This presentation talks about the context of developing the Electronic Health records for India. the guidelines as mentioned in the GOI site is described vividly with examples, for better understanding.
N.B: Please download the ppt first, for the animations to work better.
The Transition from Paper to Electronic RecordsMatthew Kim
A presentation depicting the history, selection criteria, implementation process and market share among various electronic health record (EHR) vendors.
An electronic health record (EHR) is a collection of patient’s electronically-stored health information in a digital and systematic format. EHR system can store data accurately.
This presentation talks about the context of developing the Electronic Health records for India. the guidelines as mentioned in the GOI site is described vividly with examples, for better understanding.
N.B: Please download the ppt first, for the animations to work better.
The Transition from Paper to Electronic RecordsMatthew Kim
A presentation depicting the history, selection criteria, implementation process and market share among various electronic health record (EHR) vendors.
An electronic health record (EHR) is a collection of patient’s electronically-stored health information in a digital and systematic format. EHR system can store data accurately.
Final presentation system,HEALTHCARE INFORMATION SYSTEMHector Rueda
With one of the most comprehensive IT and business services portfolios in the world, HIME Associates can tailor IT solutions with your business objectives in mind.
Our proven approach is unique in the market. We start with standard, flexible services components that we tailor for your business. Then, we apply our deep industry expertise to accelerate the results that matter most to you. We partner with you, every step of the way, to help you build and realize your vision.
By:HECTOR F. RUEDA, MBA
86 Beaver Street • Brooklyn, NY 11206 • hectournica@gmail.com • (917) 484-6446
• Leon Nicaragua • hectournica@gmail.com • cel: Mov; 81191072
How EMR can connect You and Your Doctor?75health .com
EMR software allow the transfer of data from anywhere to any place, in the shortest possible time, to enable doctors across the globe to take care of their patients in a much better way than before. This has been made possible through the wide usage of EMRs. Implementation of EMR, that has been a personal preference hitherto, may be mandated in the medical service over time.
As electronic exchange of information facilitates better service for patients and supports physicians as well, it is no wonder that a major portion of the medical professionals are beginning to lean more toward EMR as their preferred system. Quick access, reliability, ‘anytime and anywhere’ reach are the main factors that make EMRs popular among today’s learned medicos. At times, it becomes necessary to share patient details using EMRs, when patients need medical attention from different doctors. EMR involves sharing individual information over the digital media. This calls for a cautious and secure exchange of data.
Presented at "Hospital Management 2015" Program, Hospital Administration School, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand on August 18, 2015
Electronic Health Record System and Its Key Benefits to Healthcare IndustryCalance
This case study discusses how Electronic Health Record can turn out to be a solution to the problems associated with paper based clinical records. It’s a future-proof solution decreasing chances of error and loss while increasing patient-provider communication. Find out the key challenges faced by US health industry, key benefits of EHRs, and how Calance can help developing an HER solution. For more info about Calance, visit http://www.calanceus.com
Explains about Health Record Standards, ICTs, Standards for Healthcare Sector, Ministry of Health and Family Welfare. For more information visit: http://www.transformhealth-it.org/
Final presentation system,HEALTHCARE INFORMATION SYSTEMHector Rueda
With one of the most comprehensive IT and business services portfolios in the world, HIME Associates can tailor IT solutions with your business objectives in mind.
Our proven approach is unique in the market. We start with standard, flexible services components that we tailor for your business. Then, we apply our deep industry expertise to accelerate the results that matter most to you. We partner with you, every step of the way, to help you build and realize your vision.
By:HECTOR F. RUEDA, MBA
86 Beaver Street • Brooklyn, NY 11206 • hectournica@gmail.com • (917) 484-6446
• Leon Nicaragua • hectournica@gmail.com • cel: Mov; 81191072
How EMR can connect You and Your Doctor?75health .com
EMR software allow the transfer of data from anywhere to any place, in the shortest possible time, to enable doctors across the globe to take care of their patients in a much better way than before. This has been made possible through the wide usage of EMRs. Implementation of EMR, that has been a personal preference hitherto, may be mandated in the medical service over time.
