08+Health

 =Health Exam questions =

1. ICT is widely used in medicine. (a) Medical analysts use spreadsheet software to process patient data. Define each of the following features of the spreadsheet and give an appropriate example of how each can be used in processing patient data: (i) Graphs; [2] (ii) Templates. [2] (b) Describe how the following are used for patient care in medicine: (i) Bar code systems; [2] (ii) Computer control systems. [2]

2. Many different ICT systems are now widely used, such as medical expert systems and e-commerce systems. (a) (i) Describe what you understand by the term // medical expert system //. [1]  (ii) By referring to a suitable example, describe ** two ** specific advantages of a medical expert system. [2]

[|News story about how sensors are being used to monitor senior citizens.]

**__ ICT & Health __** __ Sensors & Computer Control __ __ MRI: Basic Idea __ __ MRI: How it works __ __ MRI: Safety Requirements __ __ MRI: Future Developments __ __ Advantages of MRI __ __ Disadvantages of MRI __ __ CAT Scanners __ __ Scanning Procedure __ __ Advantages of Computerised Axial Tomography __ __ Disadvantages of Computerised Axial Imaging __
 * Sensors used in hospitals to monitor patients do if there about to die they know.
 * Sensors measure: Heart Rate, Breathing Rate, Blood Oxygen, Pulse & Temperature.
 * Sensors are connected to the systems and they can be manipulated and analysed.
 * Sensors if they receive certain readings can sound alarms to inform staff.
 * Computer controls the drips on the wards at timed periods.
 * Maternity Wings used computer control recently. If a child has just been born and is currently in the process of being kidnapped then the wristband triggers an alarm.
 * Magnetic Resonance Imaging a powerful diagnostic, the diagnoses have become more accurate and this has improved many lives.
 * MRI machine looks like a giant cube with the horizontal tube running through it; it’s a super conducting magnet.
 * Patient lies in the tube on a table; they are positioned in the centre of a magnetic field.
 * Patient receives RF Energy Waves pulses bounce of the tissue of the patient and identified by the MRI Scanner.
 * Different tissues bounce back different levels of energy, damaged tissue can be found.
 * All of the signals are co-ordinated into an images and models.
 * MRI zooms in on a small area of the patient then using computer imaging it produces an image. Body can be mapped out point by point to gain 2D Images or 3D Models.
 * It is very detailed and depending on the RF waves and magnetic fields it can provide the answer for a certain medical question being asked.
 * It could lift a car, while in the tube loose metal things should not be around when it’s switched on.
 * Patients with heart pacemakers as the strength of the magnetic field would be disrupted they would have an artificial heart attack and be dead.
 * Fixed metal things like gold teeth and metal hip replacements should be fine.
 * MRI machines are getting smaller, lighter and scan bigger patients.
 * They are more patient-friendly that less time is needed in them so less claustrophobia.
 * Patient doesn’t need to get cut open.
 * Contrast injections of radioactive isotopes is unnecessary.
 * No ionising radiation.
 * Few side effects.
 * More flexible than X-Rays.
 * High resolution images.
 * More flexibility to examine the specific tissue needed.
 * Good for diagnosing brain tumours, infections of spine and brain and predict strokes.
 * Metal complications like pacemakers forbid its use in cases.
 * People might be far too obese to use the MRI.
 * Worries of the affects of magnetic fields on foetus.
 * Claustrophobia.
 * MRI machine is noisy.
 * Patients need to restrain from moving for long periods of time.
 * MRI Systems are expensive.
 * Fixed metal objects in the patient are good after scar tissue has formed.
 * Computerised Axial Tomography it is developed from X-Rays.
 * CAT produces X-Rays which pass through soft tissue onto a mix of X-Ray detectors.
 * X-Rays produce shadows in one way, larger bone could obstruct view of smaller one; to see the smaller bone they need another X-Ray.
 * CAT Scans take X-Ray shots from different angles so it can be put together for a 3D view.
 * Patient lies down in the centre which moves through the hole.
 * Ring contains X-Ray detectors opposite the X-Ray tubes.
 * Motor oscillates the ring so X-Ray detectors gyrate around the patient.
 * Each turn scans a horizontal slice of the patient.
 * It then lowers the patient further in the hole to scan next slice.
 * After all stages are complete the CAT produces a detailed image.
 * CAT Scans are more comprehensive than conventional X-Rays.
 * Cheaper than Magnetic Resonance Imaging.
 * No magnetic field effect so it doesn’t affect pacemakers.
 * Use of Ionising Radiation, therefore not suitable for use during pregnancy.

