Informatics Applications in Neonatology

Informatics Applications in Neonatology

Malcolm Battin (National Women’s Health, Auckland City Hospital, New Zealand), David Knight (Mater Mother’s Hospital, Brisbane, Australia) and Carl Kuschel (The Royal Women’s Hospital, Melbourne, Australia)
Copyright: © 2009 |Pages: 21
DOI: 10.4018/978-1-60566-078-3.ch009
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Abstract

Neonatal care is an extremely data-intensive activity. Physiological monitoring equipment is used extensively along with web-based information tools and knowledge sources. Merging data from multiple sources adds value to this data collection. Neonatal databases assist with collecting, displaying, and analyzing data from a number of sources. Although the construction of such databases can be difficult, it can provide helpful support to clinical practice including surveillance of infectious diseases and even medical error. Along with recording outcomes, such systems are extremely useful for the support of audit and quality improvement as well as research. Electronic information sources are often helpful in education and communication with parents and others, both within the unit and at a distance. Systems are beginning to be used to help with decision making – for example in the case of weaning neonates from ventilators, and this work is likely to become more important in the future.
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Clinical Care

An informatics approach has much to offer in terms of both efficiency and clinical safety. Firstly, it may serve as a web-based resource or repository for information. Secondly, it can provide web-based tools, such as drug calculators or nomograms, which aid the clinician with procedures such as estimation of length of insertion of catheters or endotracheal tubes 2, 3. Thirdly, informatics may include the provision of a portal or web-based interface with other applications giving up-to-date access to clinical information stored elsewhere such as radiology, lab results, and clinical documents. Fourthly, data from physiological monitoring can be analyzed, albeit largely after a clinical event requiring review. Finally once data has been collected it can then be used to generate an automated discharge summary that includes physiological parameters, radiology and laboratory results, as well as clinical information.

In the screenshot above, an example is given of the clinical workstation interface in place in our institution. The menu to the left provides the user with access to clinical information for specific patients (Figure 1). Electronic results can be “signed off” by the clinician once the results have been acknowledged or acted on. Other results, such as radiology reports, can also be viewed. Radiology images can be viewed directly for this patient by choosing the logo resembling an x-ray of the hand. Similarly, the electronic clinical record used within our institution can be accessed directly through this interface. The triangle logo with an exclamation mark alerts the user to the presence of important specific information such as a drug reaction, child protection issues, or infection with an organism that may have infection control implications. (Figure 2 and Figure 3)

Figure 1.

Clinical workstation interface in our institution

Figure 2.

Trend graph of pulse oximeter saturation in a newborn infant with congenital cyanotic cardiac disease

Figure 3.

Output from a bedside EEG monitor demonstrating both real time raw EEG data (upper two boxes) and trend amplitude integrated summary data (bottom two boxes) to assess response to treatment

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Editorial Advisory Board
Table of Contents
Foreword
Neil Pattison
Preface
Emma Parry, David Parry
Acknowledgment
Emma Parry, David Parry
Chapter 1
Peter Stone
Improving women’s health is a vital task for the world. The consequences of obstetric and gynecological disease are serious both for the women... Sample PDF
An Introduction to Women's Health and Informatics
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Chapter 2
Premila Fade
Principlism (derived from common sense morality) is the most common theory used within the healthcare sphere. The elements of this theory are... Sample PDF
Women's Health Informatics: The Ethical and Legal Issues
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Chapter 3
David Parry
Recording information about symptoms, observations, actions, and outcomes is a key task of health informatics. Standardization of records is vital... Sample PDF
Coding and Messaging Systems for Women's Health Informatics
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Chapter 4
Gareth Parry
Women’s health in primary care is a large part of the generalist’s practice. Information technology (IT) is now an integral part of the generalist’s... Sample PDF
Women's Health Informatics in the Primary Care Setting
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Chapter 5
Emma Parry
The seamless electronic health record is often hailed as the holy grail of health informatics. What is an electronic health record? This question is... Sample PDF
The Electronic Health Record to Support Women's Health
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Chapter 6
Graham Parry
Information technology and communication systems have made imaging in women’s health easier at many levels. There are now many commercial systems on... Sample PDF
Imaging and Communication Systems in Obstetrics and Gynecology
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Chapter 7
Emma Parry
Pregnancy is unique in medicine in providing a discrete event with a fixed end. It is well suited to data collection and statistical assessment.... Sample PDF
Statistical Measures in Maternity Care
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Chapter 8
Kiran Massey, Tara Morris, Robert M. Liston
Our ultimate goal as obstetric and neonatal care providers is to optimize care for mothers and their babies. As such, we need to identify practices... Sample PDF
Building Knowledge in Maternal and Infant Care
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Chapter 9
Malcolm Battin, David Knight, Carl Kuschel
Neonatal care is an extremely data-intensive activity. Physiological monitoring equipment is used extensively along with web-based information tools... Sample PDF
Informatics Applications in Neonatology
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Chapter 10
Jenny Westgate
During pregnancy the fetus requires an adequate supply of oxygen and clearance of carbon dioxide which is a waste product of metabolism. In fetal... Sample PDF
Computerizing the Cardiotocogram (CTG)
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Chapter 11
Liron Pantanowitz
Automation and emerging information technologies are being adopted by cytology laboratories around the world to augment Pap test screening and... Sample PDF
Computer Assisted Cervical Cytology
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Chapter 12
Laurie Elit, Susan Bondy, Michael Fung-Kee-Fung, Prafull Ghatage, Tien Le, Barry Rosen, Bohdan Sadovy
Ovarian cancer affects 2,400 women annually in Canada with a case fatality ratio of 0.70. There are several practice guidelines that indicate women... Sample PDF
Informatics and Ovarian Cancer Care
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Chapter 13
Jamila Abuidhail
Information and communication technologies include computers, telecommunication, digital networks, and television. Using informatics in healthcare... Sample PDF
Women's Health and Health Informatics: Perinatal Care Health Education
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Chapter 14
Shona Kirtley
In an age where health professionals lead very busy working lives, electronic information sources provide ease of access to vast amounts of health... Sample PDF
Electronic Information Sources for Women's Health Knowledge for Professionals
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Chapter 15
David Parry
Decision analysis techniques attempt to utilize mathematical data about outcomes and preferences to help people make optimal decisions. The... Sample PDF
Computerised Decision Support for Women's Health Informatics
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Chapter 16
Michelle Brear
The influence of organizational factors on the success of informatics interventions in healthcare has been clearly demonstrated. This health... Sample PDF
Organizational Factors: Their Role in Health Informatics Implementation
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Chapter 17
Josipa Kern
When things go well then often it is because they conform to standards (ISO, 2005). According to the Oxford Dictionary of Modern English, there is a... Sample PDF
Standardization in Health and Medical Informatics
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Chapter 18
Elske Ammenwerth, Stefan Gräber, Thomas Bürkle, Carola Iller
This chapter summarizes the problems and challenges which occur when health information systems are evaluated. The main problem areas presented are... Sample PDF
Evaluation of Health Information Systems: Challenges and Approaches
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Chapter 19
Pirkko Nykänen
eHealth refers to use of information and communication technologies to improve or enable health and healthcare. eHealth broadens the scope of health... Sample PDF
eHealth Systems, Their Use and Visions for the Future
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Chapter 20
Nilmini Wickramasinghe, Santosh Misra, Arnold Jenkins, Douglas R. Vogel
Superior access, quality and value of healthcare services has become a national priority for healthcare to combat the exponentially increasing costs... Sample PDF
The Competitive Forces Facing E-Health
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About the Contributors