As electronic exchange of information facilitates better service for patients and supports physicians as well, it is no wonder that a major portion of the medical professionals are beginning to lean more toward EMR as their preferred system. Quick access, reliability, ‘anytime and anywhere’ reach are the main factors that make EMRs popular among today’s learned medicos. At times, it becomes necessary to share patient details using EMRs, when patients need medical attention from different doctors. EMR involves sharing individual information over the digital media. This calls for a cautious and secure exchange of data.
Presented at "Hospital Management 2015" Program, Hospital Administration School, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand on August 18, 2015
Electronic Health Record System and Its Key Benefits to Healthcare IndustryCalance
This case study discusses how Electronic Health Record can turn out to be a solution to the problems associated with paper based clinical records. It’s a future-proof solution decreasing chances of error and loss while increasing patient-provider communication. Find out the key challenges faced by US health industry, key benefits of EHRs, and how Calance can help developing an HER solution. For more info about Calance, visit http://www.calanceus.com
Explains about Health Record Standards, ICTs, Standards for Healthcare Sector, Ministry of Health and Family Welfare. For more information visit: http://www.transformhealth-it.org/
A framework for secure healthcare systems based on big data analytics in mobi...ijasa
In this paper we introduce a framework for Healthcare Information Systems (HISs) based on big data
analytics in mobile cloud computing environments. This framework provides a high level of integration,
interoperability, availability and sharing of healthcare data among healthcare providers, patients, and
practitioners. Electronic Medical Records (EMRs) of patients dispersed among different Care Delivery
Organizations (CDOs) are integrated and stored in the Cloud storage area, this creates an Electronic
Health Records (EHRs) for each patient. Mobile Cloud allows fast Internet access and provision of EHRs
from anywhere and at any time via different platforms. Due to the massive size of healthcare data, the
exponential increase in the speed in which this data is generated and the complexity of healthcare data
type, the proposed framework employs big data analytics to find useful insights that help practitioners take
critical decisions in the right time. In addition, our proposed framework applies a set of security
constraints and access control that guarantee integrity, confidentiality, and privacy of medical information.
We believe that the proposed framework paves the way for a new generation of lower cost, more efficient
healthcare systems.
Insights into the Canadian eHealth Landscape - MaRS Future of MedicineMaRS Discovery District
In recognition of the need to develop a national digital health strategy and to co-ordinate activity across the country, the Conference of Deputy Ministers established Canada Health Infoway in 2001.
This lecture describes Infoway’s role and the progress that it and its jurisdictional partners have made over the last decade. It outlines the challenges to achieving our collective goal of using technology to improve the health of Canadians and describes key enablers that must be in place for us to be successful. It also contains the results of recent public opinion research conducted with Canadians and healthcare providers and outlines the priorities for moving forward and the opportunities for action.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
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ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Antimicrobial stewardship to prevent antimicrobial resistanceGovindRankawat1
India is among the nations with the highest burden of bacterial infections.
India is one of the largest consumers of antibiotics worldwide.
India carries one of the largest burdens of drug‑resistant pathogens worldwide.
Highest burden of multidrug‑resistant tuberculosis,
Alarmingly high resistance among Gram‑negative and Gram‑positive bacteria even to newer antimicrobials such as carbapenems.
NDM‑1 ( New Delhi Metallo Beta lactamase 1, an enzyme which inactivates majority of Beta lactam antibiotics including carbapenems) was reported in 2008
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
DISSERTATION on NEW DRUG DISCOVERY AND DEVELOPMENT STAGES OF DRUG DISCOVERYNEHA GUPTA
The process of drug discovery and development is a complex and multi-step endeavor aimed at bringing new pharmaceutical drugs to market. It begins with identifying and validating a biological target, such as a protein, gene, or RNA, that is associated with a disease. This step involves understanding the target's role in the disease and confirming that modulating it can have therapeutic effects. The next stage, hit identification, employs high-throughput screening (HTS) and other methods to find compounds that interact with the target. Computational techniques may also be used to identify potential hits from large compound libraries.
Following hit identification, the hits are optimized to improve their efficacy, selectivity, and pharmacokinetic properties, resulting in lead compounds. These leads undergo further refinement to enhance their potency, reduce toxicity, and improve drug-like characteristics, creating drug candidates suitable for preclinical testing. In the preclinical development phase, drug candidates are tested in vitro (in cell cultures) and in vivo (in animal models) to evaluate their safety, efficacy, pharmacokinetics, and pharmacodynamics. Toxicology studies are conducted to assess potential risks.
