Lesson 10 Discussion
Covid-19 has significantly changed the telemedicine landscape. Telemedicine was originally designed for patients in under-served areas to receive specialty care from physicians via video conferencing. A nurse is generally in the exam room with the patient to support the physician on camera. Since Covid-19 has required social distancing, physicians have been granted permission to care for their patients from home using telemedicine.
What do you think are the pros and cons of telemedicine?
Proceedings of the 4th National Conference; INDIACom-2010 Computing For Nation Development, February 25 – 26, 2010 Bharati Vidyapeeth’s Institute of Computer Applications and Management, New Delhi Role of Information Technology in Health Care Sampada S. Gulavani * and R.V. Kulkarni ** *Asst. Professor, Bharati Vidyapeeth Institute of Management, Kolhapur,
[email protected] ** Director, Chh. Shahu Central Institute of Business Education & Research, SIBER, Kolhapur,
[email protected] ABSTRACT Information Technology (IT) has the potential to improve the quality, safety, and efficiency of healthcare. This paper focuses on the expanding role of IT in Healthcare Information. Communication technologies had a significant impact on healthcare and the delivery of health services. From Telemedicine to electronic health records ,a variety of healthcare services have been shown to improve operational and administrative efficiencies, clinical outcomes, documentation and information flow in a global settings, home care units, rural health centers and large urban hospitals. However adoption and benefits have not been uniformly distributed and reliability of success has been difficult. So it is necessary to improve the quality, cost, efficiency and capacity of the healthcare service. KEYWORDS Healthcare, Information Technology, Clinical Decision Support, Clinical Data Processing, Electronic Health Record, CPOE, Electronic Prescribing, PHR. 1.0 INTRODUCTION Healthcare comprises directing and controlling a group of one or more people or entities for the purpose of coordinating and harmonizing that group towards accomplishing a goal. Healthcare often encompasses the deployment and manipulation of human resources, financial resources, technological resources, and natural resources. Indian healthcare Industry is growing at 12% annually, according to a recent report by Springboard Research. The Indian healthcare sector has started to serve customers or patients better to balance the profitable business operation and meeting social objectives. The main area of focus is to improve the service to the end customer i.e. patients. It is observed that if substantial improvement is to be achieved over the coming decade, then automation of clinical, financial, and administrative transactions is essential to improve the quality, preventing errors, enhancing consumer confidence and improving efficiency in the health care system.[1] 2.0 INFORMATION TECHNOLOGY Information Technology (IT) has the potential to improve the quality, safety, and efficiency of health care. Delivering quality health care require providers and patients to integrate complex information from many different sources. By increasing the ability of physicians, nurses, clinical technicians, and others to readily access and use the right information about their patients should improve care. The ability for patients to obtain information to better manage their condition and to communicate with the health system can also improve the efficiency and quality of care. IT allows healthcare providers to collect, store, retrieve, and transfer information electronically. To capture the role of informal interactions in the process of knowledge diffusion, physicians relies on the recommendations of colleagues with whom they interact on a day-to-day basis. Colleague recommendations are helpful because they can link specific treatments to the clinical needs of particular patients under a physician’s care, but these recommendations are not sufficient to resolve the problem of information overload. After all, physicians making recommendations have limits on their own cognitive abilities and these limits will generally make it hard for them to keep abreast of all the newest procedures. For this reason, physicians will also have to devote time to independent reading in medical journals. Reading journal articles may expose the physician to the newest innovations, but journal articles do not identify for physician the specific patients for which the innovation applies. The influence of IT enabled decision support follows naturally in this set-up. In comparison to traditional learning modalities (colleagues’ recommendations and independent reading of medical journals) , the computer based decision support tools are more likely to suggest treatments that are both new and relevant to the care of a specific patient. As a result, the new information technology will have greater influence on physicians and under plausible conditions, enhance the rate of diffusion of new knowledge. [3] IT enable doctors, paramedics, patients, insurers and regulators everywhere to become aware of new information quickly. A remarkable feature of IT is its capacity to establish and disseminate publicly accessible global databases of prices of healthcare commodities and services. The core role of IT in healthcare may be understood from the way designs of healthcare development and delivery enabled and supported by IT include or exclude people and encourage or discourage their participation in influencing decisions about allocation of healthcare resources. Participation is a vital aspect of healthcare because health consumption requires participation in its production at every level starting from individual persons (diet, hygiene, lifestyle, belief and trust in one or more medical systems) to communities (safety, pollution control, sanitation, public hygiene), and nations (healthcare standards, budgetary allocations, medical education).