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AIS. Development of an anesthetic information system VUmc Amsterdam H.H. Ros N. van Schagen K. Gigengack A. van Dusseldorp. AIS. Time and Money: 1985 Multichannel data acquisition Renewal anesthetic equipment Philosophy Structure Demands Implementation Demonstration.
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AIS Development of an anesthetic information system VUmc Amsterdam H.H. Ros N. van Schagen K. Gigengack A. van Dusseldorp
AIS • Time and Money: 1985 • Multichannel data acquisition • Renewal anesthetic equipment • Philosophy • Structure • Demands • Implementation • Demonstration
AIS - History • Separate units for each monitoring function • High number of single units • Different Manufacturers • PDMS: not existing or adapted to specific hardware • “Total Design” systems • Hardware and Software mutual dependent • Simple and not structural output (analog / RS232 ) • Changing setup
AIS - History II • Equipment central in development • IT – development neglected / rejected • No standardization • Of software • Of interfaces
AIS – History III • Limited functionality • Number of signals / parameters • Methods of sampling fixed • Information transfer fixed • All equipment different (interface) protocols
AIS – History IV • Alarm strategy not standardized • Depending the manufacturer • Systems not flexible • New development = buying new system • Each OR an own / separate system • Limited role of the anesthesiologist
Situation before development AIS Patient Monitor(s) Anesthetic Equipment Anesthetics Drugs etc Display/control Display/control Display/controle Anesthesiologist Outside World
AIS – Concepts • Information System – ” Information Brains” • Efferent stream of data • Afferent stream of data • Data acquisition – full disclosure • No discussions about the dataset • All parameters will be recorded (if possible) • The chosen filter will display what is needed or wanted. • Processing data in IS independent of recording
AIS – Concepts II • Transducers outside IS • Intelligence in IS: • Feedback to anesthesiologist • Individual adaptation of alarms, performance of IS system subject to users • Standard human interface
AIS – Open System Architecture • Constructed for several hardware platforms • No dedicated software for communication and data acquisition: • Standard commercial software / freeware • Direct connections to the outside world • Full disclosure possible • Plug and Play • Worldwide standard supported • Simple maintenance with easy access - standard technology • Automatization considered as a process
AIS – OUTSIDE WORLD • Libraries – digital support systems • Laboratories • Other OR’s / wards • Hospital information system • Decision support / expert system • Management support • Quality assurance • Medical Audit • Reports –including anesthetic chart • Research • Education and training • Internet etc • Servers for recorded data.
AIS- implementation • Use of existing hardware • Use of existing software • Afferent data acquisition • Full Disclosure • No operating of equipment - efferent • If possible standard available software
Situation before development AIS Patient Monitor(s) Anesthetic Equipment Anesthetics Drugs etc Display/control Display/control Display/controle Anesthesiologist Outside World
Situation after implementation of the AIS Patient Monitor Anesthestic equipment Anesthetics, Drugs Information system Information system Display/control Display/control Display/control Anesthesiologist Communication Outside world
Monitor Anesthetic Equipment Other recording possibilities: Infusion pumps, ECC, WEB-devices Information system: AIS Outside World: Patient ID and data Preoperative assessment data Pharmacy – reference Bloodgasanalyzer HL7 General terminal: web, mail, medicating system Report generators (web based) Anesthetic List as web application Display and control Planning, Pharmacy, Waiting list, Clients Operation Complex, Management, Upload to Hospital Information System, DB of operations