2. Massively Multiplayer Online Role Playing Games (MMORPG)
2.1 El juego
In this section, typical applications of wireless technology in a modern hospital environment are considered. Particular attention is devoted to emphasizing advantages which mobility brings to standard medical procedures. The WLAN communication technology is the most frequently used one in this area of applications.
Computers and computer networks dominate our lives – and hospitals are no exception. In every modern hospital, a number of specialized systems operate. Three such systems will be presented shortly.
The goal of the Hospital Information System (HIS) is gathering, processing, and retrieving patient care and administrative information for all hospital activities. It also helps as a decision support system for the hospital authorities for developing comprehensive healthcare policies. The most important tasks of HIS systems [5], [8] can be divided into several groups:
x Storing patient data and monitoring their state:
1. providing an accurate, electronically stored medical record of the patient, e.g. containing drug allergies,
2. generating a visual or audible alert on workstation, CRT or printer at nurse station upon receipt of abnormal test results or other important data,
3. specifying a time period during which no tests are permitted for a patient,
4. processing data for statistical purposes and for research. x Data flow and managing staff:
5. supporting automatic transfer of patient data between outpatient and inpatient clinics,
6. supporting the ability to display graphical, digitized diagnostic images from hospital digital imaging storage and retrieval systems, 7. providing digital signatures to electronically approve orders,
8. providing communication with Laboratory Information Systems (LIS),
9. scheduling staff resources. x Financial aspects:
10. efficient administration of finance,
11. monitoring of drug usage and ordering effectiveness,
12. tracking and reporting on expected and actual treatment costs, 13. automatically scheduling nurse staffing requirements,
14. evaluating bed status and whole hospital performance.
Virtually all healthcare personnel in a hospital need to use a computer terminal in their everyday work. Cooperation and exchanging data via the Internet with external entities – other clinics, deliverers, etc. – is also a requirement placed on HIS systems. A popular scenario involves teleconsultations, when physicians consult their patients’ cases with domain experts in other hospitals (see Section 6 for a case study).
Radiology Information Systems (RIS) specialize in management of radiology data. Their most important goals are as follows [7]:
x processing patient and film folder records,
x monitoring the status of patients, examinations, and examination resources,
x scheduling examinations,
x creating, formatting and storing diagnostic reports with digital signatures,
x performing profiling and statistical analysis.
Picture Archiving and Communication Systems (PACS) [6] have been designed to store digitally represented medical images in many so-called modalities (e.g. standard X-rays, CT, MRI, ultrasound and NMR) and allow images to be distributed electronically and interpreted on computer workstations. Thanks to digital representations, processing costs are reduced and patient healthcare is drastically improved. Patients and hospitals do not need to store film images any longer and instant simultaneous access to digitally- stored data from anywhere is possible immediately after processing and at any later time. PACS systems can be seen as a foundation of a totally digital hospital, with no film images, although for those situations, where films are still needed, the hospital will have the ability to print them.
When speaking of the influence of wireless systems on patient care and hospital operations, it has to be noted that mobile computer access can rationalize the functioning of virtually any large organization. Instant access to any piece of data from anywhere can make the enterprise less error-prone, faster and more efficient, leading to customer satisfaction. Nevertheless, one must be conscious of the fact that even the best wireless network is not able to help if the management computer system is not working correctly and suited to the enterprise’s needs. This is why several of the above paragraphs have been devoted to HIS, RIS and PACS systems.
Adapting systems to a wireless reality can sometimes pose real problems. The issue is mainly in the limited resources (unless we consider laptop computers) of mobile devices. Tablet PCs, palmtops and other similar appliances are usually provided with small displays and have little in the way of memory, computing power, etc. This must be taken into consideration when expanding existing systems to include a wireless infrastructure. The case study presented at the end of this section partially addresses the issue in the context of a DICOM viewer running on a PDA device.
The advantages of using wireless networks in hospitals seen as enterprises, as mentioned above, are manifold. We will concentrate only on direct benefits for patients.
Patient care can be administered instantly. In hospitals, important decisions are often taken on the run – in halls or lifts. Thanks to a wireless infrastructure, the patient’s complete Electronic Health Record (EHR) is accessible from
anywhere. This seems to be especially important for patients requiring respiratory care, but even during routine visits at the patient’s bed immediate access to EHR is desirable, since common practice used to involve a consulting team with files of paper charts, and sending nurses to collect missing documentation.
Sophisticated measurements and tests can be performed at the patient’s bed with no necessity of taking him/her to a laboratory and the results can be immediately entered into EHR, thus eliminating the possibility of a mistake when copying data at a later time.
Specialized appliances – Point of Care (POC) terminals – can be attached to a patient, continuously monitoring his/her various vital functions depending on the illness or diagnosis. In an emergency, they are able to alert both nurses and doctors, who can be anywhere inside the hospital. In the future, so-called expert systems may try to automatically react on the alert and initiate appropriate procedures. In today’s medical practice, POC terminals automatically administering the prescribed medicine doses are quite popular.