HEALTH CARE AUTOMATION AT ASIAN INSTITUTE OF GASTROENTEROLOGY - - PowerPoint PPT Presentation

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HEALTH CARE AUTOMATION AT ASIAN INSTITUTE OF GASTROENTEROLOGY - - PowerPoint PPT Presentation

May 03, 2023 325 likes •728 views

HEALTH CARE AUTOMATION AT ASIAN INSTITUTE OF GASTROENTEROLOGY Pradeep R MS, M.Ch., D Nageshwar Reddy MD, DM, Dsc, FAMS, FRCP. About AIG Tertiary care single specialty referral center for Gastrointestinal (GI) diseases Offers GI services

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SLIDE 1

HEALTH CARE AUTOMATION AT ASIAN INSTITUTE OF GASTROENTEROLOGY

Pradeep R MS, M.Ch., D Nageshwar Reddy MD, DM, Dsc, FAMS, FRCP.

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SLIDE 2

About AIG

 Tertiary care single specialty

referral center for Gastrointestinal (GI) diseases

 Offers GI services to national and

international patients

 Trains specialists in the field of

Gastroenterology

 Exclusive research wing - research

in various areas of GI

 Telemedicine project to cover GI

healthcare to rural areas

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SLIDE 3

Magnitude of problem

  • Increasing health care costs, patient demands,

need for improving health care standards is a must

  • Possible only by IT and Automating processes
  • Integrating the various technologies – Major

problem

  • Health care personnel acceptance ?
  • Fear
  • Refusal to learn and change
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SLIDE 4

HIS

Patient appointment Clinical case Entry (OP and IP)

Pharmacy

EMR

Reports Case sheet Discharge Summaries

Financial Billing Insurance Research Projects Telemedicine Rural Health Project

Inventory

Purchase Indenting

Investigations

Laboratory Endoscopy Us, CT . X-ray, ERCP, Capsule, Colonoscopy. Manometry, Magnification Endoscopy, Operation Theater, Pathology

P A C S

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SLIDE 5

PROPOSED SOLUTION A SCHEMATIC OVERVIEW OF 21st CENTURY HEALTH SOLUTION

EMR LIS IMAGING

CLINICAL MODULES

* Biochemistry * Haematology * Microbiology * Clinical Pathology * Immunoassay * Histopathology * Serology * 2D / Stress Echo * ECG * CathLab * Endoscope * C-Arm * OT Imaging * Central Station

HOSPITAL ADMINISTRATION / ACCOUNTING MODULES

PATIENT ADMINISTRATION MODULES

Health and Hospital Information Network Backbone Document Spreadsheet XML Output Templates:

* Consultation Summary * Surgeon Notes * Anaesthetist Notes * Discharge Summary * Referral letters * Certificates * General Medicine * Internal Medicine * Dermatology * Gynaecology * Paediatrics * Obstetrics * Urology * ENT * other specialties * Pathology Reports * ECG Waveforms * Cath Lab Reports * Cath Lab Loops * Endoscopy films

* Appointment Scheduling * Out Patient Registration * Out Patient Billing * Casualty Registration * Casualty Billing * Indoor Patient Regn * Indoor Patient Billing * A D T * Wards Management * OT Management * MIS

* Pharmacy * Materials Management * Kitchen/Diet * Linen/Laundry * CSSD * Finance * Doctor Honorarium * MIS * Equipment Maintenance

Health and Hospital Information Network INTERFACE TO Health and Hospital Information Network Management Information Systems Business intelligence

  • Medical

Gastroenterology

  • Surgical

Gastroenterology

  • Gastroscopy
  • Colonoscopy
  • EUS
  • Capsule
  • Enteroscopy
  • ERCP
  • C Arm
  • Cath Lab
  • ESWL
  • US
  • CT
  • ECG
  • Magnification

Endoscopy

  • Elastography
  • OT
  • Scanner
  • Pathology
  • Endoscopy Reports
  • CT Reports
  • US Reports
  • ERCP Reports
  • Capsule Endoscopy Reports

Asian institute of Gastroenterology

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SLIDE 6
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SLIDE 7

