Bealth Infoimation Systems

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This uocument uesciibes a PhB level couise, coiiesponuing to a Cuiiiculum 0nit
cieuiteu with S ECTS (!"#$% '()*'+,-), intenueu foi the NAP-I uoctoial
piogiam. It is offeieu by Seivio ue Bioestatistica e Infoimtica Nuica,
Faculuaue ue Neuicina, 0niveisiuaue uo Poito.

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Bealthcaie is infoimation anu knowleuge uiiven. uoou healthcaie uepenus on
taking uecisions at the iight time anu place, accoiuing to the iight patient uata
anu applicable knowleuge (1). Communication is of most ielevance in touay's
healthcaie settings, as health ielateu activities, such as ueliveiy of caie, ieseaich
anu management uepenu on infoimation shaiing anu teamwoik (2).

Pioviuing high-quality healthcaie seivices is an infoimation-uepenuent piocess.
Inueeu, the piactice of meuicine has been uesciibeu as being uominateu by how
well infoimation is piocesseu oi iepiocesseu, ietiieveu, anu communicateu (S).
An estimateu SS to S9 peicent of total hospital opeiating costs have been
associateu with patient anu piofessional communication activities (4).
Physicians spenu ovei a quaitei (S, 6) anu nuises half (7) of theii time wiiting
up patients' chaits.

A patient iecoiu is a set of uocuments containing clinical anu auministiative
infoimation iegaiuing one paiticulai patient, suppoiting communication anu
uecision making in uaily piactice, anu having uiffeient useis anu puiposes (8). It
exists to memoiise anu communicate the uata existing on a paiticulai inuiviuual,
in oiuei to help uelivei caie to him oi hei. Recoius aie not only an infoimation
system but also a communication system, that enable communication between
uiffeient health piofessionals anu between the past anu the piesent (9, 1u).
Patient iecoius, the patient anu publisheu eviuence aie the thiee souices neeueu
foi the piactice of eviuence-baseu meuicine (1). They aie useu foi immeuiate
clinical uecisions (eithei by the authoi, oi by otheis), futuie clinical uecisions,
quality impiovement, euucation, clinical ieseaich, management anu
ieimbuisement, anu to act as eviuence in a couit case (11).

Patient uata quality in computei-baseu patient iecoius has been founu to be
iathei low in seveial health infoimation systems (12-14). Nost souices of pooi
uata quality can be tiaceu back to human eiioi (1S, 1S) oi bau system uesign
(14). Noieovei, the assessment of the coiiectness of collecteu patient uata is a
uifficult piocess even when we aie familiai with the system in which it was
collecteu (16). 0ne of the main challenges of health infoimation systems oi
netwoiks is to be able to gathei the uiffeient paits of the meuical iecoiu of a
patient without any iisk of mixing them with those of anothei patient (17, 18).

The pioposeu unit intenus to be a specialization in health infoimation systems
(BIS), namely in the ueveloping BIS, integiation anu inteiopeiability issues,
teiminologies, auuiting anu clinical uata quality, anu BIS evaluation.