Before clinical trials can begin, an Investigational New Drug (IND) application must be submitted to regulatory authorities. This application includes data from preclinical studies and plans for clinical trials. Clinical development involves human trials in three phases: Phase I tests the drug's safety and dosage in a small group of healthy volunteers, Phase II assesses the drug's efficacy and side effects in a larger group of patients with the target disease, and Phase III confirms the drug's efficacy and monitors adverse reactions in a large population, often compared to existing treatments.
After successful clinical trials, a New Drug Application (NDA) is submitted to regulatory authorities for approval, including all data from preclinical and clinical studies, as well as proposed labeling and manufacturing information. Regulatory authorities then review the NDA to ensure the drug is safe, effective, and of high quality, potentially requiring additional studies. Finally, after a drug is approved and marketed, it undergoes post-marketing surveillance, which includes continuous monitoring for long-term safety and effectiveness, pharmacovigilance, and reporting of any adverse effects.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
ADVANCED BIOPHARMACEUTICS & PHARMACOKINETICS : UNIT 5
APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMS By - AKANKSHA ASHTANKAR
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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Mexico Pittsburgh Ece Introduction
1. IMSS EHR &
::
VistA Implementation ::
VistA Community Meeting
Robert Morris University
Pittsburgh, PA
June 29th, 2006
2. Contact Information
• Gabriel E. Rivera
Electronic Health Record Division Manager
(011-5255) 5238-2700 Ext. 12826
gabriel.riverag@imss.gob.mx
• Alexis Diez
IMSS-VISTA Development Manager
(011-5255) 5238-2700 Ext. 12642
alexis.diez@imss.gob.mx
4. Mexico
• 1,964,375 km² total territory
• 31 States, 1 Federal District
• (Capital: México, Distrito Federal)
• Total population (2000): 97,483,412
• Annual population growth rate (1990-
2000): 1.85%
•
Urban population (2000): 74.6%
•
Population density (2003): 53.0
Hab/Km2
• Life expectancy: 68.5, males; 74.7,
females
• Ethnic groups: 60% mestizos
(Amerindian-Spanish) ; 30%
amerindian; 9% white; 1% other
Source: Secretaría de Relaciones Exteriores http://www.sre.gob.mx
5. IMSS is a unique Social Security
institution...
• It employs 380,000 workers and has a seventeen
Billion USD annual operating budget.
• Aside from providing disability and retirement
pensions to 3 million people, similar to those
provided by the Social Security Administration in the
United States, it also offers medical services for
around half of all Mexicans, that is, over forty five
million people.
• In addition, IMSS provides day care centers for
working women and cultural and sports facilities for
affiliated workers.
• Lastly, the IMSS is Mexico's second largest Tax
Authority, after the Finance Ministry, collecting
annually over ten billion dollars in Social Security
contributions.
6. IMSS’ quick facts
Quick Facts
• Daycare centers with a population of over 150,000 children.
• 1 out of every 3 children in Mexico is born at IMSS.
• 25% of all medical research country-wide.
• 37% of all hospital beds.
• 74% of all Kidney Transplants.
• 76% of all Heart Transplants.
• 65% of all Pancreas Transplants.
• 2nd largest collection authority (Approx. 9.5 BUSD).
Medical Units
– 1st Level (primary care) 1,200
– 2nd Level (community hospitals) 223
– 3rd Level (tertiary/educational) 40
Covered Population
• Workers 15,130,640
• Beneficiaries (relatives) 27,098,612
• Pensioned and Relatives 3,643,151
• Total 45,872,403
8. EHR in MEXICO
IN MEXICO THERE ARE SEVERAL INDEPENDANT EFFORTS TOWARDS AND ELECTRONIC HEALTH RECORD.
THE CURRENT TREND IS THE INTEGRATION OF STANDARDS SUCH AS HL7, CDA AND DICOM .
Ministry of Health
– Disperse efforts in several Medical Facilities in the country.
– Currently analyzing a standardization process.
Private Medical Centers
– Clínica Lomas Altas: Ambulatory Patient Care + PACS
– Clínica Londres: EHR System
– Hospital Ingles: PACS
– Hospital ABC: EHR + PACS
ISSSTE
– Tele-medicine services being developed.
– Deploying an appointment control system.
IMSS
– HL7, CDA and DICOM standards are adopted.
