Component of Policing Diseases System MIIDSS : Major Incident Investigation and Disaster Support...
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Component of Policing Diseases Component of Policing Diseases System 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 RecordsSARS-CCIS : SARS-Case Contact Information
SystemCTS : Contact Tracing System
MIIDSSMIIDSSMajor 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 Forceresponsible to facilitate the critical validation and
analysis of persons, time and placehelp to identify the chain of human transmission of
SARSspeedy identification and isolation action was very
important to control and stop the spread of SARS.
CMSCMSClinical Management Systemwas developed by Hong Kong Hospital
Authorityis 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.
eSARS eSARS Electronic Severe Acute Respiratory Distress
Syndrome Systemwas 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
ePR ePR Electronic Patient Recordsis 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.
SARS-CCISSARS-CCISSARS-Case Contact Information Systemis a data management system developed by
Department of Healthis to group analysis function for field
epidemiologists to construct cluster trees and extract cases of identified clusters for analysis
CTSCTSContact 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.
The infrastructure of eSARSThe infrastructure of eSARSHospital Authority (HA) is a statutory body established under theHospital 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
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.
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)
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.
Network infrastructurenetwork 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
How PolicingHow Policing Disease System Work 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
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.
DifficultiDifficulties in implementing eSARSes in implementing eSARS
Data InaccuracyCostAchieving Rapid Change of EnvironmentToo Many Set Up LocationSecurity Incapability to meet the current and future
needsLack of computer knowledge of frontline
staffs
Data InaccuracyData InaccuracyIn the early stage of the SARS doctors have different views or suggestions
about SARS
CostCostHighly 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
Achieving Rapid Change of Achieving Rapid Change of EnvironmentEnvironmenteSARS have to update everydayfulfill the flexible information transfer
Too Many Set Up LocationToo Many Set Up Location huge information transfer between many
hospitals and departments
Security Security HA is a private organization information can’t be disclosed to the private
sectorfirewall for the security protection
Incapability to meet the current and Incapability to meet the current and future needsfuture needsnew 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
Lack of computer knowledge of the Lack of computer knowledge of the frontline staffsfrontline staffsnot 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
Solution to tackle the Solution to tackle the difficultiesdifficultiesStandardization of dataMonitoring groupInter-operation of the systems with private
hospital Hotline for frontline staffs
Standardization of dataStandardization of dataStandardize the format or terms of the data can
help to provide a more reliable information Easy retrieval of data
IT Monitoring group for eSARS IT Monitoring group for eSARS operationoperation
Update the systems for sustainable operationCheck the areas for improvementEnsure the privacy and security of the systems
Inter-operation with the private hospitalsInter-operation with the private hospitals Sharing data Have more reliable information to carry out
certain policy
Hotline for Technical EnquiryHotline for Technical EnquiryProvide hotline to help frontline staffs adapt to
the new systems
Latest news about Policing Latest news about Policing Diseases SystemDiseases 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 ePRReal Time Update of the Online Doctors’ List
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
Improvement of Policing Improvement of Policing Disease System Disease System establish an enhanced information
management system across the sectors for communicable disease control on a permanent basis
relevant information should be sharedthe system should enclose links to all health
sectors, including the private sector and community clinics.
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
Influence of theInfluence of thePolicing Disease SystemPolicing Disease SystemStockholm Challenge Award in 2004innovativecombining the criminal tracking system with
clinical informationsmart tracking systemdaily life with modern technology
CommentsComments
timelymultidisciplinaryhigh accuracyreal-timehigh securityfeasible