IS-H*MED
Overview and News
SAP Healthcare
Sales Partner Summit
Roll-based Concept of Workplace and Authorization
Authorized activity sets for
- Managers
- Admission and billing
- Physicians
- Nurses
- Medical controlling
- Maintenance, procurement
IS-H*MED Standard Modules
•
Clinical Workprocess Support
– Out- and Inpatient Departments‘ Workplaces
– Service Request Workflow
– Scheduling for Patients and Services
– Work Organizers
•
Clinical Documentation
– Patient‘s EMR
IS-H*MED Standard Modules: Recent Developments
•
Clinical Workplace
– For outpatients‘ departments
– For functional units
•
Scheduling
– Admission scheduling
– Multiappointment
– e.g. Preoperative Planning
– Waiting List Management
•
Patient Organizer
IS-H*MED Standard Modules - Clinical Workplace
•
Unified Workplace Look&Feel
•
Shows
– Service Requests
– Appointments
– Visits
•
Freely defineable
– Displays
– Set of functions
•
Functionality
IS-H*MED Standard Modules - Scheduling
•
Multiappointment Planning
– Caseless registry of patients for intended operations/treatments
– Optional admission planning
– Requesting services for clearing up
– Coordinated planning of accompanying visits
– Progress check of e.g. preoperative phase
•
Waiting List Mgmt
– Based on preregistration
– In clinical workplace
IS-H*MED Standard Modules - Patient Organizer
•
Aspects offer various views on patient‘s clinical history
– Cases, Movements
– Requests, Appointments
– Diagnoses, Documents
– Services
– Customer-specifics
•
Quick navigation
•
Personalization
•
Integrated object viewer
IS-H*MED Application-specific Modules
Surgery
Nursing
Radiology
Patient Transport
Doctor‘s Round
Vital Parameters
Guidelines
IS-H*MED Selected Modules
IS-H*MED Radiology
The Situation
•
Increasing DICOM Application Entities
– Evolving PACS Implementations
– Development of DICOM-capable Endoscopes
and Ultrasound Devices
•
Increasing need for Telemedicine Applications
•
Report and Image Access (Workplace Solutions)
– Clinic wide
– General Practicioners
–
Patients
•
Report and Image Delivery
IS-H*MED Radiology
An integrated solution for radiology must support
•
Radiology workflow
•
Clinical Workflow
IS-H*MED Radiology Workflow
Request
Scheduling
Planning
Pat. Arrival
Preparation
Execution
Deriving Findings
Writing Findings
Transferring Findings
Archiving
Prefetching
Findings
Ex-Docu
Work Organizer
ID-Stamping, Labels
Single Pat.
Worklist Management
Perf.Proc.Step
Query/Retrieve
IS-H*MED Radiology - Clinical Workflow
Integrated IS-H/IS-H*MED with
•
ADT-Management
•
Request communication
•
Appointment planning
•
Findings communication
Clinical Workplace
Service-Request
Appointment Planning
IS-H*MED Radiology - Business Partners
Service
Request
SAP R3
General Practitioner
Patient
Transfer
XML, PDF
DICOM
mySAP.com
Workplace
Historical Findings
IS-H*MED Radiology Workplace
User- and/or
Profession-specific
Worklist
Patient-based
Navigation-Bar
(Computerized Medical Record)
Service- and Workplace-related
Hierarchical Finding-Documentation
Detailed
Image
Information
concerning
selected
items of the
worklist
Technical
Navigation-Bar
(PACS-Study)
Application-Controled
Viewer Integration
Direct
Dictation
and
IS-H*MED Radiology – Reports and Evaluation
•
Device and Service Related
– X-Ray Register
– Service Statistics
•
Person-Related
– Experience History,
– Radiation Dosage
•
Open
– Studies
IS-H*MED Radiology - Technical Features
•
Worklist-Server
– Event-based generation of worklist entries in the MSI-Format (Customizing)
•
Patient Management
– Generation of ADT-information in the MSI-Format, for admissions,,
discharges, transfers, etc. in IS-H, IS-H*MED (HCM)
•
Study Management
– Overview of the entire examination flow
• PACS-IDs in the Study Document
• DICOM Study Status in the Examination Document
•
Integrated Radiological Image Findings Work Station
– Calling the Load Study Servers Including Viewer-Interface Using
RIS-Communication Client (RCC)
•
Report Management
IS-H*MED Radiology Summary
• Institution-wide Image & Cineframe Access
• Access of Findings and their related Images
• Standard Programming Architecture (BAPI) allows easy
transfer of findings via Internet-technology (PDF, XML).
• New applications as the mySAP Enterprise Portals allow
direct access to findings and related pictures for GPs or even
patients.
IS-H*MED Current Developments
Doctor‘s Round
IS-H*MED Doctor‘s Round
•
Objective
– Support of doctor‘s round via online-connected mobile device
– All needed patient-related information at his fingertip
•
Vital parameters
– Blood pressure, temperature, pulse, ...
