This is a text written by Jon Berg <jon.berg|a|turtlemeat.com> spring 2005 in the Computer Science course Medical Informatics at Tromsø University, Norway.
Current and future possibilities of Medical Informatics
3. Medical Data
Medical data has a central role in the modern medical informatics. All the processes in medical informatics are tightly connected around the medical data. The lifeline of data in medical systems is; the data is first collected with some sensor device, they are stored in standardized format on persistent storage and then used in various applications. This chapter will discuss the process of collecting, storing and using medical data. Some of the other chapters in this essay will also get more into details on some specific uses of medical data like medical imaging, decision making and patient monitoring. The chapter in this essay concerning medical standards is also closely related to the collection, storage and use of medical data.
(President’s Information Technology Advisory Committee. 2004. Revolutionizing Health Care Through Information Technology.) advices that security in the treatment of medical data must have the means of Unambiguous Patient Identification, Encrypted Internet Communications, “Trust Hierarchy and Authentication” and Tracing Access Requests.
Data is collected through observations of the patient. That could be for example the reading of the patient’s temperature or blood pressure. One single observation of a medical fact is called a medical datum. Some medical datum consists of multiple medical data. For example the reading of the blood pressure is best red as a difference between two values, the diastolic pressure and the systolic pressure. In medical systems it is important to store the data in a data model that is appropriate for what type of data it is going to use. In the case of the blood pressure the medical data is multiple observations.
A single datum most often consists of four important elements; an identifier of the patient, the parameter being observed, the value of that parameter and the time of the observation.
The requirements put on storage of health data are that they must be stored in such a way that they can be read by many types of applications. The best way to archive interoperability among different health systems is by the use of coding standards.
The primary use of medical data is in applications that a health professional uses. The range of applications is as wide as there are tasks a health professional need to solve. Examples of tasks could be analysis of x-ray images or it could be managing the medical journal.
Medical data is a legal record. Medical data can be used for back-tracking the treatments a patient have received, and for determining what was basis the decisions was made in. The possibilities of what can be logged and back-tracked are improved as more and more media is included in the journals. This logging is in the benefit of both the health professions that make the decisions and the patients. With more elements of the diagnostic and treatment process documented in the journals it is more easy to determine if the health personnel have made wrong decisions or have done everything that could be expected.
Medical data collected and stored digitally opens for using the data for more than just the direct treatment of the patients. These large repositories of patient information can be used in research. The data is already available and it does not require the data to be collected specifically for the research projects. The data can be very efficiently used in the research setting just by making research systems that connect into the same data used for regular patient treatment.
The digital medical data can be much more easily used in new applications than medical data on paper. A whole new set of possibilities opens up with digitized medical data. It would be possible to make solutions that automatically monitor the medical data and generate warnings to the health professional. Automatically do quality checks of the medical data for possible errors. It could also be used to provide feedback on deviations in the medical data. The patient’s data could be compared to a broader set of data that defines what the norm is for a person with a particular disease situation and also considering gender and age. If this were to be done with journals being on paper it would be impossible. The human resources that would have to go into searching and sorting the medical data in the paper journals would be overwhelming, and impractical in all sense with respect to the money and time it would cost to do such things.
In the past it has usually been the practice of having one family doctor that cared for all the problems a person might get through his life. This doctor would get to know the person very well and would have detailed knowledge of the diseases his patients have. The modern way of treating patients is to have a team of specialists that help the patient with specific problems. The new team based healthcare also puts emphasis on the need for good health records. In team based healthcare the health record also serves as a communication media between the various health professions.
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