GROUP 10

 Key Steps in radiology Workflow and its analysis

 4. Integration, Standards, and Interoperability
 z 4.1 Integration Challenges and General IT
standards
 Key Steps In
Radiology
Workflow
z And Its
Analysis
1. New patient arrives at hospital
for radiological imaging
examination (exam).

2. Patient registers in radiology

area. If the patient is new, they are
registered in the
hospital information system (HIS).
 3. Exam ordered at radiology information
system (RIS) upon arrival at radiology
registration desk. Exam accession number is
automatically assigned, and a requisition is
printed and registered.

4. Technologist receives information from clerk

and calls the patient in the waiting area for
exam.
5. Patient escorted into the
modality room.

6. Exam is performed by a
technologist.
 7. Exam is completed.

8. Clerk pulls out old films if

needed, or the patient previous
digital imaging records and
reports.
9. Clerk prepares all necessary papers and
films or digital images at workstations
(WS) for
radiologist.

10. Films or images on WS are

prepared for radiologist’s review.
 11. Radiologist reviews images, check
examination record, and dictates
reports.

12. Transcriptionist types

the draft report from the
dictation.
13. Radiologist reviews the
report and signs it off.

14. Final reports are input into

RIS for clinician viewing.
 INTEGRATION,
STANDARDS,
z
AND
INTEROPERABILITY
z

WHAT IS INTEGRATON IN
HEALTH INFORMATICS?
 The Integration of health Information Technology (IT) into
primary care includes a variety of electronic methods that are
used to manage information about people's health and health
care, for both individual patients and groups of patients. The
use of health IT can improve the quality of care, even as it
makes health care more cost effective. The integration of health
IT into primary care includes a variety of electronic methods
that are used to manage information about people's health and
health care, for both individual patients and groups of patients.
 - Integration is the act of bringing together
smaller components into a single system that
functions as one. In an IT context, integration
refers to the end result of a process that aims

What is to stitch together different, often disparate,

subsystems so that the data contained in each
becomes part of a larger, more

integration? comprehensive system that, ideally, quickly

and easily shares data when needed. This
often requires that companies build a
customized architecture or structure of
applications to combine new or existing
hardware, software, and other
communications.
 What are standards?
- Data standards are created to ensure that all parties use the
same language and the same approach to sharing, storing, and
interpreting information. In healthcare, standards make up the
backbone of interoperability — or the ability of health systems
to exchange medical data regardless of domain or software
provider.
z

In primary care, examples of

health IT include the following:
 Clinical decision support.
 Computerized disease registries.
 Computerized provider order entry.
 Consumer health IT applications.
 Electronic medical record systems (EMRs, EHRs, and
PHRs).
 Electronic prescribing.
 Telehealth.
z

Why Is Health IT (Integration)

Important?

 Health IT makes it possible for health care providers

to better manage patient care through the secure
use and sharing of health information. By
developing secure and private electronic health
records for most Americans and making health
information available electronically when and where
it is needed, health IT can improve the quality of
care, even as it makes health care more cost
effective.
z

WHAT IS DATA STANDARDS IN

HEALTH INFORMATICS?
 Data standards are the principal informatics component necessary
for information flow through the national health information
infrastructure. With common standards, clinical and patient safety
systems can share an integrated information infrastructure whereby
data are collected and reused for multiple purposes to meet more
efficiently the broad scope of data collection and reporting
requirements. Common data standards also support effective
assimilation of new knowledge into decision support tools, such as
an alert of a new drug contraindication, and refinements to the care
process.
z

WHAT IS INTEROPERABILITY IN HEALTH

INFORMATICS?
 Interoperability in healthcare is the ability for various
healthcare information technology (HIT) to exchange,
interpret and use data cohesively. In other words,
Interoperability means the ability of health information
systems to work together within and across organizational
boundaries in order to advance the effective delivery of
healthcare for individuals and communities.”

