香港醫學會
THE HONG KONG
MEDICAL ASSOCIATION
Funded by:
› the Office of the Government Chief Information
Officer (OGCIO) ( 政府資訊科技總監辦公室 ) under the
Sector-specific Programme (SSP) scheme
Course Structure
Lesson 1 Basic Health Informatics AND
Introduction to Clinic Management System
(HKMA HKMA CMS 3.0)
Lesson 2 Basic Health Informatics
Introduction to Clinic Management System
(HKMA HKMA CMS 3.0)
Lesson 3 Free and Open Source Software
HKMA CMS 3.0 - Nurse's Perspective
Lesson 4 Free and Open Source Software
HKMA CMS 3.0 - Nurse's Perspective
Lesson 5 Safety in Handling Patient Data AND
HKMA CMS 3.0 - Doctor's Perspective
Lesson 6 Safety in Handling Patient Data AND
HKMA CMS 3.0 - Doctor's Perspective
Lesson 7 Internet Technology Update AND
HKMA CMS 3.0 - Administrator’s Perspective
Lesson 8 Internet Technology Update AND
HKMA CMS 3.0 - Administrator’s Perspective
Session 1 Basic Health Informatics
Information Technology
› study, design, development, implementation,
support or management of computer-based
information system (software + hardware)
› I.T. deals with the use of computers (i.e.
hardware) and software to:
convert, store, protect, process, transmit,
and securely retrieve information.
A. I.T. Basic concept review
Output Output
Data Information Knowledge
Management /
Process
Input Input Analysis
Storage
A. I.T. Basic concept review
Information System
Concepts / Methodologies / Theories
Software Hardware
Data /
Information
People Procedures
B. Electronic Medical Record Systems
Application Areas
› According to scope or scale (i.e. size) of the system, it
can be implemented from small clinic to a world-wide
hospital network.
› Apart from medical centers, this kind of system is also
suitable for health care center, elderly caring center,
psychiatric hospital, birthing center…etc.
Show Case
› Cabarrus Family Medicine in Concord, North Carolina,
a practice that has 26,000 patients across 4 clinics
with intranet-enabled eMR System.
B. Electronic Medical Record Systems
eHR e-communication framework
C. ePR / eHR in Hong Kong
Current HA PPI-ePR and future eHR exchange
platform
Background
› PPI – ePR Public–Private Interface –
Electronic Patient Record Sharing Pilot Project
HA has employed CMS (Clinical Management
System) since 1995.
Currently, there are over million patient records
in HA’s Patient Master Index using HK ID Card
number.
A pilot on the sharing of Electronic Patient
Records with the private sector has implemented
since April 2006.
C. ePR / eHR in Hong Kong
Project Objectives
› Enhance collaboration between the public and
private health sectors
› Allow continuity of care for patients
› Facilitate free flow of patients between two
sectors
› Provide timely access of information
C. ePR / eHR in Hong Kong
Project Scope
› Acceptance test of concept for all involved
parties
› Technical feasibility with security issue
› Content of patient record review with
sensitive information concern
C. ePR / eHR in Hong Kong
Phases of the project
C. ePR / eHR in Hong Kong
Logon and Logged On screens
C. ePR / eHR in Hong Kong
Logon and Logged On screens
C. ePR / eHR in Hong Kong
Current Status
› Since 2006, more than one thousand private
healthcare professional
› 40,000 patients had already enrolled in PPI-
ePR with more than 33,000 numbers of ePR
access made.
The current concern or issue of project can be
revealed by its newsletters.
For instance, the latest one (dated on 30 Apr
2009) has informed all registered doctors and
healthcare partners regarding a new feature has
been added to allow them easy access to most
up-to-date information from Centre for Health
Protection (CHP) of Human Swine Influenza
(H1N1).
