thomas bruessel, fanzca prof of anaesthesia canberra hospital canberra, aus aims – orms – emr
TRANSCRIPT
Thomas Bruessel, FANZCAProf of AnaesthesiaCanberra HospitalCanberra, AUS
AIMS – ORMS – EMR
Australian Institute of Medical ScientistsAustralian Institute of Mine SurveyorsAustralian Institute of ManagementAustralian Institute of Marine ScienceAustralian Institute of Medical ScientistsAustralian International Motor ShowAfrican Institute for Mathematical SciencesAfghanistan Information Management ServiceAssociation of International Marathons Races
AIMS – ORMS – EMR
AIMSAnaesthesia Information Management
System
AIMS – ORMS - EMR
ORMSOperating Room Management System
EMRElectronic Medical Record
ORMS
EMR
AIMS
AIMS
eHealth
?
EMR
ORMS
“Ether Chart”
Codman EA, Cushing H
1st written record
1894 at MGH
On permanent loan from the Treadwell Library of Massachusetts General Hospitalto the Francis A. Countway Library of Medicine
Hand written anaesthesia
record~
100 years
Preadmission Clinic
Post AnaesthesiaCare Unit
Intraoperative Data
Automated anaesthesia record
HR, BP, CVP
FiO2, etCO2, SaO2 Temp
CVP
Sevo etRR, PIP
PCWP,CO
Data sampling (RS 232 port)
more frequently more accurately
medico-legal advantage ?
Automated anaesthesia record
A Anaesthesia I InformationM ManagementS System
Server
NetworkConnection
Patient Monitor
Other Devices
Anaesthesia machine
Operating Room
Communicationmultiplexer Workstation
Serial data
Position
Anaesthesia data chart: Missing information
Instrumentation
Type of anaesthesia
Fluid balance
Action / interventions
Drugs
Events
●
●
●
●
●
●
●
AIMS
Collects intraoperative physiologic data
Collates these with patient information
Adds interventions of anaesthetist
Stores this information
Allows retrieval and analysis
●
●
●
●
●
PAC: information
Medication Safety
Performance
Data retrieval & Analysis
AIMS
Adverse events, near misses
Clinical competence/performance
Compliance with standards, rules and regulations
●
●
●
PAC: history, exams, test
Intraoperative: data + events
PACU: data, pain, discharge info.
AIMS
ORMS
Central Database“Server”
Medical Records
PreOpClinic
HoldingArea
ReferringPhysician
AdmissionsScheduling
OperatingRoom
ICU/FloorPACU
Perioperative Setting: Data Flow
ORMS
Billing (professional fees)
● Scheduling of cases
Organisation of clinical and support staff Organisation of equipment and suppliesCoordination of access to Biomedical engineering
Capture of patient information
Documentation of clinical information
● Tracking of patient flow● Organisation of postsurgical placement of patients
● Documentation of time stamps ●
●●●
●
●
AIMS Lab Imaging Pharmacy
●●●
Allow maximal integration
Medication Management: Storage /Supply
ORMS
ORMS
AIMS
Integration = Application + Platform
Data SharingRedundancy!!!
Jerry StonemetzKeith Ruskin Editors
Springer, London2008
HealthSMART (Vic)National E-Health Strategy
Electronic medical record
File:Electronic medical record.jpgFrom Wikipedia, the free encyclopedia
Medical record generated outside OR
Intergration/Linking GPs and Hospitals
Providing access to medical staff
Very expensive
E-HealthNational E-Health Strategy
Electronic Medical Record
E-Health
E-Health takes time and cost money
IDEAL SYSTEM
ORMS
EMR
AIMS
PathologyPathology
ImagingPhysician
Order Entry
IDEAL SYSTEM
ConfidentialityPrivacy ?