– State of the art technological infrastructure being used: Unisys
ES7000 Orion as central repository, BEA WebLogic 8.1
– 1000+ Medical Units online by end of 2006.
– Medical Imaging Centralization project currently under
development to be tied into the EHR.
9. Investment Reach Achievements
Similar Scenarios
United States of America
Served population: 295,000,0001
Impl. due date: 20142
Est. investment: 600 BUSD3
United Kingdom: NHS
Served population: 60,400,0001
Impl. Due date: 20104
Est. investment: 20 BUSD5
Canada: Canada Health Infoway Inc.
Served population: 16,400,0001 & 6
Impl. due date: 20096
Est. investment: 1.3 BUSD7
IMSS
Served population: 45,872,403
Impl. due date: 2006
Est. investment: 102 MUSD
10. Integration
Integrated Services
Laboratory Hemodialysis Blood Bank
Impromed Pisa Falcon Hospital
Primary Care
Falcon Baxter Hemoser Information
Family
Centrum Fresenius Systems
Medicine Syst. Imaging
Nipro
Gambro
SICEH
SIMF VISTA
HL7 and DICOM3
EHR
11. IMSS Electronic Health Record
o The electronic health record project will
centrally host the clinical information
generated by all services provided by IMSS:
• 1st Level – Family Medicine Units
(1,200+)
• 2nd Level – General and Regional
Hospitals (223)
• 3rd Level – Highly Specialized Medical
Units (40)
o The objective is to have a unique EHR for
every IMSS user that will last for their whole
life time.
o It will be available in any time and place
connected to the IMSS network.
o IMSS EHR will enhance and expedite the
healthcare services provided by the Institute.
12. IMSS Electronic Health Record
o IMSS EHR will also consolidate a
tremendous knowledge database that will
support research, education and
administrative activities.
o Data will be consolidated from the different
clinical applications that IMSS uses such as:
• The Family Medicine System (SIMF)
• The Ambulatory Appointment System
(SICEH)
• The Hospital Information System
(IMSS-VistA)
• The different treatment and diagnostic
auxiliary services systems.
o Starting operation date: April 2004.
o Approximate investment: 102 MUSD.
13. IMSS Electronic Health Record
IMSS EHR ALLOWS THE INFORMATION INTERCHANGE BETWEEN CLINICS AND HOSPITALS NO
MATTER THEIR SIZE OF GEOGRAPHIC LOCATION.
Clinic B
Clinic A
CENATI
Monterrey
1. The physician creates a note that is
stored in a local server.
14. IMSS Electronic Health Record
IMSS EHR ALLOWS THE INFORMATION INTERCHANGE BETWEEN CLINICS AND HOSPITALS NO
MATTER THEIR SIZE OF GEOGRAPHIC LOCATION.
2. The note is sent to the IMSS EHR in
an HL7 file and is stored in a
Clinic B
database.
Clinic A
CENATI
Monterrey
15. IMSS Electronic Health Record
IMSS EHR ALLOWS THE INFORMATION INTERCHANGE BETWEEN CLINICS AND HOSPITALS NO
MATTER THEIR SIZE OF GEOGRAPHIC LOCATION.
Clinic B
Clinic A
CENATI
Monterrey
3. When the information is required in
another medical facility, a copy of the
note is sent to it’s local
16. IMSS Electronic Health Record
IMSS EHR ALLOWS THE INFORMATION INTERCHANGE BETWEEN CLINICS AND HOSPITALS NO
MATTER THEIR SIZE OF GEOGRAPHIC LOCATION.
4. The note is then seen by the
personnel that requested it.
Clinic B
Clinic A
CENATI
Monterrey
17. Use of standards by the EHR project
o HL7
• Health Level 7 is a standard used to provide a comprehensive
framework and related standards for the exchange, integration,
sharing, and retrieval of electronic health information that supports
clinical practice and the management, delivery and evaluation of
health services. Specifically, to create flexible, cost effective
standards, guidelines, and methodologies to enable healthcare
information system interoperability and sharing of electronic
health records.
o CDA
• Clinical Document Architecture is a defined complete document which
can include text, images, sounds and any other multimedia
information.
o DICOM
• Digital Communications in Medicine (DICOM) for interoperability the
distribution and view of medical images.
• Describes the structure, file formats and specification of information
of an image and the header required, describing a common language
to different medical systems.
