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Component of Policing Diseases System

The use of telecommunications in developing Policing Disease System ITISM 3410 Telecommunications & Networking in Bus. Component of Policing Diseases System. MIIDSS ： Major Incident Investigation and Disaster Support System ( 重大事件調查及災難支援工作系統 ) CMS ： Clinical Management System.

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Component of Policing Diseases System

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  1. The use of telecommunications in developing Policing Disease System ITISM 3410 Telecommunications & Networking in Bus.

  2. Component of Policing Diseases System • MIIDSS：Major Incident Investigation and Disaster Support System(重大事件調查及災難支援工作系統) • CMS：Clinical Management System. • eSARS：Electronic Severe Acute Respiratory Distress Syndrome System. • ePR：Electronic Patient Records • SARS-CCIS：SARS-Case Contact Information System • CTS：Contact Tracing System

  3. MIIDSS • Major Incident Investigation and Disaster Support System(重大事件調查及災難支援工作系統) • originally owned by the Hong Kong Police Force • responsible to facilitate the critical validation and analysis of persons, time and place • help to identify the chain of human transmission of SARS • speedy identification and isolation action was very important to control and stop the spread of SARS.

  4. CMS • Clinical Management System • was developed by Hong Kong Hospital Authority • is an integrated clinical workstation giving clinicians access to all available electronic clinical information • over eight million patient records are saved into the system. • all records are uniquely identified by using patient’s Hong Kong Identity Card number.

  5. eSARS • Electronic Severe Acute Respiratory Distress Syndrome System • was developed with the network infrastructure, workstation penetration and user base of the Clinical Management System • deployed at an extremely accelerated mode for the end users to enter the SARS case information and for the management to study the trend

  6. ePR • Electronic Patient Records • is a web-based integrated platform, allows people to view the data stored in a clinical data repository. • To provide a high quality care and effective management, Hong Kong Hospital Authority determined to integrate the Picture Archiving and Communications Systems (PACS) and ePR.

  7. SARS-CCIS • SARS-Case Contact Information System • is a data management system developed byDepartment of Health • is to group analysis function for field epidemiologists to construct cluster trees and extract cases of identified clusters for analysis

  8. CTS • Contact Tracing System • responsible to control the communicable diseases. • are to confirm the diagnosis determine the extent of secondary transmission, and identify control measures. • prevent disease spread in the community.

  9. The infrastructure of eSARS Hospital Authority (HA) is a statutory body established under the Hospital Authority Ordinance to manage all public hospitals in HK. 43 Hospitals 52,000 staff 46 SOPD and 74 GOPD Currently manages a Head Office 41 public hospitals / institutions, 48 specialist outpatient clinics 74 general outpatient clinics

  10. HA has a good infrastructure to support its system manages 44 public hospitals 1.2 million in-patient and day patient discharges about 1.4 million annually 7,000,000 patient records Over 27,600 hospital beds which represented around 4 public hospital beds per 1,000 population In Hong Kong , there are 162 HA Locations. 12,000 workstations to operate the system. 29,000 clinical users who have knowledge and The eSARS and CMS system are operated by Single Sign on 24x7x52 service.

  11. Hardware Server Components • UNIX server which is IBM RS6000 • with operating system of AIX 4.3X. Software Components • Backend: Sybase 12.5 ASE DBMS (same as the platform of CMS)Informix DBMS (for data warehouse) • Middle tier : Windows 2000 server (OS)IIS 5.0 as Web Server Crystal Report for reporting. • Frontend tier : PowerBuilder 6.5 (same as the platform of CMS)IE 5.0 or above (for browser)

  12. Hardware infrastructure 3 data warehouses : Hong Kong Island, Kowloon & New Territories. Served by different ISP. The structure of eSARS & design are built on CMS eSARS.home is built on Intel based server for the Middle tier. Since management do not have the workstations in front of them, they uses it to generate the report and analysis the data. Software infrastructure CMS and eSARS are all Web-based system. CMS is built by PowerBuilder and Sybase. eSARS and eSARS.home is built by IIS, ASP, JavaScript, Sybase.