Intio on PACSRIS


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1. Wyatt }C, Wiight P. Besign shoulu help use of patients' uata. Lancet. 1998 0ct;SS2:1S7S-8.
2. Coieia E. uuiue to health infoimatics: Ainolu; 2uuS.
S. Bainett 0. Computeis in meuicine. }ANA. 199u;26S:26S1-S.
4. Richait R. Evaluation of a meuical uata system. Comput Biomeu Res. 197u;S:41S-2S.
S. Auuit Commission. Foi youi infoimation: a stuuy of infoimation management anu systems
in the acute hospital. 199S.
6. Namlin }, Bakei B. Combineu time-motion anu woik sampling stuuy in a geneial meuicine
clinic. Neu Caie. 197S;11:449-S6.
7. Koipman R, Lincoln T. The computei-stoieu meuical iecoiu: Foi whom . } Am Neu Infoim
Assoc. 1998;2S9:S4S4-6.
8. Wyatt }C. Clinical uata systems, Pait 1: Bata anu meuical iecoius. Lancet. 1994
Bec;S44:1S4S-7.
9. Bick R, Steen E. The Computei-baseu Patient Recoiu: An Essential Technology foi
BealthCaie1997.
1u. Nygien E, Wyatt }C, Wiight P. Belping clinicians to finu uata anu avoiu uelays. Lancet. 1998
0ct;SS2:1462-6.
11. Wyatt }. Clinical uata captuie anu piesentation. Neuical Infoimatics Summei School2uuS.
12. Bogan W, Wagnei N. Accuiacy of uata in computei-baseu patient iecoius. } Am Neu Infoim
Assoc. |Reviewj. 1997;4(S):S42-SS.
1S. Bammonu K, Belbig S, Benson C, BN B-S, euitois. Aie electionic meuical iecoius
tiustwoithy. 0bseivations on copying, pasting anu uuplication. ANIA Annual Symposium;
2uuS.
14. Bohnlosei }, Fischei N, Konig A, Emmeiich B. Bata quality in computeiizeu patient iecoius.
Analysis of a haematology biopsy iepoit uatabase. Int } Clin Nonit Comput. 1994;11(4):2SS-
4u.
1S. Weii C, Buiule }, Felgai N, Boffman }, Roth B, Nebekei }. Biiect Text Entiy in Electionic
Piogiess Notes - An Evaluation of Input Eiiois. Nethous Inf Neu. 2uuS;42(1):61-7.
16. Beinei E, Noss }. Infoimatics Challenges foi the Impenuing Patient Infoimation Explosion. }
Am Neu Infoim Assoc. 2uuS;12(6):614-7.
17. Quantin C, Binquet C, Bouiquaiu K, Pattisina R, uouyon-Coinet B, Feiuynus C, et al. A
peculiai aspect of patients' safety: the uisciiminating powei of iuentifieis foi iecoiu linkage.
Stuu Bealth Technol Infoim. 2uu4;1uS:4uu-6.
18. Aiellano Nu, Webei uI. Issues in iuentification anu linkage of patient iecoius acioss an
integiateu ueliveiy system. } Bealthc Inf Nanag. 1998;12(S):4S-S2.


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The couise aims:
Nake stuuents acknowleuge anu uesciibe the main chaiacteiistics anu
pioblems ielateu to BIS uevelopment
Pioviue the stuuents with a tools to help uevelop BIS that aie compliant
with the best inteinational piactices of BIS uevelopment
Belp the stuuent uevelop iigoious BIS evaluation methouologies.
Pioviue the stuuents a hanus on appioach to the PACSBIC0N univeise

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1. Bevelopment of BIS
a. To iuentify the neeu foi an IS
b. Implementation of BIS
c. Electionic Patient Recoius
2. Integiation anu inteiopeiability in BIS
a. Stanuaius (BL7, BIC0N, 0penEBR, CEN TC2S1)
b. Semantic inteiopeiability
c. Integiation of exteinal seivices to the institution
S. Couing anu classification
a. Teiminologies, nomenclatuies anu ontologies of clinical concepts
b. Inteinational Classification of Biseases anu the Biagnosis Relateu
uioups
4. Auuiting anu clinical uata quality
a. Possible types of eiiois
b. Nethous foi eiioi uetection
c. Nethous to inciease uata quality
S. BIS evaluation
a. Levels of eviuence
b. Bevelopment of measuiement instiuments
c. Bemonstiation stuuies
u. Cost-benefit anu cost-effectiveness stuuies
e. Stuuy planning
6. RISPACS
a. Image uemogiaphics
b. Aichitectuies
c. Image Bistiibution, Stoiage anu Aichiving Stiategies
u. Woikflow e Bataflow in Rauiology
e. Ciitical Scenaiios: Caiuiac PACS
f. Futuie: S-PACS (Suigeiy-PACS);
g. Secuiity anu Piivacy
h. PACS anu E-Leaining in Neuical Science
i. PACSRISBIS integiation issues
j. Regional PACS, Telemeuicine anu Telewoik
7. The BIC0N stanuaiu
a. Bistoiy
b. Stanuaiu: Stoiage anu Communications
c. Bata Stiuctuie anu uata Encouing
u. BIC0N Seivices
e. Woikflow e Woiklist Seivice
f. Stiuctuieu Repoiting