– 1st step to doctor‘s round support
– Presentation in grid or graphics
– Entry for one or more patients
IS-H*MED Doctor‘s Round
Clinical Workplace
•
Vital Parameters: integrated in clinical workplace
Tick patient(s)
Date
Time Pulse
Temp
RR Sys
RR Dia
...
...
...
06:00
115
37,6
130
75
12:00
120
38,0
15:00
135
80
17:00
115
37,6
135
75
18:00
90
Vital parameters - Kirsten, Gulliver (m/27)
Toolbar
27.09.2001
•
Grid
•
Graphics
RR Pulse Temp 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
Vital parameters
Pulse Max 92
Temperature
105 92 80 115
IS-H*MED Doctor‘s Round
•
Medication
– Support the Workflows relating to Drug Therapy
– Documentation of Prescribed and Administered Medications
Clinical Workplace
Clinical Workplace
IS-H*MED Current Developments
IS-H*MED Guidelines
What are guidelines?
•
Systematically developed conclusions aimed at supporting physician
and patient’s decisions concerning appropriate health care for specific
clinical situations.
•
Reproduce the status of the knowledge and the methodology
comprehensively although simply for a detailed problem
Using Guidelines
•
Improves the quality of medical and non-medical services.
•
Improves the quality of the execution and results of clinical research.
•
Fundamentally better acceptance and therefore also a permanent
behavioral change.
•
Cost savings due to reduction in unprofitable diagnostic and
therapeutic processes.
IS-H*MED Guidelines
•
Example
chest trauma
2 indicated, often additional findings
1 indicated, rare additional findings
Suitability of diagnostic test:
clinically instable
clinically instable
chest deformation
cardiopulmonary findings
spine xray studies
? cardiac tamponade
chest xray pa 4
CT scan 4
MRI 3
CT scan 4
rib xray ao/po 4
pericardiocentesis 4
CT scan 4
chest xray pa if n/a 4
accurate visualization
of morphology
4 absolutely indicated
Implementation of 4.63 B
•
Informative (Can be implemented immediately)
–
Case-related, linked information, here in user-defined textual format or
via external applications.
•
Simple Rules (Project Solution)
– Simple, parametrizable service rules that check the time reference of
services and their relations to diagnoses.
•
Rule Interpreter (more as Application)
– Layout of an interpreter that checks the rules of a certain syntax using
two-valued logic.
•
Dedicated Application (Concept)
IS-H*MED Guidelines: Informative
Clinical Work Station (CWS)
Patient Organizer (PO)
Internet
IS-H*MED Guidelines: Dedicated Application
Miller, Max
* 01.01.1920
Guideline: Myocardial Infarction
Level: 1
Day: 3 / 5
Time
Lab
Diagnostic
non invas invasiv
conservative operative
Therapy
Activity
Nursing Procedures
Diet
Procedure
Day 1
EKG
check weight
Other
Heparin
ß-Blocker
Check BP
Back
cont. NOK
walk 20m
IS-H*MED Guidelines: Dedicated Application
Miller, Max
* 01.01.1900
Guideline: Myocardial Infarction
Level: 1
Day: 3 / 5
Time
Lab
Diagnostic
non invas invasiv
conservative operative
Therapy
Activity
Nursing Procedures
Diet
Procedure
Day 1
EKG
check weight
Heparin
ß-Blocker
Back
Change
On/Off
sit up
Lab Request
Service Request
Charts
Nursing Documentation / Charts
Work Organizer
Other
IS-H*MED Guidelines: Relevance
•
Demand for approx. 10 guidelines per year as provided for in SGB V
§137 (German Social Insurance Code).
•
Existing discussions concerning financial incentives in remuneration
system if guidelines are used.
•
Current discussion concerning financing for the development of
guidelines by self-governing partners.
IS-H*MED Current Developments
IS-H*MED Mobile Solutions
The situation in healthcare:
• Computer workplace is fixed on a desktop
• Medical stuff has more and more rotative workplaces
Medical data lacks where it is needed
Paper documentation is further on widespread
Much time for documentation and information retrieval means
less time for the patient
Conclusion:
•
Wireless LAN
•
SAP ITS
•
SAP Web Server
•
Laptop
•
Webpads
•
Organizer
•
Handheld
•
WAP-Handy
Technology an mobile devices are on-hand
Personal Digital Assistant
Laptop
WAP-Handy
Web-Pad
Palm-PC
Mobile solutions are
– an extension of the existing system
Using
– IS-H*MED with RFC und BAPI
– Existing network infrastructure
Extending with
– SAP Portal
– Wireless LAN Devices
R/3 DB
ApplicationServer ApplicationServer ApplicationServer Computer Computer Computer
Computer
Laptop
RS CS TR RD TD CD
TALK / DATATALK Accesspoint
The Laptop as a complete mobile Client with
– Good mobility
– Familiar usage of IS-H*MED
– Optimised for usage of keyboard and mouse
– Easy implementation
R/3 DB
ApplicationServer ApplicationServer ApplicationServer Computer Computer Computer
Computer
Laptop
RS C S TR RD TD CD
TALK / DATATALK Accesspoint
ITS
PDA
