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

2. AIMS – ORMS – EMR Australian Institute of Medical Scientists
Australian Institute of Mine Surveyors
Australian Institute of Management
Australian Institute of Marine Science
Australian International Motor Show
African Institute for Mathematical Sciences
Afghanistan Information Management Service
Association of International Marathons Races

3. AIMS – ORMS - EMR AIMS Anaesthesia Information Management System ORMS
Operating Room Management System
EMR
Electronic Medical Record

4. AIMS
EMR ?
AIMS
ORMS
ORMS
EMR
eHealth

5. “Ether Chart” Codman EA, Cushing H 1st written record 1894 at MGH
On permanent loan from the Treadwell Library of Massachusetts General Hospital to the Francis A. Countway Library of Medicine

6. Hand written
anaesthesia
record ~
100 years

7. Preadmission
Clinic
Intraoperative
Data
Post Anaesthesia
Care Unit

9. Automated anaesthesia record
HR, BP, CVP
FiO2, etCO2, SaO2
Temp
RR, PIP
Sevo et
CVP
PCWP,CO

12. Automated anaesthesia record Data sampling (RS 232 port)
more frequently
more accurately
medico-legal advantage ?

13. A Anaesthesia I Information M Management S System Server
Patient Monitor
Anaesthesia
machine
Communication
multiplexer
Workstation
Serial data
Network
Connection
Other Devices
Operating Room

15. Anaesthesia data chart: Missing information●
Position ●
Instrumentation ●
Type of anaesthesia ●
Drugs ●
Fluid balance ●
Action / interventions ●
Events

16. AIMS Collects intraoperative physiologic data●
Collects intraoperative physiologic data
Collates these with patient information
Adds interventions of anaesthetist
Stores this information
Allows retrieval and analysis ● ● ● ●

17. PAC:
information

18. Medication Safety

19. Performance

20. Data retrieval & Analysis
AIMS
Data retrieval & Analysis ●
Adverse events, near misses
Clinical competence/performance
Compliance with standards, rules and regulations ● ●

21. AIMS PAC: history, exams, test Intraoperative: data + events
PACU: data, pain, discharge info.
ORMS

22. Perioperative Setting: Data Flow
Scheduling
Admissions
Central Database
“Server”
Medical Records
Referring
Physician
PreOp
Clinic
Holding
Area
Operating
Room
PACU
ICU/Floor

23. ORMS ● Scheduling of cases ● Documentation of time ●
stamps ●
Capture of patient information
Documentation of clinical information
● Tracking of patient flow
● Organisation of postsurgical
placement of patients ●
AIMS
Lab
Imaging
Pharmacy ● ● ● ●
Organisation of clinical and support staff
Organisation of equipment and supplies
Coordination of access to Biomedical engineering ● ● ●
Billing (professional fees)

24. Allow maximal integration
Medication Management: Storage /Supply

25. Integration = Application + Platform
ORMS
AIMS
ORMS
Data Sharing
Redundancy!!!

26. Jerry Stonemetz
Keith Ruskin Editors
Springer, London
2008

27. Electronic medical record
HealthSMART (Vic)
National E-Health Strategy
File:Electronic medical record.jpg
From Wikipedia, the free encyclopedia

28. Electronic Medical Record
Medical record generated outside OR
Intergration/Linking GPs and Hospitals
Providing access to medical staff
Very expensive
E-Health
National E-Health Strategy

29. E-Health

31. E-Health takes time and cost money

32. EMR IDEAL SYSTEM AIMS ORMS Pathology Pathology Imaging Physician
Order Entry
ORMS

33. IDEAL SYSTEM
Confidentiality
Privacy ?