ABC of Medical Computing 2008-01-18 MNIA Introduction to Health Informatics ABC of Medical Computing Perry Poulsen/Kieran Savage Manitoba eHealth.

ABC of Medical Computing2008-01-18

MNIA Introduction to Health Informatics

ABC of Medical Computing Perry Poulsen/Kieran Savage

Manitoba eHealth

ABC of Medical Computing2008-01-18

TopicsComputing Basics

What is a computer• terms• networks • connecting it all together (WWW,WAN,LAN)

Applications• local and centralized

Account management• security, authentication and your profile

Discussion of the Clinical system network• architecture, governance model and change management

On the horizon• hand held, radio-frequency identification (RFID) , facial recognition, remote access

MB Health / eHealth and WRHA Services• project management, service desk, work orders, H/W S/W upgrades

ABC of Medical Computing2008-01-18

What do computers have to offer?

The common reason for buying a computer is the need to write simple letters, medical reports, papers - a word processor but they can do much more.

Computers are good at storing and manipulating large amounts of information. Database programs collect, sort, and analyze and perform repetitive tasks extremely fast and without error.

General practitioners computerize their practices which offer comprehensive

recording of medical records, issue repeat prescriptions, and provide call and recall facilities.

Hospitals have many computer systems for Admitting, Scheduling, Lab systems and PAC,s to name a few.

These systems make it possible for us to build the Electronic Health Record (EHR) giving authorized healthcare providers rapid access to patients' complete, up-to-date health information to support clinical decision-making and case management.

ABC of Medical Computing2008-01-18

Computer Basics

• Computers are everywhere you look, and even in places you can't see.

• Computers check out your groceries, pump your gas, dispense money at the ATM, turn the heat on and off in your home

• There are different kinds of computers for different purposes

ABC of Medical Computing2008-01-18

Computer Basics What is a computer?

• A computer is an electronic device that executes the instructions in a program.

• A computer has four functions:

a. accepts data as input

b. processes data

c. produces output

d. stores results - storage

ABC of Medical Computing2008-01-18

Computer Basics Types of Computers

Computers for personal use come in all shapes and sizes

• PC (personal computer)– Desktop or referred to as a workstation– Laptop provides mobility– Tablets you use an electronic stylus to write on the

screen• PDAs (personal digital assistant)

– Black Berry or Palm Pilot

ABC of Medical Computing2008-01-18

Computer Basics Terms

• Hardware – the physical parts of the computer

• Software – the programs (instructions) that tell the computer what to do

• Data – individual facts like first name, price, quantity ordered

• Information– which has been massaged into a useful form, like a complete mailing address

• CD ROMs – (compact disks read only memory) Similar to the audio compact disc, are an excellent

way of distributing large amounts of information

ABC of Medical Computing2008-01-18

Computer Basics Terms

• Network– A network is a set of computers which are linked together on a permanent

basis. This can mean two computers cabled together on the same desk, or thousands of computers across the world.

• Internet– global computer network: a network that links computer networks all over the

world by satellite and telephone, connecting users with service networks such as e-mail and the World Wide Web

• Intranet– computer network within organization: a network of computers, especially one

using World Wide Web conventions, accessible only to authorized users such as those within a company

• Firewall– similar to firewalls with fire door in building construction. In former case, it is

used to prevent network access and intrusion to the private network

ABC of Medical Computing2008-01-18

Computer Basics Terms

• Server – The term server refers to a specific kind of computer. – It handles the sharing of equipment like printers and the communication between

computers on the network. – A computer somewhat more capable than a personal computer which requires

more power, larger memory & storage capacity with high speed communications

• Main Frame– A main frame allows hundreds of people to work at the same time on the same

data. It requires a special environment - cold and dry, backup power.

• Storage– May be referred to as storage area network ( SAN ) providing data storage on a

local disk or a network connected device such as disk arrays , tape libraries.

ABC of Medical Computing2008-01-18

Networks

In the world of computers, networking is the practice of linking two or more computing devices together for the purpose of sharing data. Networks are built with a mix of computer hardware and computer software. Networks can be categorized different ways. Usually defined according to the geographic area it spans. Local area networks (LANs), typically reach across a single home or officeWide area networks (WANs), reach across cities, states, or even across the world. The Internet is the world's largest public WAN.

