The transition from Island Healthcare Information Systems to integrated Care Record Systems

1
The transition from Island Healthcare
Information Systems to integrated Care Record
Systems

• Christopher Varian
• Kodak Health Imaging

2
European spend on ICT as a of healthcare budget

• ICT Health budget and status of integration

Healthcare budget spend -HCIT

• EU Acceleration of ICT spend
• UK NHS ICT Budget 2
• EU Industry ICT spend 7

6 5 4 3 2 1
EU / Global Integration
Regional Integration
Ad Hoc Integration
Communication between applications
Isolated applications
1990
2000
2010
3
The challenge for ICT in healthcare

• Providing appropriate clinical information at the
  point of care to improve efficiency and quality
• Complexity of the healthcare process and the
  interdependences between the departments,
  hospitals and clinicians
• Legacy Information systems need to be integrated
  to provide the clinical pathway
• Validation of patient identification and the
  migration of data in island systems
• Security and authorisation of access to data
• Cost of implementation and overall complexity of
  the integration of island departmental systems
  due to different architectures
• Lack of investment in ICT in health

4
The solution

• A system that will automate clinical information
  at the point of care
• Simplify the Complexity of the healthcare process
  by providing a longitudinal healthcare record
• Enable Legacy Information systems to be
  integrated to provide a clinical data repository
• Ensure an appropriate unique patient identifier
  is the starting point in for the master patient
  index.
• Reduce costs by Enterprise Information Management
  by consolidation and simplification
• Use existing industry standards IHE DICOM HL7 XML
  FTP .

5
Standard Hospital environment Today
MPI PAS
Other applications
Radiology
..ologies
Cardiology
Archive
Archive
Storage
Backup

• DICOM archive
• 50MB files
• First generation obsolete
• Closed archives
• Archive dedicated to each PACS

• DICOM or non-DICOM
• Little or no archiving (DVD)
• 500MB/1GB files
• Dedicated archive

• Non-DICOM
• Backup and archiving
• Small to very large files
• Dedicated tape libraries

• Non-DICOM
• Little or no archiving
• Small files
• Dedicated storage

• Different vendors, isolated archives
• No sharing of infrastructure
• No sharing of information base
• May be located at different sites

6
Hospital general storage content
Other applications
Radiology
..ologies
Cardiology
Data volume

• 75 is fixed content
• Storage volumes mainly in imaging
• Exponential storage growth in the next 3 years

7
Enterprise Information management Solution
Other applications
Radiology
..ologies
Cardiology
Archiving function
Main Advantages

• Share the infrastructure

• Optimize investment

• Consolidate information

• Ease information sharing

• Globalize data protection

• Enhance information security

• Ease long term information management

• Ease architecture evolution

• Enhance IT productivity

• Ease Obsolescence Management

8
Scope of LSP Responsibility
Overall Requirements for a national system
Nationally built locally Implemented
Locally configured and locally implemented
Sample Set of Generic Processes
Confidentiality
Ambulatory Care Management
Screening
Authentication
MPIDemographics
Domiciliary Care Management
Clinical Correspondence/Summary
Master Patient Index (eMPI)
Resource scheduling
Clinical Noting
Order Entry
Bed Management
Integrated Care Pathways
E-prescribing
E-booking
Clinical Decision Support
Results
Casenote and Film tracking
Image Management
Reporting
Mental Health Act Administration
Management Information
Graphical Analysis
E-booking
Flexible Toolkit to Support Range of Data and
Viewing Requirement
Cardiology
Anaesthesiology
Radiology
Radiotherapy
Palliative Care
Colposcopy
INTEGRATED CARE RECORD SERVICE
Electronic Transfer of prescriptions
Diabetes
Theatres
Pathology
Child Health Screening
Respite Care
Nephrology
Intensive Care
Maternity
Old Age Psychiatry
Trauma
Rehabilitation
Endoscopy
Range of Care Settings
CommonServices
DTCs ACADs
General Practise
Acute Hospital
Community Nursing
Hospital Psychiatry
Therapies (OT/PT)
Community Mental Health
Diagnostic Departments
Home
Tertiary Care
Social Care
Private Health
Walk-In Centres
NHS
Prison
Hospices
Ambulance
9
Kodak HCIS as part of a national record CRS

• Simplified system architecture and flexible
  workflow
• Both presentation (pull) and routing (push)
  models are supported
• Data moves from modalities to system RAID and is
  distributed from there
• Optimized use of distributed storage
• Central database manages all image storage
  components
• Centralized or physically distributed storage,
  including workstation storage
• Global view of all studies with sophisticated
  worklists
• Customized worklists based on filtered views of
  global database at any workstation or client in
  the enterprise
• Enhanced system scalability and availability
• Software components are easily replicated across
  multiple hosts
• High-availability clustered server configurations
• Supports and uses DICOM 3.0 HL7 IHE standards
• Integrates into CIS systems by agreed
  international standards
• Will support XDS and HL7v 3 when finalised

10
Kodak Enterprise archiving model
Viewing/ diagnostic
Viewing/diagnostic capabilities
Radiology

• Searching and viewing
• Statistics
• Reports

Archive
Clinical Data Repository - CDR
An enterprise wide Clinical data repository,
accessible to every authorised users
11
Kodak VIParchive enterprise archive management
view
12
VIP archive key features

• Multi source/Open archive
• DICOM/Non DICOM, ology and IT sources
• Patient data consolidation
• Makes use of IHE HL7 DICOM and future XDS
  standards
• Enhanced lifecycle management, clinical based
• Adapt performance to content
• Adapt preservation/retention to content
• Transparent access across multi sites
• All data available from anywhere
• With standard interface to End User tools
• Built in disaster recovery
• Local or remote
• From manual to automatic recovery
• Media technology and storage vendor neutral
• All storage technologies supported (disk, tape,
  DVD)
• Management of obsolescence
• Scalability by design
• Same software from small to large enterprise
  systems
• Incremental architecture

13
Thank youQuestions