Information Architecture and Technologies that Support Health Care ...

glibdoadingAI and Robotics

Oct 20, 2013 (3 years and 9 months ago)

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Chapter 8


Gain a basic understanding of the core technologies
behind health care information systems:


System software


Data management


Networks and data communications


Information processing distribution schemes


Internet, intranets, and extranets


Clinical and managerial decision support


Discuss emerging trends in information technology
(such as mobility, Web services, Internet, wireless).


Identify some of the major issues in the adoption of
information technologies in health care organizations.


Discuss why it is important for a health care
organization to adopt an overall information systems
architecture.


Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser

Why IT/IS: Error
Rates



World
-
class
competitiveness in
Manufacturing
< 230 errors per
million
opportunities



Financial
services < 5 errors per million



Healthcare
: 6000

300,000 errors
per million


Healthcare errors are likely under reported



malpractice
threats



practitioner
confidentiality concerns


Error
rates in healthcare are orders of
magnitude
higher than in
other industries


Core Technologies


System Software


Data management and access


Networks and data communications


Information processing distribution schemes


Internet, intranets, and extranets


Clinical and managerial decision support


Trends in user interactions with systems


System Architecture



A series of programs that carry out
basic computing functions


Manage user interface, files and memory


Operates peripherals


Allows development of applications without
have to include basic computer instructions


Operating
Sytems

(Personal
Systems)


Proprietary


Windows


Mac OS


Open source


Linux


Production Systems


MVS


UNIX

Interface Engine

a software program designed
to simplify the creation of management of
interfaces between applications systems
(
Altis
, 2004)


Relational Databases


Relational Database Management System
(RDMS)


Applications have three layers


Interface


Data manipulation


Tables


Object
-
oriented Database


Object
-
oriented database management
system (OODBMS)


Object
-
Relational Database management
system (ORDBMS)


Data dictionaries

document data
definitions


Clinical data repositories

large
databases that include data from a
variety of sources


Data Warehouse and Data Mart


Non
-
relational structure to facilitate “drill
down” retrieval


Data mining

discovering patterns
in data




Network Communication protocols


Network Types and Configurations


Network Media and Bandwidths


Network Communication Devices



Needed for communication among networked
computers an devices


Open Standards Interconnection (OSI)


Seven Layers


Conceptual model, not a set of actual specifications


Internet Model

Transmission Control
Protocol/Internet Protocol (TCP/IP)


Layered model


Represents a set of actual protocol specifications at each
layer


Other protocols


Ethernet

Local Area Networks


Asynchronous Transfer Mode (ATM)

fast
transmission speeds


Bluetooth

wireless devices


IEEE
802.11
(Wi
-
Fi)

popular for wireless
computers


Local Area Network (LAN) vs. Wide
Area Network (WAN)


LAN

devices are under the control of one
organization in the same geographic area


WAN

an network that extends beyond a
LAN


Topology


Physical or Logical


Example of Ethernet is a Physical “Star” and Logical
“Bus”


Common Types


Twisted pair wire (Category
5 most common)


Coaxial cable (older)


Fiber optic
cable


Microwave


Spread
spectrum


Communications across WAN
require a service carrier


POTS


Leased line


Integrated services digital network (ISDN)


Purchased T
-
1 (or other) line


Bandwidth = Capacity of the
transmission med1a


Greater capacity = greater speed


Rates expressed as bits per second
(bps)


Hub

device in which data from the
network come together


Bridge

connects neworks at the
data link layer; networks with the
same protocols


Router

operates at the network
layer; help determine the
destination of data


Gateway

connects networks with
different protocols; operates at or
above the transport level


Switch

may be a gateway or a
router; all switches rout data to their
destinations


Terminal to Host

dumb terminal
interacts with host computer


File Server

application and
database are on one computer;
user’s computer gets data files from
file server


Client/server

multiple servers with
specialized functions; client runs
application & server has data


Every computer or device has a
unique Internet Protocol (IP)
address


Use changed dramatically with the
introduction of Hypertext Transfer
Protocol (http) and the World Wide
Web (www)


WWW


Uniform Resource Locator (URL)

Example
--

http://www.josseybass.com


Web Browser


Plug
-
ins


Mark up languages


HTML


XML


Other Protocols


E
-
mail (smtp, pop3, imap)


File Transfer (ftp)


Internet telephoning (VoIP)



Intranets


Secure computer network that uses Internet
technologies, but is internal to an
organization


Extranets


Similar to intranets, but includes business
partners or the organization


Web 2.0

is a range of Web
-
based
communities, services, and technologies,
including
social
-
networking
sites,

wikis,
blogs,
and messaging capabilities.


The “2.0”reflects the view that this
collection represents the second
generation of Web technologies and
capabilities.

Health Care Information Systems: A Practical Approach for Health Care Management 2nd Edition Wager ~ Lee ~ Glaser


Decision Support Systems (DSS)


Artificial Intelligence


Three steps of Decision Making


Intelligence


Design


Choice


Problems are


Structured


Unstructured


semistructured


Transaction based systems use for
structured problems


DSS is needed for semi and un
-

structured problems



Stand alone generally has three
components


Data Management Module

database, data
warehouse, clinical data repository


Model Management Module

user selects
model to be applied to problem


Dialog Module

the user interface


(Oz, 2004)


A branch of computer science that is
devoted to emulating the human
mind


Example: Google


Multiple types


Expert systems


Natural language processing


Neural networks


Fuzzy logic


Input Devices


Output Devices


External Storage Devices


Mobile Personal Computing
Devices


Standard

mouse & keyboard


Other


Trackball or trackpad


Touch screens


Source data input devices, such as bar coding


Document Imaging


Speech Recognition


Computer Monitor


Printer


Speech


Sequential


Magnetic tape


Direct Access


Magnetic disks


Floppy disks


Zip drives


RAID


CDs & DVDs


Optical tape


Flash memory


Personal Digital Assistants (PDAs)


Pocket PCs


Laptop computer


Tablet computer


Cellular phone combinations


The coming together of an
information system is guided by the
IS architecture


Consists of concepts, strategies, and
principles


Platforms are specific vendors and
technologies


Infrastructure generally refers to
networks and network applications


Characteristics and Capabilities


Architecture ensures organizationally defined
characteristics and capabilities


Application Integration


Best of Breed


Monolithic


Visual integration




It is important for health care organizations to
have thoughtful architecture discussions



System Software


Data Management and Access


Networks and


Data Communications


Network Communication protocols


Network Types & Configurations


Network Media & Bandwidth


Network Communication Devices


Distribution Schemes


Internet


Intranets & Extranets


Decision Support


Decision Support System


Artificial Intelligence


User Interactions


Input Devices


Output Devices


External Storage Devices


Mobile Personal Computing


Information System Architecture