Information and Communications Technology in the Clinical Environment

Module details

Title

Information and Communications Technology in the Clinical Environment

Type

Rotation

Module code

SBI102

Credits

10

Requirement

Compulsory

Aim of this module

This module introduces the trainee to the application of ICT in the clinical environment and provides the knowledge that underpins this rotation*, which is important to the application of bioinformatics in clinical practice. Scientists may also oversee the interconnection of critical patient safety computer systems, e.g. networks planning, imaging, controlling and verifying radiotherapy treatments. It may also include the development of novel image and signal processing applications.

This module will provide the trainee with an overview of how information and communications technology (ICT) is used in the clinical environment and will enable the trainee to apply analytical and judgement skills to novel or complex clinical measurements, implement new clinical measurement solutions, and understand and configure novel ICT hardware and software solutions safely within the clinical environment with due respect for patients and patient safety.

*Initially this rotation is likely to be in a Medical Physics or Clinical Engineering environment but may be in part or wholly undertaken in a Physiological Sciences department.

Competencies

#	Learning outcome	Competency	Action
# 1	Learning outcome 1	Competency Assist staff undertaking clinical measurement procedures, including set-up, calibration, test performance, analysis, reporting and filing/storage of results.	Action View
# 2	Learning outcome 1,2	Competency Analyse data and report on the use of specific measurements (particularly in terms of accuracy, reproducibility, bias, specificity and sensitivity) in the context of bioinformatics.	Action View
# 3	Learning outcome 2	Competency Identify the need for a software application to support image processing and develop the prototype, document and comment appropriately.	Action View
# 4	Learning outcome 2	Competency Test and, where possible, deploy the image processing software.	Action View
# 5	Learning outcome 3	Competency Analyse, manipulate, summarise and present complex data using a spreadsheet or database for clinical and scientific applications.	Action View
# 6	Learning outcome 3	Competency Present complex data using spreadsheets or databases for clinical and scientific applications.	Action View
# 7	Learning outcome 3	Competency Explain complex data to a non-expert.	Action View
# 8	Learning outcome 4	Competency Participate in the implementation of ICT components in a controlled fashion, taking into account the impact on existing facilities and clinical service.	Action View
# 9	Learning outcome 4	Competency Participate in the maintenance of protective measures for ICT systems, including disaster measures, anti-virus protection, maintenance, updating, firewalls and virtual servers/networks.	Action View

Assessments

You must complete:

• 1 case-based discussion(s)
• 1 of the following DOPS/ OCEs:

Analyse and present clinical or scientific data using a spreadsheet, including both descriptive and analytical statistical summaries of the data, and indicating any limitations on the inferences to be drawn.	DOPS
Participate in the maintenance of backup arrangements for clinical ICT systems in accordance with local procedures	DOPS
Explain complex data to a non expert, including clinical implications.	OCE

Learning outcomes

1. Observe and assist during a range of clinical measurement procedures effectively and safely with due regard to the patient, health and safety, data security and governance in ICT within the context of your work placement.
2. Develop a prototype image processing application.
3. Manipulate data using a spreadsheet or database environment and an appropriate programming language.
4. Use configuration control in relation to PC software installations and local area networks, including the installation of systems and applications.

Learning outcomes

1. Describe and justify the legislation and standards that underpin the safe use of ICT within the clinical environment, including the control of medical devices.
2. Discuss the basis of data capture, measurement, presentation from clinical and laboratory equipment.
3. Discuss the usage of clinical data generated by a device.
4. Discuss the basis of image formation, reconstruction and presentation.
5. Discuss the interconnectivity of ICT equipment and computer systems within the clinical environment.
6. Discuss how database systems/data management and modern software processes contribute to patient pathways and the provision of high-quality safe and effective patient care.
7. Discuss and evaluate the role of the HCS workforce and the Clinical Scientist in innovation and service development.

Indicative content

Safety

• Health and safety legislation specific to division/workplace
• Risk assessment techniques
• Electrical safety: medical equipment, leakage currents, fault conditions, isolation and circuit protection; biological/physiological response to electric shock; treatment of electric shock; equipment testing
• Workshop safety

Information and communications Technology

• Range of general purpose computer software in common use, including spreadsheets, flat-file and structured databases, online reference and collaborative resources
• Computing applied clinically, including the additional safeguards when the computer acts as a medical device. This includes an understanding of the role of the Medicine and Healthcare products Regulatory Agency (MHRA), the Food and Drugs Administration (FDA) and the International Electrotechnical Commission (IEC), and their role in Conformance European (CE) Marking
• Data exchange standards and an awareness of some of the common standards, e.g. Digital Imaging and Communications in Medicine (DICOM) and Healthcare Level 7 (HL7)
• Networking systems in common clinical and laboratory use and the role of local trust information technology policies
• Data compression technologies for storage and transmission
• Basic principles of applicable legislation and of local policies, including the Data Protection Act, Computer Misuse Act and Freedom of Information Act

Data from medical devices: integrity and processing

• The physiology of pressure, flow, temperature, pH, blood gases, respiratory function and electrophysiology
• The physical principles underpinning these measurements
• Transducers for physiological measurement
• Calibration, traceability of standards
• Sources of error: random, systematic and human
• Error propagation
• Error analysis
• Sensitivity and specificity of measurement techniques
• Relationship of measurement results to clinical pathology, data processing and interpretation
• Usage of data generated by medical devices and the overview of medical device life cycle

Introduction to imaging

• The physics and mathematics of image formation as it relates to two examples from the list below:
  • the radiological image
  • computed tomography (CT) scanning
  • gamma camera
  • positron emission tomography (PET)
  • magnetic resonance imaging (MRI)
  • ultrasound
• Introduction to image reconstruction techniques
• Introduction to image processing and analysis
• Image display characteristics
• Clinical application and a basic understanding of normal and pathological appearances within the image
• Introduction to image registration

Innovation and service improvement

• Role of ICT in innovation and service improvement
• Project management
• Process mapping
• Equipment life cycle
• Specification, procurement, installation and commissioning
• Critical review of protocols, techniques and equipment
• Health Technology Assessment
• Horizon scanning

Activities

• Observe the work of the department and discuss the role of ICT hardware, software and network components within the context of Medical Physics and Clinical Engineering with your training officer, identifying areas of good practice and potential improvements.
• Observe and participate in a range of clinical measurements (which may cover electrophysiology, pressure and/or flow) and reflect on how each contributes to the care pathway of the patient, attending multidisciplinary team meetings where practicable.
• Observe the administration of a local area network (user specification, initial set-up, shared resources and security issues) and reflect on the impact and risks of local area networks within the department and wider NHS with your training officer.
• Observe the transfer, archiving and display of medical images within radiology and other relevant areas within secondary care, and critically analyse the process, identifying strengths and potential for improvement against local guidelines.
• Follow the ICT workflow from patient referral and appointment, through modality work list, data acquisition, archiving and reporting, and discuss with your supervisor the impact of ICT workflow on the throughput of the department and the patient.
• Follow the ICT workflow from subject identification and consent through to Clinical Report Form completion and collection of other data sources such as images or genomic sequences. Discuss with your supervisor the impact of ICT workflow on the recruitment process.
• Observe a clinical trial(s) at different stages, focusing on how ICT is used to support clinical trials, and assist in data processing for a clinical trial, focusing on how data quality is ensured and the methods by which data are transferred and processed, and discuss the limits to which routinely collected clinical data can be used for research and how such uses can be provisioned and controlled with your training officer.