AS Level ICT - Topic 6c Uses of ICT in Healthcare

Electronic Patient Record Keeping (EPR)

All patient records used to be kept on paper causing numerous problems:

 - > Lots of medical staff needed them at the same time so photocopying was required (dear and wasteful), storage and retrieval problems, illegible hand written notes due to quick writing, records frequently went missing, patient records were filed in the wrong place leading to lots of tests being carried out again and again costing money and time, notes didn't arrive in time for patient appointments and handwritten prescriptions couldn't be understood by the pharmacist and this wasted time

Advantages of storing data electronically rather than on paper - Patient details are available to be viewed wherever there is a terminal, only one set of data kept so it is easier to ensure consistency, security is improved, easier to back up data, don't need to transport patient files from place to place and patient information is available in many different places instantly

New and Future Developments of Medical Databases

NHS National Database

- Database is currently being developed which will be the world's largest database containing secure information about patients' healthcare

 - It will provide patient care records

 - Will store info on allergies, current prescriptions and bad reactions to medicines as well as all the patient information held by GPs and hospitals

 - Will contain information on more than 70m patients and there will be 400,000 registered users of the system

The Electronic Prescription Service

- Will allow prescribers like GPs to send prescriptions electronically to a dispenser like a pharmacy of the patient's choice

 - This will make the prescribing and dispensing process safer and more convenient for patients and staff

 - It will save doctors time and allow them more time with patients

Patients Identification

- Each patient is allocated a unique number which can be their NHS number and it is important because it gives the key field for the patient database and it is used to distinguish between patients with the same name living at the same address

 - Each patient is given a wristband with a bar code on it and this system allows identification

 - They contain patient names, DOB, blood type and NHS number / another number

Blood Bar Coding and Tracking Systems (Blood Tracking)

- Blood is taken from donors and is tested to determine certain characteristics of the blood such as blood group

 - Blood is then stored at the National Blood Transfusion Service -> Cross matching is carried out and bar coded labels are produced during testing and attached to the blood bags

 - Matched blood sent to hospital where it is kept in a blood bank/fridge -> Details are scanned beforehand

 - Hospital staff remove the required blood by first scanning their ID card and then the magnetic locks unlock -> ID bar code is scanned and blood is taken to the ward

 - Person who needs it has barcode scanned on their wristband using a handheld PDA and if it matches the patient can have the blood transfusion

Advantages - Completes full audit trail, eliminates paper records, provides security

Bar coding can also be used for identifying specimens and papers (bar code on them)

Use of the Internet

- Send e-mails to patients they find hard to contact via phone, communication via a hospital website, research, patients can communicate with their friends and family and sending information on lab tests or X-rays in primary or secondary care

Use of the Intranet

- Only hospital are allowed access to the intranet

 - Lots of hospitals use intranets as a form of transferring patient data to different devices

Use of the Extranet

- Can be used by suppliers, other agencies and general practitioners

Distributed Medical Databases

- These are collections of patient information spread over two or more servers in a network

 - When a healthcare professional needs to see a patient's medical record the distributed bits are found and merged together to create a single record

Advantages - Security can be improved as data is not all kept in one place and spped of access is improved as one server doesn't have to deal with all the requests for information from users

Backup and Recovery Procedures

- Must be in place so staff can recover any lost data

 - Considerations for backup include -> Whether any downtime is allowed, the quantity of data needed to be backed up, where the data is going to be stored etc.

Ensuring the Privacy of Patient Records

Privacy of the EPR system is assured by:

1 - Access levels

2 - 128-bit encryption

3 - Passwords

4 - Audit trails

Sensors (Analogue and Digital)

- Sensors are devices which can be used to detect physical, chemical and biological signals and provdie a method of measuring and recording them via processors / computers

 - Analogue sensors -> Measure an analogue quantity (quantity that can have an almost infinite set of values like temperature etc.

