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Program Systems Institute Russian Academy of Sciences

Program Systems Institute Russian Academy of Sciences. INTERIN TECHNOLOGY : A COMPLEX INFORMATION MANAGEMENT SOLUTION FOR A HEALTH CARE DELIVERY INSTITUTION. Medical Informatics Research Centre. INTERIN Technology About the project.

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Program Systems Institute Russian Academy of Sciences

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  1. Program Systems InstituteRussian Academy of Sciences INTERIN TECHNOLOGY: A COMPLEX INFORMATION MANAGEMENT SOLUTION FOR A HEALTH CARE DELIVERY INSTITUTION Medical Informatics Research Centre

  2. INTERIN TechnologyAbout the project INTERIN TECHNOLOGY,a complex of software tools and techniques for building health care information systems, was developed in the Program Systems Institute, Russian Academy of Sciences. Objective: improve the efficiency of care providers and enhance the overall quality of clinical care, increase the productivity of diagnostic laboratories and clinical units by putting into practice the potential of new health care information technologies.

  3. INTERIN TechnologyStrategy TRANSPARENCY Patientcare Care monitoring ANALYZABILITY Medical document flow Decision support Servicemanagement Reference information MANAGEABILITY Ancillary services Medical supplies OPTIMIZEDresource usage Common information space

  4. INTERIN TechnologyApplied tasks general and administrative tasks diagnosis and treatment process laboratory and diagnostic studies information support for specialist physicians supervision of care by more experienced physicians, heads of divisions and other officials information support for the efficiency evaluation of care information servicing of the personnel

  5. INTERIN TechnologyFunctionality classes Office tasks–enterprise information support and document management. Resource planning and enterprise management–physician scheduling, room and equipment scheduling, appointment and treatment scheduling, etc. Care monitoring –patient record keeping; record review, processing, and analysis. Laboratory and diagnostics –entry, storage, processing and analysis of diagnostic results. Decision support –expert assessment and quality control of the care process.

  6. INTERIN TechnologyPatient’s total medical record Medical record (MR) Case history Case history Case history Outpatient record Information security system 1st user N-th user Remote access

  7. INTERIN TechnologyPatient-centred approach Passport data Diaries Physical examinations Diagnostic orders Prescriptions Medication orders Health inspections Examination results Preventive medical checkups Operation and transfusion protocols Epicrises Patient’s total medical record

  8. INTERIN TechnologyKey principles and features Integration of information flows Administration Office Medico-social expert commissions Financing Planning Supplies department Pharmacy Prevention Supplies Commercial department Diagnostics Commercial activity Paraclinic Treatment Staff management Personnel department Research Clinical nutrition Clinic Supervision Nutrition unit Library Chief specialists Embracing all dimensions of health care enterprise activity

  9. INTERIN TechnologyStandards maintained Maintenance and development of standards Project Management Standards: State Standard (34.201, 34.601); CSDS (Common Software Documentation Standard). Health care delivery standards: MES (Medical-Economic Standards); Moscow health care standards. Data communication standards: XML (W3C recommendations); CENTC1251 recommendations.

  10. INTERIN TechnologyKey principles and features System being developed relies on a number of user-edited reference guides and directories: • IDC-10 • health care services and procedures offered by the institution • clinical guidelines • surgery guides and directories • State registry of medicines • institution’s functional structure • service location • companies and their essential data • referral sources • list of staff members • specialists’ examinations • physician order templates, etc.

  11. Control of order justification Billing of persons andorganizations Generalized anddetailed Registries Balances Σpayments=Σservices INTERIN TechnologyKey principles and features Patient accounting and billing Health care institution Contracts Payments Institutions Health service directory Services Affiliation: assignment, insurance policy, etc. Price lists Health care programmes Patients Medical and economic standards

  12. INTERIN TechnologyKey principles and features Document management Replication-free multiple access to patient data Automatic generation of documents to be printed Use of document templates Various auto-fill options Preset values Template Case history title page Operation protocol Document Physical …. Complaints, history... Updating Passportdata Epicrisis

  13. Subject reference guides Physical examination summary containing images Temperature and vital signs INTERIN TechnologyKey principles and features Integration of heterogeneous data The integrated information system handles data of various nature – texts, images, etc.

  14. INTERIN TechnologyKey principles and features Autogeneration of aggregate reports Chronic Hemodialysis Dept. Patient transfer summary for a specified period Summary of medication orders for a specified period Inpatient medical record

  15. INTERIN TechnologyKey principles and features Visualizing the dynamics of medical data Case History 32. Intensive Observation Data Chart Sex M Age 70Weight 95 kgHeight 185 cm PulseBlood pressure Orders Breath rate

  16. INTERIN TechnologyKey principles and features Patient information access regulation On the one hand, every workstation can be accessed from any hospital computer via the local network. On the other hand, the user access level is determined by his/her job responsibilities.