OUT PATIENT

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SLIDE 8

Service Departments

Diagnostic Imaging Pathology Lab Day Care procedures Other services

Reception / Regn / Billing

FRONT OFFICE

Reports Dispatch

CENTRAL DISPATCH

PHARMACY

Consulting

CONSULTING

Patient Portal

OP Workflow

Corporate Billing / Insurance / Doctors Honorarium

BACK OFFICE

ADT

ADMISSIONS

Relative Patient

EMERGENCY

Ambulance

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SLIDE 9

Reception / Regn / Billing

FRONT OFFICE

Reports Dispatch

CENTRAL DISPATCH

PHARMACY

Consulting

CONSULTING

Patient Portal

Service Departments

Diagnostic Imaging Pathology Lab Day Care procedures Other services

OP Workflow

Corporate Billing / Insurance / Doctors Honorarium

BACK OFFICE

ADT

ADMISSIONS

Relative Patient

EMERGENCY

Ambulance

Service Departments

Diagnostic Imaging Pathology Lab Day Care procedures Other services

Service Departments

Diagnostic Imaging Pathology Lab Day Care procedures Other services

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SLIDE 10

IN PATIENT

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SLIDE 11

Indoor Registration

REGISTRATION

PHARMACY

Service Departments

Diagnostic Imaging Pathology Lab

IP Workflow

Corporate Billing / Insurance / Doctors Honorarium

BACK OFFICE

OPERATION THEATRE

ADMISSION

Admission, Transfers

IP BILLING

Indoor Billing

Nursing Station

WARDS / ICU / NICU

Intensive Care Relative Patient

IP MIS IP MIS

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SLIDE 12

LABORATORY INFORMATION SYSTEM

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SLIDE 13

Relative Patient

Consultant

OPD

Consultation & Service Registration

OPD Reception

COLLECTION ROOM

Sample Collection Barcode Generation

Phlebotomist Patient Nurse

WARDS / ICU / OT

Service Registration Sample Collection Barcode Generation

Nursing Station

OPD

IPD / ICU / OT

LABORATORY

Sample Verification Sample Segregation Worksheet Generation Sample Distribution

Lab Tech

Work Sheet

Dispatch Desk

DISPATCH

Final Report

Batch Printing

Centralized Printing Centralized Dispatch

WARDS / ICU / OT

Final Report

Ward Printing Nursing Station

Reporting Printing Reporting View

Ward View

HEM/AB00123456-P (14-Mar) Ajit Srivastav 26Y/M /AB00 101123456

MICRO-BIOLOGY HISTOPATHOLOGY/CYTO BIOCHEM/HEMAT/ SEROLOGY/OTHERS

BIOCHEMISTRY / HEMATOLOGY / SEROLOGY / OTHER DEPTS MICROBIOLOGY DEPT HISTOPATHOLOGY DEPT

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SLIDE 14

ELECTRONIC MEDICAL RECORDS

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SLIDE 15

Holistic EMR Sources of data capture Clinical aspects of data capture

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SLIDE 16

IMAGING Pathology

Holistic EMR

Back

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SLIDE 17

Rural Health Camp – Telemedicine

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SLIDE 18
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SLIDE 19

Rural Health Camp – Telemedicine

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Data Generated - Gastroenterology 2005-2010

Modes Number Clinical Data Out Patients 3,45,960 In Patients 54, 634 Imaging Images Upper GI Endoscopy 1,64,693 4,94,079 Colonoscopy 50,905 1,52,715 ERCP 36,011 1,44,044 EUS 9347 37,388 US 2,60,280 5,20,560 CT 19,822 Capsule Endoscopy 633 Rural Programme & Telemedicine Patients Treated 1,47,263 Endoscopy 4,640 US 3,244

5 GB/Day

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HIS – Implementation Difficulties & Limitations

Software:

 Integration of Different modules  Cost and Maintenance  Version upgrade related

User Acceptance:

 Administrators – Good  Paramedical – Fair  Medical – Bad

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Data Acquisition

 History , Physical etc – Text based  Predefined Templates – Data fields  Images – DICOM & Non DICOM  Lab Data – Integration with HIS

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Data Usage - Present

 Retrieval – Patient Management  Analysis :

 Retrieved by user defined coding and third party

program for analysis

 Research  To evaluate pattern of diseases – Geographical, Seasonal  Genetic study  Hospital infections – Alerts  Auditing – Quality care  Images PACS – Diagnostic Automation

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Data Usage - Present

Limitations of Manual analysis:

 Large Data bases  Hidden and Potential relationships of data may

not be recognized

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SLIDE 25

Data Usage - Future

These tools and techniques bring out the hidden patterns in the data which will help us in making decisions

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SLIDE 26

Data Usage - Future

Diagnostic Dilemma Evaluating Treatment Choices

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SLIDE 27

Inflammatory Bowel Disease

Data:

No of Subjects: >1100 No of Fields / Subject: 78 Data Components: Clinical, Investigations, Genetic, Drugs, Surgery, Follow up. Data Format: Text, Tables, Excel, Images

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SLIDE 28

PATIENT HISTORY

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SLIDE 29
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Case scenario – Crohns Disease Diagnosis

Problem:

Intestinal TB – Common in India Crohns Disease – Incidence increasing in India Differentiation: Difficult Critical – Treatment is different

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Case scenario – Crohns Disease Diagnosis

Question: In a given number of patients (>4000) – (TB & Crohns):

 Can we diagnose the disease accurately?  Predict the outcome of treatment?  Recommend best treatment based on previous

treatments?

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SLIDE 32

Japan 27.4/100000 France 26/100000 USA 41.7/100000 South India 126/100000

Chronic Pancreatitis: Prevalence

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Chronic Pancreatitis

Data: 5 Years

No of Subjects: >5000 No of Fields / Subject: 58 Data Components: Clinical, Investigations, Genetic, Drugs, Endoscopic Procedure, Surgery, Follow up. Data Format: Text, Tables, Excel, Images

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Chronic Pancreatitis - Proforma

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SLIDE 35

3.4 3.4

5.1

34.8

6.8 44.9

0.9 0.8

Data of Chronic Pancreatitis

(1st Aug 2011 to 8th Dec 2011)

N= 313

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SLIDE 36
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SLIDE 37

Case scenario – Chronic Pancreatitis Treatment

Problem:

Chronic Calcific Pancreatitis – Heterogeneous group of disease Different modalities of Treatment - Available Controversy : Which modality in Which Patient ?

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SLIDE 38

Case scenario – Chronic Pancreatitis Treatment

Question:

Stent ESWL Drainage Resection Success % 50-70 60-80 65-90 87-95

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SLIDE 39

Data Usage - Future

Outcomes

  • f Evidence

Based Medicine

Decision Tools Patient Records Knowledge Refinement Knowledge Bases