  13. Network infrastructure • network connections are using WAN to connect 162 locations of HA. • use Fiber-Optic Cable to transmit the data for its Work-to-Internet connection. • Each HA location has 2 broadcast network (LANs) which served by 2 different ISP. • each HA locations transmit the data to 2 different data warehouses & LANs are using to connect the Internet among the workstations

  14. How Policing Disease System Work • The ESARS system is based on the development of CMS, so the basic operation flow is quite similar. The flow of the system is as follow: Ref: eSARS (Electronic Severe Acute Respiratory Distress Syndrome System ) – Development and Technical Perspective

  15. Once the suspected patients are brought into the hospitals, the ward staff will enter this information on top of the normal clinical data that will be kept in the CMS. • The case and management reporting module generated statistical and trend information for the HA management to study and analyze at their daily steering committee meetings. • if the suspected patient is confirmed as a SARS patient, those information mentioned above will transfer to DM Zone • Then eSARS data is retrieved to the Health Department, Hong Kong Police and Universities.

  16. Difficulties in implementing eSARS • Data Inaccuracy • Cost • Achieving Rapid Change of Environment • Too Many Set Up Location • Security • Incapability to meet the current and future needs • Lack of computer knowledge of frontline staffs

  17. Data Inaccuracy • In the early stage of the SARS • doctors have different views or suggestions about SARS

  18. Cost • Highly Rely on hardware for CMS, cost $256,502,000 per year • Highly rely on software for CMS, cost $101,317,000 per year • Large IT financial burden to the government

  19. Achieving Rapid Change of Environment • eSARS have to update everyday • fulfill the flexible information transfer

  20. Too Many Set Up Location • huge information transfer between many hospitals and departments

  21. Security • HA is a private organization • information can’t be disclosed to the private sector • firewall for the security protection

  22. Incapability to meet the current and future needs • new IT technology grow fast • gaps between the linkage of the new systems recently developed in hospitals and those older CMS systems implemented at earlier stages

  23. Lack of computer knowledge of the frontline staffs • not all frontline staffs are familiar with the new system • most frontline staff had not yet recognized the full or potential benefits • gain clinicians' acceptance in the IT roll out plan

  24. Solution to tackle the difficulties • Standardization of data • Monitoring group • Inter-operation of the systems with private hospital • Hotline for frontline staffs

  25. Standardization of data • Standardize the format or terms of the data can help to provide a more reliable information • Easy retrieval of data

  26. IT Monitoring group for eSARS operation • Update the systems for sustainable operation • Check the areas for improvement • Ensure the privacy and security of the systems

  27. Inter-operation with the private hospitals • Sharing data • Have more reliable information to carry out certain policy

  28. Hotline for Technical Enquiry • Provide hotline to help frontline staffs adapt to the new systems

  29. Latest news about Policing Diseases System • there are 55,000 patients and 1,200 private medical practitioners have enrolled in the PPI-ePR scheme. • Public- Private Interface - Electronic Patient Record Sharing Pilot Project • Support Chinese Characters Input of ePR • Real Time Update of the Online Doctors’ List

  30. The CMS development project started last July, beta version of CMS will be available in March, expecting 120 clinics to join the test by April • The ePR serve as tests of the bigger e-health record project to meet the needs of future

  31. Improvement of Policing Disease System • establish an enhanced information management system across the sectors for communicable disease control on a permanent basis • relevant information should be shared • the system should enclose links to all health sectors, including the private sector and community clinics.

  32. updating, modification and maintenance of the system are needed • In order to improve the efficiency and effectiveness of the system, the management should have meeting frequently • Deficiencies and improvements of the system should be discussed

  33. Influence of thePolicing Disease System Stockholm Challenge Award in 2004 innovative combining the criminal tracking system with clinical information smart tracking system daily life with modern technology

  34. Comments timely multidisciplinary high accuracy real-time high security feasible

  35. The End

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