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Lectuies
Lectuies of inviteu speakeis
Piactical implementaiions of Bealth Infoimation Systems oi mouules
Integiation of stuuents on Reseaich Piojects

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Su% - A wiitten final exam coveiing the topics stuuieu in the leaining unit.
Su% - A wiitten scientific aiticle, conceining eithei iesults obtaineu uuiing
theii expeiimental woik oi a state-of-the-ait ieview on a Bealth
Infoimation System topic, which must be piesenteu oially in a public
seminai.

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B. Paiues , Baiolu P. Lehmann , Patiicia A. Abbott , Nancy K. Roueiei , Auam
Rothschilu , Steven F. Nanuell , }oige A. Feiiei , Robeit E. Nillei , Naiion }.
Ball. Aspects of Electionic Bealth Recoiu Systems. Spiingei; 2 euition
(Naich 21, 2uu6)
Euwaiu B. Shoitliffe , }ames }. Cimino. Biomeuical Infoimatics: Computei
Applications in Bealth Caie anu Biomeuicine. Spiingei; S euition (Nay 2S,
2uu6)
Kaien A. Wagei, Fiances Wickham Lee BBA, }ohn P. ulasei. Nanaging
Bealth Caie Infoimation Systems: A Piactical Appioach foi Bealth Caie
Executives. }ohn Wiley anu Sons
B. K. Buang, "PACS anu imaging infoimatics : basic piinciples anu
applications" , }. Wiley & Sons, 2uu4
Keith Bieyei et al (eus), "PACS A uuiue to the Bigital Revolution", 2Eu,
Spiingei 2uu6
Beiman 0osteiwijk, "BIC0N Basics Book ", Siu Eu, 0Tech, 2uuS
0leg S. Pianykh "Bigital Imaging anu Communications in Neuicine (Bicom):
A Piactical Intiouuction anu Suivival uuiue", Spiingei 2uu8

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The teaching staff is composeu by:
Ricaiuo Coiieia (piincipal instiuctoi), computei scientist, PhB in the
integiation of hospital IS, cuiiently with 21 publications, teaching Bealth
Infoimation Systems on the Nastei couise of Neuical Infoimatics of the
0niveisity of Poito, anu whose cuiient inteiest is Electionic Patient
Recoius anu Bealth Infoimation Systems;
}oo Fonseca, meuical uoctoi, PhB in meuicine, teaching Evaluation of
Bealth Infoimation Systems on the Nastei couise of Neuical Infoimatics
of the 0niveisity of Poito, anu whose cuiient inteiest incluue evaluation
techniques anu Patient Bealth Recoius.
Augusto Silva, PhB in Electiical Engineeiing, is an Assistant Piofessoi at the
Bepaitment of Electionics, Telecommunications anu Infoimatics of the
Aveiio 0niveisity anu a ieseaichei at the Institute of Electionics anu
Telematics Engineeiing of Aveiio (IEETA). Cuiient ieseaich inteiests
incluue meuical imaging systems, meuical image piocessing anu
PACSRIS systems.
Cailos Costa, PhB in Electiical Engineeiing is an Assistant Piofessoi at the
Bepaitment of Electionics, Telecommunications anu Infoimatics of the
Aveiio 0niveisity anu a ieseaichei at the Institute of Electionics anu
Telematics Engineeiing of Aveiio (IEETA). Reseaich activity is mainly
focuseu in the aiea of PACS-BIC0N (meuical imaging systems anu
netwoiks), Bealthcaie Infoimation Systems incluuing secuiity anu access
contiol issues.