Free Short Course: IT & Health Informatics - Module 2
ITMastersCSU
[{'start': '5.340', 'end': '31.079', 'text': "IT Masters: Okay, good evening, everybody. As you file in. Welcome to Week 2 of it, and health informatics. We will, as always, just give it one to 2\xa0min for everybody to come in before we get going on the webinar. Remember to have your chat open and start to say hello to all of us. Set your chat to everyone, not just host and panelists, and tell us where you're from and what your day's been like."}, {'start': '31.220', 'end': '40.170', 'text': "IT Masters: where it is, what it's like in your part of the world today. And we will be right back in literally a minute or 2. Once everybody's in."}, {'start': '47.390', 'end': '52.220', 'text': "IT Masters: Okay, it looks like people are starting to settle down, and everybody's here."}, {'start': '52.390', 'end': '60.669', 'text': 'IT Masters: Lots of people from Sydney and Melbourne tonight, I can see, and from places like Sierra Leone and la So and Brisbane.'}, {'start': '60.830', 'end': '66.170', 'text': 'IT Masters: and it is, I agree, cold in Sydney this evening as it was yesterday. It was very surprising.'}, {'start': '66.310', 'end': '73.060', 'text': "IT Masters: Anyway, my name is Shane Murphy. I am the host and Mc. For this week's session"}, {'start': '73.240', 'end': '78.040', 'text': 'IT Masters: of Module, 2 of it, and health informatics. Welcome tonight.'}, {'start': '78.220', 'end': '87.740', 'text': 'IT Masters: This is, as we said last week, our 1st joint short course held with the College of Health Sciences, who do health management, degrees, postgraduate degrees. Of course'}, {'start': '88.370', 'end': '107.729', 'text': "IT Masters: I'll be your mentor for the next week or 2 as well. Sorry not your mentor, your host. Your mentors, will be Doctors Mohammed, Khalifa, and Vasusud, who are both from Chs, and they will be with us very shortly. In the meantime, though, I will do a bit of housekeeping, and I hope you're all safe and well, and not wet from the rain."}, {'start': '108.490', 'end': '116.369', 'text': "IT Masters: As we know all webinars, for this course will be at 7 o'clock on Sydney time, if you wish, miss, one or more, and I already see some people asking."}, {'start': '116.570', 'end': '130.089', 'text': 'IT Masters: please be advised that they are on both the website, the learn.itmasters.edu website, where you do the short course information and also on our it. Masters Csu website, Youtube Channel.'}, {'start': '131.249', 'end': '158.770', 'text': "IT Masters: You recordings are always there. You can always grab them and do it. It means that gives you a bit of time, but we do encourage everybody to come along to the live sessions because it gives you a chance to ask live questions of our mentors and to participate in the chat. Often we find that it's the people in the chat that have fantastic answers and a lot to contribute to the sessions. So please don't miss those. We do also post the Chat transcripts for that information to be available for everyone."}, {'start': '159.420', 'end': '189.020', 'text': "IT Masters: Obviously we use zoom, and it would be good if you remember to put your chat to everyone. If you've got questions during the presentation for either of our mentors, please pop them in the Q. And A. And I will ask them at the end. We're going to just do questions at the end, because we've got quite a lot to get through this time, and I hope we can chunk through all your questions as we get to the end of the presentations. The doctors will swap back and forth. So Dr. Pursu will"}, {'start': '190.170', 'end': '193.729', 'text': 'IT Masters: present first, st and Mohamed will present the middle section.'}, {'start': '194.366', 'end': '203.839', 'text': "IT Masters: This is, as we said, our 1st joint short course, so it is about health, and it is about it, and we hope you're interested in both in one way or another."}, {'start': '203.980', 'end': '209.949', 'text': "IT Masters: We'd like these courses to be fun as well as informative and useful to your careers."}, {'start': '210.360', 'end': '220.890', 'text': "IT Masters: To date. We've got well, I think we were up around 14, 1,500 people enrolled so far and as always quite a lot come to the sessions and quite a lot view them afterwards."}, {'start': '221.456', 'end': '232.899', 'text': "IT Masters: Kit is here tonight, and as is John as well, they're both here to look after the chat. Say hello to them. They will give you lots of information about the nuts and bolts of what goes on at Itm."}, {'start': '233.060', 'end': '246.220', 'text': 'IT Masters: If you need to find out how to get into the short course, tell people how to enroll all that sort of stuff that information is in the chat. And Kid is there to help you, as is John, who is just doing this for his 1st time?'}, {'start': '246.680', 'end': '256.369', 'text': 'IT Masters: If you need to find out more information about things later on, something that comes up in the chat. You can also email us at shortcourses@itmasters.edu.au'}, {'start': '257.160', 'end': '268.110', 'text': 'IT Masters: one last thing before we get going for those who are keen on it. And Hello, Ian Robertson, who is one of our mentors, by the way, has just Ian presented one of our last short courses.'}, {'start': '268.645', 'end': '280.729', 'text': "IT Masters: For those of you who are interested in it, masters, and potentially going on and doing a higher degree. We are ho hosting an open evening next week. Next Wednesday night at 7 o'clock."}, {'start': '280.780', 'end': '301.360', 'text': "IT Masters: the sign up for it is on the It Masters website. And in those evenings we just encourage you to come in. Have a chat to some of our course advisors. We'll be giving some short presentations from our CEO and from a senior Academic at Charles Sturt University. There'll also be something from a student, we hope, as well."}, {'start': '301.980', 'end': '308.980', 'text': "IT Masters: but should be a fun evening, and it'll give you a chance if you've got some interest in just finding out a little bit more about how we do things."}, {'start': '309.740', 'end': '316.929', 'text': "IT Masters: But anyway, we will talk about that a little bit later, and really that's more than enough for me. Good evening, Vasu. How are you this evening?"}, {'start': '317.220', 'end': '319.819', 'text': "Vasu Sood: Good thanks, Jane. I'm fine."}, {'start': '321.580', 'end': '324.189', 'text': "IT Masters: Excellent. Well, let's let's get cracking."}, {'start': '326.670', 'end': '329.540', 'text': 'Vasu Sood: Thank you. Would like to'}, {'start': '329.900', 'end': '336.020', 'text': "Vasu Sood: call Muhammad Khalifa. Please share the screens presentation. I can't see them at the moment."}, {'start': '336.020', 'end': '338.040', 'text': 'Dr Mohamed Khalifa: Let me share my screen again.'}, {'start': '339.400', 'end': '340.819', 'text': 'Dr Mohamed Khalifa: You see my screen now.'}, {'start': '340.820', 'end': '342.090', 'text': 'Vasu Sood: Yes, yes.'}, {'start': '342.090', 'end': '343.200', 'text': 'Dr Mohamed Khalifa: Hey? Thank you.'}, {'start': '346.070', 'end': '348.309', 'text': 'Vasu Sood: All right, Shane. Shall we start now?'}, {'start': '348.310', 'end': '349.560', 'text': 'IT Masters: Yes, please.'}, {'start': '349.560', 'end': '364.930', 'text': 'Vasu Sood: Thank you. Welcome to Module 2 in this module we are focusing on examples of health informatics, if you remember, or if you were present last week from last module. We were talking about health informatics.'}, {'start': '365.190', 'end': '382.329', 'text': "Vasu Sood: Today we are going to dive deeper into that area and develop a clear understanding of the various types of health information systems used in healthcare domain like last week. Today's module also covers 4 topics"}, {'start': '382.510', 'end': '387.879', 'text': 'Vasu Sood: topic one and 2 are focusing on electronic Health Record'}, {'start': '388.020', 'end': '399.859', 'text': 'Vasu Sood: Topic 3 and 4 are focusing on clinical decision support system and other supportive information system used in healthcare domain.'}, {'start': '400.390', 'end': '410.320', 'text': "Vasu Sood: Let's start with our topic, one that is electronic health record. This is one of the example of health information system"}, {'start': '411.400', 'end': '417.789', 'text': 'Vasu Sood: before we think about electronic health record. If we recall our knowledge from last week'}, {'start': '417.920', 'end': '430.230', 'text': 'Vasu Sood: we have understood how technology is revolutionizing all aspects in healthcare, what benefits and drawbacks it can bring in healthcare domain.'}, {'start': '430.960', 'end': '441.680', 'text': 'Vasu Sood: For example, health information, technology allow easy access to patient information, improving diagnosis and treatment as well as better decision making'}, {'start': '442.020', 'end': '458.309', 'text': 'Vasu Sood: moving further, if we look at the challenges, we have understood various challenges last week. One of the key challenge which we have not discussed last week is lack of collaboration between it experts and clinicians'}, {'start': '458.650', 'end': '464.920', 'text': "Vasu Sood: who often in isolation work. They don't work work jointly."}, {'start': '465.710', 'end': '477.149', 'text': "Vasu Sood: So what problem it can bring when it professionals and clinicians work in silos, they may fail to understand each other's needs"}, {'start': '477.330', 'end': '485.850', 'text': 'Vasu Sood: resulting in systems that are not user friendly or do not meet clinicians, requirements'}, {'start': '486.040', 'end': '493.820', 'text': 'Vasu Sood: which may further bring the problem of poor adoption or increased operational cost.'}, {'start': '494.160', 'end': '520.320', 'text': 'Vasu Sood: Till now we have made understanding about various technologies used in health domain and their benefits as well as drawback from the next slide. We are going to understand much more elaborated definition about electronic health record, which is, as I mentioned earlier, is one of the example of health information technology used in health domain.'}, {'start': '520.520', 'end': '540.619', 'text': 'Vasu Sood: If we can move to electronic Health Record slide, this slide indicate the definition coming from Us Department and Hl, 7 standard. So from this definition we can extract, 4 features of electronic health record.'}, {'start': '540.620', 'end': '557.320', 'text': 'Vasu Sood: For example, it says, electronic health record and electronic record of health related information. This means electronic health record keep health related information of an individual in digital format.'}, {'start': '558.350', 'end': '568.419', 'text': 'Vasu Sood: Its scope is nationwide and it allow it allows interoperability standards. We have discussed about these standards last week.'}, {'start': '568.620', 'end': '572.770', 'text': 'Vasu Sood: Another feature we can extract from this definition is'}, {'start': '572.930', 'end': '589.999', 'text': 'Vasu Sood: that the data access or the information which is available in electronic health record, only authorized person can have access for those information. This mean, the data is secure and safe.'}, {'start': '590.500', 'end': '611.159', 'text': "Vasu Sood: If we understand the complete definition or the complete meaning of electronic health record from this definition from Us Department and Hl, 7 standard. This means an electronic health record is a digital version of an individual's health related information."