18. Architecture
Front End Layer Application Layer Persistence Layer
11.254.171.171
WebLogic 8.1.4
11.254.91.11
IIS
PlugIn IIS-WebLogic
Clientes ECE
11.254 .171 .174
Cluster SQL Server
SIMF
Clientes ECE
VPN
11.254.91.10
IP Virtual
SICEH
11.254.91.12
IIS
VISTA
PlugIn IIS-WebLogic
11.254.171.172
• HEMODIÁLISIS
WebLogic 8.1.4
• BANCO DE SANGRE
Clientes /
• LABORATORIO
Proveedores
19. Architecture
o The Design of the technical platform was
based on six main concepts to achieve full
functionality:
• Security
• Interoperability
• Completeness
• Portability
• Durability
• Policy Compliance (NOM 168A, IMSS
111A)
o Context
• To capture faithfully the original
meaning of information and preserve
the medical-legal integrity: containers,
content and context.
20. Facts on the EHR technological platform
Level of availability of 99.5%.
o
Interoperability platform implemented in a
o
UNISYS ES7000 Orion enterprise server.
RAID Architecture to warranty availability of data.
o
IMSS EHR front-end is using Network Load
o
Balancing.
Disaster Recovery Plan designed to work in an
o
alternate location.
Implementation of industry security standards
o
such as WS Security, WS Addressing and WS RM.
Platform is able to process up to 180 TPS with a
o
normal operation scheme of 80 TPS.
ISO 9001:2000 Quality System implemented and
o
certified in December 2005.
21. Achievements
o IMSS EHR has registered the following information:
• Hemodialysis (320,000 sessions)
• Laboratory (10.4 million studies)
• Blood Bank (65,000 orders)
• Medical Notes (30 million – clinical notes only)
• Incapacities (52,300 + 570 cancellations)
• Stomathology (8,336 studies)
• Pharmacy (160,000 prescriptions)
23. Achievements
Feb Abr Jun Ago Oct Dic
Salud en el Trabajo
Transferencias
PrevenIMSS
Pre -
Agenda de Citas
Liberación
Climaterio y Menopausia
Imaginología
Trabajo Social
Planificación Familiar
Vigilancia Prenatal
Nutrición y Dietética
Análisis
Hojas de Control
Historia Clínica
Diseño
DiálisisPeritoneal
Desarrollo
Transfusiones
Notas Hospitalarias
24. 2006 Goals
IMSS EHR PROJECT HAS SET THE FOLOWING GOALS FOR 2006
o Centralization of information of more than 1,000 Family Medicine Units, 70
Secondary Level Hospitals and 25 Highly Specialization Medical Units.
o Complementing the high availability scheme of the architecture by
implementing a geo-cluster.
o Platform modification in order to support messaging transactions via SSL.
o Integration of digital signatures in the HL7 messaging operations.
o CMM Level 3 certification for the messaging development process.
26. •Description
IMSS HAS ADOPTED THE WORLD-WIDE RECOGNIZED
US VETERAN AFFAIRES' VISTA SYSTEM AS THE
HOSPITAL INFORMATION SYSTEM TO BE USED AT
IMSS HOSPITALS.
IMSS HAVE LOCALIZED AND MODIFIED VISTA's
FUNCTIONALITY TO MEET HOSPITAL
REQUIREMENTS, ALSO HAVE ADDED NEW
FUNCTIONALITY, FOR EXAMPLE:
•Web-interfaces for modules that originally were
text-based.
•Integration to the existent IMSS systems like:
Central EHR, Pharmacy and Lab results.
SPLASH SREEN OF THE
LOCALIZED VERSION OF CPRS
27. •Architecture (Vista & EHR)
Legacy Architecture - VistA
RPC’s
GT.M /
telnet & VistA
Web
HL7v2
Application
Web
Services Central Eligibility Module
AcceDer &
Master Patient Index
WAN
Central EHR
EHR
Web
Services
(HL7v3)
28. •Architecture (HISes & RIS)
Services for
Outpatients
SICEH
OE/RR
Services for
Inpatients
IMSS-VISTA
CENTRAL EHR
Auxiliary
Services
IMAGING
29. •New web interfaces
PATIENT REGISTRATION.
o
• A completely new web user interface for
patient registration, uses web services to
check eligibility and demographics if
patient already has EHR.
