PC Network for Hospital Information System

Abstract

It was my intention to go toward an integrated HIS that covers both the whole clinical operations and the management information system. However the importance of integration was realised neither by department head physicians and economic people nor by the top management -so we started to develop and purchase local (departmental) LAN-based systems since 1988. I tried to use homogeneous tools (network hardware/software, database formats e.t.c) to make more easy the forthcoming integration though. Presently about 50 PCs (with common user menus) are cabled together across our 250 bed hospital. At the clinical side we started with the admission department, chemical laboratory, pediatry cardiology systems; followed by the ergometry and holter lab system, the heart surgery complex (including intensive care unit and post operation follow up), the animal research department, the cath lab, the cardiomyopathy lab. Then we replaced with own development the chemical lab system, and partly the cath-lab, the pharmacy system followed soon and the new pediatry cardiology system under beta test by now. Our institute was the first in Eastern-Europe to have online connection to US data networks (for heart wall motion analysis study in 1977), and last year we joined the X.25 network in Hungary for cardiology cooperation. At the management side we started with personnel administration and salary (payroll) system, continuing with financial department(general ledger) and equipment & material stock register system. However to use real business principles in the two stage production process of a hospital we need more serious department cost analysis and product line analysis.

For the technical side I’ve selected multiserver Novell 3.1 LAN with Arcnet, MS-DOS 3.2 based desktop stations and palmtops (Poquet) for bedside data collection and decision support. The applications we developed in Clipper and Microsoft C. For medical statistical analysis we developed bigger databases in PC Oracle on local 386 based computers hooked to the network. For the management information system we’ll follow this approach to, probably changing from DOS to UNIX but remaining at the same SQL with graphical user interface as front-end.

As we’ve got at the cath-lab a DSA that real time stores movie sequences of the biting heart on hard disk we’ve started to develop an Ethernet based Micro PACS as part of our HIS. I named it micro because it’ll store preselected cardiac images from DSA sequences, from digitised ultrasound and from gamma camera (SPECT) only, and because it’ll consist of (super) microcomputers only.

For archiving of alphanumerical and image data we try to use a multifunction drive that can handle both WORM (for mandatory long time storage) and magneto optical media (for security backup). Introducing new information law in Hungary and 2Mbyte optical patient cards at admission/dismission departments the archiving/retrieval philosophy should be modified.