}, {'start': '611.340', 'end': '628.790', 'text': 'Vasu Sood: It is designed to be shared across different healthcare settings nationwide, so its scope is throughout the nation. Following recognized interoperability standards. This means the system should be talking with each other'}, {'start': '628.940', 'end': '640.950', 'text': 'Vasu Sood: as well as access to electronic health record is restricted to only authorized healthcare, professional, which ensures data, privacy and security.'}, {'start': '641.850', 'end': '662.310', 'text': 'Vasu Sood: If we think about the future of electronic health record. The future of electronic health record is bright where we are heading. Further in electronic health record, we are looking to centralize personalize medication.'}, {'start': '663.420', 'end': '676.619', 'text': "Vasu Sood: provide the personalized care to the patient. This means electronic health record will serve as a comprehensive digital repository of a patient's medical record."}, {'start': '676.670', 'end': '691.279', 'text': 'Vasu Sood: their lifestyle factor, their genetic information and real-time health data collected through wearable devices and through remote monitoring tools or devices. So'}, {'start': '691.280', 'end': '707.480', 'text': 'Vasu Sood: future electronic health record will be bringing the features of predictive analytics which are where we are heading in electronic health record in the future.'}, {'start': '708.030', 'end': '717.599', 'text': 'Vasu Sood: moving further and understanding various components of electronic health record. If we look at this diagram'}, {'start': '719.146', 'end': '728.480', 'text': 'Vasu Sood: it has provided so many components if we count them. There are 11 components mentioned here. So basically we can'}, {'start': '728.480', 'end': '752.679', 'text': 'Vasu Sood: see that the major component in electronic health record. If we think from front end and back end perspective, we can say there are 2 major things in electronic health record in the front end. That is the user interface where we can see all the information patient record we can enter patient record. We can see the reports at.'}, {'start': '752.680', 'end': '766.590', 'text': 'Vasu Sood: but the back end is the database where from where those results are coming, they are coming from the database, for example, they may be coming from master patient index. They may be coming from'}, {'start': '766.590', 'end': '792.009', 'text': 'Vasu Sood: repository. They may be coming from data dictionary or knowledge base. Dr. Muhammad Khalifa will be taking you through each of these component in topic 2. So basically, if we look at this diagram, if we think from front end and back end perspective, we can say that in front end we have application user interface, we say. And in backend we have database'}, {'start': '792.790', 'end': '813.350', 'text': 'Vasu Sood: plus, we can say we have 3rd component in electronic health record. That is interface engine. Now, what interface engine does, for example, if a laboratory information system is generating a patient test in one format.'}, {'start': '813.670', 'end': '832.689', 'text': 'Vasu Sood: and the electronic health record is expecting those results in another format. So the interface engine can work as a middleman, it will convert the format of the test result before transmitting it to the electronic health record.'}, {'start': '832.780', 'end': '844.310', 'text': 'Vasu Sood: Another component. Here we can see our ancillary department system. So other supportive information system which may be useful.'}, {'start': '844.940', 'end': '866.189', 'text': 'Vasu Sood: they are integrated with electronic health record or some of them are already integrated with electronic health record. Moving further, trying to understand the capabilities of electronic health record. There are 8 capabilities of electronic health record if we can move to the next slide'}, {'start': '867.280', 'end': '871.560', 'text': 'Vasu Sood: and the next one please.'}, {'start': '873.730', 'end': '889.820', 'text': 'Vasu Sood: So we have a capability core capability of electronic health record. For example, we can say the functions or the features of electronic health record. One of them is health information and data.'}, {'start': '889.820', 'end': '905.830', 'text': 'Vasu Sood: So we all understand by now that this is one of the core function of electronic health Record. Any health information system which is used to capture store and manage'}, {'start': '905.830', 'end': '921.679', 'text': 'Vasu Sood: data here in electronic health record. We are talking about patient data which may include patient demographics, their medical history, their allergies, medication. They are on, etc.'}, {'start': '922.470', 'end': '929.119', 'text': 'Vasu Sood: Another core function of electronic health record is result management.'}, {'start': '929.220', 'end': '939.989', 'text': 'Vasu Sood: This function enable the secure storage and retrieval of various results. Those results may be laboratory, test'}, {'start': '940.140', 'end': '945.730', 'text': 'Vasu Sood: or radiology report, or any other diagnostic findings'}, {'start': '945.840', 'end': '955.019', 'text': 'Vasu Sood: moving further, if we look at the 3rd function or core function of electronic health record, that is order, entry management.'}, {'start': '956.150', 'end': '986.060', 'text': 'Vasu Sood: electronic health record facilitate the electronic ordering and management of various kinds of medical services as well as medications. Electronic health Record can also help us if we look at the 4th core function can also help healthcare professional to make much more better decision. So they can also help as a decision support system.'}, {'start': '986.490', 'end': '1001.069', 'text': 'Vasu Sood: This may include alerts, reminders, and guidelines based on evidence, best practices moving further to the next core function of electronic health record is'}, {'start': '1001.100', 'end': '1022.629', 'text': 'Vasu Sood: efficient and secure communication. It can help healthcare professional healthcare provider and the patient to have secure communication with each other. This may include electronic messaging, sharing the files, sharing the results, appointment reminders, etcetera.'}, {'start': '1023.640', 'end': '1030.309', 'text': 'Vasu Sood: If we move further, electronic health record can also support patient.'}, {'start': '1031.420', 'end': '1058.349', 'text': 'Vasu Sood: This function provides tools in electronic health record that empower patients to actively participate in their care, including online portal for accessing their record or scheduling appointment and communicating with the healthcare Provider. Moving further the 7th core function of electronic health record is administrative processes.'}, {'start': '1058.350', 'end': '1073.969', 'text': 'Vasu Sood: so it can help including all the patient information sharing the result. It can also help administrative staff to with the billing insurance, verification, patient registration, etcetera.'}, {'start': '1074.080', 'end': '1100.379', 'text': 'Vasu Sood: The last core and major function of electronic health record is reporting and population health management. So electronic health records facilitate the generation of report and data analysis which can enable healthcare provider to track the trend, it can identify the area of improvement and manage patient population.'}, {'start': '1101.290', 'end': '1114.889', 'text': 'Vasu Sood: Moving further, these are the core 8 functions of electronic health record. Now, sometime, you may have heard the term of electronic health record and electronic medical record'}, {'start': '1116.098', 'end': '1122.351', 'text': 'Vasu Sood: electronic Health record is a term often used interchangeably with electronic'}, {'start': '1123.400', 'end': '1132.569', 'text': 'Vasu Sood: medical record. However, there are some key differences between electronic health record and electronic medical record.'}, {'start': '1133.150', 'end': '1158.629', 'text': "Vasu Sood: An electronic medical record specifically refers to the digitized version of patient's paper chart used within a single clinician office clinic, or in the hospital. It may contain notes, medical histories, and information collected by and for health care provider in that specific setting."}, {'start': '1158.900', 'end': '1172.159', 'text': 'Vasu Sood: So if we think about electronic medical record electron or electronic health record, for example, we are working in a health facility. We are working in 2 health facilities.'}, {'start': '1173.150', 'end': '1191.370', 'text': 'Vasu Sood: If those health facilities are using electronic medical record, then, for example, for 1st 2 days, Monday, Tuesday, you worked in one health facility, and you have a patient visiting you. You kept record of that patient in that health facility.'}, {'start': '1191.390', 'end': '1215.100', 'text': "Vasu Sood: Then Wednesday, Thursday, and Friday, you worked in another health facility which is in a different location. And that same patient visiting you in another health facility. If those 2 health facilities will be using electronic medical record, then you won't be able to access the record which you have entered in 1st"}, {'start': '1215.120', 'end': '1230.720', 'text': 'Vasu Sood: facilities. So that is the difference between electronic health record and medical, whereas if the organization will be using electronic health record, the patient result will be accessible because it has nationwide access'}, {'start': '1231.620', 'end': '1260.169', 'text': 'Vasu Sood: moving further, almost finishing the topic. What is happening with technology adoption. Biggest contributor for adopting these health information technology here in Australia as well as globally, the biggest contributor are increased Internet access and various kinds of Internet of the things. If we look at this chart.'}, {'start': '1260.631', 'end': '1274.930', 'text': "Vasu Sood: maybe it's just conveying the information until 2,005. But according to United States Census Bureau, the latest report, I think it is maybe 2021 or 22,"}, {'start': '1274.930', 'end': '1294.239', 'text': 'Vasu Sood: which says over 90% of us households have Internet access. If we talk about Australia, according to Australian Bureau of Statistics in Australia, technology adoption among household has also experienced significant growth.'}, {'start': '1294.710', 'end': '1302.319', 'text': 'Vasu Sood: we think about what is the major contributor. These are some of the contributor. We can also think about'}, {'start': '1302.350', 'end': '1325.679', 'text': 'Vasu Sood: the COVID-19 pandemic which has acted as a catalyst for technological change in the healthcare industry. So the widespread adoption of Internet of things and the Internet, as well as COVID-19 pandemic has laid a strong foundation for expansion of'}, {'start': '1325.900', 'end': '1347.869', 'text': 'Vasu Sood: health information, technology or digital health services and other technology driven innovations in healthcare. With this I will finish my topic here and will hand over to Dr. Muhammad Khalifa to take you through the various components of electronic health records and clinical disease and support system. Thank you.'