Thomas Bruessel, FANZCAProf of AnaesthesiaCanberra HospitalCanberra, AUS

AIMS – ORMS – EMR

Australian Institute of Medical ScientistsAustralian Institute of Mine SurveyorsAustralian Institute of ManagementAustralian Institute of Marine ScienceAustralian Institute of Medical ScientistsAustralian International Motor ShowAfrican Institute for Mathematical SciencesAfghanistan Information Management ServiceAssociation of International Marathons Races

AIMS – ORMS – EMR

AIMSAnaesthesia Information Management

System

AIMS – ORMS - EMR

ORMSOperating Room Management System

EMRElectronic Medical Record

ORMS

EMR

AIMS

AIMS

eHealth

?

EMR

ORMS

“Ether Chart”

Codman EA, Cushing H1st written record1894 at MGH

On permanent loan from the Treadwell Library of Massachusetts General Hospitalto the Francis A. Countway Library of Medicine

Hand written anaesthesia

record~

100 years

Preadmission Clinic

Post AnaesthesiaCare Unit

Intraoperative Data

Automated anaesthesia record

HR, BP, CVP FiO2, etCO2, SaO2

Temp

CVPSevo et

RR, PIP

PCWP,CO

Data sampling (RS 232 port)

more frequently more accurately

medico-legal advantage ?

Automated anaesthesia record

A Anaesthesia I InformationM ManagementS System

Server

NetworkConnection

Patient Monitor

Other Devices

Anaesthesia machine

Operating Room

Communicationmultiplexer Workstation

Serial data

Position

Anaesthesia data chart: Missing information

InstrumentationType of anaesthesia

Fluid balanceAction / interventions

Drugs

Events

●●●●●●●

AIMS

Collects intraoperative physiologic data

Collates these with patient information

Adds interventions of anaesthetist

Stores this information

Allows retrieval and analysis

●

●

●

●

●

PAC: information

Medication Safety

Performance

Data retrieval & AnalysisAIMS

Adverse events, near misses

Clinical competence/performance

Compliance with standards, rules and regulations

●

●

●

PAC: history, exams, test

Intraoperative: data + events

PACU: data, pain, discharge info.

AIMS

ORMS

Central Database“Server”

Medical Records

PreOpClinic

HoldingArea

ReferringPhysician

AdmissionsScheduling

OperatingRoom

ICU/FloorPACU

Perioperative Setting: Data Flow

ORMS

Billing (professional fees)

● Scheduling of cases

Organisation of clinical and support staff Organisation of equipment and suppliesCoordination of access to Biomedical engineering

Capture of patient information Documentation of clinical information

● Tracking of patient flow● Organisation of postsurgical placement of patients

● Documentation of time stamps ●

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●

●

AIMS Lab Imaging Pharmacy

●●●

Allow maximal integration

Medication Management: Storage /Supply

ORMS

ORMS

AIMS

Integration = Application + Platform

Data SharingRedundancy!!!

Jerry StonemetzKeith Ruskin Editors

Springer, London2008

HealthSMART (Vic)National E-Health Strategy

Electronic medical record

File:Electronic medical record.jpgFrom Wikipedia, the free encyclopedia

Medical record generated outside OR

Intergration/Linking GPs and Hospitals

Providing access to medical staff

Very expensive

E-HealthNational E-Health Strategy

Electronic Medical Record

E-Health

E-Health takes time and cost money

IDEAL SYSTEM

ORMS

EMR

AIMSPathologyPathology

ImagingPhysician

Order Entry

IDEAL SYSTEM

ConfidentialityPrivacy ?