 - Digital sensors -> Sensors which can detect digital quantities

 - Signal from analogue sensor would need to be converted into a digital signal before it can be processed or stored by a computer (If connected to a computer)

Data Measured by Sensors and its Uses

- Used in medicine to measure temperature, blood pressure, central venous pressure, pulse, blood gases, blood sugar, brain activity, electrical activity of the heart, intra cranial pressure, breakdown of gases from a patient's breath, respiratory rate

Advantages of Using Sensors for Patient Monitoring

- Measurements never missed (taken automatically)

 - Real-time monitoring

 - Frees up medical staff

 - Reduces costs (human resource costs - Staff)

 - Trends can be spotted

 - More accurate readings

Monitoring and Control of a Patient's Condition

- Life support systems use data from sensors to control medical equipment that helps or replaces important bodily functions which enable patients to live who might otherwise die

 - Used to control respirtation, excretion, heart function, kidney function and drips

Scanning Devices

MRI (Magnetic Resonance Image)

- MRI scanner uses magnetic and radio waves to create a picture of the inside of a patient

 - Patient lies inside a large cylindrical magnet and powerful radio waves are sent into the patient's body

 - Hydrogen atoms in patient's body give out radio waves of their own and the scanner picks these up and turns them into a picture

 - MRI scan can be used for examining heart and its blood vessels for damage and examining joints and the spine for damage and checking function of certain organs

CAT (Computerised Axial Tomography)

- CT scans send out several X-ray beams at different angles to the body -> The X-rays are detected after they have gone through the patient's body where the strength is measured

 - Picture can be formed via signal strength

Advantages of Scanning Devices - Higher cure rate, reduces unnecessary operations, helps surgeons plan operations, faster diagnosis, scanning can be done routinely, safe in the case of MRI scans and 3D viewing

Disadvantages of Scanning Devices - Sophisticated computer-controlled scanning equipment is expensive, can break down, can be dangerous for staff to use and MRI scans are uncomfortable and distressing (lie still for ages)

Backup and Recovery Procedures

- Backup recovery plan uses mirrored hard drives, backup tapes which use a tape rotation system and off-site archiving of data

 - All scanners and ICT systems in hospitals have an uninterruptible power supply (UPS) which keeps the power running when the supply to the hospital has been cut (powercut)

Limitations

- Bandwith can be limited, life support malfunctions, ethical problems and expensive

Artificial Intelligence

- Reasoning process performed by computers that enables it to draw deductions, produce new information and modify rules or write new rules

Neural Networks

- Biological systems which are used by brain for learning new things

 - Scientists can develop ICT sytems making use of artificial neural networks

 - Artificial neural networks can learn by example, just like humans do

 - Ordinary ICT systems are good at fast processing and obeying instructions however they are not good at adapting to circumstances, dealing with data in parallel and dealing with data which is imprecise or contains errors

 - ICT systems which use neural networks are good where algorithms can't be developed, they are good where there are many examples to learn from and they are good where structure can be identified from existing data

 - ICT systems using neural networks are only suited to certain tasks, the examples used to teach the system must be chosen carefully and the neural network learns on its own which means its operation can be unpredictable

How Parallel Processors Work

- Human brain is able to process data in parallel (parallel processing)

 - Specalist computers like supercomputers are available which can carry out parallel processing used for things where millions of individual items of data need processing very quickly like production of weather forecasts

Expert Systems

- ICT system which uses artificial intelligence to make decisions based on data supplied in the form of answers to questions

 - Consist of knowledge base, inference engine and a user interface

 - Use a problem-solving model which organises and controls the steps which need to be taken to solve the problem

 - IF - THEN rules to form a line of reasoning (part of inference engine), knowledge base is info used to make a decision or diagnosis -> Series of Qs are asked to help make decision or diagnosis

Expert System Shells

- You can create an expert system by either building it from scratch using software language suited to the task or by using a piece of development software called an expert system shell

 - It is a generic piece of software used for creating expert systems

 - Consists of an inference engine and user interface but knowledge base is not supplied but is created by person/expert who is building the expert system

 - 'Shell' is used because user has to build knowledge base themselves

Software Languages -> Programming languages have been developed which are specialist languages for development of expert systems (use English-like statements which are facts along with results and questions) e.g. PROLOG and ASPRIN

Medical Uses of Expert Systems

 MYCIN -> Earliest expert system used in medicine and uses a patient's blood tests and results to allow doctors to pinpoint the correct organism which is responsible for a blood infection -> Specific drugs can be given to the patient which will treat that particular organism

Features of MYCIN -> Uses around 500 rules, system will ask for further information, it will ask for certain additional laboratory tests if needed, it will suggest best medication, it will give list of drugs with probabilities of drug working and it will make a final choice of drug based on a series of questions system asks about patient allergies

NEOMYCIN -> Developed in order to train doctors and it took doctors through various example cases checking the doctors' conclusions and then explaining where they went wrong if they did go wrong

Advantages of expert systems - Consistency, cheaper, available 24/7, uses all information it has

Disadvantages of Expert Systems - No common sense, absurd errors, relies on R+K