}, {'start': '1348.520', 'end': '1362.630', 'text': 'Dr Mohamed Khalifa: Thank you very much. Razul. This was a very interesting presentation and introduction for electronic health records. So now I will go through the different models and components of electronic health records that we have'}, {'start': '1362.670', 'end': '1386.270', 'text': 'Dr Mohamed Khalifa: and based on the definitions that we have in research. The clinical Data Repository is an aggregation of granular, patient centric health data usually collected from multiple sources, it systems. And it represents the core or the foundation for electronic health records. So data is very critical for electronic health records and must be'}, {'start': '1386.280', 'end': '1394.829', 'text': 'Dr Mohamed Khalifa: valid and must be reliable as well, and must be protected from unauthorized access or leakage.'}, {'start': '1394.990', 'end': '1402.560', 'text': 'Dr Mohamed Khalifa: This is why privacy confidentiality and security are very important topics in the area of electronic health records.'}, {'start': '1402.910', 'end': '1416.389', 'text': 'Dr Mohamed Khalifa: When we look at the different models of electronic health records or clinical data repositories, we will find that we have 2 main types and one of them, and the 3rd one, which is the hybrid.'}, {'start': '1416.390', 'end': '1438.679', 'text': 'Dr Mohamed Khalifa: The 1st type is the centralized model where we have everything consolidated under one system, and every end user is connecting to that centralized model through a terminal computer. So you can imagine that there is like a big server, and all end users are connecting to that big server'}, {'start': '1439.533', 'end': '1457.220', 'text': 'Dr Mohamed Khalifa: the decentralized model means that parts of the system could be, 50% could be. 70% of the system is installed already on the computers of the end users, not just on a mains. server'}, {'start': '1457.611', 'end': '1475.600', 'text': 'Dr Mohamed Khalifa: the main server could be the source for the data, for the, for the database for the back end. But the front end and part of the data is stored distributedly on or decentralized model on different end user computers and terminals.'}, {'start': '1475.630', 'end': '1493.860', 'text': 'Dr Mohamed Khalifa: Now, what is the advantages or disadvantages of these 2 different models, the centralized and the decent centralized or the distributed. The centralized model has the advantage that you can update everything one time in one place'}, {'start': '1494.010', 'end': '1513.460', 'text': "Dr Mohamed Khalifa: and then every end user connect to that big server. Then they will get the new updated system running. They don't need to update anything from their end. As if you are viewing, for example, a website. So your browser has nothing to do with the content of the website. You can"}, {'start': '1513.460', 'end': '1528.889', 'text': 'Dr Mohamed Khalifa: update the website anytime and then, instantly any end user connecting to that server or website, for example, will see the new updated version, the new colors, the new downloaded applications, the new buttons, everything'}, {'start': '1529.140', 'end': '1546.590', 'text': 'Dr Mohamed Khalifa: now the the disadvantage is that this makes the data at risk. If this server failed, or if the connection failed between the end user and the system, the end users are not keeping anything at their end.'}, {'start': '1546.840', 'end': '1551.189', 'text': 'Dr Mohamed Khalifa: Now the the distributed model has a very good advantage. Is that'}, {'start': '1551.300', 'end': '1565.609', 'text': 'Dr Mohamed Khalifa: even if the central server was down or was hacked, or anything happened, you still have a copy or major part of the system and the data on your end.'}, {'start': '1566.455', 'end': '1586.450', 'text': "Dr Mohamed Khalifa: Let's say, terminal computer. But the problem is that when we try to update the system. You need to download the updates on every single machine that is connecting to that central server or to that system, because the system itself is distributed and decentralized."}, {'start': '1586.490', 'end': '1608.099', 'text': 'Dr Mohamed Khalifa: and there is a 3rd model, as we mentioned, which is the hybrid model, which is a mixture of these 2 models together. But the 2 concepts stay existing nowadays until today, we find them differently used by different applications and different systems. So these are the 2 main models, the centralized and the decentralized.'}, {'start': '1608.270', 'end': '1632.919', 'text': 'Dr Mohamed Khalifa: Now, when we look at the systems like electronic health records, including clinical data repositories, we will find that these are of 2 main types. Also, one of them is the encounter or the episodic, which means that every time the patient comes and visits our hospital, our clinic, our medical center lab center radiology department, radiology center'}, {'start': '1633.270', 'end': '1661.300', 'text': 'Dr Mohamed Khalifa: anywhere, there is a new encounter created and link it to the patient information. So we have each encounter separate, even if it is the same patient visiting again and again. But we still can. Of course, we can link these encounters together. So we know that this patient, for example, came to the emergency department 8 times during 2024, 10 times during 2023. So we have the data, and we can aggregate the data together.'}, {'start': '1661.480', 'end': '1676.880', 'text': 'Dr Mohamed Khalifa: Now, the longitudinal based record, on the other hand, stores the data across all encounters, and sometimes turned from cradle to grave or worm to tomb, which means from start to end, including everything from birth until death of an individual.'}, {'start': '1676.990', 'end': '1700.279', 'text': 'Dr Mohamed Khalifa: And this actually applies more to. As we mentioned, maybe last week. It applies more to the electronic medical records that are implemented in smaller population countries. In Scandinavia, for example, like Sweden and Norway, not like Canada or Australia, Uk or the Us. Because of the difference in the number of populations and people.'}, {'start': '1700.330', 'end': '1725.239', 'text': 'Dr Mohamed Khalifa: and the difference also in the level of adoption in electronic medical records. So these are the main 2 models. And, by the way, the encounter or episodic model is more prevalent among vendors, companies selling electronic health records. So the usual thing that you will see is that every visit to the hospital, every admission to the hospital, every visit to the emergency department.'}, {'start': '1725.240', 'end': '1733.060', 'text': 'Dr Mohamed Khalifa: is considered one encounter, but is identified definitely by the patient information and identifiable'}, {'start': '1733.060', 'end': '1737.250', 'text': 'Dr Mohamed Khalifa: data like date of birth, medical id number, and so on.'}, {'start': '1738.190', 'end': '1760.530', 'text': 'Dr Mohamed Khalifa: Now, the most important part of the electronic medical record or electronic health Record, as we mentioned, is the Master Index. This master person or patient index, and it keeps the information that does not do not change over time, such as date of birth or mobile phone number or license number, driver license'}, {'start': '1760.550', 'end': '1778.590', 'text': 'Dr Mohamed Khalifa: could be social security number in the United States could be address phone number, and so on. So this information stays the same unless the patient changes their address, for example. But they will never change their date of birth'}, {'start': '1778.620', 'end': '1792.750', 'text': 'Dr Mohamed Khalifa: or Medicare number, for example, that will not be changed. So we use the Mpi. Or the master patient index to link different episodes together to link different parts of the system together.'}, {'start': '1793.150', 'end': '1805.110', 'text': 'Dr Mohamed Khalifa: Now, when we look to other electronic health record components, we find that clinical applications can provide the user with views of the electronic health records for the clinicians to work'}, {'start': '1805.110', 'end': '1824.379', 'text': 'Dr Mohamed Khalifa: so these could include, as Vasu mentioned, could include, order. Entry could include results. Management could include placing, for example, a request for scheduling operations, scheduling radiology, investigations, lab tests, and so on.'}, {'start': '1824.590', 'end': '1854.239', 'text': 'Dr Mohamed Khalifa: They also can use review and reporting, which is one of the most widely used functions in hospitals, and this can summarize a different range of information and data across all patients or across a specific department or a specific, for example, service, so that we can, for example, generate the average waiting time in the emergency department. How many patients on average are waiting in the emergency department. What is their'}, {'start': '1854.240', 'end': '1865.749', 'text': 'Dr Mohamed Khalifa: turnaround time of radiology tests, for example, reports, lab tests, and so on. So all of that falls under the review and reporting'}, {'start': '1866.396', 'end': '1879.989', 'text': 'Dr Mohamed Khalifa: data collection is also another type of electronic health record components where we can use automated systems such as smartphone apps, smart watches.'}, {'start': '1879.990', 'end': '1898.819', 'text': 'Dr Mohamed Khalifa: or even those systems that are used in the triage area where vital signs are collected and registered to the system as part of the data collection. In addition also to patient management, including, as we mentioned, ordering and care, planning, and other clinical tasks that we can use'}, {'start': '1899.240', 'end': '1907.769', 'text': 'Dr Mohamed Khalifa: when we say clinical productivity, we are discussing more about displaying information in a more actionable'}, {'start': '1907.800', 'end': '1926.780', 'text': 'Dr Mohamed Khalifa: style. Like, for example, using dashboards, dashboards is more like a speedometers showing colors, showing delays in emergency departments, delays in admission to the inpatient departments'}, {'start': '1927.133', 'end': '1956.509', 'text': 'Dr Mohamed Khalifa: showing how many beds are available in the hospital for admission, showing how many for example, operating rooms are working and how many are still vacant, or ready for the next patient, and so on. So these dashboards provides more operational day to day, minute to minute, could be live or near live display of information. So that helps a lot in clinical productivity and improving the flow of patients from one service to the to the to the next'}, {'start': '1957.310', 'end': '1984.209', 'text': 'Dr Mohamed Khalifa: data. Dictionaries are key components as well of electronic health records and contain medical vocabulary and terms that we can use, including coding systems such as Icd, 9, icd-ten, snomed and other coding systems for diagnoses, for diseases, for procedures, for medications, and so on. The knowledge based usually is a storage of knowledge. Medical knowledge could be in the form of evidence-based'}, {'start': '1984.270', 'end': '1996.420', 'text': 'Dr Mohamed Khalifa: guidelines, clinical guidelines, publications, textbooks, and so on. And then the clinical decision support which we will discuss today in more details in topic. In the 3rd topic.'}, {'start': '1997.160', 'end': '2006.980', 'text': 'Dr Mohamed Khalifa: Now, interoperability, as we mentioned, is one of the major components or foundations that we need to make systems work together.'