Thomas Bruessel, FANZCA Prof of Anaesthesia Canberra Hospital Canberra, AUS AIMS – ORMS – EMR.

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Thomas Bruessel, FANZCA Prof of Anaesthesia Canberra Hospital Canberra, AUS AIMS – ORMS – EMR

Transcript of Thomas Bruessel, FANZCA Prof of Anaesthesia Canberra Hospital Canberra, AUS AIMS – ORMS – EMR.

Page 1: Thomas Bruessel, FANZCA Prof of Anaesthesia Canberra Hospital Canberra, AUS AIMS – ORMS – EMR.

Thomas Bruessel, FANZCAProf of AnaesthesiaCanberra HospitalCanberra, AUS

AIMS – ORMS – EMR

Page 2: Thomas Bruessel, FANZCA Prof of Anaesthesia Canberra Hospital Canberra, AUS AIMS – ORMS – EMR.

Australian Institute of Medical ScientistsAustralian Institute of Mine SurveyorsAustralian Institute of ManagementAustralian Institute of Marine ScienceAustralian Institute of Medical ScientistsAustralian International Motor ShowAfrican Institute for Mathematical SciencesAfghanistan Information Management ServiceAssociation of International Marathons Races

AIMS – ORMS – EMR

Page 3: Thomas Bruessel, FANZCA Prof of Anaesthesia Canberra Hospital Canberra, AUS AIMS – ORMS – EMR.

AIMSAnaesthesia Information Management

System

AIMS – ORMS - EMR

ORMSOperating Room Management System

EMRElectronic Medical Record

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ORMS

EMR

AIMS

AIMS

eHealth

?

EMR

ORMS

Page 5: Thomas Bruessel, FANZCA Prof of Anaesthesia Canberra Hospital Canberra, AUS AIMS – ORMS – EMR.

“Ether Chart”

Codman EA, Cushing H

1st written record

1894 at MGH

On permanent loan from the Treadwell Library of Massachusetts General Hospitalto the Francis A. Countway Library of Medicine

Page 6: Thomas Bruessel, FANZCA Prof of Anaesthesia Canberra Hospital Canberra, AUS AIMS – ORMS – EMR.

Hand written anaesthesia

record~

100 years

Page 7: Thomas Bruessel, FANZCA Prof of Anaesthesia Canberra Hospital Canberra, AUS AIMS – ORMS – EMR.

Preadmission Clinic

Post AnaesthesiaCare Unit

Intraoperative Data

Page 8: Thomas Bruessel, FANZCA Prof of Anaesthesia Canberra Hospital Canberra, AUS AIMS – ORMS – EMR.
Page 9: Thomas Bruessel, FANZCA Prof of Anaesthesia Canberra Hospital Canberra, AUS AIMS – ORMS – EMR.

Automated anaesthesia record

HR, BP, CVP

FiO2, etCO2, SaO2 Temp

CVP

Sevo etRR, PIP

PCWP,CO

Page 10: Thomas Bruessel, FANZCA Prof of Anaesthesia Canberra Hospital Canberra, AUS AIMS – ORMS – EMR.
Page 11: Thomas Bruessel, FANZCA Prof of Anaesthesia Canberra Hospital Canberra, AUS AIMS – ORMS – EMR.
Page 12: Thomas Bruessel, FANZCA Prof of Anaesthesia Canberra Hospital Canberra, AUS AIMS – ORMS – EMR.

Data sampling (RS 232 port)

more frequently more accurately

medico-legal advantage ?

Automated anaesthesia record

Page 13: Thomas Bruessel, FANZCA Prof of Anaesthesia Canberra Hospital Canberra, AUS AIMS – ORMS – EMR.

A Anaesthesia I InformationM ManagementS System

Server

NetworkConnection

Patient Monitor

Other Devices

Anaesthesia machine

Operating Room

Communicationmultiplexer Workstation

Serial data

Page 14: Thomas Bruessel, FANZCA Prof of Anaesthesia Canberra Hospital Canberra, AUS AIMS – ORMS – EMR.
Page 15: Thomas Bruessel, FANZCA Prof of Anaesthesia Canberra Hospital Canberra, AUS AIMS – ORMS – EMR.

Position

Anaesthesia data chart: Missing information

Instrumentation

Type of anaesthesia

Fluid balance

Action / interventions

Drugs

Events

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AIMS

Collects intraoperative physiologic data

Collates these with patient information

Adds interventions of anaesthetist

Stores this information

Allows retrieval and analysis

Page 17: Thomas Bruessel, FANZCA Prof of Anaesthesia Canberra Hospital Canberra, AUS AIMS – ORMS – EMR.

PAC: information

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Medication Safety

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Performance

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Data retrieval & Analysis

AIMS

Adverse events, near misses

Clinical competence/performance

Compliance with standards, rules and regulations

Page 21: Thomas Bruessel, FANZCA Prof of Anaesthesia Canberra Hospital Canberra, AUS AIMS – ORMS – EMR.

PAC: history, exams, test

Intraoperative: data + events

PACU: data, pain, discharge info.

AIMS

ORMS

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Central Database“Server”

Medical Records

PreOpClinic

HoldingArea

ReferringPhysician

AdmissionsScheduling

OperatingRoom

ICU/FloorPACU

Perioperative Setting: Data Flow

Page 23: Thomas Bruessel, FANZCA Prof of Anaesthesia Canberra Hospital Canberra, AUS AIMS – ORMS – EMR.

ORMS

Billing (professional fees)

● Scheduling of cases

Organisation of clinical and support staff Organisation of equipment and suppliesCoordination of access to Biomedical engineering

Capture of patient information

Documentation of clinical information

● Tracking of patient flow● Organisation of postsurgical placement of patients

● Documentation of time stamps ●

●●●

AIMS Lab Imaging Pharmacy

●●●

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Allow maximal integration

Medication Management: Storage /Supply

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ORMS

ORMS

AIMS

Integration = Application + Platform

Data SharingRedundancy!!!

Page 26: Thomas Bruessel, FANZCA Prof of Anaesthesia Canberra Hospital Canberra, AUS AIMS – ORMS – EMR.

Jerry StonemetzKeith Ruskin Editors

Springer, London2008

Page 27: Thomas Bruessel, FANZCA Prof of Anaesthesia Canberra Hospital Canberra, AUS AIMS – ORMS – EMR.

HealthSMART (Vic)National E-Health Strategy

Electronic medical record

File:Electronic medical record.jpgFrom Wikipedia, the free encyclopedia

Page 28: Thomas Bruessel, FANZCA Prof of Anaesthesia Canberra Hospital Canberra, AUS AIMS – ORMS – EMR.

Medical record generated outside OR

Intergration/Linking GPs and Hospitals

Providing access to medical staff

Very expensive

E-HealthNational E-Health Strategy

Electronic Medical Record

Page 29: Thomas Bruessel, FANZCA Prof of Anaesthesia Canberra Hospital Canberra, AUS AIMS – ORMS – EMR.

E-Health

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E-Health takes time and cost money

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IDEAL SYSTEM

ORMS

EMR

AIMS

PathologyPathology

ImagingPhysician

Order Entry

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IDEAL SYSTEM

ConfidentialityPrivacy ?