Informations Systems in Health Care

Mapping out the terrain

Types of systems in health informaticsBioinformatics

1. Biological structure informatics2. Computational biology3. Expression profiling and microarrays4. Genomic ontologies5. Genomics6. Linking the genotype and phenotype7. Neuroinformatics8. Pharmacogenomics9. Proteomics

Clinical Informatics10. Barriers to clinical system implementation11. Clinical systems in ambulatory care12. Clinical systems in high intensity care13. Careflow and process improvement systems14. Disease management15. E-health and clinical communication16. Evaluation of health information systems17. Health data warehousing18. Health information systems19. Integrated health and financial systems

Education and Training20. Computer-assisted medical education21. Consumer health information22. E-learning or distance learning23. Education and training24. Library information systems25. Medical informatics teaching26. Patient education and self-care27. Professional education

Human Information Processing and Organizational Behavior28. Cognitive models and problem solving29. Data visualization30. Natural language understanding and text generation31. Human factors and usability32. Human factors and user interfaces33. Human-computer interaction34. Models of social and organizational behavior35. Natural language processing

Imaging and Signal Analysis36. Image processing and transmission37. Image recognition, registration, and segmentation methods38. Imaging and signal standards39. Knowledge representation and ontologies for imaging40. Model-based imaging41. Signal processing and transmission42. Virtual reality and active vision methods and applications

Innovative Technologies in Health Care43. Computer-communication infrastructures44. Internet applications45. Mobile computing and communication46. Portable patient records47. Security and data protection48. Software agents and distributed systems49. Telemedicine50. Virtual reality51. Wireless applications and handheld devicesKnowledge Management52. Automated learning and discovery53. Clinical guidelines and protocols54. Controlled terminology, vocabularies, and ontologies55. Intelligent data analysis and data mining56. Decision support systems57. Knowledge management58. Knowledge representation59. Neural network techniques60. Pattern recognition/classification

Nursing Informatics61. Nursing informatics62. Nursing care systems63. Nursing vocabulary and terminology64. Nursing education/Curriculum in nursing informatics65. Nursing documentation

Organizational Issues66. Careflow management systems67. Care delivery systems68. Cooperative design and development69. Economics of care70. Ethical and legal issues71. Health services evaluation: performance and quality72. Organizational impact of information systems73. Quality assessment and improvement74. System implementation and management issues75. Technology assessment

Patient Record76. Cryptography, database security, and anonymization77. Database access and delivery78. Database design and construction79. Data standards and enterprise data sharing80. Patient record management81. Privacy, confidentiality, and information protection82. Standard medical vocabularies83. Standards for coding84. Standards for data transfer

Public Health Informatics85. Administrative/financial systems86. Biosurveillance87. Consumer health informatics88. Emergency and disaster response89. Genetic epidemiology90. Health intervention systems91. Health promotion systems92. Health outcomes assessment93. Patient self-care and patient-provider interaction

Patient

Relative

Citizen

Physician

Nurse

Technician/support

Administrator/mamanger

Actors involvedIn Health Care

Researcher

TDT4210 Helseinformatikk - evaluation

Prevention & Care

Act Teach

Moti

vate

Role of pupil

Role of provider

Role of changer

ICT support - examples

Act

Teach

Moti

vate

Kreftregisteret

• home page: http://www.kreftregisteret.no• purpose:

– obtain and analyze data from patients with cancer in Norway

– support / conduct research to obtain new knowledge ..– give advice on the treatment of cancer– give advice on the prevention of cancer

• established in 1951 -one of the oldest national cancer registries in the world

• regulation: “Kreftregisterforskriften”– http://www.lovdata.no/cgi-wift/ldles?doc=/sf/sf/sf-200

11221-1477.html

kreftregisteret, forts• “Melding til Kreftregisteret” is mandatory for the physicians that discovers the

cancer.• Norwegian cancer registry also has many “special registries”

– Norsk Polyposeregister– Nordisk barnekreftregister for solide svulster - NOPHO– Rectumcancerregisteret– Spesialregisteret for eggstokkreft– Spesialregisteret for lungekreft– Prostatacancerregisteret

• and conduct mass screening programmes– Norwegian cervical cancer screening programme– Norwegian mammography screening programme

Fragmentation of cognition and careFrom:

Towards: Reasons: • increasing complex clinical care• more co-morbidity• more focus on patient-centred care• more part-time healthcare professionals• extramuralisation of care• …

Problem Case

• Old• Memory problems• Small social network• Limited communication

skills

Case: demential syndrome

PA: patient

GP: general practitioner

LP: local pharmacist

GC: geriatric clinic

HC: home care

RIO: regional indication

agency

(diagnostic phase only)

>> concepts: Notification, Alert, Form, Message, Process Status

PA GP1

LP2

3

GC

4

HC

66

6RIO

5

“Defragmentation” of cognition and care

ICT can play an important role in “repairing” the fragmented cognition and care by facilitation of:• communication• shared data

ICT

Helseinformatikk - Introduksjon