}, {'start': '2007.100', 'end': '2021.309', 'text': 'Dr Mohamed Khalifa: So why do we need interoperability? Because different systems come from different vendors come from different companies developed could be by different technologies. And then we need all of these systems like electronic medical records.'}, {'start': '2021.310', 'end': '2050.209', 'text': 'Dr Mohamed Khalifa: with lab systems, with radiology systems with admission and discharge with reporting, with databases, with back end with data warehousing solutions. We need all of these systems to work together. So we need interoperability, interoperability. We need data exchange to be standardized. So when we send or receive information from one system to the other. We can understand each other'}, {'start': '2050.350', 'end': '2076.089', 'text': "Dr Mohamed Khalifa: just like when you send a text message from your mobile phone. We don't. Look if this mobile phone is apple or or Android or Samsung, the the same message will go through different vendors through different technologies, because we are using a kind of interoperability and standards. So the same thing applies, but so much more sophisticated for electronic health records."}, {'start': '2076.199', 'end': '2092.390', 'text': 'Dr Mohamed Khalifa: Now, Hl, 7 or health level 7 is one of these internationally acknowledged standards to transfer, send, and receive clinical and administrative data between different software applications coming from different vendors.'}, {'start': '2092.510', 'end': '2108.599', 'text': 'Dr Mohamed Khalifa: We also have a lot of other standards like the Iso, the international organization for standardization. They also provide different types of standards. So Hl, 7 is one of these standards that we you will be dealing with when you work in the implementation'}, {'start': '2108.990', 'end': '2117.240', 'text': 'Dr Mohamed Khalifa: of electronic health records or the integration of these systems with other systems existing systems.'}, {'start': '2117.510', 'end': '2146.230', 'text': 'Dr Mohamed Khalifa: Now, when we look at Hl. 7, for example, you will find at least 7 sections, including primary standards, foundational standards, clinical domains, implementation guides, rules, and so on. So these sections standardize the definition, standardize the format of each type of information and data so that we can exchange these different types of information among different types of systems.'}, {'start': '2146.470', 'end': '2161.769', 'text': 'Dr Mohamed Khalifa: Now, again, clinical decision support, we will come to that in topic 3, simply, these systems provide clinicians, staff and even patients and other individuals with the required knowledge and information that they might need to make'}, {'start': '2161.900', 'end': '2176.129', 'text': 'Dr Mohamed Khalifa: clinical decisions. Now, most of the decisions are either in the area, or in the phase of diagnosis, or in the phase of treatment or management of the case, and we will come to that very shortly.'}, {'start': '2176.730', 'end': '2200.780', 'text': 'Dr Mohamed Khalifa: So the main 5 rights for Cds, which we will discuss later today very shortly, is to provide the right information to the right users in the right format through the right channels and at the right times, so that we can make key decisions or actions accurately and efficiently.'}, {'start': '2202.070', 'end': '2226.340', 'text': 'Dr Mohamed Khalifa: Now, what are the benefits of electronic health records as Vasu discussed today in the 1st topic, Ehr or Emr, they have very good comprehensive view of the patient and the data so that providers can have all the data in one context, and they can navigate from one component to the other easily. Even if these components or data types are coming from different systems.'}, {'start': '2226.500', 'end': '2254.169', 'text': 'Dr Mohamed Khalifa: we can achieve better coordination of care between different services and different disciplines of care. We can share information. We can streamline workflows and the flow of patients from one service to the other without delays as much as we can. We have the power of data because we can work on indicators, kpis and and different types of determinants of performance.'}, {'start': '2254.180', 'end': '2263.720', 'text': 'Dr Mohamed Khalifa: including improving efficiency and cost effectiveness plus reducing human errors because we have better communication and better accuracy.'}, {'start': '2263.970', 'end': '2286.980', 'text': 'Dr Mohamed Khalifa: Now, sometimes we focus more on nurses and electronic health records because nurses represent almost 60 to 65% of the healthcare workforce, and they are among the highest users or the most users using health information systems. So we need to do more training for the nurses and also for the doctors, so that they come to the healthcare systems'}, {'start': '2287.300', 'end': '2297.890', 'text': 'Dr Mohamed Khalifa: while they have the sufficient training, at least on the basic or generic tasks. And then they can have more specific training on the commercial or the vendor side of the system.'}, {'start': '2299.110', 'end': '2309.020', 'text': 'Dr Mohamed Khalifa: Now we come to the 3rd topic of today, which is about clinical decision support. And then, after I finish that, I will leave you with Vaso to cover the 4th topic.'}, {'start': '2309.300', 'end': '2317.469', 'text': 'Dr Mohamed Khalifa: Now, clinical decision support. We always hear about clinical decision support and clinical decision support systems. Cds or Cdss.'}, {'start': '2317.700', 'end': '2342.490', 'text': 'Dr Mohamed Khalifa: so clinical decision support is one of the key components in healthcare. It is very related to the Electronic Health record and could be part of the electronic health record. It is responsible, as we mentioned, about providing right information to the right person at the right time in the right format and in the right channel and location, so that Cds can provide the clinicians with information'}, {'start': '2342.760', 'end': '2359.710', 'text': 'Dr Mohamed Khalifa: at the point where they do diagnose the conditions, or at the point where they do manage or add treatment or lab tests, or request for investigations or radiology, or view their reports and results.'}, {'start': '2359.870', 'end': '2375.109', 'text': 'Dr Mohamed Khalifa: So we can find that systems could generate computerized alerts and reminders for care. They could provide us with clinical guidelines. They can provide the users as well, including the doctors with condition specific order sets.'}, {'start': '2375.140', 'end': '2399.829', 'text': 'Dr Mohamed Khalifa: So, for example, if you have a diabetic patient, then the system automatically after you place diabetes. Type one or diabetes. Type 2 as a diagnosis. Then it will show you as an end user all the detailed order sets to investigate diabetes such as random blood, glucose levels, hemoglobin a. 1 c tests and other tests that could include radiology as well.'}, {'start': '2399.850', 'end': '2409.040', 'text': 'Dr Mohamed Khalifa: Examining the eyes for the retina to make sure that no complications are affecting the eye or the kidney, and so on, and so on.'}, {'start': '2409.140', 'end': '2419.329', 'text': 'Dr Mohamed Khalifa: So these also help to remind the doctors and the nurses about what specific orders they should do in light of this diagnosis.'}, {'start': '2419.470', 'end': '2449.029', 'text': 'Dr Mohamed Khalifa: They also can provide focused patient data and reports and summaries. They can provide templates for reports, diagnostic tools and support and contextual relevant reference information connecting the end user to the textbook to a very recent guideline, the updated clinical guideline by the government, a new published paper studies, and so on. So all of these are different forms of clinical decision support.'}, {'start': '2449.920', 'end': '2456.140', 'text': 'Dr Mohamed Khalifa: Now, we can also have systems that can directly interact with users'}, {'start': '2456.290', 'end': '2483.280', 'text': 'Dr Mohamed Khalifa: or passively interact with users directly or positively interacting with users. They can stop the users, they can provide alerts, they can provide warnings and messages that can interrupt the workflow. To stop, for example, the doctor from prescribing a drug that interacts with the condition of the patient or interact with other medications like drug to drug interactions.'}, {'start': '2483.570', 'end': '2499.489', 'text': 'Dr Mohamed Khalifa: The system could also be passive, for example, providing critique or reports on the different levels of validity and accuracy of what the doctors and the nurses did so that they can learn from after they provide care.'}, {'start': '2499.550', 'end': '2519.179', 'text': 'Dr Mohamed Khalifa: Usually most of the systems have the 2 types of these interactions, the active ones and the passive ones. The system can also suggest ideas, suggest other lab tests, suggest related lab tests. And then the end user makes the final decision about following this advice or not. Following this advice.'}, {'start': '2519.250', 'end': '2547.670', 'text': 'Dr Mohamed Khalifa: the systems can also provide medication dosing based on body weight based on date of birth and age and facilitate the orders. Point of care. Alerts and reminders could display expert views, workflow support, telling you that this patient need to be scheduled for surgery, and then you need to do these lab tests before surgery at least 24\xa0h. And these lab tests. Some of them needs the patient to be fasting, and so on.'}, {'start': '2547.850', 'end': '2569.990', 'text': 'Dr Mohamed Khalifa: So all of these are different functions that clinical decision support systems can do. And here we can see a screenshot of a similar system that we call Cpoe stands for computerized physician or provider order entry, which refers to the process of providing support during the entry of an order.'}, {'start': '2570.120', 'end': '2592.099', 'text': 'Dr Mohamed Khalifa: An order, as I mentioned, could be a lab tests. An order could be, prescription of a medication could be a radiology. Investigation could be scheduling for surgery, scheduling for admission, discharge, and so on. So from that screen you can see that the system can provide alerts can provide support, shortlisting of lab tests, and so on.'}, {'start': '2592.250', 'end': '2615.330', 'text': 'Dr Mohamed Khalifa: Similarly, we can do for medication prescription. We can support the end users by dosing, reminding the doctors about how frequent this antibiotic, for example, should be prescribed. If this dose is good for adult patients, if the dose needs to be adjusted for children based on body weight, and so on. If there is any drug to drug interaction, and so on.'}, {'start': '2615.810', 'end': '2629.370', 'text': 'Dr Mohamed Khalifa: and then care reminders and their examples, including reminders for investigations that could be frequently done like hemoglobin a 1 c. Every 12 weeks or 3 months.'}, {'start': '2629.370', 'end': '2648.940', 'text': 'Dr Mohamed Khalifa: doing complete blood. Count every week, for example, monitoring blood, iron before blood, transfusion, and after blood transfusion. So these are called care reminder examples and sample of these care reminders.'