__Ultrasound__
 * Use of high frequency (1-5 MHz) sound waves and echoes similar to SONAR.
 * Sound Waves reverberate through tissue until it hits an obstacle, they then bounce back to the probe, some continue until they hit a secondary periphery then they bounce back.
 * The probe registers the results to a machine.
 * Machine calculates the distance from the probe to the peripheries like organ or bone tissue; using the speed of sound in tissue at the time of each “bounce back.”

__Features of the Ultrasound Machine__ __ Advantages of Ultrasound __ __ Disadvantages & Hazards of Ultrasound __ __ Uses of Ultrasound __
 * Transducer Probe: The probe that detects bounced back sound waves.
 * Central Processing Unit: Place in the machine where computations take place.
 * Display: Shows the image that the machine generates.
 * Keyboard & Cursor: User input.
 * Disk Storage Device: Where the generated images are held.
 * Printer: Output device to output the generated Ultrasound image.
 * No Ionising Radiation.
 * Faster than X-Rays and Computerised Axial Tomography and other radiographic imaging.
 * 3D Imaging provides closer insight to the tissue being examined.
 * Tissues absorbing too much Ultrasound Energy will over heat and lead to desiccation.
 * Cavitation caused by dissolved gases due to convection currents.
 * Still only to be used when absolutely necessary.
 * Checking the foetus is in the right position.
 * Checking number of foetuses in womb.
 * Checking sex of the foetus.
 * Viewing tumours.
 * Look inside the Heart organ to find abnormalities.
 * Measuring blood flow.
 * Viewing kidney stones.
 * Detect prostate caner.

__ Future Developments of Ultrasound __
 * Speed may increase.
 * Portable probes to look inside organs.
 * Machine will get smaller.
 * Virtual reality conception of patient for non- invasive procedures like biopsy.

__ Electronic Patient Record Keeping __
 * Patient records contain sensitive information about prescriptions and conditions.
 * When a patient is admitted to the hospital the record is called up to aid diagnosis.
 * It acts like a plan for the patients care and treatment.
 * Medical record keeping are legal requirement or the Health Service.
 * Poor record keeping compromises good patient care.

__ Advantages of Electronic Patient Record Keeping __
 * Legibility improved than written records.
 * Better accountability.
 * Standardisation of information and formats.
 * Easy to locate and find specific records.
 * Secondary information support.
 * Speed of data processing.
 * No need to handwrite patient notes.
 * Audit trails.
 * Properly designed can efficiently support general practioners and clinicians.

__ Blood Bar Coding & Tracking Systems __
 * In 2005 2.1 million blood donations given by 1.6 million, 5% of the population.
 * PULSE tracks the blood from its donation, unique donation numbers are given at donor.
 * The blood is labelled with the unique donation numbers and barcodes and then goes for safety checks in a laboratory.
 * Tests look for diseases that can be transferred to the patient and then it is refrigerated until the results return negative.
 * The blood is labelled with its blood group and then it’s put in the blood-bank and temperature controlled to stop bacterial multiplication.
 * When needed for patients safety checks are made or it can lead to heart failure.
 * A doctor puts patient details into blood-bank database then it finds a match for blood.
 * Nurse then delivers it she scans her identity badge then the patient’s wristband and blood bag tag and blood transfusion is complete.

__ Use of Internet __
 * Computer networks allow data transferral from system to system, person to person.
 * Internet can view websites, e-mailing and file attachments.
 * It doesn’t need to be secure and good for public viewing.

__ Use of Intranet __ __ Use of Extranet __
 * Intranet has more security its internal protected from exterior viewing.
 * It is positioned around several buildings with usernames and passwords.
 * Intranet e-mail and website may only be offered to those internally able to.
 * Hybrid system of Internet and Intranet.
 * It allows REMOTE users to work remotely. They can connect to their work network in their main office building.
 * The link is encrypted and secured.
 * The users can access their e-mail, shared files, internal corporate website and transfer files from the office system to their remote system.

