Medical Informatics Representation and Computation on Medical and Health Care Information

Targetted at Design and Development of Information System for Medical Science and Technology Health Care Services Business world invoving health care

Health Care Informatics Suppliers’ Enterprise Systems Pharmacies Medical suppliers Insurance providers Providers’ Enterprise Systems ERP GDSS DSS CDSS Physicians And Specialists Patients Internet EXTRANETSEXTRANETS INTRANETSINTRANETS PRMPRM Src: K.Siau, “Health Care Informatics”, IEEE trans. On Info. Tech. In Biomedicine, 7(1), March, 2003, pp. 1-7

Enterprise Resource Planning Full integration of an organization's information from pay-roll and human resources to accounting and finance. Database integration (Information Sharing) Information logged once and accessed by different modules maintaining the data consistency. Track inventory, order information and delivery requirements Determine equipment usage and maintenance schedule

Decision Support System (DSS) Conventional DSS: financial and scheduling. Clinical DSS (CDSS): diagnosis, pharamacy, emergency and nursing practices. CDSS used to send alerts and reminders to patients about preventive care.

Patient Relationship Management (PRM) Primary focus on determining and meeting patients' needs. Tracking patients information from diet and exercise data to past diagnosis information from family history and allergy information. Send s satisfying queries, informing newly published health care studies and reminding about preventive measures.

Standards for exchange and management of medical information To maintain interoperability between systems across different platforms. HL7 (Health Level 7): aims to provide standards for the exchange, management and integration of data that support clinical patient care and management, delivery and evaluation of health care services. Digital Imaging and Communications in Medicine (DICOM): Diagnostic images, waveforms and test reports.

HL7 Message Structure Event Message1 MessageN Seg1 SegN Field1 Comp1 CompN Terminated by Separated by '|' Separated by '^'

Message Encoding Sequence of segments separated by '|' Compulsory and optional segments Segments as sequence of fields separated by '^' Compulsory and optional fields A field is described by a data type (e.g. AD datatype denoting an Address)

MSH | ^~ \ & | Clinic || Central|Reg ||| ADT^A01 |MSG00005 | P | 2.3 EVN | A01 | PID ||| || Evans^Carolyn || | F |||903 Diane Circle^^Phoenixville^PA^19460|| (610) 555 – 1212 | (610) 555 – 1212 || S | C ||156 – 96 – 2542 PV1|| E | Emergency |||| 0148^Addison^James ||| SUR An example of HL7 message for patient admission

1. Message Header (i) From: Clinic (ii) To : Central 2. Event (i) Date: (ii) Time: 15:30 3. Patient Identification (i) Internal Patient ID Number: (ii) Family Name: Evans (iii) Given Name: Carolyn (iv) Birth Date: (v) Sex: F Admit/Visit Notification

3. Patient Identification (contd.) (vi) Street Address: 903 Diane Circle (vii) City: Phoenixville (viii) State of Province: PA (ix) Zip or Postal Code: (x) Phone (Home): (610) 555 – 1212 (xi) Phone (Office): (610) (xii) Marital Status: S (xiii) Religion: C (xiv) Social Security Number: Patient Visit (i) Patient Class: E (ii) Point of Care: Emergency (iii) Attending Doctor's ID: 0148 (iv) Family Name: Addison (v) Given Name: James (vi) Hospital Service: SUR Admit/Visit Notification (Contd.)

Digital Imaging Communications in Medicine ( DICOM ) originally the ACR-NEMA  developed by American College of Radiology (ACR) and the National Electrical Manufacturer's Association (NEMA) provides standardised formats for image capture and storage coupled with a common information model specifying service definitions and protocols for communication

Patient is subjec t of Study contain s series contain s create s Spatially of Temporall y defines Equipment Frame of Reference Image (Pixels) Curve VOI LUT Modality LUT Overlay Waveform 1 1,n ,n 0,1 DICOM Composite Image IOD Information Model

Patient is subjec t of Study contain s series contain s create s temporall y defines Equipment Frame of Reference 1 1,n ,n Waveform 1,n DICOM Waveform IOD Information Model

Patient is subjec of Study contain s Series Contai ns Waveform contain s Multiplex Group contain s Channel contain s Sample Waveform Attribute Time of Acquisition Acquisition Context Annotation Multiplex Group Attributes Number of Channels Sampling Frequency Timing Channel Definition Attributes Channel Source Metric Anatomic Location(s) Function Technique Channel Sensitivity Baseline Skew Filter Characteristics 1 1,n DICOM Waveform Information Model

Preamble (128 bytes) DICM (4 bytes) DE1 DEn DICOM File Structure

Data Element……………D EData Element VFVLVRTag Explicit VR VFVLTag Implicit VR DICOM Data format Dicom Information Structure

An Example of Data Element Sridhar Raja000CPN0010 Sridhar Raja C0010 Patient Information Patient Name VR VLVF Explicit VR Implicit VR

Some vital tags for rendering images in DICOM Standard Tag DescriptionHex Encoding (Group, Element) Transfer Syntax Tag Samples per pixel Numbers of Frames Number of Rows Number of Columns Number of Bits Allocated Number of Bits Stored Pixel Data (0x0002, 0x0010) (0x0028, 0x0002) (0x0028, 0x0008) (0x0028, 0x0010) (0x0028, 0x0011) (0x0028, 0x0100) (0x0028, 0x0101) (0x7FE0, 0x0010)