}, {'start': '2649.700', 'end': '2669.780', 'text': 'Dr Mohamed Khalifa: Chronic disease management is another also another component that can be developed. So we can monitor. And we can manage chronic conditions, and from that application nowadays we have more smartphone apps that can be implemented and run on. Your smartphone'}, {'start': '2669.780', 'end': '2680.070', 'text': 'Dr Mohamed Khalifa: to help the end users or patients at home to control their diabetes or to control their heart condition or to control their hypertension.'}, {'start': '2680.070', 'end': '2691.830', 'text': 'Dr Mohamed Khalifa: They keep the readings there. Any abnormal reading is flagged, and these readings are sent to the hospital to the Gp. And through that we can achieve better chronic disease management.'}, {'start': '2691.830', 'end': '2712.629', 'text': "Dr Mohamed Khalifa: Do we have still challenges and barriers. Yes, definitely, because we have lack of incentives to adopt technologies and new technologies. And sometimes these incentives are usually in the form of financial incentives. We don't have clear return on investment to implement the most recent technology or to replace a system that is"}, {'start': '2712.720', 'end': '2732.590', 'text': 'Dr Mohamed Khalifa: currently working. For example, for 7 years or 10 years. Why do we need to change that with the most recent? What are the advantages? What are the cost, effectiveness, or return on investment? We have also implementation challenges. For example, technology challenges, training challenges.'}, {'start': '2733.030', 'end': '2734.659', 'text': 'Dr Mohamed Khalifa: time and money'}, {'start': '2734.950', 'end': '2754.449', 'text': 'Dr Mohamed Khalifa: dedication of healthcare professionals and so on. Sometimes we also have low electronic health record adoption. In certain countries, therefore, public hospitals, hospitals, there will not be adopting these sophisticated or expensive electronic health records.'}, {'start': '2754.680', 'end': '2780.880', 'text': 'Dr Mohamed Khalifa: multiple data sources, little integration, less interoperability could be among the challenges. Lack of adequate clinical decision support systems and capabilities in most of electronic health records, especially for the interaction between the medications and the clinical conditions drug to drug interactions are easily identified. But drug to conditions is not easy to identify.'}, {'start': '2780.880', 'end': '2790.180', 'text': "Dr Mohamed Khalifa: Some doctors perceive the clinical decision support systems as a cookbook medicine. It's a standard that represents the least"}, {'start': '2790.220', 'end': '2791.449', 'text': 'Dr Mohamed Khalifa: or the minimum'}, {'start': '2791.500', 'end': '2813.039', 'text': "Dr Mohamed Khalifa: of the doctor's performance. So why, if I'm a senior consultant, why should I follow the very naive, very simple, very basic advice that the system is providing to me. This is just like a resident or a junior doctor suggesting something to a senior consultant. So this is another perception that could be part of the challenge."}, {'start': '2813.200', 'end': '2825.159', 'text': 'Dr Mohamed Khalifa: On the positive side we still have evidence for effectiveness. Some good case studies where clinical decision support systems saved lives and evidence for financial impact on the long term.'}, {'start': '2825.670', 'end': '2833.470', 'text': 'Dr Mohamed Khalifa: the most important commandments and advice to get these clinical decision support systems effective and acceptable.'}, {'start': '2833.630', 'end': '2844.489', 'text': 'Dr Mohamed Khalifa: We have to consider speed, because if the system is slow, nobody will like to use it. We have to anticipate the needs of the end users. We have to fit into the workflow.'}, {'start': '2844.550', 'end': '2863.749', 'text': "Dr Mohamed Khalifa: We we don't, we don't. We should avoid always to interrupt the workflow, to stop the doctors and ask them to go to the other room, to go to the next doctor, to go to the next system, to open a different system, to open a different screen. It has all to be integrated in one workflow. Little things can make big differences in terms of usability."}, {'start': '2864.000', 'end': '2888.869', 'text': "Dr Mohamed Khalifa: Usually doctors resist stopping changing direction is better than stopping. Simple interventions work better than complex interventions. Ask for information only when you need it. Don't provide end users with too much information that they don't ask for monitor impact and get feedback and then manage the knowledge base so that we can maintain the system."}, {'start': '2889.350', 'end': '2908.579', 'text': 'Dr Mohamed Khalifa: So these are the main advices. And and again, the challenges. As we mentioned, we need to improve the computer human computer interaction and interface usability, summarizing the level of information prioritizing recommendations to the users.'}, {'start': '2908.580', 'end': '2920.490', 'text': "Dr Mohamed Khalifa: For example, if you have 10 recommendations, don't provide the users with the 10 recommendations, you can provide them with the most important, most critical 2 or 3 of these recommendations."}, {'start': '2920.570', 'end': '2931.279', 'text': 'Dr Mohamed Khalifa: and then we need to create new clinical decision support interventions that match the workflow and do not interrupt the end users. As we mentioned.'}, {'start': '2931.880', 'end': '2938.089', 'text': 'Dr Mohamed Khalifa: Now, I will leave you for the last topic. Supportive information systems with Dr. Faso Surd.'}, {'start': '2939.080', 'end': '2943.820', 'text': "Vasu Sood: Thank you, Dr. Mohammad. Let's move forward with supportive information system."}, {'start': '2944.744', 'end': '2966.990', 'text': 'Vasu Sood: There are many supportive information systems within the healthcare designed to facilitate the delivery of healthcare domain. These are financial systems, practice management system supply chain management, material management, human resource management system, etcetera.'}, {'start': '2967.530', 'end': '2984.410', 'text': "Vasu Sood: Let's have a look at financial information system. Financial information system are basically used in healthcare for managing and optimizing the financial operations of the healthcare institution."}, {'start': '2984.710', 'end': '2989.679', 'text': 'Vasu Sood: A a hospital may use a financial information system'}, {'start': '2989.780', 'end': '3012.200', 'text': 'Vasu Sood: to track patient billing or insurance claim. They may be using financial information system for forecasting budgets. Budget needs for the next year for next fiscal year, or maybe using this system to comply with national health financial regulation.'}, {'start': '3012.580', 'end': '3034.220', 'text': 'Vasu Sood: For example, Cerner is a global health it company that provide financial information system to healthcare organization here in Australia, their solutions focus on streamlining financial processes and improving efficiency in managing hospital and clinical finances. Moving further.'}, {'start': '3035.060', 'end': '3043.320', 'text': 'Vasu Sood: what value financial information system can bring. As I mentioned earlier, they may help healthcare organization'}, {'start': '3043.390', 'end': '3068.640', 'text': 'Vasu Sood: to to manage the cash flow, cash flow. They may be helpful in cash, flow management, or maybe helping healthcare organization in investment of excess fund excess funds, or maybe helping organization for profitability analysis. For example, this system can evaluate the performance of customers, products.'}, {'start': '3068.880', 'end': '3084.289', 'text': 'Vasu Sood: services and departments to determine the most and the least profitable areas. So the future strategies can be designed around those products or services.'}, {'start': '3084.620', 'end': '3108.299', 'text': 'Vasu Sood: Financial information system may also help to identify operational bottlenecks. These systems can detect areas where resources, resource constraints or inefficiencies may hinder financial or operational performance. They may also help in dividend distribution, planning as well as debt, capacity, assessment.'}, {'start': '3108.300', 'end': '3116.399', 'text': 'Vasu Sood: moving further to the next information system, health information system, that is, practice management system.'}, {'start': '3116.590', 'end': '3134.759', 'text': 'Vasu Sood: a practice management system. All these systems are actually a kind of software software solution which can be used in healthcare setting. If we talk about practice management system, it is you? It can be used to manage day to day operation administrative'}, {'start': '3135.278', 'end': '3157.590', 'text': 'Vasu Sood: task in healthcare organization. For example, a practice management system may be used to send automated reminders to the patient about their upcoming appointment, and can also help service desk to prepare the billing details even before the patient arrive in the facility.'}, {'start': '3158.760', 'end': '3176.130', 'text': 'Vasu Sood: Moving further, the next information system is supply chain management, as the name suggests, they can be used in healthcare industry to manage the supply of the material, or maybe for the products.'}, {'start': '3177.030', 'end': '3197.589', 'text': 'Vasu Sood: So supply chain management system in healthcare is again a software solution that can help plan, manage, or optimize the flow of medical supplies. It may be medical equipment, some services, pharmaceutical services, etc.'}, {'start': '3198.560', 'end': '3217.130', 'text': 'Vasu Sood: Moving further to the next system, that is, human resource management, system or human resource information system. These platforms are essential in the healthcare sector to manage human resources.'}, {'start': '3217.280', 'end': '3222.220', 'text': 'Vasu Sood: For example, the healthcare organization need to'}, {'start': '3222.250', 'end': '3247.139', 'text': 'Vasu Sood: see how many people working in the organization need to contact them, their personal details, their job history, etc. Whether the work they are doing that is, aligning with the Hr policies that are aligning with the strategic plan of the organization. That is where these systems can be used. There are various it companies. For example.'}, {'start': '3247.140', 'end': '3259.050', 'text': 'Vasu Sood: one of the biggest company I can name. Here is sap, oracle and sap. They both provide these solution human resource management solution.'}, {'start': '3259.910', 'end': '3269.549', 'text': 'Vasu Sood: So we have covered the main other supportive information system use in healthcare industry just moving to the last'}, {'start': '3270.507', 'end': '3285.029', 'text': 'Vasu Sood: slide. Or, I would say, just the last topic talking about business intelligence in healthcare. So business intelligence. When we say business intelligence, it is made up of 2 words, business and intelligence.'}, {'start': '3285.160', 'end': '3294.249', 'text': "Vasu Sood: This means when we have to make intelligent decisions in any industry, or, let's say, in healthcare industry."}, {'start': '3294.250', 'end': '3317.580', 'text': 'Vasu Sood: then we can use the tools or the packages available. The software solution which can help to make intelligent decision. For example, the tool, like tabula and power bi is a kind of reporting tool, can be used to analyze electronic health record and the operational data.'}, {'start': '3317.780', 'end': '3339.690', 'text': 'Vasu Sood: This analysis can help to improve patient care by identifying at risk patient, they can help to streamline resources like allocating appropriate allocation of the resources, and can enhance overall outcome of healthcare industry.'