 - According to the Healthcare Information and
Management Systems Society (HIMSS),
“Interoperability describes the extent to which
systems and devices can exchange data, and
interpret that shared data. For two systems to be
interoperable, they must be able to exchange
What is data and subsequently present that data such
that it can be understood by a user.” When it

Interoperability comes to the healthcare industry,

interoperability has to do with the capability of

? disparate computer and software systems to

exchange and share data from a range of vital
sources, including laboratories, clinics,
pharmacies, hospitals, and medical practices.
z

LEVELS OF HEALTH INFORMATION TECHNOLOGY (HIT)

INTEROPERABILITY FOUNDATIONAL

 Foundational
interoperability
 Structural interoperability
 Semantic interoperability
 03
Integration
Challenges and
General IT Standards
 Integration Challenges in Health
Informatics:
1. DATA MANAGEMENT TRENDS

What are the The needs and expectations for greater

data information access, integration, and

Integration storage capacity are only going to grow.

Imaging has become more precise,

Problems? creating larger file sizes and more storage

capacity requirements. Artificial
intelligence (AI) and data collected from
medical devices must be processed to add
insight to diagnoses and treatments,
increasing processing demand.
2. INCREASED CYBERSECURITY

The pandemic proved to be a golden opportunity for cybercriminals, as more shoppers,

workers, and businesses moved online. According to the FBI Internet Crime Report, a record-
breaking 791,790 cybercrime complaints were made in 2020. The figures for 2021 may top that
record. Hospitals and healthcare systems have found themselves targets in this rising
cybercrime wave, with multiple hospitals often targeted at once in coordinated ransomware
attacks.

3. EXPANSION OF TELEHEALTH

Once touted for its convenience and potential to increase healthcare access to those in rural
areas, telehealth became a necessary healthcare technology in the midst of the COVID-19
pandemic, as lockdowns took hold and medical offices reduced capacity.
4. APPLICATION OF ARTIFICIAL INTELLIGENCE, MACHINE LEARNING AND
PREDICTIVE ANALYTICS

Like so many facets of healthcare, the application of artificial intelligence (AI) and machine
learning (ML) took an abrupt shift due to the COVID-19 pandemic. While long used on the
finance and operations sides of healthcare, the pandemic proved the true potential of AI and ML
for predictive medicine in diagnosing illness and advising treatment plans, with a number of
research institutions and health systems using it to estimate the risk of their COVID-19 patients
developing severe symptoms.

5. ADVANCES IN ELECTRONIC HEALTH RECORDS CAPABILITIES

It can be argued that electronic health records (EHR) are the starting point of healthcare
digitization when the “meaningful use” mandate required the adoption of EHR. The COVID-19
pandemic exacerbated EHR system usability and interoperability issues, speeding up the U.S.
Department of Health and Human Services’ implementation of interoperability rules and
standardization, and giving patients free, secure access to their EHR.

What are the general IT
standards?
- ONC or the Office of the
National Coordinator for Health
Information Technology publishes
the Interoperability Standards
Advisory (ISA) as a way of
recognizing interoperability
standards and implementation
specifications for industry use to
fulfill specific clinical health IT
interoperability needs.
Here are some examples of Health IT Standards to Watch:
- Consolidated-Clinical Document Architecture (C-CDA)-
C-CDA is a framework for creating clinical documents that
contain both human-readable text and machine-readable
XML
- Direct- is a standard for sending health information
securely over the internet.
- Fast Healthcare Interoperability Resource (FHIR)- FHIR is
a specification for exchanging clinical and administrative
health care data. The standard is based on REST and OAuth.
- Validated Healthcare Directory Implementation Guide- an
HL7 FHIR-based implementation guide and architectural
considerations for attesting to, validating, and exchanging
validated data as well as a RESTful FHIR API for accessing
data from that directory.
 z
1. Technical
Interoperability
refers to technical aspects
of interconnecting
computer systems.
Terms in HIS Integration
Intraoperability
2. Syntactic
Intraoperability
is the ability of 3. Structural Intraoperability
exchanging information
between information provides a common agreed
systems model of clinical or other
domain concepts.
4. Semantic Interoperability

is the ability to provide

meaningful exchange of
information in order to the content
of message be understood by the
recepient system or process

5. Operational Interoperability

focuses on how administrative, clinical

or statistical information should be
represented and interpreted.

6. Organizational Interoperability

is concerned with processes, policies, roles,

management and frameworks around the
integration of data from different administrative
domains.
 z

IHOMIS  The Integrated Hospital Operations and

Management Information System
(iHOMIS) is a computer-based information
system developed by the Department Of
Health to support the hospital
management for effective and quality
healthcare by providing timely, relevant
and reliable information.