9. Integration of HIS, RIS and PACS Flashcards
A computerized management system for handling three categories of tasks in a healthcare
environment;
Hospital Information System (HIS)
- Support clinical & medical patient care activities
in the hospital - Administer the hospital’s daily business
transactions (financial, personnel, payroll, bed
census, etc) - Evaluate hospital performances & costs, project
the long-term forecast
Hospital Information System (HIS)
▪ Radiology
▪ Pathology
▪ Pharmacy
▪ Clinical Laboratories
Hospital Information System (HIS)
Hospital Information System (HIS) Have ______ that
differ from the GENERAL HOSPITAL OPERATIONS
Specific Operational Requirements
They need their own separate information systems &
must develop mechanisms to integrate data between
these systems and his
Hospital Information System (HIS)
TYPES OF HOSPITAL MANAGEMENT SYSTEM AND ITS USES
- Electronic Medical Record (EMR) and Electronic Health Record (EHR)
- Practice Management System
- Master Patient Index (MPI)
- Patient Portal
- Clinical Decision Support (CDS)
- Remote Patient Monitoring (RPM)
EMR
Electronic Medical Record
EHR
Electronic Health Record
MPI
Master Patient Index
CDS
Clinical Decision Support
RPM
Remote Patient Monitoring
replaces the paper version of a patient’s medical history
Electronic Medical Record
includes more health data, test results, and treatments.
Electronic Health Record
It also is designed to share data with other electronic health
records so other healthcare providers can access a patient’s
healthcare data
Electronic Health Record
Helps healthcare providers manage daily
operations such as scheduling and billing.
Practice Management System/Software
Healthcare providers, from small practices
to hospitals, use practice management
systems to automate many of the
Administrative tasks
Connects separate patient records across
databases.
Master Patient Index
The index has a record for each patient
that is registered at a healthcare
organization and indexes all other records
for that patient.
Master Patient Index
Used to reduce duplicate patient records
and inaccurate patient information that can
lead to claim denials
Master Patient Index
allows patients to access
their personal health data such as appointment information, medications
and lab results over an internet connection
Patient Portal
allows active
communication with their physicians,
prescription refill requests, and the
ability to schedule appointments
Patient Portal
Remote Patient Monitoring also known as
Telehealth
allows medical sensors to
send patient data to healthcare professionals
Remote Patient Monitoring / Telehealth
It frequently monitors blood glucose
levels and blood pressure for
patients with chronic conditions
Remote Patient Monitoring / Telehealth
The data is used to detect medical
events that require intervention and
can possibly become part of a larger
population health study
Remote Patient Monitoring / Telehealth
A system that analyze data from various
clinical and administrative systems to help
healthcare providers make clinical decisions
Clinical Decision Support
The data can help prepare diagnoses or
predict medical events — such as drug
interactions.
Clinical Decision Support
These tools filter data and information to help
clinicians care for individual patients.
Clinical Decision Support
BENEFITS OF HEALTH INFORMATION SYSTEMS
Data Analytics,
Collaborative Care,
Cost Control,
Population Health Management
The healthcare industry constantly produces data
Data Analytics
Health information systems help gather, compile and analyze health data to help manage population health and reduce healthcare costs.
Then the healthcare data analysis can improve patient care.
Data Analytics
Patients often need to treatments from different healthcare providers.
Collaborative Care
HIE
Health information Exchange
allow healthcare facilities to access
common health records — such as health information exchanges (HIEs)
Health information systems
Using digital networks to exchange healthcare data creates efficiencies and cost savings
Cost Control
When regional markets use health information exchanges to share data, healthcare providers see reduced costs.
Cost Control
On a smaller scale, hospitals aim for the same efficiencies with electronic health records.
Cost Control
Health information systems can aggregate patient data, analyze it and identify trends in populations.
Population Health Management
The technology also works in reverse.
Population Health Management
Clinical decision support systems can use big data to help diagnose individual patients and treat them
Population Health Management
BEST HOSPITAL INFORMATION SYSTEM YOU CAN CONSIDER
USING
Aarogya,
e-Hospital,
e-Visit,
Caresoft Hospital Information System
A hospital management system that aims to
streamline the daily operations of a hospital for
maximized performance output
Aarogya
This system offers a comprehensive set of tools
that enables to manage of all aspects of a hospital
— from administrative to clinical, and financial
tasks
Aarogya
It is best suited for large- or- mid-sized hospitals
Aarogya
e-Hospital was developed by
Adroit Infosystem
A hospital information system developed by one of the IT product development companies — Adroit Infosystem
e-Hospital
Best suited for clientele like multi-specialty clinics,
healthcare facilities, and medical practitioners.
e-Hospital
Some of its functionalities include electronic sharing
of patient records, scheduling facility to book the next appointment, and more
e-Hospital
Doctors can even view lab results and past medical
records of the patient online to save time and
provide quick treatment.