D. Importance of Data Exchange Standards
(e.g. HL7, DICOM)
ICPC
› It stands for International Classification of Primary
Care
› The latest edition of ICPC is second edition (ICPC-2)
› ICPC was developed to order medical concepts into
classes that have been chosen for their relevance for
family medicine.
› It classifies patient data and clinical activity in the
domains of General / Family Practice and primary care
› Taking into account the frequency distribution of
problems seen in these domains.
F. Disease Classification Standards
/**
* The HelloWorldApp class implements an application that
* simply prints "Hello World!" to standard output.
*/
class HelloWorldApp {
public static void main(String[] args) {
System.out.println("Hello World!"); // Display the string.
}
}
B. Concepts and Advantages of FOSS
Benefits to Developers
› more innovation and interaction in the industry, as
a result, industry grows faster technologically.
› developers learn more from other developers,
exchange and share more ideas among
developers and communities.
› intangibly, developers will gain recognition, even
being famous, through this model easier
C. FOSS Licensing Concepts
Copyleft
› The word “copyleft” can make people thinking the
word “copyright” easily. Here, the word “left”
means the inverse of “right”.
› It is a general method for making a program or
other work free, and requiring all modified and
extended versions of the program to be free as
well.
› The simplest way to do so, put the software in the
public domain, i.e. not copyrighted.
C. FOSS Licensing Concepts
e-Cert
› is for secure on-line identification.
› is issued by a CA, [Recognized] Certification Authority,
for the purpose of supporting a digital signature which
purports to confirm the identity.
› identify the CA issuing it.
› name or identify the person to whom it is issued.
› contain the public key of person to whom it is issued.
› be signed by a responsible officer of the CA issuing it.
› can be on HK [Smart] ID Card and/or e-Cert File Card.
› Hongkong Post is a recognized CA.
C. Public Key System Examples
e-Cert & Smart ID
Smart ID
› Since 23 June 2003, HKSAR Government had started
issuing Smart ID Cards to the general public.
› The card stores basic personal data and templates of
two thumbprints.
› Applications of it include immigration application, e-
Cert, Library Card and Leisure Link Self-service Kiosk.
D. Case Study of recent news of privacy breach with
group discussion
18-4-2008 屯門兒童體能智力測驗服務中心發生失竊,涉及一個存有近
700 名病人資料的 USB 記憶體。
截至 08 年 4 月底的過去十二個月內共有九宗遺失電子儀器引致病人資料遺
失的呈報個案。
事件共涉及 5,988 名病人,其中 3,117 名不涉及個人資料。至於餘下的
2,871 名病人,其中 961 名( 33% )並沒有密碼保護。
20-3-2009 九龍東醫院聯網 1 名眼科醫生遺失 1 具個人電子儲存媒體,內
有 47 名眼科手術病人的個人資料。
11-4-2009 基督教聯合醫院一名婦產科駐院女醫生遺失了一具電子儲存媒
體,有關的電子儲存媒體未有任何密碼保護或加密的系統,有關電子儲存媒
體載有八位病人個人資料。
4-2009 基督教聯合醫院一名眼科女醫生於月初遺失了 1 具個人電子儲存媒
體,內存工作紀錄文件,共載有 47 名眼科手術病人的個人資料。
D. Case Study of recent news of privacy breach with
group discussion
Group discussion on
› causes
› consequences
› possible solutions
for cases of HA staffs lost USB flash drives
E. Data Encryption for USB flash drives
Anti-virus
› Anti-virus software must be installed to whole
organization, no exception.
› It protects the organization from virus attack with
always up-to-date virus definition file.
Firewall
› It can be hardware device or software package that
blocks unauthorized access to the organization
system(s) or network(s).
› The operation is based on a “policy” which defines
different conditions for access.
F. Other Security Measures
Intrusion Detection
› It can be hardware device, software package or extra
function coming with a Firewall.
› It is an activity of detecting actions that attempt to
compromise the confidentiality, integrity or availability of a
resource (e.g. network, database).
