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1 병원정보시스템 연세대학교의과대학의학공학교실연세의료원의료정보실유선국

2 IT Information Technology Digital World Computer Software Communication

3 IT 의시작 : Digital -> Computer Bit, Quantization, Sampling Bit : 한글의 digital 표현 ㄱ : ㅈ : ㅓ : : ㄴ : ㅊ : ㅕ : 10001, : ㄷ : ㅋ : ㅗ : ( ): ㄹ : ㅌ : ㅛ : 10011! : ㅁ : ㅍ : ㅜ : 10100? : ㅂ : ㅎ : ㅠ : : ㅅ : ㅏ : ㅡ : : ㅇ : ㅑ : ㅣ : / : 11111

4 Bit 의사용 : Computer Arithmetic Ex) 3+5= 컴퓨터와계산기에사용

5 Sampling & Quantization 악보를통한이해 음과음사이가시간적으로끊어져있다. (Sampling) 음과음사이에는다른음이존재하지않는다. (Quantization)

6 Analog vs. Digital

7 디지털신호의장 / 단점 저장이쉽다. 보안이잘된다. 압축이가능하다. 양자화의두지점사이에는값이없다. 시간축사이의값을찾을수없다. 미디어의차가움과따뜻함이인간성에지대한영향을미친다 ( 멕루한 ) 주사선의집합인 TV 동영상이차가운매체의대표적인예 (300여개의주사선과한주사선당 200여개의픽셀, 한픽셀당 8bit로구성 ) 인간들은거칠은해상도에장기간노출 차가운매체에의한정서적목마름상태 데이터가많은고선명 TV로옮겨가야한다. CD Audio(44.1 KHz, 16 bits) => HDDVD Audio (192 KHz, 20 Bits)

8 전자제품의디지털화 카세트테이프 아날로그자동응답기 녹음기 아날로그휴대폰 VTR 카메라 TV CD(1987) 디지털자동응답기 (1993) 디지털녹음기 (1994) 디지털휴대폰 (1996) DVD(2001) 디지털카메라 (2001) 디지털TV(2002) 저장과전송이용이한순서로.. 1st : 음성신호 ( 디지털녹음기, 디지털자동응답기, 디지털휴대폰 ) 2 nd : 오디오신호 (CD, MP3, Dolby AC3) 3rd : 정지영상 ( 디지털카메라 ) 4th : 동영상 (DVD, IMT2000)

9 5 대미디어의디지털화 컴퓨터 전화 (1996) 위성통신 인터넷 텔레비전 (1999년시험방송시작 ) 21 세기? Information Highway Computer Software Communication

10 병원정보시스템 ( IT ) HIS EMR Data Warehouse Data Mining ERP EDI Telemedicine PACS

11 HIS (Hospital Information System) OCS: 환자에게발생하는처방을중심으로진료와진료지원및원무행정부서간정보전달을전산화한시스템 ( 진료, 원무, 진료지원 ) Order Communication System

12 EMR (Electronic Medical Record) 기존의환자의정보기록에이용하던종이차트대신컴퓨터를이용하여컴퓨터에직접환자의정보를기록하는것 (Paperless, Chartless System)

13 Data Warehouse A centralized, multidimensional repository of corporative data, need mainly for decision support Data Mining A process of looking for unknown relationship and patterns and extracting useful information from volume data Decision Support System A computer based information system to provide support for decision makers in solving problems with extensive user interface

14 Data Warehouse ETT: Extraction/Transformation/Transportation

ERP (Enterprise Resource Planning) An integrated process of planning and managing all major business process, including contacts with business partners and

15 ERP (Enterprise Resource Planning) An integrated process of planning and managing all major business process, including contacts with business partners and with customers EDI(Electronic Data Interchange) The electronic movement of business documents between business partners ( 구매, 보험청구 ) CRM(Customer Relation Model)

16 ERP (Enterprise Resource Planning)

17 Telemedicine The delivery and provision of healthcare and consultative services to individual patients over distance using telecommunication technologies. Trauma care in rural area: Emergency home care: Mobile Ambulance (Stroke)

18 PACS Picture Archiving and Communication System 의료영상을획득하여기존의필름대신디지털데이터로저장하고, 저장된영상및검사정보를워크스테이션에서병원네트웍을통하여조회하여진료하는시스템 Imaging Modality Archiving Communication Computer Reading

19 PACS From MDIS (Medical Diagnostic Imaging Support System) DICOM 3.0 (Digital Imaging and Communications in Medicine) - American College of Radiology (ACR), - National Electrical Manufactures Association (NEMA) Reduction in number of lost films Reduced retakes Potential for improved communications, productivity, and efficiency Availability of images and reports to remote clinics and wards shortly after acquisition Reduction of storage space and film

20 PACS 9 CR 4 CT 4 MR 12 US 2 BMD 4 RF 7 ENDO 4 DP 1 PET 4 NM 3 DSA Backbone Controller Workgroup LTS (4.5TB MOD Jukebox) PATHO. DICOM Print Server Laser Camera X 2 Radiological Workstation X 21 STS (ISU 1 TB/DB Server) STS (IV 2 TB) Web serverx 2 MIU X 18) HIS/PACS Gateway x 2 Clinical workstation X 434

21 Integrated PACS HIS RIS Other IS ODBC Patient ADT Order Creation/Update/Cancel Report.. RIS G/W HL7 Direct RIS Interface Broker DICOM Modality Worklist Query(DICOM) CT1 CT2 MR CR RIF ENM PACS Database order MIU images Profiling Store images

22 Multi-modality PACS 병리 방사선 심장

23 Enterprise PACS Interconnecting Multi-hospital PACS systems with shared DB and long-term storage through high-speed network IV1 IV2 LDB IV1 STS 2 STS 1 W/S 2 W/S 1 STS 3 GE W/S 3 Each Hospital : Short Term Storage Control Storage Server : Seamless operation

Cardiology PACS Echocardiography Angiography Bi-plane angiography Video Images (Large Volume) Large Storage Wide BW Compression Short term Size (1 month) Estimated Storage ( 1)Year Long term storage

24 Cardiology PACS Echocardiography Angiography Bi-plane angiography Video Images (Large Volume) Large Storage Wide BW Compression Short term Size (1 month) Estimated Storage ( 1)Year Long term storage ( 3 years) Compressed Short term (25:1 / 2:1) Compressed Long term Echocardiography 4,125 G Bytes 49,500 G Bytes T Bytes 165 G Bytes 5.94 Tbytes Angiography 192 G Bytes 2,300 G Bytes 6.9 T Bytes 96 G Bytes 3.45 T Bytes Total 4,317 G Bytes 51,800 G Bytes T Bytes 261 G Bytes 9.39 T Bytes Echo (27000/year), Angio (4700/year)

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untitled IV Digital Hospital - EMR (Electronic Medical Record) Digital Medicine U-hospital U-healthtown Opened in May 2003 Has 950 beds + 3000 outpatients/day 270 MD + 530 nurses Performs over 50,000 radiological