e-Hospital
Considered as one of the best hospital information systems
e-Visit
Aims to improve patient care and satisfaction
e-Visit
Offers an intuitive and interactive platform, suitable for all
sizes of healthcare centers — from small private medical
practice to a large hospital
e-Visit
Simplifies the complex operations of running a hospital. Some
of its core functionalities are medical charting, data collection,
billing, reimbursement management, payment processing, and
ePrescription
e-Visit
A cloud-based application
e-Visit
Streamlines the entire workflow of managing a
healthcare center
Caresoft Hospital Information System
Uses the latest technology to deliver the best in
quality patient care
Caresoft Hospital Information System
Enables easy integration of data exchange
between different interfaces and users, thus
prevents duplication of data entry
Caresoft Hospital Information System
Other Hospital Infomation Systems
- myNapier
- Mediware
- ProMed
- Insta HMS
- MocDoc HMS
- SoftClinic HIS
- Intelligent Medical Software (IMS)
- Medstar HIS
- MMI Mediface
- MediSteer by Adroit
IMS
Intelligent Medical Software
A networked software system for managing
medical imagery and associated data.
Radiology Information System
Especially useful for tracking radiology
imaging orders and billing information
Radiology Information System
Used in conjunction with PACS & VNAs to
manage image archives, record-keeping and
billing
Radiology Information System
BASIC FUNCTIONS OF
RADIOLOGICAL INFORMATION SYSTEM (RIS)
- Patient Management
- Scheduling and Sharing
- Patient Tracking
- Result Reporting
- Image Tracking
- Billing
RIS
Radiological/Radiology Information System
RIS can track a patient’s workflow within the
radiology department
Patient Management
It can add images and reports to EHRs where
they can be viewed by authorized radiology
staff
Patient Management
It facilitates patient management as processes
like patient registration, scheduling, and Patient
Tracking is digitized
Patient Management
Radiological Information System (RIS) allows
staff to make appointments for patients and
other people
Scheduling and Sharing
It enables the distribution of patient data and
medical images
Scheduling and Sharing
The interaction between physicians is made
easier by allowing access to documents
within the computer system
Scheduling and Sharing
With the RIS system, providers can
easily track patients’ radiology history from admission to discharge
and coordinate with past and future appointments.
Patient Tracking
A RIS can generate statistical reports
for a single patient, group of patients or
particular procedures.
Result Reporting
Radiology providers use RIS to track the
patient’s associated data
Image Tracking
Like EHRs have become a standard to use in the
healthcare sector, PACS is widely adopted in the
medical enterprise
Image Tracking
RIS provides a detailed financial report of
automated claims and electronic payments
Image Tracking
RIS systems provide detailed financial record-keeping and process electronic payments and
automated claims, though these functions are
becoming incorporated into medical organizations’
overall EHR systems
Billing
Radiological Information System Began as a component of
HIS
were developed because of the limited support from HIS in handling special
data & information required by the radiology operation
Independent RIS
Integration of these two systems is extremely important for the healthcare center to operate as a total functional entity
HIS and RIS
Designed to support both the administrative & clinical operation
Radiology Information System
Manages general radiology patient information from schedule, examination, to reporting
Radiology Information System
Similar to HIS configuration but much smaller in scale
Radiology Information System
WS
Without Image Display
consists of a computer system with peripheral devices such as RIS WS (without
image display), printers, barcodes readers
RIS equipment
Autonomous systems with limited access to HIS
Radiology Information System
Some HIS offer embedded RIS as _____ with a higher degree of integration
subsystem
Maintains many types of patient/examination-related information
Radiology Information System
medical, administrative, patient demographics, & billing information
(RIS) Patient-related information
procedural descriptions & scheduling, diagnostic reporting,
patient arrival documentation, film location, film movement, & examination room scheduling
(RIS) Examination-related information
The exchange of information between a Radiology
Information System (RIS), Hospital Information System (HIS)
and PACS in order to optimize the utility of PACS for sharing
of information, its retrieval, etc. with the help of a common
platform
Interfacing
2 METHODS OF TRANSMITTING DATA BETWEEN INFORMATION SYSTEMS
A. Database-to-Database Transfer
B. Interface Engine
Allows 2 or more networked information systems to share a subset of data by storing them in a common
local area
Database-to-Database Transfer
Most often used to share information between the HIS and the RIS
Database-to-Database Transfer
Provides a single interface and language to access distributed data in networked heterogeneous information
systems
Interface Engine
To interface HIS, RIS and PACS, some guidelines are required:
- Each system (HIS, RIS, PACS) remains unchanged in its configuration, data & functions
- Each system is extended to both hardware & software, to allow each system to
communicate with the other systems. - Only data are shared; functions remain local
INTERFACING HIS, RIS & PACS
REQUIRES THE FOLLOWING STEPS
- Identify the subset data that will be shared by other systems.
