Medical Informatics

• The intersection of information science, computer science, and health care.

• It deals with the resources, devices, and methods required to optimize the acquisition, storage, retrieval, and use of information in health and biomedicine. A good job for people who like medical stuff but not people!!

• Should love to work with computers.

Physician’s offices

• Use computers for scheduling & accounting

(like billing)

Clinical Application of computers in medicine!

• Scientific or medical function

i.e. Electronic patient monitor

Administrative Applications

• Works to develop, maintain, implement, and provide on-going support for all administrative applications (i.e. scheduling, payroll,etc.)

Computer-Assisted Surgery

• i.e. Helps the surgeon precisely align the artificial knee joint in the bone and may increase the long term effectiveness of knee replacements.

Bloodless Surgery

• Uses digital imaging to accomplish less-invasive surgery. The main benefit is smaller incisions.

Smaller incisions = less blood

Prosthetics

• Amputation is a life-changing event.

• An artificial extension that replaces a missing body part.

• Usually due to a traumatic injury or a birth defect

Computerized Prosthetic Device

• Computerized leg that allows people who have had amputations above the knee to approximate a normal gait.

• The total cost was $5.3 million.

Wilhelm Conrad Röntgen A German physicist who, on 11/6/1895, produced

and detected electromagnetic radiation in a wavelength range today known as X-rays.

Traditional vs. Digital X-Ray

• Traditional x-rays are used most frequently.

• Electromagnetic waves are used to make pictures. i.e. broken bones & mammograms.

• New imaging techniques use computers to generate pictures of internal body organs.

• Difference is the ability to emphasize & enlarge certain areas.

Fluoroscopy

An imaging technique to obtain real-time moving images of the internal structures of a patient through the use of a fluoroscope.

Mammography

• The process of using low-dose x-rays to examine the human breast

• Major imaging area currently dominated by traditional x-rays.

• Other techniques may be used if an abnormality is spotted by mammogram

Ultrasound• Uses high frequency

sounds waves to generate a moving picture on a screen.

• Distinguish between cysts or tumors. Can be used in mammograms & to see fetuses

3D/4DUltrasound

• Fetal ultrasound is a test done during pregnancy that uses reflected sound waves to produce a picture of a fetus, the organ that nourishes the fetus (placenta), and the liquid that surrounds the fetus (amniotic fluid).

Fetal Doppler

• Allows you to hear your unborn baby's heartbeat using ultrasound waves

Computerized Tomography

• Abbreviated as CT

• Uses x-rays and digital technology to produce a cross-sectional image

• Sometimes uses dye

Magnetic Resonance Imaging

• Abbreviated as MRI• Produces images of soft tissue within

the body and DOES NOT use radiation

Positron Emission Tomography

• Abbreviated as PET• Uses radioscope technology• i.e. Used to study Alzheimer’s,

Parkinson's disease, and ADHD.

Interventional Radiology

• Needle biopsy

• Subspecialty of radiology in which minimally invasive procedures are performed using imaging guidance.

Stereotactic Radiosurgery

• Uses a gamma knife (painless device)

• Highly precise form of radiation therapy used primarily to treat tumors and other abnormalities

Focused Ultrasound Surgery

• Uses sound waves, which create a powerful ultrasonic beam

• In order for a rural hospital to have telepathology capabilities with a large research hospital they must purchase a microscope, camera & a monitor.

Telemedicine• The use of

computers, the Internet, and other communication technologies to provide medical care to patients at a distance.

• Telemedicine is generally cost-effective

Telemedicine Continued…biggest obstacle would be lack of

telecommunications lines

• Forms:– Voice– Data– Still images– Motion Video

• Includes:– Diagnoses– Patient monitoring– Treatments

Interactive Videoconferencing

• Videoconferencing is a live, two-way, interactive electronic means of communication. Two or more people in different geographic locations can engage in face-to-face audio and visual exchanges using cameras, monitors, and document software.

• Collects real-time electrocardiogram (ECG) signals from a mobile or homebound patient, combines these signals with global positioning system (GPS) location data, and transmits them to a remote station for display, diagnoses and monitoring. I.e.: physician in the emergency department

EMT’s use telemedicine with patients having chest pain! HOW?

i.e. paramedic in

ambulance sending

EKG to ER

physician

Computerized Charting

• Using a computer to store & keep a clinical records of the important facts about a patient and the progress of their illness. The patient's medical history, a nursing history, results of physical examinations, laboratory reports, results of special diagnostic tests, and the observations of the nursing staff.

Pharmacy

• Refilling medications into the Pyxis® MedStation™ system is a critical and time-consuming process. With thousands of doses of medications selected each day and numerous dosing alternatives for many, the potential for error is great.

• Monitors who takes out medicine and how much

• Reduce medication refill errors and improve pharmacy workflow

Telehealth

• Larger field that includes health-related education, public health research, and health services administration.

Telehealth Continued…

• Advantages:– Brings high quality medical care to

anyone regardless of distance.– Decreases patient wait time.– Decreases patient travel time.

Teleradiology

The oldest form of telemedicine using computers and telecommunications

• i.e.: sending digital chest x-rays overTelecommunication

lines

• Telepsychiatry: used in special circumstances but does not replace face to face counseling. Teleconferencing is used to deliver psychotherapy

Arrhythmia Monitoring

– ECG telemetry that monitors a patient’s cardiac status and sends it to a remote location

– ECG tech watches monitors that show heart rhythms of many patients.

Telespirometry:

used by asthma patients, information transmitted over telephone lines to remote location used for asthma patients

• information transmitted over telephone lines to remote location

Remote Monitoring Devices(Devices used to monitor patients at home)

Effectiveness of Telemedicine

• Examining a patient at a distance is not the same as examining the patient face-to-face.

• In prisons, telemedicine has led to decreased costs & improved health care for inmates.

Effectiveness Continued..• Small hospitals & clinics may find

hardware costs prohibitive.• Research studies generally favor

telemedicine for medical effectiveness as well as cost effectiveness.

• What is the BEST reason for using telemedicine….

Makes high quality medical care available to people in remote places!!

Insurance Clerk

• To prepare for a job using technology you would need to learn computerized billing.

Insurance Coding System

• Coding diseases, surgeries, medical procedures, and other therapies for billing and collection.

• i.e. 969=pneumonia

Should not have procedures on that bill that are not related to that code.

i.e. papsmear

Technical Issues

• Appropriate telecommunications infrastructure must be in place.

• Some telecommunications services may not be available in some rural and urban areas.

• Requires high bandwidth (cable modems)

Insurance Issues

• Insurance may not cover all telemedicine.

Legal Issues

• Licensing laws differ in each state.• Liability is not clear from state to

state.

Privacy Issues

• Electronic medical record subject to more misuse.

• Confidential health information transmitted electronically must comply with HIPAA, privacy and security standards.

FUTURE We have some of the most advanced health care in the world.

Improvements in medicine are helping people to live longer and more active lives.

• And yet, for more and more people health care is a problem.

• Nearly one out of every six people do not have health insurance

• Each year thousands of people die from preventable medical errors

• Individuals, businesses, federal and state governments are all struggling with soaring health care costs.

• WHAT IS THE SOLUTION??????????????