MEDSET Нужная информация В нужное время В нужном месте [email protected] Жизнь после смерти, или о технологии перехода

MEDSETMEDSETНужная информация В нужное время В нужном месте

[email protected] www.mml.ru

Жизнь после смерти, или о технологии перехода к новой

медицинской информационной системе с помощью интеграционной платформы

Жизнь после смерти, или о технологии перехода к новой

медицинской информационной системе с помощью интеграционной платформы

М.А.ШифринНИИ Нейрохирургии им. Н.Н.Бурденко РАМН

Москва15 сентября 2009 г.

Симпозиум InterSystems



Life After Death,or on Technology of Transition

to a New Medical Information System Using Integration Platform

Life After Death,or on Technology of Transition

to a New Medical Information System Using Integration Platform

M.ShifrinN.N.Burdenko Neurosurgical Institute

Moscow15 SEptember, 2009

InterSystems Symposium



N.N.Burdenko Neurosurgical Institute (R&D)N.N.Burdenko Neurosurgical Institute (R&D)of Russian Academy of Medical Sciencesof Russian Academy of Medical Sciences

•Established in 1932

•Now: new surgical building (1999)

►300 neurosurgery beds

►40 beds in ICU

►14 operating rooms

►Radio surgery department

►Neurorehabilitation department

►Full set of diagnostic and laboratory equipment

►~5500 admissions/year

►Out-patient department



• 1 workplace ~ 400 • 5 users ~ 600• 1 user function ~ 150, supporting about

90% everyday clinical activity• A single interruption of the work of the system, all critical

functions were running• A single breakdown which halted a system for 24 hours

• 1 workplace ~ 400 • 5 users ~ 600• 1 user function ~ 150, supporting about

90% everyday clinical activity• A single interruption of the work of the system, all critical

functions were running• A single breakdown which halted a system for 24 hours

Electronic Patient Record SysytemElectronic Patient Record Sysytem2000 - 2009

Electronic Patient Record SysytemElectronic Patient Record Sysytem2000 - 2009



Evolutionary development (1) Evolutionary development (1)

“spatial”“spatial” “functional”“functional”

“cognitive”“cognitive”



Evolutionary development (2)Evolutionary development (2)

“Spatial” dimension:

• 1 working place ~ 400

• 4 users ~ 600

“Functional” dimension:

• 1 function (admission/discharge) ~ 130

“Cognitive” dimension:

• free text adequate formalization

“Spatial” dimension:

• 1 working place ~ 400

• 4 users ~ 600

“Functional” dimension:

• 1 function (admission/discharge) ~ 130

“Cognitive” dimension:

• free text adequate formalization



What nextWhat next??What nextWhat next??



Following Hamburg scoreFollowing Hamburg score……Following Hamburg scoreFollowing Hamburg score……

+Works 24/7

Intuitive interface

"Fine tuning" accordingly to the needs of the hospital

Support – 3 persons

The system is habitual

-Unsatisfied expectations:

•display of diagnostic images•connection with analyzers •connection with financial system•analytical options:

for scientific investigationsfor business and medical administration

• …



""Inborn defectsInborn defects""""Inborn defectsInborn defects""

e-med – home-made system

•Poor documentation

•Business logic – part of the programme code

•A little supporting team – pluralism of functions

Transition to industrial system Transition to industrial system Transition to industrial system Transition to industrial system



Objective difficultiesObjective difficultiesObjective difficultiesObjective difficultiesStructural contradictions

•Clinics vs. science: different data models

•Electronic document flow vs. decision support:different information technologies

•Heterogeneity of subject domain:diagnostic and treatment process (CIS)laboratory processes (LIS)obtaining, storing and transfer of images(RIS)administrative processes

IntegrationIntegrationIntegrationIntegration



Transition DifficultiesTransition DifficultiesTransition DifficultiesTransition Difficulties

"Single step" or step-by-step?

•Large number of users, low level of IT qualification

•Variety of functions

•Variety of running systems

•Impossibility of halting main business processes

Transition platformTransition platformTransition platformTransition platform



Industrial systemIndustrial system

+ + IntegrationIntegration

+ + Transition platformTransition platform

Industrial systemIndustrial system

+ + IntegrationIntegration

+ + Transition platformTransition platform

Integration platformIntegration platformIntegration platformIntegration platform




OldOldOldOld Other systemsOther systemsOther systemsOther systems

EPREPREPREPR




NewNewNewNewOldOldOldOld Other systemsOther systemsOther systemsOther systems

EPREPREPREPR




NewNewNewNewOldOldOldOld Other systemsOther systemsOther systemsOther systems

EPREPREPREPR




NewNewNewNew Other systemsOther systemsOther systemsOther systems

EPREPREPREPR



AdvantagesAdvantagesAdvantagesAdvantages• Smooth transition without halting

business processes

• Permanent development

• "Best of Breed"

• Creating of integrated information environment

• Smooth transition without halting business processes

• Permanent development

• "Best of Breed"

• Creating of integrated information environment



Last but not leastLast but not leastLast but not leastLast but not least

A hope not to meet transition problem in 10 years –

transition will be permanent

A hope not to meet transition problem in 10 years –

transition will be permanent

Transition to a new integration platform -

the problem for the supplier

Transition to a new integration platform -

the problem for the supplier



DifficultiesDifficultiesDifficultiesDifficulties

As far as they appear…As far as they appear…



HUB - MPIHUB - MPIHUB - MPIHUB - MPIe-mede-mede-mede-med

««ParusParus»»««ParusParus»»

LISLISLISLIS HSCHSCHSCHSC

PACSPACSPACSPACS

New services of New services of the EPRthe EPR

New services of New services of the EPRthe EPRPilot projectPilot projectPilot projectPilot project

IS IS ««Radiology Radiology treatmenttreatment»»

IS IS ««Radiology Radiology treatmenttreatment»»



Pilot project: e-Med – TrakCare LabPilot project: e-Med – TrakCare LabPilot project: e-Med – TrakCare LabPilot project: e-Med – TrakCare Labe-mede-mede-mede-med

Buffer DB (MS SQL)Buffer DB (MS SQL)Buffer DB (MS SQL)Buffer DB (MS SQL)

Orders Results

TrakCare LabTrakCare LabTrakCare LabTrakCare Lab

Laboratory devicesLaboratory devicesLaboratory devicesLaboratory devices

Orders Results

EnsembleEnsembleEnsembleEnsemble

EPR

LIS



Thank you for your attention!

Thank you for your attention!

[email protected]@nsi.ru

Documents

MEDSET Нужная информация В нужное время В нужном месте [email protected] Жизнь после смерти, или о технологии перехода