  17. INTERIN TechnologyKey principles and features Telemedicine The integrated information system architecture enables patient information to be accessed both from specialized hospital workstations and via the Internet, as determined by the user rights and established regulations. In that way, specialist physicians can have access to all of the information they need from their patient’s medical record.

  18. INTERIN TechnologyKey principles and features Diagnosis and treatment support Diagnosis, treatment Planning of diagnostic studies and treatment Supervision of diagnosis and treatment Access to patient information Clinical guidelines Order justification HIS Objective evidence (total medical record)

  19. INTERIN TechnologyA HCI common information space HCI located at a single site (hospital, outpatient clinic, etc.) Geographically distributed HCIs (hospital – oupatient clinic) HCI – a network of health units HCIs – mobile agents Combined option

  20. INTERIN TechnologyPaper-based documents, summaries, reports Inpatient medical record Bed use summary for a specified date Hospital monthly activity summary

  21. INTERIN TechnologyInformation analysis Examining an ECG wave. Data can be displayed on different charts and graphs.

  22. INTERIN TechnologyInterface solution The conceptual interface solution relies on: • the conceptionof a Desktop • the idea of a so-called «Botkin’s chart»

  23. INTERIN TechnologyDesktop The user’s Desktop is a unified interface that handles data via Information objects. The Desktop is configured for a particular user. Desktop objects

  24. INTERIN Technology «Botkin’s chart» Visualization of information from the patient’s total medical record, according to clinical practice standard requirements and the user access rights. Mitral valve prolapse. Congenital heart disease Admission diagnosis Temperature Medication orders Test orders Blood sugar Medical information Leucocytes (WBC), 10^9/liter Print vital signs chart Print entire record «Botkin’s chart»

  25. INTERIN TechnologyEconomic benefits Permanent storage of EMR No data duplication Resource planning Efficient resource utilization Telemedicine Cost reduction Clinical nutrition management Minimizing food product loss Bed management, hospitalization plan Full use of inpatient facilities, even provision of health careservices Efficiency control of unit operation Ensuring flexible and maximum efficient operation Minimizing expenses for the repeat development of subsystems System openness

  26. INTERIN TechnologyEconomic benefits

  27. INTERIN TechnologyKey principles and features Supporting various types of health care institutions Complex health centres Diagnostic centres Aid posts Various outpatient facilities Inpatient clinics Specialty outpatientclinics Sanatoriums Health careinformationsystem

  28. INTERIN TechnologyApplications: scales of implementation • Number of users: 10 to 1000 • Number of computers in the network: 5 to600 • Number of servers: 1 to 15

  29. INTERIN TechnologyImplemented systems Interin Technology has been the basis for several implementations of health care information systems: Automated patient care management system of the Мedical Centre of the Central Bank of Russia. Developed jointly with the Medical Centre’s clinicians and other staff. “COTEM-2001” – Information management system of the Clinical Hospital No. 83, “MedBioExtrem” Federal Department,Ministry of Health of the Russian Federation. Developed in cooperation with the hospital staff. Information management system of the State Hospital No. 1 –National Health Care Centre, Ministry of Health of the Republic Sakha (Yakutia).Implemented with the participation of the Health Care Centre specialists.

  30. INTERIN TechnologyIntegration with laboratory systems and equipment Integrated information system of a health care institution Interaction with laboratory equipment Integration Third-party vendor products

  31. Для анимации 1 Для анимации 2 Integration with LISOrdering diagnostic studies

  32. Для анимации 1 Для анимации 2 Integration with LISIntegration with LISILIMS, ILEX Medical

  33. INTERIN TechnologyAcademic accomplishments • 3PhD theses • Over 50publications • 8PhD students majoring in medical informatics (currently) • 2monographs are being prepared, and 1PhD thesis is in the works

  34. INTERIN TechnologyInterin PROMIS InterinPROMIS, a model information system based on INTERIN technology, is an integrated informational and functional environment incorporating elements of different classes of information systems. Interin PROMIS provides information support to the entire range of services involved in patient care: from document management and accounting to patient record keeping, integration with clinical equipment, and decision support.

  35. Interin PROMISComputerized divisions Outpatient clinic • Reception • Medical certificates office • Assignment and hospitalization dept • Physicians rooms • At-home assistance Sanatorium • Document management • Accommodation • Physicians and nurses rooms • Services Hospital • Admissions dept • Ward sections • ICUs Paraclinic • Functional diagnostics • Clinical diagnostic laboratories • Radiodiagnostics Ancillary units • Nutrition unit • Pharmacy • Personnel dept • Library • Information service Administrative units • Administration • Office • Medical statistics • Commercial dept • Financial dept

  36. For further detail, please contact: Medical Informatics Research Centre Program Systems Institute Russian Academy of Sciences 152020 Pereslavl-Zalessky Russia Phone/Fax: +7 (48535) 98911 E-mail: info@interin.ru Web-site: http://www.interin.ru Thank you for your attention!

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