Management of the Electronic Patient Records in the Web Based Platform for Diagnosis and Medical Decision for Optimization in Healthcare-PROMED Roxana ANTOHIa, Cristina OGESCUa, Livia STEFAN b, Mircea RAUREANU c, Mircea ONOFRIESCU d, Marius TOMAd a
-The Company for Research, Development, Engineering and Manufacturing for Automation Equipment an Systems -IPA SA, Bucharest Romania b-
Institute for Computers- ITC SA, Bucharest Romania
c-
National Institute for R&D in Informatics –ICI, Bucharest Romania
d
- University of Medicine of Iassy Romania.
The project is financed by the CEEX - National Program ICMCC 2007
- Currently, in the Romanian Medical System, the patient information is stored only as written records.
- These records are kept in many places: from the family physician to the consulting physician and in the hospital.
- The patient does not take these records with him.
- The physician has access only to patient records from hospital or from polyclinic.
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Web Based Platform for Diagnosis and Medical Decision for Optimization in Healthcare- PROMED removes all this drawback
- The patient is able to see his complete record with all registering (from Family physician, from consulting physician and from hospital)
- The Physician can ask the patient to present his record to understand the medical history of the patient and so he is able to determine quickly and correctly the diagnosis of the patient
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2. General description of the PROMED The Platform for Diagnosis and Medical Decision for Optimization in Healthcare-PROMED is implemented as a web portal application, supporting:
creation and management of the electronic patient records by hospitals and ambulatory healthcare providers; visualization of the electronic patient records by the patient; health statistics and medical research; healthcare providers directory lists; medical discussion forum for exchanging healthcare information among healthcare professionals; assistance for system users.
For emergency situations the system is able to provide and transmit the vital patient information through a wireless communication service respectively the blood group, the rhesus factor, allergies, chronic diseases, health risks.
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The web portal application contains the following functional modules/services:
- The “Authentication” module; - The “Electronic Patient Record Management” module with three sub modules: -The “Patient” module; - The “Physicians” module with 2 sub modules ”Hospital Electronic Patient Record“ module and “Primary Care Electronic Patient” module; - “Hospital Emergency Room“ module. - The “Health resources” module; - The “Medical statistics and research “module; - The “Emergency “ module; - The “Forum “ module; - The “Help” module ICMCC 2007
¾ The “Authentication” module gives the authorized user access to specific functionalities of the PROMED platform ¾ The “Electronic Patient Record Management“ module represents the central part of the platform and provides functions for creating, editing, manipulating, and printing patient administrative and healthcare data. The information is organized in keeping with data model of the record of the patient which is in use in the Romanian healthcare system. The electronic patient record is structured in two main subsets: administrative data and medical data. The administrative data contains the following information: name, surname, national personal identification number, residency and home address, phone, education level, occupation, healthcare insurance level The “Patients” module allows the patients to visualize their electronic record. It is accessed through a user authentication and a “patient “user role.
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The “Hospital Electronic Patient Record” module allows the hospital physicians to update and manage the electronic patient record. It is accessed through a user authentication and a “hospital physicians” user role. In this module the patient data is organized in two sections: a section which contains emergency information: the blood group, the rhesus factor, chronic diseases, allergies; a section which contains information about the consultations at the hospital reception (emergency room) and the hospitalizations. The “Primary Care Electronic Patient Record” module is intended to be used by primary care providers (family doctors, ambulatory healthcare centers). If the patient is not yet registered in the system, his administrative data will be introduced in this module. The electronic patient record can be visualized and updated with the physician‘s recommendations The “Hospital Emergency Room” module is the hospital reception module and manages the patient's administrative data. In this module the following information is registered: the patient administrative data if he is a new patient; the data about the medical examination of the patient in the emergency room. ICMCC 2007
¾The “Healthcare resources” module manages information about resources related to the national healthcare system: Healthcare providers (hospitals, ambulatory centers, public health institutions); Physicians. This module data are recorded by the system administrator for all participants interested in joining the PROMED platform and being publicly available ¾ The “Medical statistics and research“ module is intended to present synthetic information regarding the health status of the comply population. Various reports are designed to be used for medical research and statistics for healthcare providers reporting needs. The reports comply with the privacy and confidentiality rules for medical data, revealing no information about individual patients. ¾ The “Forum “module is designed to facilitate the exchange of medical information among healthcare professionals in order to help solving various medical issues