}, {'start': '3340.090', 'end': '3346.500', 'text': 'Vasu Sood: So with this we done with our module. 2. Thank you very much for listening.'}, {'start': '3347.300', 'end': '3349.230', 'text': 'Vasu Sood: Happy to take.'}, {'start': '3349.730', 'end': '3360.459', 'text': "IT Masters: Well, that was fantastic, and we're getting some questions in. So I would again encourage everybody to ping your questions into our Q. And a thanks very much. Dr. Vasut and Dr. Mohammed."}, {'start': '3361.790', 'end': '3366.610', 'text': "IT Masters: Eduardo's got the 1st question, can an electronic health record be shared internationally?"}, {'start': '3368.850', 'end': '3371.730', 'text': 'Dr Mohamed Khalifa: Yes, I, yeah, yeah, go go and pass me. Yeah.'}, {'start': '3372.086', 'end': '3397.050', 'text': 'Vasu Sood: Yeah, I think we can share them. But it is going to be complex, because at the moment we are trying to make them nationally, and there is the possibility. Future direction can be where we can think about to integrate them internationally. At the at the moment we are trying to join the whole nation. We have different states. So we are trying to integrate all those States together.'}, {'start': '3397.100', 'end': '3404.350', 'text': 'Vasu Sood: So the I would say, yes, there is the chance. There is the possibility. But we need to think about the complexity as well.'}, {'start': '3404.610', 'end': '3409.760', 'text': "IT Masters: I would imagine there's all sorts of privacy issues with Gdpr. And New Australian legislation, too."}, {'start': '3410.070', 'end': '3425.260', 'text': "Vasu Sood: Yeah, yeah, that's right. The legal issues and rules and regulations, the protocols of every nations. They are a bit different. So depending on nation, whether they support each other's laws, each other's policies, then yes, it is possible."}, {'start': '3426.466', 'end': '3431.179', 'text': 'IT Masters: Can you please discuss what type of messaging systems are used in Hl. 7.'}, {'start': '3434.130', 'end': '3454.530', 'text': 'Vasu Sood: That is from my understanding. here in Australia we use Hl, 7 version 2, and we also use fire version for the secure messaging or data sharing. If we talk about from the technical perspective, from'}, {'start': '3455.040', 'end': '3477.729', 'text': "Vasu Sood: the network layer perspective, then we use the file transfer protocol. We use the simple mail transfer protocol. So various protocols are used there at the moment. I can't recall all the protocols. But yes, we have those protocol. For example, Ftp. Smtp. Protocols."}, {'start': '3477.730', 'end': '3498.410', 'text': 'Dr Mohamed Khalifa: Yeah, we we have a lot of many, many of these. Messaging standards. For example, we have the admission discharge and transfer. We have order entry. We have scheduling messages, pharmacy and treatment orders. Financial.'}, {'start': '3498.853', 'end': '3511.660', 'text': 'Dr Mohamed Khalifa: We have different like types of messaging systems within the Hl. 7, and some of them are adopted here in Australia. When we talk about data exchange between different systems.'}, {'start': '3513.490', 'end': '3521.930', 'text': 'IT Masters: Excellent. Farah has given us a few questions about doing ehr? And how you sort it out in rural African settings.'}, {'start': '3522.150', 'end': '3536.110', 'text': 'IT Masters: for example, how reliable are clinical decision support systems in improving diagnostic accuracy and patient outcomes, especially in low resource settings where Internet access Internet access is limited or inconsistent.'}, {'start': '3537.340', 'end': '3563.720', 'text': 'Dr Mohamed Khalifa: Well, this represents a challenge because these systems has to be working independently from a big server. Because, as we mentioned today, we have the centralized and we have the decentralized model. Right? So the decentralized model could be better than the centralized because the Internet could be slow or interrupting in certain areas, especially rural areas and remote areas.'}, {'start': '3563.720', 'end': '3590.309', 'text': 'Dr Mohamed Khalifa: So this is why these clinical decision support systems better for them to be implemented on the machines that the end users are using directly without the need to connect. To a server. However, this makes these systems require a lot of maintenance or updating with new knowledge or evidence, and so on in a way that could be difficult, but better than having no connection with the main server.'}, {'start': '3590.850', 'end': '3618.919', 'text': 'Dr Mohamed Khalifa: Again, if the question is about the cost, effectiveness. Of these systems. These systems could provide good support for the management of of clinical conditions, but again, needs the sufficient technology to be provided, including databases, including knowledge base expert systems algorithms that can help the end users to choose among order sets and so on.'}, {'start': '3619.380', 'end': '3625.160', 'text': 'IT Masters: You could even see things like SMS based systems for very, very low tech stuff like we.'}, {'start': '3625.160', 'end': '3633.200', 'text': 'Dr Mohamed Khalifa: Yeah, these, yeah, these could be all good alternatives based on the low resource environment that these systems are working within.'}, {'start': '3634.040', 'end': '3639.049', 'text': 'IT Masters: Basanta is asking who manages the backend infrastructure for the electronic health records here.'}, {'start': '3639.930', 'end': '3656.610', 'text': 'Dr Mohamed Khalifa: Well, it depends on the on the commercial package. For example, here in Australia we have Cerner, we have intersystems. These are the major 2 vendors for electronic health record systems in, for example, most of the States in Australia, like New South Wales and Victoria'}, {'start': '3656.750', 'end': '3678.649', 'text': 'Dr Mohamed Khalifa: and Brisbane as well. Queensland. So those who manage these back ends usually are the It teams of the hospital, not the It team of the vendor, because after the training finishes after the implementation finishes from the vendor side. The it team of the hospital is is becomes responsible for'}, {'start': '3678.993', 'end': '3694.780', 'text': 'Dr Mohamed Khalifa: managing these back ends to make sure of the integrity confidentiality, privacy, and security as well. And then the end users are using the front end. So it is the it of the hospital who are responsible for maintaining and keeping all of that.'}, {'start': '3696.060', 'end': '3696.700', 'text': 'IT Masters: Right.'}, {'start': '3697.187', 'end': '3706.980', 'text': "IT Masters: Stephen's asking. This is a very Australian question. Patients can access their imaging as results, such as cat scans, etc. Via mygov. Even before their doctors have seen them."}, {'start': '3707.170', 'end': '3714.390', 'text': 'IT Masters: I assume that patients only have access to a limited summary of these, whereas doctors have access to the details. Is that right.'}, {'start': '3715.870', 'end': '3718.799', 'text': "Dr Mohamed Khalifa: It's not right. Yeah. It was looking."}, {'start': '3718.800', 'end': '3723.120', 'text': 'Vasu Sood: Yeah, you can. Please go ahead in my understanding.'}, {'start': '3723.740', 'end': '3743.720', 'text': "Vasu Sood: yes, patient can have limited access. For example, if I open my go account, then I can see. When I have visited the doctor I can see those details. I may be able to see the medication details, but I won't be able to see all the summary of my health"}, {'start': '3743.840', 'end': '3749.540', 'text': 'Vasu Sood: information. So, yeah, in my understanding, a patient have limited access.'}, {'start': '3750.160', 'end': '3759.600', 'text': 'Dr Mohamed Khalifa: In addition to that as well. The access of the patient includes, like sample of the images, not the actual full resolution'}, {'start': '3759.760', 'end': '3762.200', 'text': 'Dr Mohamed Khalifa: of the cat, Scan, or MRI,'}, {'start': '3762.300', 'end': '3772.779', 'text': 'Dr Mohamed Khalifa: and sometimes we have further notes or comments from the physician or the radiologists that cannot be accessed except by the the doctors, not the patients.'}, {'start': '3773.375', 'end': '3775.750', 'text': 'Dr Mohamed Khalifa: But this is the only limitation'}, {'start': '3776.300', 'end': '3779.709', 'text': 'Dr Mohamed Khalifa: or the difference between the patient access and the doctor. Access.'}, {'start': '3781.200', 'end': '3787.740', 'text': 'IT Masters: And then they go to Dr. Google. Which systems would you recommend for a vaccine manufacturing plant.'}, {'start': '3789.930', 'end': '3794.560', 'text': "Dr Mohamed Khalifa: This. This could be a completely industrial system. It's not an electronic health record."}, {'start': '3794.740', 'end': '3796.580', 'text': 'IT Masters: Yep, okay.'}, {'start': '3798.140', 'end': '3803.220', 'text': 'IT Masters: How would decentralized systems follow the patient journey within a hospital, for example.'}, {'start': '3804.990', 'end': '3832.840', 'text': 'Dr Mohamed Khalifa: Well, it all depends on the way the system is designed. So if the system is designed again in episodic or encounter design we can see these different encounters either from the front end or from the back end. If we would like to develop like dashboards or scorecards to show, for example, how many operations were done last year, how many admissions were done last year? What is the percentage of admission out of'}, {'start': '3832.840', 'end': '3848.410', 'text': 'Dr Mohamed Khalifa: emergency visits, for example, usually between 20 to 30% of emergency visits result in an admission. So this is an aggregated level of data that cannot be collected simply from the front end. It has to be collected from the back end.'}, {'start': '3848.862', 'end': '3854.499', 'text': 'Dr Mohamed Khalifa: So again again, what was the question? I I just forgot part of the question.'}, {'start': '3854.500', 'end': '3861.800', 'text': 'IT Masters: How does how does the decentralized record? How does it cope with it as you follow the journey from department to department, for example.'}, {'start': '3861.800', 'end': '3865.829', 'text': 'Dr Mohamed Khalifa: Well, this, again, is based on the structure of the system.'}, {'start': '3866.255', 'end': '3884.099', 'text': "Dr Mohamed Khalifa: Because the decentralized keeps most of the information in the hospital server it communicates with the server for just backup or updating. But it doesn't need an online connection with the server. You can store the system in the hospital"}, {'start': '3884.450', 'end': '3907.199', 'text': 'Dr Mohamed Khalifa: on the server of the hospital, not the central server of the vendor or cloud, or something that is distant, which facilitates also the transition of patient data from one department to the other, because all of them are accessing the basic data that are reported back to the hospital server, not a main server that the system is connecting to.'}, {'start': '3907.370', 'end': '3929.780', 'text': 'Dr Mohamed Khalifa: unless we are considering the centralized model as the hospital server and the decentralized model. This is another configuration and the decentralized model is a a the terminal computer in the at the hands of each of the end users. Then we need to make sure that the data goes to the back end, but not the application.'}, {'start': '3930.070', 'end': '3938.590', 'text': 'Dr Mohamed Khalifa: So the application stays at the level of the terminal computers at the hands of the end, users not at the server level.'