Set up access rights & authorizations. - Convert the subset data to HL7 & standard form.
- Define the protocol of data transfer (e.g. TCP/IP or DICOM)
NECESSITY OF INTERFACING
- Avoidance of mistyped data entry
- Development of compatible data bases
- Development of more automated, more
intelligent PACS
BENEFITS OF INTERFACING
- Prevents repetitive data entry
- Sharing of Information
- Reduction in workload
THE RIS-PACS INTERFACE CAN BE IMPLEMENTED BY EITHER (PROTOCOL):
- Trigger Mechanism Between Two Databases
2. Query Protocol
ADT
Admission Discharge Transfer
IHE
Integrating the Healthcare Enterprise
OSI
Open Systems Interconnection
LIMS
Laboratory Information Management System
Most important rationale of interfacing with HIS and RIA
- Only data are shared; functions remain local
The PACS is notified of the following events in HL7 format when they occur in the RIS: ADT,
order received, patient arrived, examination cancelled, procedure completed, & report approved.
Trigger Mechanism Between Two Databases
Application Level of the interface software waits for the occurrence of one of
these events & triggers the corresponding data to be sent
Level 1-4
Communication Level transfers the HL7 file to the PACS server
Level 5-7
The PACS server receives this file and archives it in the database for subsequent use
Trigger Mechanism Between Two Databases
Allows access to information from the HIS, RIS and PACS
databases by using an application-layer software on top of
these heterogeneous database systems
Query Protocol
From a PACS Workstation, user can retrieve information
uniformly from any of these systems & automatically integrate
them to the PACS database
Query Protocol
IHE patient information can be used to combine different data: ADT in HIS, RIS
in radiology, and DICOM image management archive in PACS
Reconciliation Profile
This integration profile can extend the scheduled workflow profile by providing
the means to match images acquired for an unidentified patient’s registration &
order history.
Example: Emergency room patient (trauma)
Reconciliation Profile
The ______ is a part of the hospital,
thus is the ___ a part of the HIS.
imaging center,
RIS
AS THE SYSTEM IS INTEGRATED WITH HIS;
THE INFORMATION THAT RIS & HIS EXCHANGE WOULD BE:
A. Patient Registry
B. Examination of the Patient
C. Status of Examination and Reports
D. Delivery of findings and distribution to patients
E. Synchronization of data in HIS and RIS
New patient data, updating data of existing patients
Patient Registry
Which type of review is requested, who requested radiological examination, the diagnosis, urgency, etc
Examination of the Patient
Radiological findings, report of a specialist, laboratory findings, etc.
Status of Examination and Reports
(methods of examination, doctors, departments, etc.) and other pieces of information
Synchronization of data in HIS and RIS
In order to achieve an integration of RIS into a unique HIS, it is necessary that information systems communicate by exchanging messages (information) according to \_\_\_\_ standard
HL7
Enables the exchange of medical information between different information systems of healthcare organization units within one hospital regardless of the written program language and the platform they are realized at.
HL7 (Health Level 7) Standard
is not a software application, but a standard that includes thousands of pages
that contain detailed explanations, which presents the concept of the standard,
allowing analysts and programmers to implement it technically
HL7
In the OSI reference model, communication between software and hardware is
divided into ____ layers.
seven
is primarily focused on issues and problems that occur on the
seventh layer, the application level (Level 7).
HL7 standard
Data, time of data exchange and
communication are shared at this
level, where errors between certain
applications can be seen
Level 7
▪ A modern system for image archiving and communication
▪ It is designed as a computer system for paper and film archiving
▪ It is based on the web technology
PACS (Picture Archiving and Communication System)
▪ It deals with medical records and information
▪ Provides archiving, viewing and distribution of medical images to radiologists, physicians of
other specialties, doctors in other hospitals
▪ Communicates with HIS, RIS & DIS, and allows data to be accessed from different locations
within a health facility or outside the health care facility
PACS (Picture Archiving and Communication System)
can be integrated into RIS & HIS or
other medical information systems;
most used in RIS
PACS (Picture Archiving and Communication System)
combines the functions of teleradiology
services and systems for archiving,
searching and reviewing of medical
images and patient data
PACS (Picture Archiving and Communication System)
stores images from various medical devices (modalities): ultrasound (color Doppler, ultrasound, etc.), MRI, CT, mammography, angiographic, digital X-ray machines, PET scanners, nuclear medicine cameras and other devices
PACS (Picture Archiving and Communication System)
EACH COMPUTER IS IDENTIFIED BY ITS NETWORK ADDRESS IN
THE PACS NETWORK
Internet Protocol (IP), Transmission Control Protocol
TCP
Transmission Control Protocol
IP
Internet Protocol
makes sure the pieces arrive at their
destination address
Internet Protocol
puzzle assembler on the receiving side who
puts the pieces together in the right order
Transmission Control Protocol
