films

• Paper records

• Referral letters

Improves Interdepartmental CommunicationsVirtually instant access to:

• Existing patient records films/images

• Previous reports

• New images and reports

• Laboratory tests and results

• Referral letters

Improves efficiencyElimination of:

• Manual filing of films/images

• Manual retrieval of films/images

• Need to copy images

• Need to file images separate from patient records

Improves Confidentiality and Security

• Files, reports and patient details can be very secure

• Passwords would only allow access to specific levels of information

Automated Data CollectionImproves information handling on, e.g.:

• Staffing

• Budgeting

• Patient attendances

• Use of equipment

• Servicing

• Research

The Patient Journey

Overview

• Examination request is made, including clinical details

• The request is accepted (or rejected)

• The appointment is made

• Instructions and information sent to the patient

• DICOM worklist is generated

• The examination is completed and it is electronically signed that the work has been done

• Images sent to PACS

• PACS acknowledgement of receipt of the images

• Additional examinations/images added to file using PACS and DICOM

• The image, notes and clinical details placed on PACS workstation

• Image is reported on using voice recognition software

• The report is electronically signed

• Text is automatically available on:

Radiological Information System (RIS)

Hospital Information System (HIS)

Electronic Patient Record (EPR)

Integrating Health Enterprise (IHE)An initiative introduced in 1999
Aim:

• To bring together manufacturers of clinical information systems, PACS systems and imaging equipment

• To talk about integration requirements and systems

Individual Computer SystemsOverview

• The hospital information system (HIS) is the central hub

• Other systems are linked to it, e.g.

Picture Archiving and Communication Systems (PACS)

Electronic Patient Record (EPR)

Electronic Remote Requesting System (RRS)

Radiological Information System (RIS)

• DICOM is the protocol used so that the different parts can communicate with each other

Fig. 4.1 Individual computer systems.

Web-based IntegrationWorks in a similar way to the World Wide Web and has:

• An internet server

• A search engine

• Stores information on the web

• RIS and HIS, etc. are stored as data sets

• User can browse the individual data sets

Advantages

• Upgrades can be done on the central server

• Navigation is done using a mouse

• Hyperlinks can be used to aid the search facility

Digital Imaging and Communications in Medicine (DICOM)An initiative sponsored by the Radiological Society of North America and the Health and Management Systems SocietyAim

• To integrate information and management systems so that clinical information can be communicated among all specialities and providers

• Any doctor will eventually have access to a wide range of tests and images, on computer

• The primary concern is patient confidentiality

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