}, {'start': '3939.990', 'end': '3955.909', 'text': "IT Masters: Couple of questions about the 2 companies that are managing all of our Ehr? And it's got a few people scape. What do you think Oracle's acquisition of Cerner and its rebuild using Oracle's AI engine will have in terms of impact on the medical health records."}, {'start': '3957.150', 'end': '3960.599', 'text': "Dr Mohamed Khalifa: That's the creative question, Vasu. Do you have any insights about or."}, {'start': '3961.105', 'end': '3968.694', 'text': "Vasu Sood: Yeah, I can provide my insights. I'm just thinking, if we talk about"}, {'start': '3969.450', 'end': '3973.686', 'text': 'Vasu Sood: the data which is available at the back end and'}, {'start': '3975.277', 'end': '3982.662', 'text': 'Vasu Sood: including artificial intelligence. So what we can bring with the help of AI'}, {'start': '3983.480', 'end': '3991.910', 'text': 'Vasu Sood: we can have insightful information. The the AI algorithm or AI tool can analyze the data'}, {'start': '3991.940', 'end': '4010.689', 'text': 'Vasu Sood: and can provide insightful information. For example, in the back end we have patient images stored. Now, the scanning the Ct scan stored. We are not quite sure. Healthcare professional are not quite sure whether those patient'}, {'start': '4010.690', 'end': '4027.319', 'text': 'Vasu Sood: have the traces of cancer, for example. So with the help of AI tool. With the help of those algorithm, it may be finally looking at those images and can providing may provide the insight to the healthcare professional.'}, {'start': '4027.520', 'end': '4030.650', 'text': 'Vasu Sood: So it it is going to be helpful.'}, {'start': '4032.380', 'end': '4036.019', 'text': "IT Masters: Yes, it's gonna be very interesting to see how it all transforms."}, {'start': '4036.020', 'end': '4044.360', 'text': 'Vasu Sood: That is what is the future of healthcare. We say electronic healthcare is heading towards.'}, {'start': '4044.800', 'end': '4046.609', 'text': 'IT Masters: And sorry'}, {'start': '4048.293', 'end': '4057.570', 'text': "IT Masters: in terms of then of business continuity. How are we placed for risk given? There's only 2 vendors. If one goes belly up. What do we do?"}, {'start': '4058.710', 'end': '4068.430', 'text': "Dr Mohamed Khalifa: No, it's it's not only 2 vendors. The the market is full of vendors, but these are the most could be the most important or the most prominent among"}, {'start': '4068.570', 'end': '4072.619', 'text': 'Dr Mohamed Khalifa: almost 20 other vendors that we know in Australia.'}, {'start': '4073.077', 'end': '4094.649', 'text': "Dr Mohamed Khalifa: But it's it's about it's a it's a commercial or business aspect of like market share. How many hospitals each system or vendor is is providing how many annual implementations each system is is doing, how many hospitals are they are implementing every year. But in case that one of these vendors"}, {'start': '4094.650', 'end': '4106.320', 'text': 'Dr Mohamed Khalifa: disappeared or something happened, we could have alternatives from other vendors definitely with the same level of technology and could be the same level of cost or expenses.'}, {'start': '4106.726', 'end': '4121.360', 'text': 'Dr Mohamed Khalifa: The only difference would be the reliability of these systems based on previous records, like how many other countries and how many other hospitals have been implemented using these these other systems or alternative systems.'}, {'start': '4121.490', 'end': '4126.290', 'text': "IT Masters: And let's face it. The database will still be there. Somebody's just got to access it."}, {'start': '4126.950', 'end': '4132.360', 'text': 'Dr Mohamed Khalifa: Yeah, you can integrate a new system to the same data or migrate the whole database to their own database system.'}, {'start': '4132.760', 'end': '4133.300', 'text': 'IT Masters: Yeah.'}, {'start': '4133.479', 'end': '4134.395', 'text': 'Dr Mohamed Khalifa: Yeah.'}, {'start': '4136.069', 'end': '4146.130', 'text': 'IT Masters: What was I going to ask? I was going to ask, is AI use much recent currently. But before I do that, I should remind, or let everybody know, that we will in 3 weeks'}, {'start': '4146.180', 'end': '4166.569', 'text': "IT Masters: be doing a session on AI in healthcare with Dr. Mohamed Presentian, and he has done a number of papers on AI over the last few years, so we'll be very interested to do that. So there will be a lot more information about that. Not in this short course, but in a specific chs. Webinar coming up on the 21st of May. We'll be launching that next week."}, {'start': '4166.729', 'end': '4170.639', 'text': "IT Masters: I'm just pre letting you know. Sorry, doctor, away you go."}, {'start': '4171.770', 'end': '4174.140', 'text': 'Dr Mohamed Khalifa: Yeah, yeah, you can go with your question. I think.'}, {'start': '4174.140', 'end': '4176.770', 'text': 'IT Masters: How much is AI used? Currently.'}, {'start': '4177.380', 'end': '4181.390', 'text': "Dr Mohamed Khalifa: Well, AI is not used fully. It's"}, {'start': '4182.000', 'end': '4185.200', 'text': "Dr Mohamed Khalifa: I guess it's about 20% of its capabilities"}, {'start': '4185.460', 'end': '4193.789', 'text': 'Dr Mohamed Khalifa: used in healthcare. Still, it is used in lab examination of things like'}, {'start': '4193.920', 'end': '4198.580', 'text': "Dr Mohamed Khalifa: it's still in the development phase. It's not in the implementation phase. Yet"}, {'start': '4198.750', 'end': '4204.899', 'text': 'Dr Mohamed Khalifa: the the problem with the AI is that AI for us in healthcare is like a black box.'}, {'start': '4205.220', 'end': '4215.149', 'text': "Dr Mohamed Khalifa: You're sending all of that information and data or images, even to the AI. And then no one knows where this information"}, {'start': '4215.330', 'end': '4226.460', 'text': 'Dr Mohamed Khalifa: goes, and and how this information is being processed, for example, and how the AI is, is reaching to these conclusions or suggestions.'}, {'start': '4226.460', 'end': '4247.869', 'text': 'Dr Mohamed Khalifa: So this is still very sophisticated and needs a lot of legal and ethical regulation in the area of using AI in healthcare, especially that the data is very sensitive, related to humans, related to their conditions, to their future, to their life expectancy, complications'}, {'start': '4248.350', 'end': '4270.610', 'text': 'Dr Mohamed Khalifa: could affect their their jobs, employability, insurance, and and many other things, so I think it will be a little bit longer journey. It might take 3 or 5 more years to get some regulations clearly stating how AI should or should not be used, in what way should or should not be used?'}, {'start': '4271.080', 'end': '4282.120', 'text': "Dr Mohamed Khalifa: In healthcare, but it definitely in terms of research, in terms of experimenting. AI. It's achieving very great results, but not still in production."}, {'start': '4282.744', 'end': '4289.009', 'text': "IT Masters: Paul's asking, do clinicians put a lot of trust into the use of AI? Or are they just toe in the water."}, {'start': '4289.530', 'end': '4292.540', 'text': "Dr Mohamed Khalifa: Unfortunately, they don't trust them yet."}, {'start': '4293.980', 'end': '4303.050', 'text': 'Dr Mohamed Khalifa: because clinicians think that AI could hallucinate and could produce wrong information or false information.'}, {'start': '4303.160', 'end': '4317.890', 'text': "Dr Mohamed Khalifa: or could leak that information to 3rd parties and other technology companies, and so on. Because we don't really see how the AI is using this information. It's like a black box, something something yeah."}, {'start': '4318.090', 'end': '4322.689', 'text': "IT Masters: I imagine it's an iterative process. It'll get to prove a little bit, and elsewhere."}, {'start': '4322.690', 'end': '4323.500', 'text': 'Dr Mohamed Khalifa: Exactly.'}, {'start': '4323.500', 'end': '4325.770', 'text': 'IT Masters: Is ehr cloud based.'}, {'start': '4327.450', 'end': '4335.039', 'text': 'Dr Mohamed Khalifa: Not every Ehr. Could be. Nowadays we have companies that sell accounts rather than implement hospitals.'}, {'start': '4335.300', 'end': '4354.750', 'text': "Dr Mohamed Khalifa: So as a Gp. For example, or a medical center in a country that doesn't have much technology or major vendors, or a lot of money to support implementations in millions of dollars. You can buy an account for a hundred doctor, for example, and keep everything on cloud"}, {'start': '4355.700', 'end': '4357.820', 'text': 'Dr Mohamed Khalifa: right? This is just one model.'}, {'start': '4359.260', 'end': '4366.920', 'text': "IT Masters: Okay, only a minute or 2 more before we close the questions. If you've got a couple of last minute ones, we still got a few here, but a few."}, {'start': '4368.330', 'end': '4377.930', 'text': "IT Masters: What are some reliable Ehr systems that you can advise with the most adequate Cds tools? I'm not sure that we're in the business of giving commercial recommendations."}, {'start': '4379.230', 'end': '4387.239', 'text': 'Dr Mohamed Khalifa: Yeah, we have seen, maybe sooner, power charts and and intersystems track here'}, {'start': '4387.550', 'end': '4392.650', 'text': "Dr Mohamed Khalifa: among the existing systems, but I can't really judge if they are the best or not"}, {'start': '4392.960', 'end': '4399.049', 'text': 'Dr Mohamed Khalifa: based on their clinical decision, support capabilities compared to other systems. You could have a smaller vendor'}, {'start': '4399.517', 'end': '4419.120', 'text': 'Dr Mohamed Khalifa: less famous with less number of implemented hospitals and their systems could be much better. We you never know you have to test these systems and see them in action. So if you are a hospital manager. Before you decide to purchase these systems, you have to visit other hospitals that have already implemented successfully these systems'}, {'start': '4419.300', 'end': '4424.309', 'text': 'Dr Mohamed Khalifa: in. Even if if this visit is to another country to to make sure that the systems'}, {'start': '4424.540', 'end': '4438.489', 'text': 'Dr Mohamed Khalifa: are actively working and and you have to listen to this is like a site visit. You have to listen to the end users. What do they say about the system? And how was their journey into training and and implementation of systems?'}, {'start': '4440.340', 'end': '4441.210', 'text': 'IT Masters: Excellent'}, {'start': '4443.190', 'end': '4462.010', 'text': "IT Masters: Just catching up with some. I've just put in the chat. By the way, somebody has posted an interview with Larry Ellison, Sir John Bell to see how AI is now being used in the Nhs. So I've taken that out of the Q. And a most clinics and hospitals use different software. So what are the differences for? How do we? How do we get them all together? What's the best practice?"}, {'start': '4462.280', 'end': '4465.279', 'text': 'IT Masters: It says Genie. Here is the genie, the answer.'}, {'start': '4467.624', 'end': '4470.005', 'text': "Dr Mohamed Khalifa: Really can't judge."}, {'start': '4470.920', 'end': '4495.069', 'text': 'Dr Mohamed Khalifa: because practice is different. If if the question means the the practice of GPS or medical centers, it all depends on the. Is it primary care, secondary care? Is it hospital based? Is it Gp, based? Is it the medical center? So there is. There is no like off the shelf solution that could fit'}, {'start': '4495.500', 'end': '4496.920', 'text': 'Dr Mohamed Khalifa: for everyone.'