From Big Medical Encyclopedia

AUTOMATED CONTROL SYSTEM (ACS). Concept ACS first of all is connected with automation of organizational (administrative) management. Also automated process control systems are of great importance. The main automation equipment of processing of information used in work of ACS is electronic computer (see). COMPUTERS are used in ACS as well for preparation of versions of possible decisions (e.g., diagnoses) which acceptance remains for the person.

Need of automation of processes of organizational management is caused by growth of scales of the managed objects and the increased volumes of information necessary for development of managing (organizational) decisions.

During the works on implementation of the COMPUTER to the sphere of administrative management it is necessary to consider existence of three possible ways of their use.

1. Use of the COMPUTER as an automatic arithmometer for performance of separate computing works. The effect of use of the COMPUTER is reached due to more bystry and exact calculations.

2. Use of the COMPUTER in the automated directory system (ADS) implemented within the existing control system. The purpose of implementation of AISS — upgrading of management due to timely providing information to workers in required terms and in shape, the most convenient for further use. Being exempted from routine work on processing of information, the personnel have an opportunity to pay bigger attention to questions of adoption of more rational decisions on the basis of complete and reliable information. The existing systems of organizational management developed or created counting on work in them only people. Taking into account their opportunities structures of the organizations, methods of work, document flow, forms and character of the used documents etc. formed. Many of the existing control systems were created without preliminary justification, quite often their structure developed accidentally. Simple implementation in the existing control systems of such powerful tools as the COMPUTER, on allows to use completely potentialitys of cars and to gain the maximum effect of this use. Therefore the most perspective is the third way — use of the COMPUTER in ACS.

3. Use of the COMPUTER in automated control systems. ACS is developed at once taking into account that in them along with people powerful technical means, and first of all will work with the COMPUTER.

The purpose of implementation of ACS consists in sharp upgrading of management at the expense of opportunities of stay most rational from the point of view of the established criteria of decisions on separate tasks of management, providing optimization of criterion of functioning of all control system.

At the first two ways of use of the COMPUTER implementation of cars is directed to improvement of the existing control system.

During the development of ACS the task of creation of the new human-machine control system intended for the replacement existing is set.

The greatest effect of use of cars in the field of management, full use of their potentialitys it is possible to receive only if the control system was developed at the rate on the automated work. Therefore automation of the existing control systems cannot give that effect which is provided with implementation of ACS.

So, e.g., in the conditions of hospital, significantly without changing the used documents and methods of work, it is possible to use the COMPUTER for statement of diagnoses (see. Diagnosis machine ). However in this case it is necessary to rewrite the diseases of the data which are contained in the history on special machine carriers and only after that to enter into the COMPUTER. Therefore other way consisting in change of forms of case histories, techniques of inspection of patients etc. is much more effective, having from the very beginning oriented them to the fact that not only people, but also cars will work. At implementation of the COMPUTER it is reasonable as well change of methods of storage and the accounting of medicines, financial and reporting documents, methods of overseeing by patients etc. Thus, it is necessary to understand the control system which is specially created taking into account that in it people and cars as ACS are «equal» functional elements, i.e. ACS — human-machine system with the automated preparation, acceptance and control of implementation of the organizational decisions directed to achievement of the uniform established purpose with the structure, methods of work, documents, document flow which are specially developed for effective (in sense of the established criterion) uses of all its elements and development of the best organizational and managing decisions for these conditions. Organizational and managing decisions are understood as any decisions (e.g., according to the diagnosis) which are made by people and on the basis of which the corresponding actions follow.

During the development of ACS it is necessary to solve the same complex of problems, as during creation of the usual control system which is (not automated) plus a number of the additional, connected with existence in ACS COMPUTERS.

Development and deployment of ACS demand therefore use of considerable temporary, financial and human reserves.

So, e.g., development of ACS of large hospital demands up to 5 years of work of the qualified group of developers. Usually as developers staff of the specialized research and proyektnokonstruktorsky organizations is attracted. However successful development demands their close interaction with the management and the staff of that institution, for to-rogo is developed by ACS (customers).

Development of ACS has a number of specific properties and is conducted usually on separate tasks (functions). On a Mercedes of the decision and implementation of separate tasks there is a transition to the automated methods of work to ACS.

The choice of priority of the solution of separate tasks is made generally taking into account importance of a task (function) and a possibility of gradual accumulation of power of ACS.

So, during the development of ACS of medical establishment perhaps serial problem solving: supplying, machine diagnosis, overseeing by patients, financial etc.

In medical institutions automation of performance of a number of functions is reasonable. E.g., systems of automation at which information obtained at inspection of patients comes to computer memory are known. Respectively grouped and processed, it makes the automated case history, edges in case of need is easily removed from the COMPUTER.

In practice the automated systems of overseeing by patients are more and more widely used. Rather easily the system of storage of drugs and control of their stocks gives in to automation. Automation of administrative management by medical institutions gives considerable effect.

Memory sizes of the modern COMPUTERS, a possibility of connection of the car with a set removed on considerable distances from final devices allow to automate the functions connected with medical service of the population of the whole territorial units — areas, areas, the republics. Conditions of centralization of medical information, delivery from a uniform data bank, data connected with health care, etc. are created.

Any ACS includes a number of subsystems. Usually subsystems are allocated on corresponding with the basic, main, to functions.

ACS for multi-profile medical establishment can include a number of subsystems, excellent from each other appointment and specifics of solvable tasks. Main subsystems of such ACS:

1. «Chemical laboratory» — the subsystem intended for data processing, coming from automatic chemical analyzers, and results of manual analyses, entering of results of processing to the automated case history or their deliveries on the printer.

2. «Radiology» — the subsystem intended for automatic calculation of exposure doses, the data processing arriving from devices during radiological inspection, and management of radiotheraphy for receiving optimal conditions of radiation of the patient.

3. «Intensive observation» — the subsystem servicing chambers of intensive observation. This subsystem makes control of a condition of seriously ill patients, gives messages on crisis conditions of patients and can report at the request of the doctor various data on the patient for a certain span, napr, change of pulse or pressure of the patient in the last hours.

4. «Health service» — the subsystem intended for automation of administrative service of establishment, napr for the account and distribution of bed fund etc.

5. «Case history» — a subsystem, function a cut is automation of maintaining a case history, the statistical account and so forth. This subsystem is connected with other subsystems issuing data in it, napr, results of analyses etc.

6. «Drugstore». The functions which are carried out by ACS for pharmacy chain of hospitals following: 1) the accounting of existence and receipt of medicines on a warehouse of a drugstore; 2) processing of the orders for medicines arriving from divisions of hospital; 3) issue of certificates to personnel of a drugstore of existence of this type of medicines in a warehouse of a drugstore; 4) issue of inventory and reporting documents on a drugstore, napr, about existence of medicines of all types which are available in a drugstore as of this day; 5) issue of accompanying documents for the processed orders (the sheet to the unit manager of hospital on the medicines given to this division); 6) conducting finansovobukhgaltersky activity of a drugstore; 7) control of the validity of the medicines which are in a warehouse (on periods of validity); 8) control of normative stocks in a warehouse; b) statistical accounting of an expense of medicines.

The first attempts of implementation of the COMPUTER in medicine were made in the late sixties. the 70th years became years of broad expansion of works on creation of ACS for different medical institutions. Further implementation of ACS and the COMPUTER in medical practice perhaps only with active participation in this work of doctors and specialists but the organization of health care.

Bibliography: Mamikonov A. G. Methods of development of the automated systems management, M., 1973, bibliogr.

O. I. Aven.