Backup
› It is an action of making copies of data so that additional
copies may be used to restore the original in case there is
a data loss.
› A backup schedule should be implemented for different
type of data, like daily, weekly and monthly backup.
› The backup copies should be placed in a safe place with a
sufficient distance (e.g. 200 m) from the premises.
F. Other Security Measures
Internet
› is a collection of interconnected networks.
› employs some different technologies, most of them
are telecommunication technologies.
› TCP/IP
Transmission Control Protocol / Internet
Protocol
The latest version is 6. (i.e. TCP/IP v6)
B. Current Internet Technologies
› TCP/IP
Protocol is a set of standard rules for data
representation, signaling, transmission, and error
detection over a communication channel.
The IP address is a numerical identification and
logical address that is assigned to devices
participating in a computer network (Internet) for
communication.
e.g. 202.43.220.99 (it is v4) is yahoo.com.hk
e.g. of v6 (hexadecimal format)
2001:0db8:85a3:0000:0000:8a2e:0370:7334
B. Current Internet Technologies
› TCP/IP Versions
B. Current Internet Technologies
more humanization
more multimedia effects
Java
› is a general purpose programming language.
› supports standalone applications, browser-based
applets, and server-side programs (servlets).
› is compiled to bytecode which can be run on any
platform that supports a Java Virtual Machine (JVM).
B. Current Internet Technologies
Java
multiple editions – standard edition (Java SE), enterprise edition (Java
EE) and micro edition (J2ME)
› sample code (Hello World)
/**
* The HelloWorldApp class implements an application that
* simply prints "Hello World!" to standard output.
*/
class HelloWorldApp {
public static void main(String[] args) {
System.out.println("Hello World!"); // Display the string.
}
}
B. Current Internet Technologies
XML (Extensible Markup Language)
› to structure, store, and transport data while HTML was
designed to display data
› sample code
<?xml version="1.0"?>
<note>
<to>Tove</to>
<from>Jani</from>
<heading>Reminder</heading>
<body>Don't forget me this weekend!</body>
</note>
B. Current Internet Technologies
Examples:
› Video-sharing sites allow people to upload video
clips for sharing with the public.
e.g. www.youtube.com
› Wikis is a website that allows the easy creation and
editing of any number of interlinked web pages.
› The collaborative encyclopedia
e.g. www.wikipedia.org
It is an “open to everyone” public
community that is a free encyclopedia and
anyone can edit.
C. Web 2.0 Concepts
Examples:
Blog (short for weblog) is a personal (not always, maybe by a
group of people)
› online journal that is (should be) frequently
updated and intended for general public
consumption
› The most latest post will be at the top of the blog.
› Individual (blogger) may not need to own a web
site, rather than acquiring blog hosting service
from providers, like yahoo (hk.myblog.yahoo.com)
C. Web 2.0 Concepts
Examples:
› Forum usually belongs to its parent site.
› It is a public discussion platform on a particular
interested area or various areas.
› E.g. www.uwants.com & www.discuss.com.hk
› My forums: louieau.freeforums.org
D. Semantic Web
FTP, File Transfer Protocol, for exchanging files over Internet; download
and upload file to and from a [FTP] server.
A. Functional Overview
B. System Requirement with Typical Clinic Setup
C. Basic Screen Design
D. Typical Workflow
A. Functional Overview
A. Functional Overview
Server
› Windows XP / Vista / Server 2003 / Server 2008, Linux
› Min: Intel P4 2.8GHz, 1GB Ram, 6GB of free disk space
› Recommended: Intel Core 2 Duo 2.4GHz, 2GB RAM, 10GB of
free disk space
Client
› Windows XP / Vista, Linux
› Min: Intel P4 2GHz, 512MB Ram, 2GB of free disk space
› Recommended: Intel Core 2 Duo 2.4GHz, 1GB RAM, 2GB of
free disk space
C. Basic Screen Design