}, {'start': '4497.040', 'end': '4511.980', 'text': 'Dr Mohamed Khalifa: It depends on how much tailoring the organization need before implementing such system. And then they make the decision based on many, many factors, including money and training requirements and licensing'}, {'start': '4512.440', 'end': '4525.500', 'text': 'Dr Mohamed Khalifa: and updates. And if the technology is open source, if it needs regular updating, and and many other indicators that could govern the process of choosing'}, {'start': '4525.710', 'end': '4527.040', 'text': 'Dr Mohamed Khalifa: the system.'}, {'start': '4527.150', 'end': '4529.849', 'text': 'Dr Mohamed Khalifa: Answering this question is is not easy.'}, {'start': '4530.090', 'end': '4531.879', 'text': "IT Masters: It's horses per courses, I guess."}, {'start': '4531.880', 'end': '4532.780', 'text': 'Dr Mohamed Khalifa: Yeah, yeah.'}, {'start': '4533.100', 'end': '4537.959', 'text': 'IT Masters: Is virtual reality starting to be used for remote diagnostics or operations.'}, {'start': '4539.000', 'end': '4541.178', 'text': 'Vasu Sood: I can ask Vasu to to answer this question.'}, {'start': '4541.420', 'end': '4562.789', 'text': "Vasu Sood: Thank you, Muhammad. I'm just thinking, not quite 100% sure. But yes, it has the potential. We can, for example, virtual reality we can use in dementia world where or we can use it with the elderly people who have some mobility issues"}, {'start': '4562.790', 'end': '4588.450', 'text': 'Vasu Sood: so it can be somewhere giving them confidence. They just have to sit in one place using those handheld devices, and a headset will be fitted on their head so they can see a parallel world, a different universe, where they will be using their hands to, for example, grab a cup of coffee or making a tool so that may be bringing, making them much more confident'}, {'start': '4589.110', 'end': '4595.070', 'text': "Vasu Sood: so far, not quite sure. Can't 100% say if we are using them at the moment."}, {'start': '4596.298', 'end': '4598.489', 'text': 'Vasu Sood: Some applications, I guess.'}, {'start': '4598.700', 'end': '4602.589', 'text': 'Dr Mohamed Khalifa: We have a virtual reality. Applications in healthcare.'}, {'start': '4603.310', 'end': '4604.700', 'text': "IT Masters: Right. There's"}, {'start': '4605.980', 'end': '4613.309', 'text': "IT Masters: sorry I'm just dissecting this question from your experience. What do you think is the use of blockchain in the healthcare industry?"}, {'start': '4615.385', 'end': '4628.489', 'text': 'Vasu Sood: Blockchain can be used in healthcare industry, it has potential. It can be used for a more secure sharing of data.'}, {'start': '4628.490', 'end': '4655.309', 'text': 'Vasu Sood: If we say, the blockchain technology in blockchain technology, we use the distributed system. So in distributed system, if we have, that is somewhere will be helpful. If we in centralize system. We have all the database stored in, for example, in one server. So what will happen if server will crash, the data will be lost, or there will be some issues.'}, {'start': '4655.310', 'end': '4671.049', 'text': 'Vasu Sood: But in decentralized system the data will be stored in different systems. So saying that if one server is not working, or if data is not accessible, or if there are so many requests coming to the one server'}, {'start': '4671.050', 'end': '4693.670', 'text': 'Vasu Sood: and then another server is there also available to help. So if some, for example, there are 1 million requests coming for a server, so some can be diverted to the next server if it is decentralized, so it is going to be helpful blockchain technology going to be helpful in healthcare industry.'}, {'start': '4694.990', 'end': '4697.650', 'text': 'IT Masters: Is Hris integrated with ehr.'}, {'start': '4699.140', 'end': '4699.940', 'text': 'Vasu Sood: Sorry.'}, {'start': '4699.940', 'end': '4704.749', 'text': 'IT Masters: Is HIHR. IS. Integrated with the Hr system.'}, {'start': '4704.750', 'end': '4707.570', 'text': 'Dr Mohamed Khalifa: Does it stand for radiology, information, system.'}, {'start': '4707.920', 'end': '4709.619', 'text': "IT Masters: I'm not sure I haven't."}, {'start': '4709.620', 'end': '4710.630', 'text': 'IT Masters: Might have to tell us.'}, {'start': '4710.630', 'end': '4715.545', 'text': 'Dr Mohamed Khalifa: We need Arvin to explain that. Okay.'}, {'start': '4716.160', 'end': '4718.729', 'text': 'IT Masters: I thought it might have been one of the acronyms earlier.'}, {'start': '4718.965', 'end': '4720.850', 'text': 'Dr Mohamed Khalifa: We have so many acronyms. This is the'}, {'start': '4721.560', 'end': '4727.520', 'text': 'Dr Mohamed Khalifa: yeah, the the radiology information system and and packs the picture archiving and communication system.'}, {'start': '4727.900', 'end': '4729.070', 'text': 'IT Masters: Human resources.'}, {'start': '4729.070', 'end': '4743.159', 'text': "Dr Mohamed Khalifa: Yeah, and and dicom human resources. Okay, that's fine. And the dicom and and so on. So all of these systems should be integrated electronic health records human resource systems,"}, {'start': '4743.600', 'end': '4771.779', 'text': 'Dr Mohamed Khalifa: usually are partially integrated, but just in terms of deciding, for example, the ratios of nurses to work the level of skills required. For example, when you have a very sophisticated level of conditions in the intensive care, what level of training do you need? You need, for example, a registered nurse, a senior nurse so that could be dragged that could be communicated from the human resource'}, {'start': '4771.780', 'end': '4778.800', 'text': 'Dr Mohamed Khalifa: information system, but not direct integration with electronic health records, because electronic health records is more about'}, {'start': '4779.401', 'end': '4783.970', 'text': 'Dr Mohamed Khalifa: the clinical content rather than the administrative content.'}, {'start': '4785.510', 'end': '4787.720', 'text': 'IT Masters: 2 questions to go. Sorry.'}, {'start': '4787.720', 'end': '4788.280', 'text': 'Dr Mohamed Khalifa: Yeah.'}, {'start': '4789.001', 'end': '4797.350', 'text': 'Vasu Sood: Yeah, I was saying, these are supportive systems, so they they can be integrated and can be helpful. But it is going to be very complex.'}, {'start': '4797.350', 'end': '4798.080', 'text': 'Dr Mohamed Khalifa: Yes.'}, {'start': '4798.270', 'end': '4808.649', 'text': 'Vasu Sood: So the use of electronic health record for healthcare professional. If there will be so many tabs, if there will be so many features, so many options. It is going to be very complex to use.'}, {'start': '4810.050', 'end': '4814.160', 'text': 'IT Masters: Are there any open source? Emr, ehr, systems being developed.'}, {'start': '4815.270', 'end': '4821.630', 'text': 'Dr Mohamed Khalifa: Well, we have. We have heard of of many of these open source systems.'}, {'start': '4821.810', 'end': '4825.285', 'text': 'Dr Mohamed Khalifa: but they are not actually commercial systems or'}, {'start': '4825.950', 'end': '4830.160', 'text': 'Dr Mohamed Khalifa: production, like implementation systems. They, these are more like'}, {'start': '4830.350', 'end': '4842.999', 'text': 'Dr Mohamed Khalifa: research systems that we use to to do further research on. For example, user behavior usability things, how how end users'}, {'start': '4843.809', 'end': '4848.720', 'text': 'Dr Mohamed Khalifa: would like to navigate through the system, or even through a screen.'}, {'start': '4848.900', 'end': '4852.530', 'text': 'Dr Mohamed Khalifa: but most of them are not actually used in healthcare.'}, {'start': '4853.250', 'end': '4857.010', 'text': "IT Masters: I would imagine being open source. They're gonna have all sorts of privacy issues, anyway."}, {'start': '4857.290', 'end': '4858.810', 'text': 'Dr Mohamed Khalifa: Yeah, yeah, exactly.'}, {'start': '4859.010', 'end': '4867.119', 'text': 'IT Masters: Okay? And I thought we would finish with this, has anyone implemented or started research on how nanotechnology could impact Australian healthcare sector.'}, {'start': '4869.778', 'end': '4877.180', 'text': "Dr Mohamed Khalifa: I don't think that we have started researching about nanotechnology. We hear about nanorobots."}, {'start': '4877.510', 'end': '4882.870', 'text': 'Dr Mohamed Khalifa: We hear about small robots that can go into blood vessels and'}, {'start': '4882.980', 'end': '4891.500', 'text': 'Dr Mohamed Khalifa: and veins, and do minor surgeries inside the body. Using nanotechnology in shielding'}, {'start': '4892.162', 'end': '4897.040', 'text': "Dr Mohamed Khalifa: some devices and covering them. But we don't have."}, {'start': '4897.420', 'end': '4904.989', 'text': 'Dr Mohamed Khalifa: I have not seen a published research on the effectiveness on Australian healthcare system'}, {'start': '4905.230', 'end': '4910.039', 'text': 'Dr Mohamed Khalifa: could be in in other systems, in the Us. But not on the system itself.'}, {'start': '4910.220', 'end': '4921.590', 'text': 'Dr Mohamed Khalifa: Rather, the studies are usually about their effectiveness, about their usability, but not about their impact. We are not there yet about their impact on the healthcare system'}, {'start': '4921.720', 'end': '4925.729', 'text': 'Dr Mohamed Khalifa: in terms of cost, effectiveness, or feasibility, and so on.'}, {'start': '4926.590', 'end': '4927.220', 'text': 'IT Masters: Right.'}, {'start': '4927.500', 'end': '4941.940', 'text': "IT Masters: Well, that was a good note to end on the future, and I'm looking forward to next week very much. Just a few little things to wrap up one reminder is that next week on next Wednesday"}, {'start': '4942.020', 'end': '4961.040', 'text': "IT Masters: for the those people interested in it parts of things. Then please come along to our information session next Wednesday night, our open evening that'd be really helpful in next week as well for those of you interested in the health side of things. We will be doing a shorter webinar. Just a 1 off thing"}, {'start': '4961.450', 'end': '4979.500', 'text': "IT Masters: about AI and healthcare with Dr. Mohammed as well. So we'll talk more about that next week. But please come along to either of those things. If, of course, you need any other information, please, you can look at either of the websites and find your way through to our course, advisors and people that will talk to you about that sort of stuff. But"}, {'start': '4979.720', 'end': '4996.319', 'text': "IT Masters: thank you very much to Kit and John for looking after the chat tonight. It's been fantastic. And where would we be without our mentors? Thank you. To Dr. Vasu Soud and Dr. Mohammed Khalifa for giving us all that information that you guys are fantastic, and we really enjoyed it very much."}, {'start': '4997.620', 'end': '4998.480', 'text': 'Dr Mohamed Khalifa: Thank you.'}, {'start': '4998.480', 'end': '4998.870', 'text': 'Dr Mohamed Khalifa: She.'}, {'start': '4998.870', 'end': '4999.430', 'text': 'Vasu Sood: And.'}, {'start': '5000.030', 'end': '5000.850', 'text': 'IT Masters: No worries.'}, {'start': '5001.750', 'end': '5008.510', 'text': "IT Masters: and thank you everyone for coming along as well and giving us your time. We really appreciate it. We know you don't have to do that, so"}, {'start': '5008.760', 'end': '5013.469', 'text': "IT Masters: we'll see you same bat time, same Bat channel, as I say each week. Thank you again. Bye."}]