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¾The “Emergency” module In case of an emergency (life risk situation), The “Emergency” module will allow access to vital information regarding the health status of the patient, namely the blood group, the Rhesus factor, chronic diseases, allergies to drugs or other substances. This module can be accessed only by authorized medical personnel without the patient's consent if he/she is unconscious or it is not able to give his/her consent. This module is designed to be accessed through mobile devices (smart phone, PDA ) ¾The “Help“ module will assist the users in platform exploitation
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3. Technical description of Web Based Platform for Diagnosis and Medical Decision for Optimization in Healthcare-PROMED Web Based Platform for Diagnosis and Medical Decision for Optimization in Healthcare-PROMED is developed under the form of a WEB PORTAL which is able to record groups of various information (administrative and medical) and to allow the access of a large number of users by means of their specific role: patients, hospital physicians, nurses, ambulatory physicians, public health authorities, anonymous users. The hardware architecture of Web Based Platform for Diagnosis and Medical Decision for Optimization in Healthcare-PROMED provides the support for all the web portal modules and ensures the stability of the main components: the Database Server and the Web Application Server. The hardware specifications of the System refers to high memory capacity, high processing capabilities for the Database Server and the Web Server. The Database Server is Oracle 10 g For the application development we took the decision to use PHP5 platform which integrates with Oracle libraries (php_oci8.dll). The operating system installed on the central server is Window 2003 Server, including IIS 6.0 web server. ICMCC 2007
The hardware infrastructure of the Multifunctional Platform
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3.1 Technical specifications of the application program The technical specifications of the application were established by means of diagrams to point the main action for: Authentication; Security; Data Saving and Retrieving. The diagnosis registered in the electronic patient medical record is compliant with ICD-10-AM (CIM – the 10th OMS revision 2/2001VOL1). The procedures for interventions in the health field are from ICD-10-AM (CIM 10–AM) revision 3/2002 edited by The National Centre for Classification in Health Sydney, translated into Romanian.
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Web Based Platform for Diagnosis and Medical Decision for Optimization in Healthcare-PROMEDweb portal's URL is www.rommed.ro/promed. A few screenshots are shown below
Patient page ICMCC 2007
The "Physician" page
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The "Emergency Room" page
The “Emergency " page
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The "Patient " page in the Emergency module
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HOME
Medical Patient Records
Patient details (administrative + chronic pathology+ allergies)
Rapports, Consultations policlinics consultation, hospitalization
Emergency Room
Physicians
Patient details (administrative)
Resources
Emergency (patient lists ) POLICLINIC (select policlinic)
HOSPITAL (select hospital)
Usual Presentation
Usual hospitalization
Associate Patients
The site map structure of the Informatics System's portal
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HELP
Statistics
FORUM
Consultations
The portal will be accessed by four user categories:
Patients; Medical personnel; Health authorities; Anonymous users.
Each user from these categories will have distinct rights to access, view and modify various information from the database of the system
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4. Conclusions Web Based Platform for Diagnosis and Medical Decision for Optimization in Healthcare-PROMED represents an Internet access point and a web healthcare information system which provides various services for users (authentication, authorization, data and information management, reporting). It will allow the interaction between the three main actors in a health system: the patients, who will actively track their own healthcare status and have an electronic patient record updated and available anytime and anywhere;
healthcare providers, who can find a patient and access its electronic patient record based on user access rights;
public health authorities, who will be able to view various reports about the population health status and to elaborate prevention and warning plans against diseases.
We consider that the healthcare Platform will eliminate many current problems occuring in the national health system, ranging from paper format healthcare records managing problems to cooperation between healthcare providers. Web Based Platform for Diagnosis and Medical Decision for Optimization in Healthcare-PROMED will be tested by physicians from two hospitals in Iassy and by physicians from Bucharest, Romania. ICMCC 2007
Thank you ITC SA
IPA SA Roxana Antohi -
[email protected]
Livia Stefan -
[email protected]
Cristina Ogescu -
[email protected]
ICI UMF – Iasi Mircea Onofriescu -
[email protected] Marius Toma
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-
[email protected]
Mircea Raureanu -
[email protected]