ABC of Medical Computing2008-01-18

NetworkLAN/WAN

LAN

WAN

ABC of Medical Computing2008-01-18

ApplicationLocal and Centralized

ABC of Medical Computing2008-01-18

Account Managementsecurity, authentication and your profile

Passwords – the Weakest Link in Healthcare Security

The temptation for users to share passwords is high. Policies such as 90 day auto reset with a rule based on no repeats has been a challenge to adopt

The more complicated the password policy, the more expensive it is to implement and support. Between 25 and 50 percent of calls to help desks are for password resets. Deloitte & Touche estimated that the typical enterprise spends an average of $150 per user, per year to support password resets.

ABC of Medical Computing2008-01-18

Account Managementsecurity, authentication and your profile

Why do we need account management?

Security •Trustees must protect personal health information by making reasonable security safeguards to ensure the confidentiality, security, accuracy and integrity of the information

Authentication •Identifies the user•Allows for auditing •Defines privileges

Profile •Categorize types of users based on their job roles within the organization into profiles that can be assigned to multiple users performing the same job.

ABC of Medical Computing2008-01-18

Clinical System Network

Architecture – many systems are designed for a specific purpose, typically the application will define the architecture.

• Hardware – systems get old and from time to time need an upgrade• Applications require added functionality or regulatory changes

Governance – How do we manage change to work flow?• Who will participate in the approval as we implement provincial

services/applications• How are they implemented – project or a work order / impact

assessment

Change Management – How is the change request managed?• Best practices (ITIL) include change, release and incident

management processes

ABC of Medical Computing2008-01-18

Clinical System Network

ABC of Medical Computing2008-01-18

On the HorizonHand Held Devices - The use of these devices to access medical literature and education, research,e-prescribing as well as specialty-specific uses for personal digital assistants (PDAs).

Radio Frequency Identification (RFID) is an automatic identification method, relying on storing and remotely retrieving data using devices called RFID tags. It can also be used to locate staff and patients within a facility

A recent survey (BearingPoint) established that RFID technology is being used for a wide variety of applications within health-care organizations, including patient flow management, access control and security, supply chain systems

You are here

ABC of Medical Computing2008-01-18

On the Horizon

Biometrics Vendors and Solutions

•Fingerprint &Hand

•Facial & Iris

•Voice & Smart cards

Fingerprint-based identification is the oldest method which has been successfully used in numerous applications. Everyone is known to have unique fingerprint.

Facial recognition - software has come a long way. It can pick someone's face out of a crowd, extract the face from the rest of the scene and compare it to a database of stored images.

Smart Cards defined as pocket-sized card with embedded integrated circuits which can process information. The card is made of plastic, just like any bank card.

ABC of Medical Computing2008-01-18

On the Horizon

Remote Access - anywhere any time

Healthcare industry is looking at secure remote access solutions. Growing number of healthcare professionals believe that it will provide improved data accuracy, reduce errors, and result in an overall improvement of patient care.

A team of radiologists deliver a 24-hour on-call service.

•Unable to access patient x-rays from their homes and, consequently, spent a lot of time traveling to hospitals.

•Secure remote access solution, the radiologists can work from remote locations, reduce travelling time, and deliver urgent reports quickly.

The Manitoba First Nations Remote Access Initiative

•Aimed at demonstrating the value of remote, dynamic access to knowledge and health human resources.

•Involved 35 First Nations communities, Tribal Councils and their health services organizations;

ABC of Medical Computing2008-01-18

MB Health / eHealth and WRHA ServiceHealth care initiative are much like any other business. Funding is provided in several ways, treasury board, infoway or grants.

Project management, depending on the initiative may be provided by MB Health, Manitoba eHealth or the WRHA delivering services such as RIS/PACs / Electronic Health Record and Client Registry.

Manitoba eHealth has centralized a service desk as a single point of contact and working with the RHA’s on a shared service model in anticipation of provincial initiatives.

Adoption of new systems and h/w s/w upgrades are becoming a fact of life, some are easy some are very complex.

What makes all of this work, is when we can all work together and better understand the risks and impact and I hope to see more interest in participating together in the future – we will all benefit regardless of roles, service support, care givers and patients alike.

ABC of Medical Computing2008-01-18

Thank for your time

Too much information…