Topic 6c: ICT in Healthcare

Question 1

Give 2 examples of where tracking technology is used in patient care in hospitals.

Answer 1

Bar codes are printed on blood bags, patient wrist bands and employees’ ID cards. They can also be used for tracking lab specimens (blood tests, urine etc) and be printed onto important documents such as patients’ paper records.

Question 2

What information would be stored in a patient’s wrist band?

Answer 2

The patient wrist band contains their name, date of birth, blood type and a unique identifier (such as their NHS number).

Question 3

What information would be stored in a barcode on a blood bag?

Answer 3

Data encoded in the barcode on a blood bag includes the blood type, the date of expiry, and information that would enable the blood donor to be traced.

Question 4

Name 3 benefits of having barcodes on blood bags.

Answer 4

An audit trail can be created so if something goes wrong, or a bag is lost, the process can be checked to find out where the bag was last located. Medical staff swipe their ID card when they take a bag from the fridge. Therefore, the audit trail includes the identity of the person who booked out the blood. Only authorised staff can book out blood. The blood type in the bag can be easily cross-checked with the blood type stored on the patient’s wrist band. It would be life-threatening if a patient was given the wrong blood type. If a serious infection is found in the blood, the original donor can be traced. The inventory system will count the number of bags booked out and automatically order new stock when it detects that supplies are running low. A paper based system would be much slower, would take up storage space and would be more prone to error. Barcode reader apps are freely available for smartphones.

Question 5

Name 3 disadvantages of a barcode tracking system.

Answer 5

Barcode scanners can be expensive (over £100). Barcodes can be damaged and become unreadable. Barcode scanners could be lost in busy hospital.

Question 6

Describe the blood audit trail. Hint see this video https://www.youtube.com/watch?v=959UhnT6kC4

Answer 6

Barcodes on blood bags can be used to track where the bag is located when it is delivered to the hospital, checked out of the fridge, delivered to the ward, used in a patient transfusion, and finally disposed of in a special bin. The audit trail will include all the details of the blood, all dates and times when it was checked out, the identity of the patient, and the identity of the medical staff.

Question 7

What is ISBT 128?

Answer 7

The International Society of Blood Transfusion 128 is the worldwide standard for tracking and processing blood.

Question 8

Sensors are used extensively in healthcare. What is a sensor?

Answer 8

Sensors inside devices are used to measure physical, chemical, and biological quantities and convert them into a digital form that can be read by computers

Question 9

Name 3 types of analogue measurement that sensors could monitor

Answer 9

Temperature

Blood pressure

Pulse Oxygen level in the blood

Blood sugar (glucose)

Brain activity

Respiratory rate

Question 10

Name 3 ways a sensor is used in patient care in a hospital

Answer 10

1. Routine measurements can be automated in order to save time for nurses and doctors on the ward. 2. Measurements that indicate a problem can trigger alerts to be sent to smartphones of medical staff. 3. Sensors can send control signals directly to medical equipment like ventilators and intravenous drips.

Question 11

Name 3 advantages of using sensors for automated patient monitoring

Answer 11

Monitoring can be 24/7 Nursing staff are freed up for other tasks Cost savings as one nurse can look after more patients Patient readings are never accidently missed Sensor readings are more accurate than manual measurements Sensor readings can be taken continuously instead of at intervals Medical staff can be alerted to problems more quickly Patient deterioration is spotted sooner

Question 12

Name a disadvantage of using sensors for patient care.

Answer 12

Calibration is needed to ensure the sensor is accurate An uncalibrated device could be very dangerous as readings would not be accurate. Having to regularly calibrate devices is an extra process that takes time and costs money as a specialist company may be needed.

Question 13

What is body scanning?

Answer 13

Scanning devices build a model of the internal structures of the patient’s body in order to aid diagnosis and select the most appropriate treatment.

Question 14

What does MRI stand for?

Answer 14

Magnetic Resonance Imaging

Question 15

What is an MRI scan?

Answer 15

The patient lies in a rotating cylinder that generates a large magnetic field. The field causes hydrogen atoms in the body to start emitting radio frequency (RF) signals. The human body contains a lot of hydrogen, which is mainly concentrated in water and fat. The strength of the RF signal therefore allows skilled radiographers to see where different types of body tissue are located and what condition they are in. The RF signals are quite weak, so the patient has to lie very still for up to 2 hours until a good image has been made.

