ICT in Healthcare Topic 6 WJEC Objectives • Scanning, life support, computer controlled equipment • sensors (analogue and digital), data measured and its use • scanning devices; MRI (magnetic resonance image); CAT (computerised axial tomography) • advantages and disadvantages of scanning devices • backup and recovery procedures • new and future developments and limitations. • Medical Databases • electronic patient record keeping (EPR) • blood bar coding and tracking systems ISBT 128 • use of the Internet, intranets and extranets • distributed medical databases • backup and recovery procedures • new and future developments and limitations. • Expert systems • Artificial Intelligence • neural networks and how parallel processors work • software languages (PROLOG, ASPRIN) • expert system shells (knowledge base, inference engine, user interface) • how expert systems work • medical uses of expert systems e.g. MYCIN, NEOMYCIN etc. • advantages and disadvantages of expert systems. Medical Expert Systems • Key word is: Artificial Intelligence • A system based on Rules to reproduce the Role of a Human Expert • Works by using Questions and Answers – (IF-Then rules) Medical Expert Systems • Go on NHS Direct website • Use system to find out what is wrong with you • Other Examples – NEOMYCIN – Used to train doctors – MYCIN – Helps doctors with obscure cases and patients can be put on correct medication 3 Parts to Expert System LEARN THIS Knowledge Base A database of all of the facts and knowledge on a subject Inference Engine A set of rules to base the decisions on (IF-Then) User Interface How the questions and answers are presented to the user Brings the parts of the database together to answer the questions being asked Exam Question Extensive use is made of Expert Systems. State the three main components of every expert system and then describe with examples the advantages and disadvantages of using an expert system in medicine. [7] Exam Question Answers Medical Databases (ERP) • Pre-Electronic Database Storage problems: Huge number of files needed Only one person can access data at the same time Problems with storing patients records manually (paper based) Records go missing Handwritten notes messy And hard to understand Medical Databases (ERP) • Patients records now stored electronically • Data can be accessed by more than one medical professional at the same time • No need to transport files (speed of data access) • Security • Latest information can be accessed from patients bedside (example: results from blood tests) Blood Bar Coding and Tracking • Tracking of blood across is an essential service the NHS provide • It is also essential that it is accurate • Identify what data is held on the blood and why it is important that it is tracked correctly Intranets and Extranets GP Consultant Supplier Surgeon Nurse Distributed Databases Radiology Intensive Care A+E Pharmacy Laptop on the ward The user uses one database software application to access the information and is likely to be unaware that the data is not stored in one place Patient data is stored on lots of separate databases Plastics Surgery Security • Access Levels • Data Encryption • Passwords • Audit Trails Exam Question • Discuss the reasons why databases were introduced for storing patient records and assess the impact they have had upon patient tracking and monitoring. [6] Exam Question Answers Sensors – Analogue to Digital • Analogue Signals • Digital Signal Sensors Used In Hospitals • What is measured using sensors in hospitals? • • • • • • Temperature Blood Pressure Pulse Blood Sugar ECG (Heart Rate) Respiratory Rate Advantages •No “Human Error” – no missed readings •More Accurate •Real Time Monitoring •Automatically Measure Trends Scanning Devices • MRI • Use Radio Waves to build up a picture of the inside of a patient • Used for checking function of organs such as liver, kidney, spleen, blood vessels and heart damage • CAT • Similar x-ray, but multiple x-ray beams are sent out at different angles to produce a more detailed scan • Used to pinpoint tumours Scanning Devices • Advantages • Can look at internal organs in 3D • MRI scans are safer than XRays • Higher cure rate due to early detection • Reduces the need for exploratory surgery • Faster Diagonosis Disadvantages • scanning equipment very expensive • Exposure to radiation is dangerous for staff operating scanners • Patients have to be still for about 1 hour in an MRI machine Future Technologies • Home Healthcare • Video conference using sensors so that consultation with doctor can be done from home • Diabetes management • Automatic blood glucose measurements are taken and if blood glucose is too low a sensor automatically releases glucose from a reservoir implanted into patient • Japanese Toilets • A Japanese company is developing a toilet that analyses urine and sends a report automatically to the GP if necessary