Healthcare Automation

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Healthcare Automation

• What is it, anyway?
• Get People back to healthcare and away from
  paperwork!

2
Why is it important?

• Give Customers what they want...
• More healthcare
• Better healthcare
• Less expensive healthcare

3
How do we store data?

• Paper
• Microfilm
• Computers

How can we help this guy out?
4
How else do we store things?

• Post-it notes
• Images (analog digital)
• Voice

5
Look to other industries for answers

• Airlines
• Banks
• Wal-Mart
• Grocery
• Retail
• UPS

6
Electronic Commerce is here NOW!

• Connections
• Records
• Transactions
• Communications
• Teamwork
• How do we do business?

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How are you involved in electronic commerce?????
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Campus Wide Healthcare Information System
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Network Design

• Make a plan
• What are you going to connect?
• Who are you going to connect?
• Whats the budget?
• Make the plan iterative
• Invest in infrastructure

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What is the major function of computers in
healthcare?
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Home Care
LTC
Imaging
Same day Surgery
Sub Acute
Acme Healthcare, Inc.
Acute care Core
Clinics
Rehab
Mental health
The vertically and horizontally integrated
healthcare center
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Employees
Managed Care
Vendors
The rest of the world
Health Care Organization
Customers (community)
Governments
Doctors
Competition
The Network
Insurance Companies
Acme Healthcare, Inc.
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The Virtual Practice of Medicine

• small town docs connected to big time resources

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What have the trends been?

• movement toward urban areas
• increased number of doctors
• fee for service to flat fee to capitation
• increased specialization
• de-emphasis of primary care
• Increase in female docs

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Why the move to the cities?

• money
• available technology
• available testing
• social network
• professional network
• money
• money
• money

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Does the Net change things?

• specialty demographics
• emphasis on primary care training
• pc literate young docs
• generally technology literate docs

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Enter the technology...

• getting connected is easy and cheap
• connections to and from specialist
• Telemedicine a reality
• teleconsulting a reality soon

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The connections...

• connect to outside experts
• connect yourself to your customers
• hospitals
• information sources
• vendors

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The main product of healthcare

• Information

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Host Based1955 - 1975
T
T
T
T
T
Mainframe
T
T
T
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Personal Computers1978 - 1990
PC
PC
PC
PC
PC
PC
PC
PC
PC
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Network Centric Model1990 Present 21st
Century
LAN
Mainframe
LAN
LAN
LAN
Mainframe
LAN
Internet Cloud
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What is this Internet, anyway?

• A network of networks
• probably a 150,000 hosts
• probably 50 million people connected
• Not a government run project
• Universities, government, professional
  organizations, commercial members, private
  subscribers, network providers

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Backbone Bandwidth
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Healthcare Providers

• Build LANs WANs
• Construct software hardware infrastructure
• Train people and connect them all up
• Reach out to make connections

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National Library of Medicine

• Grateful Med
• 50,000 users in 1991
• 250,000 minimum by the end of 1996
• Doctors and other healthcare professionals are
  using it!!!!!

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Healthcare sources

• NLM
• NIH
• Library of Congress
• CARL
• On-line journals
• Mayo Clinic
• CDC
• EBSCO

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Connection sources

• A local area network via your workplace
• Home dialup to a private subscriber or your
  workplace
• Universities or government organizations

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Providers and Helpers

• Telecos
• Baby Bells
• Computer people
• Network connectors
• Information services
• Integrators
• Entertainment people

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Services Today

• Email
• File transfer
• Interactive messages
• Listserv functions
• Telnet/FTP/email functions
• Searching schemes such as WWW and graphical
  browsers

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Tomorrows Stuff(things we can do now but not
many do them)

• Telemedicine
• Transfer of medical images
• global consulting
• electronic money
• ubiquitous computers
• CBMR

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Social Culture

• Language
• Traditions
• Procedures
• Commerce
• Technology
• Government

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The Dark Side

• Undesirable stuff
• Waste
• Rules
• Criminal acts
• Haves and have nots

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Internet Manners

• Use good netiquette
• Be polite, sometimes its not easy!
• Email is not a secure means of communication
• Peer pressure plays a unique role on the Net

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Healthcare Network Examples

• Who do we connect?
• How do we do it?
• How can we work together?

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Physician Practice Network
Clinical Workstations
Branch Office
Billing
Hand-held PC for Drs. Nurses
Network File Server
Doctors Workstations
Connection to Hospital Database
Front Desk
Communications Server
Internet
Print Server
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MANAGED HEALTHCARE
Home Office Insurance Company Communications Serve
r
Microsoft SQL Database Server
NT Server
Workstation
WAN Server
University Branch
W. Orlando Branch
Workstation
Longwood Branch
Maitland Branch
S. Orlando Branch
Internet
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CRITICAL CARE NETWORK
Monitor
Monitor
Monitor
Monitor
Patient
Patient
Patient
Patient
Network File Saver
Hand held Wireless
Bridge to Pharmacy LAN
Multiplexer
Gateway to Central Mainframe
Monitoring Station
Print Server
Communications Server
Internet
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Home Health Care Network
Hand-held Wireless FM or Cellular
Cellular Fax
Doctors Office
Communi- cations Server
Network File Server
Workstation
Workstation
Back Office
Electronic Billing
Print Server
Workstation
Workgroup
Workstation
Internet
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Paper-Based Medical RecordsDepartment
Digital Dictation System
Workstation
Workstation
Workstation
Internet
Workstation
Chart Production
Workstation
Coding
Network File Server
Main Database
Communications Server
Doctors
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Electronic Medical Imaging

• Acquire the image
• Store it
• Perform analytical methods
• Communicate it

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AUTOMATION USING TRADITIONAL X-RAY FILM
--- X-RAY FILM
NETWORK
VGA Monitor
PC
Film Scanner
Optical Drives

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X-Ray procedures without film
Network
X-Ray Machine
Video Camera
Image Board
PC
VGA Monitor
Optical Drive
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CAT/MRI/PET Imaging
CAT Scanner
Digital File
Image Board
PC
VGA Monitor
Network
Optical Drive
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MOTION X-RAYS ...CINE OR TRADITIONAL ANGIOGRAPHY
Network
X-Ray Machine
Video Black Box
Image Board
PC
VGA Monitor
Video Camera
Optical Drive
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Protecting Your System

• How to keep from winding up one of these

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Backup Whats Important

• Data and configurations
• Use daily incremental and full backups weekly
• Train your people
• Practice disaster drills

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Design Protection In

• UPS protection for all mission critical parts
• Diesel generators as needed
• Label everything
• Document everything
• Separate circuits

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Sources of Problems

• Human error
• Sabotage
• Equipment failure
• Telephone company problems
• Viruses

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Protect Your Servers and Links

• RAID systems
• Disk and server mirroring
• Hot fix
• Training/practice
• Protect telecommunications
• Redundant systems!