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Evolution of Anesthetic Information System: Advancing Anesthetic Care at VUmc Amsterdam

Explore the development of an Anesthetic Information System (AIS) at VU University Medical Center Amsterdam, focusing on the history, concepts, open system architecture, and implementation. Learn about the significant impact on anesthetic equipment, patient monitoring, drug administration, and communication within and outside the medical facility.

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Evolution of Anesthetic Information System: Advancing Anesthetic Care at VUmc Amsterdam

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  1. AIS Development of an anesthetic information system VUmc Amsterdam H.H. Ros N. van Schagen K. Gigengack A. van Dusseldorp

  2. AIS • Time and Money: 1985 • Multichannel data acquisition • Renewal anesthetic equipment • Philosophy • Structure • Demands • Implementation • Demonstration

  3. 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

  4. AIS - History II • Equipment central in development • IT – development neglected / rejected • No standardization • Of software • Of interfaces

  5. AIS – History III • Limited functionality • Number of signals / parameters • Methods of sampling fixed • Information transfer fixed • All equipment different (interface) protocols

  6. 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

  7. Situation before development AIS Patient Monitor(s) Anesthetic Equipment Anesthetics Drugs etc Display/control Display/control Display/controle Anesthesiologist Outside World

  8. 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

  9. 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

  10. 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

  11. 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.

  12. 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

  13. Situation before development AIS Patient Monitor(s) Anesthetic Equipment Anesthetics Drugs etc Display/control Display/control Display/controle Anesthesiologist Outside World

  14. 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

  15. 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

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