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Advanced Medical Informatics: Operations, Databases, and Data Modeling

Explore the intricacies of medical informatics, focusing on operations, databases, and data modeling in healthcare settings. Learn about patient records, data files, database creation, coding and classification systems, and DBMS. Discover the importance of EHR, data structures, and database management systems in improving healthcare services.

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Advanced Medical Informatics: Operations, Databases, and Data Modeling

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  1. “Victor Babes” UNIVERSITY OF MEDICINE AND PHARMACY TIMISOARA DEPARTMENT OF MEDICAL INFORMATICS AND BIOPHYSICS Medical Informatics Division www.medinfo.umft.ro/dim 2004 / 2005

  2. MEDICAL DATABASES COURSE 2

  3. Operations with informations • Generation • Acquisition – dep. on information nature • Storage – data bases, knowledge bases • Processing – for interpretation • Commitment • Protection • Use

  4. 1. PACIENT RECORD

  5. 1.1. Terminology:EHR - ELECTRONIC HEALTH RECORDEPR - ELECTRONIC PATIENT RECORDCPR –COMPUTERIZEDPATIENT RECORD

  6. 1.2. PACIENT RECORD • a. ON PAPER • AVANTAGES / DISADVANTAGES • EASY TO CARRY, EASY TO “BROWSE” • LOW COST, FREE FORMAT • FAST DATA ENTRY • ACCESSFROMONE PLACE ONLY • b. ELECTRONIC • AVANTAGES / DISADVANTAGES • ACCESSFROMDIFFERENT PLACES, MORE PERSONS • EASY TO READ, EASY TO SEARCH INFORMATION • GOOD BASEFOR DATA ANALISYS, FOR TAKE DECISSION • NEED FOR TRAINED PERSONNEL • REQUIRE MORE TIME FOR DATA ENTRY • HIGHER COST

  7. 1.3. EHRSTRUCTURE • IDENTIFICATION DATA (apart file!!!) • EVENTS: consultation, hospitalisation, surgical intervention, X-ray, etc • time scale • ACTIONS • OBSERVATIONS: case history, lab.results, investigations – signals, images • DECISIONS: diagnosis • INTERVENTIONS, THERAPY : prescriptions • RELATIONS

  8. 2. DATA FILES

  9. 2.1. DATA FILES • DEFINITIONS: • DATA = formalized representations of concepts or facts, appropriate for processing (both human or automatic processing) • FILE = an organized set of data

  10. 2.2 TYPES OF DATA • QUALITATIVE – Case history (descriptive) • NUMERICAL – Laboratory Investigations • GRAPHICS – Biosignals (EKG, EEG…) • SOUNDS: Phonocardiogram • STATIC IMAGES : x-ray, NMR • DYNAMIC IMAGES – movies (“MULTIMEDIA” FILES)

  11. DATA FILE STRUCTURE - scheme

  12. 2.3. DATA FILE STRUCTURE • a) RECORDS (+ Header + EOF) • b) FIELDS • NAME • TYPE: • NUMERICAL • CHARACTER • LOGICAL ( Y / N ) • DATE • COMMENT • SIZE

  13. 2.4. PATIENT RECORD

  14. 3. DATA BASES • 3.1. GENERAL NOTIONS • DEFINITION: DATABASE = a structured set of data - comprises both data and relations between data • STRUCTURE: • FILES (with at least 1 common field - ID) • RELATIONS between records and/or data • PROPERTIES: independence on physical support or language

  15. 3.2. Creating DataBases • Data collecting • Record Structure • Coding • Staff training for filling in • Data validation • Field type • All possible relations

  16. 3.3. Coding and classification • Thesaurus - terms list • Nomenclature - associatedcode list • Types of codes: • numerical, mnemonical, hierarchical, juxtapositional • Taxonomy – classifications rules • Taxonomic axes • Nosology - classification in medicine

  17. 3.4. Classification Systems • ICD - International Classification of Diseases (10) • ICPC - International Classification for Primary Care • SNOMED – System of NOmenclature in MEDicine - multiaxial • Specialized: Mental, Oncology, Procedures • MeSH / UMLS - Medical Subject Headings Unified Medical Language System • DRG - Diagnostic Related Groups – for finance Case-Mix

  18. 3.5. DB CLASSIFICATION • On data distribution: • Local DB (all on 1 computer) • Distributed DB (on several computers) • On structure: • RELATIONAL DB • HIERARCHICAL DB • NETWORK DB

  19. a) RELATIONAL DB • Logical structure (rows & columns) • Several searching criteria • Easy changes • b) HIERARCHICAL DB • Tree structure: each element is subordinated to only one element • Fast search and processing • No flexibility for procedure changes

  20. 4. DBMSDataBase Management System • a) DEFINITION: • DBMS = a set of software tools for: • building a DB • control access to data • assure data security and integrity • Represented by: • specialized languages • dictionaries, nomenclature

  21. b) DBMS Functions • DESCRIPTION: • data structure • relations • access conditions • DATA MANIPULATION: • create, delete, update a record • search, sort, edit virtual records • USE FUNCTION: • USER - DB dialogue

  22. c) RELATIONAL MODEL FOR DATA REPRESENTATION - DBMS Languages • Languages based on relational algebra • Languages using relational operators • ( >, $, ", L etc) • Transform oriented languages (SQL) • Graphical relational languages (QBE, Paradox) • Examples: dBase, Foxpro, Access, Oracle

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