Engineering Medical Information Systems

1. Engineering Medical Information Systems Architecture, Data and Usability & Security Jason Washo SE516 University of Scranton

2. Authors Morgan Price Department of Family Practice University of British Columbia, Canada morgan@virtualltpriceless.org Jens H. Weber-Jahnke Department of Computer Science University of Victoria, Canada jens@acm.org

3. Why Medical & IT? • Information technology professional in health insurance • Fortune 500 health care and insurance clients • Specialization in electronic medical records (article’s focus) • Hopes with incorporating experience and research into a graduate thesis • Always be a need for health care and life insurance • Medical school coming into area

4. Introduction • Sustainable health care systems highly depend on interoperable and effectively managed medical information systems (MISs) • The United States of America could save $81 billion annually by implementing or improving medical information systems • Not just the money, but the quality of care increases as well • Article targets software engineers with basic knowledge in the medical information technology field • The authors introduce the reader to essential methods and concepts for developing and maintaining these types of systems

5. Topics of Focus • Architecture & Infrastructure • Health Data and Information / Clinical Knowledge • Usability • Privacy & Security

6. Architecture & Infrastructure • Taxonomy of MISs: • Clinical Point-Of-Care (POS) • Public Health Information Systems • Primary Care Systems (PCS) • Organizations w/ Function Standards/Models: • Health Level Seven (HL7) • HL7 Messaging Standards • HL7 Reference Information Model (RIM) • Clinical Document Architecture (CDA) • HL7 Development Framework • American Medical Informatics Association (AMIA) • OpenEHR

7. Architecture & Infrastructure • When engineering an MIS, two key aspects are considered during design: • Architecture (principles of design and construction) • Macroscopic Perspective • Health authorities • State, country, or international jurisdictions • Microscopic Perspective • Provisioning and maintaining single systems • Utilizing tools and key components of single systems • Infrastructure (collections of communication components ) • Interoperability • Accommodation of evolving networks

8. Health Data & Information • Health Data Structures • Repository Design • Messaging • Health Data Coding Systems • LOINC (Logical Observation Identifiers Names and Codes ) • SNOMED CT (Systematized Nomenclature of Medicine Clinical Terms) • Health Data Representation • The combination of the database and messaging in order to provide data in way that: • High-quality decisions are made • Knowledge is transferred properly

9. Usability • Usability and ergonomics aspects needs consideration when designing the interaction portion MIS • The article mentions some frameworks and models concerning usability: • Human Computer Interaction (HCI) Frameworks • Enabling computers and humans to work together • Computer Supported Collaborative Work (CSCW) Model • Enabling humans to work cooperatively with use of computer • Both negative and positive sides to usability need consideration as well

10. Privacy & Security • Since health information is highly confidential, the privacy and security of data in the MIS is another design consideration • Legislations and standards • Health Insurance Portability and Accountability Act (HIPAA) • Enforcement and design of security with usability

11. Conclusion • Emerging area of the information technology industry • Many challenges still exist