Question 16

What does CAT scan stand for?

Answer 16

Computerised Axial Tomography

Question 17

What is a CAT scan?

Answer 17

A CAT scan involves multiple X-rays, each taken at a different angle to the body in order to build up a cross-sectional picture.

Question 18

Name 2 advantages of body scanning.

Answer 18

Rapid diagnosis, especially in emergence room Early detection of problems like cancer increases cure rate Reduce need for operations Help surgeons plan operations Assist doctors to plan treatment

Question 19

Name 2 disadvantages of body scanning

Answer 19

Very expensive equipment Not portable, patients must travel to hospital Ionising radiation risk (CAT scan) Can be stressful for patients (MRI scan can take up to 2 hours) Very high resolution digital images need to be compressed, transported, stored and made secure.

Question 20

Name 2 ways that hospitals can protect their ICT systems against the risk of losing data.

Answer 20

Data centres in hospitals have uninteruptable power supplies They also have diesel back-up generators Data can also be stored in the cloud and at multiple locations However, healthcare data is often regulated by government so that it must always stay within a country’s borders. This can prevent a hospital from using a global cloud service as the data could be stored anywhere.

Question 21

What is an uninterruptable power supply (UPS)?

Answer 21

A UPS is usually a giant battery, or other form of power storage. If the mains power is lost, the UPS provides temporary power for computer(s) to run until either they can shut down safely, or an alternative power source (such as a dielsel generator) starts up.

Question 22

Define an expert system in health care.

Answer 22

An expert system emulates the decision-making and problem-solving capabilities of human experts.

It provides confidence levels and probabilities for its findings and the for solutions that it suggests.

In healthcare it can provide diagnoses, assess potential causes, and can advise on suitable treatment and prescriptions.

Question 23

Name the three components of an expert system.

Answer 23

Knowledge base.

User interface.

Inference engine.

Question 24

What is the knowledge base of an expert system?

Answer 24

The knowledge base is a huge collection of data about a subject.

In a healthcare expert system, the knowledge base contains facts & figures from anonymised patient data, previous diagnoses, reports and journal articles, results of clinical trials, and many more sources.

Question 25

What is the user interface of an expert system?

Answer 25

The user interface is the means by which the doctor or patient can enter queries and view the results from the expert system.

Question 26

What is the inference engine of an expert system?

Answer 26

The inference engine contains the rules and algorithms for interpreting data in the knowledge base. For example, if a doctor enters a list of patient symptoms, the inference engine finds a diagnosis that is the closest fit, based on previous experience.

To ‘infer’ means “to deduce information from evidence and reasoning” (Oxford English Dictionary).

Question 27

State 3 benefits of using an expert system in healthcare.

Answer 27

An expert system has vastly more capacity to store and retrieve diagnostic information than a team of doctors could hold in the heads.

The expert system is always available 24 hours a day

Computers don’t not ‘forget’ or make mistakes – they can identify even obscure diseases

Data is constantly up-to-dated e.g. adding more results of radiology scans
Doctors will eventually ‘retire’, leading to loss of expertise

The system can be accessed at a distance over a network. Therefore rural areas or even poorer third world countries have access to experts.

Provides accurate predictions with probabilities of all suggested diagnoses

Some people prefer the privacy of ‘talking’ to a computer rather than talking to a GP

Gives the doctor more time to deal with other patients / saves overloading doctors in epidemic/pandemic / more time to deal with serious cases

Can provide a second opinion

It can help train young doctors in unfamiliar diseases.

People can do an initial diagnosis from home, saving them travel and time costs especially if in a rural area

Cheaper to update than to train doctors

Question 28

What are the disadvantages of using an expert system in healthcare?

Answer 28

Over reliance on IT system / Loss of doctor expertise
Cost to buy and set up the system
Some people do not like to talk to a computer
People can convince themselves that they are worse than they are from reading online information

Lacks the ‘human touch’ – lack of personal contact
Dependent upon the correct information being given. If data or rules are wrong, the wrong advice could be given. / GIGO