__ Distributed Medical Databases __
 * Health & Social Care Information Centre its purpose to co-ordinate sharing of data.
 * It provides a hub for clinicians, managers, regulators or patients seeking information.
 * “We will start by co-ordinating existing information channels and identifying gaps in delivery and capability.”
 * This raises concerns among healthcare staff:
 * Accessibility of information must be controlled.
 * Personal accountability.
 * Realisation that different organisations need to share information.
 * Technicians need to meet demands of every sector of the health service.

__ Back-Up __
 * All files on a system need to be stored on a separate disk and in the event of crash or total reboot the files can be put back on the system.
 * Back-ups can be on floppy disks, USB Drives, External Hard Drives, CD-R or tape drives.
 * Duplex drives exist for servers. A secondary hard drive copies every file from the primary hard drive, if the server crashes the primary swaps with the secondary hard drive.
 * Known as Redundant Array of Independent Disks 1. (RAID1)
 * RAID5 is used for large servers. It has stored data on several hard drives by splitting data and accessing them by parallel. If one crashes a new one takes its place.
 * RAID5 for further security is duplexed by another series.
 * The system has an independent power source.
 * In this way crashed servers will switch away to secondary units.

__ Back-Up Policy __
 * Organisations have responsibility to not loose sensitive data or data that is needed for it to efficiently function.
 * A Back-Up policy will determine:
 * The person who takes responsibility for the procedure.
 * How often the back-up is created.
 * Archive of storage media.
 * Safe storage of remote storage devices.
 * Actions that they take in emergency situations.
 * Test that the back-up can essentially restore data.

__ Restore __
 * A new drive replaces the corrupt or destroyed one and back-up media is transferred back on the new drive.
 * Tape Drives use a Grandfather-Father-Son system whereby the tapes are replaced in a numerical order.
 * In larger systems this is unreasonable. The servers use duplexing and RAID so data is never lost completely.

__ New & Future Developments & Limitations __
 * Hospitals trialling Radio Frequency ID to record vital signs via barcode on wristband.
 * Tag drugs and prescriptions to track them to the patient in hospitals.
 * Nurses can prescribe from the patient’s home they can gain access to the record during visit to the patient.
 * Healthcare staff can keep in touch by e-mail instead of returning to base.
 * Less time wasted through DNAs or cancellations.
 * Tighter stock control using handsets weekly instead of daily deliveries.
 * Wireless technologies could allow a robot drug dealer to deliver to hospital beds.
 * Staff could use PDAs to connect to the hospital network from patient’s home, remotely.

__ Advantages of Electronic Patient Record Keeping __
 * Better legibility than handwritten.
 * Problems made by someone can be traced to them quickly to correct the situation.
 * Standardisation of record keeping giving some conformity.
 * Information can be retrieved easily.
 * Databases could hold additional notes which aren’t available on hard copies.
 * Saves hand wring time.
 * Performance statistics can be collated from processed information.
 * ICT can aid doctors in their daily work.
 * Audit trails.
 * Use of menus and screens and interfaces make it quicker to use.
 * Hospital efficiency can be calculated quickly.
 * SavSpeed of data processing helps for quicker analysis.

__ Expert System Advantages __
 * Computer can store more information than human.
 * Computer won’t forget and it can avoid mistakes but it’s not infallible.
 * Data kept updated.
 * Availability every hour of day never absent.
 * System can be used over distances so it is far-reaching.
 * Can run simulations and predict.
 * People prefer talking to a robot doctor for privacy.

__ Expert System Disadvantages __ __ Expert System Other Uses __
 * Over reliance on ICT.
 * Capital intensive labour result in lay offs of human experts.
 * Depends on the correct information being imputed initially.
 * They lack common sense.
 * Fatal errors made by clerk who swaps age with weight.
 * Could potentially be used in artificial intelligence.
 * Several programming languages: PROLOG & ASPRIN.
 * MYCIN earliest system designed in 1970s. It was supposed to diagnose and predict treatment for blood diseases.