ADMISSION/TRANSFER/DISCHARGE
o
• A completely new web user interface for
bed control (Vista’s ADT module), uses
web services to check eligibility and
demographics if patient already has HER,
and to receive Admission Orders from
SICEH.
EMERGENCIES (ADT)
o
• A completely new web user interface for
patient admission into Urgency Service,
similar to ADT but with enhancements to
match IMSS business model.
30. •New CPRS modules
CENTRAL EHR INQUIRY
o
•Provider can consult patient’s central EHR and see all
clinical notes, lab results, haemodialysis sessions and
blood transfers made at other IMSS facilities.
CLINICAL NOTES
o
•Clinical notes with rich format and coded fields (no
just free text). Also we developed a graphic
environment to design additional clinical notes in a
easily and quickly fashion, as soon as the new design
is saved it is available within CPRS.
EMERGENCIES (CPRS)
o
•A completely new module (accessible through a
CPRS tab). Providers at Emergency Rooms have an
interactive screen that permits the capture patient‘s
information like: Glasgow scale, ISS, RTS, TRISS, AO
code (in case of fractures), a body/skeleton map to
locate burns/fractures. This information is reported
within a clinical note called “HOJA FRONTAL DEL
SERVICIO DE URGENCIAS”.
31. •New CPRS modules
NURSERY
o
• A completely new module (accessible through a
CPRS tab). Has been designed to meet IMSS
Nurses needs. Nurses can receive provider's
orders and follow up clinical attention within
CPRS.
SURGERY
o
• A completely new module (accessible through a
CPRS tab). Has been designed to meet IMSS
Surgery needs: Scheduling, Surgery Clinical
Note and automatic reports to a central IS.
DIRECT COMMUNICATION TO LEGACY HIS
o
• A completely new CPRS tab used to retrieve
information from a legacy HIS that has been
used for the last 10 years (necessary for
patients with chronic diseases).
32. •Challenges (Development)
LEARNING CURVE
o
• MUMPS.
• VISTA code (heterogeneous styles of coding).
• GTM.
INSTALATION & INITIAL CONFIGURATION
o
• VA’s documentation assumes previous knowledge of VISTA and there’s no guide to install
and bring VISTA up and running.
• Developers community documentation is based on particular distributions with particular
pre-configuration.
TRANSLATION
o
• Translate into Spanish text embedded in the MUMPS code.
• Understand effects of replace VA’s catalogs with IMSS catalogs.
CUSTOMIZATION
o
• Understand required configuration and pre-loaded information for each VISTA process
(Registration, Admission, etc.) in order to adjust it to IMSS process.
33. •Challenges (Deployment)
AUTHORIZATION
o
• Assign/Exercise budget to deploy the system.
INFRASTRUCTURE
o
• Cabling (power & network).
• Remodelling working areas.
EQUIPMENT
o
• Acquire and install PC and printers.
ACCEPTANCE AND PARTICIPATION
o
• Get Hospital Board committed with the project.
TRAINNING AND ON-SITE SUPPORT
o
• Train personnel (administrators and users).
• Support users on-site during early stage of adoption.
34. •Deployment
LARGEST UMAEs AT
3 MAJOR CITIES
LARGEST UMAEs
IN OTHER
STATES
REST
OF UMAEs
37. Sources:
1- Central Intelligence Agency; “The World Factbook”; 2006; website:
www.cia.gov/cia/publications/factbook/.
2- Thompson G., Brailer D., quot;
The Decade of Health Information Technology: Delivering Consumer-centric and Informa
“;
julio de 2004.
3- Middleton B.; “The Value of Healthcare Information Exchange and
Interoperability; 2004.
4- HIMSS; “Standards Insight”; Noviembre de 2004; website:
www.himss.org/content/files/StandardsInsight/2004/11-2004.pdf
5- Brewing B.; “Latitudes and Longitudes”; Government Health IT; 21 de
febrero de 2006; website: www.govhealthit.com/article90744-09-12-05-Print
6- Canada Health Infoway; “Who we are”; 2006; website:
www.infoway-inforoute.ca/en/WhoWeAre/Overview.aspx.
7- Canadian Healthcare manager, “The Electronic Health Record. Are We
Making The Grade?”; 2005; website:
www.chmonline.ca/images/June2005/ehr.pdf