[2] 2.1 Need for IT in Healthcare Following points discuss the need of IT in healthcare : Proceedings of the 4th National Conference; INDIACom-2010 i. The challenge in the 21st century is a surplus of patient information. The human brain, even a physician's brain, cannot keep up with the exponential growth in medical knowledge that will occur in forthcoming years. ii. The ability of human to memorize things has remained flat, but the medical knowledge that needs to be assimilated is increasing geometrically. It is difficult for the human brain to memorize all the information at a given period of time. With the help of computer we can store massive amount of data and can retrieve it when required. Rapid technology advancements and continuous increase in performance/price indexes have made information technology (IT) applicable at all levels in health care organizations and patient management. iii. It is difficult for physicians to keep up with the rapidly changing state of medical knowledge and to understand what these changes mean for the treatment of specific patients. In such situation IT based decision support system could help doctors to learn about new treatments. iv. Health Information Technology (Health IT) allows comprehensive management of medical information and its secure exchange between healthcare consumers and providers.[4] 3.0 IT TOOLS IN HEALTHCARE Today number of tools exist and are being developed to help health information technology (IT) stakeholders to plan for and to evaluate health IT. Health IT programs serve to bring it to individual stakeholders such as providers, patients, hospitals, pharmacists, and others in this industry. These Health IT tools support in specific areas and promote better, more efficient healthcare through the use of today's technologies. Commonly used health IT tools are discussed below :[6] [7] I. Electronic Medical Records (EMR) : The EMR provides a clinician with real-time access to patient information, such as patients medical condition, visits to health providers, images and reports of diagnostic procedures, schedule of services ,allergies and contact information to caregivers and a complete longitudinal record of care evidence based on decision support tools that can be used to aid clinicians in decision making. A fully integrated EMR enables a physician to update clinical and other information about a patient on a continuous basis. The EMR can automate and streamline a clinician's workflow, ensuring that all clinical information is communicated .The EMR can support the collection of data for uses such as billing, quality management, outcome reporting, public health disease surveillance and reporting. Electronic document has tremendous advantages over the paper document such as it does not require a warehouse for storage and is readily accessible from anywhere. II. Clinical Decision Support (CDS) : CDS encompasses computerized alerts and reminders to care providers and patients, clinical guidelines, condition-focused order sets, patient data reports and summaries, diagnostic support, and other tools that enhance decision making in clinical workflow. CDS provide clinicians, staff and patients with knowledge and person-specific information, presented at appropriate times to enhance health and health care. CDS has the potential to increase adherence to clinical guidelines, protocols and best practices which helps to avoid medication errors, and to prevent complications. CDS requires computable biomedical knowledge, person-specific data, and a reasoning or inferencing mechanism that combines knowledge and data to generate “advice” to clinicians. III. Computerized Physician Order Entry (CPOE) : CPOE is used by physicians for ordering medications, orders for x- rays and other diagnostic procedures, referrals, discharges, and transfers. One important higher-level application in CPOE is that providers write orders including prescriptions using computers. Computerization of ordering is important because most actions in health care follows an order. IV. Electronic Prescribing (E-prescribing ): E-prescribing is the transmission, using electronic media of prescription between a prescriber, dispenser, pharmacy manager, either directly or through an intermediary, including an e-prescribing network. E-prescribing includes, two-way transmissions between the point of care and the dispenser. It is recommended that electronic prescription applications should be robust enough to include safety checks for allergies, drug- drug interaction warning, dose appropriateness, drug-clinical condition warning, and drug-laboratory alerts. V. Health Information Exchange : It is the electronic connectivity via internet and other networks that enables health care providers to exchange patient health information. It is necessary that the networks that permit electronic communication among providers must be secure in order to safeguard the information from unauthorized access, use and disclosure. It requires to develop data and messaging standards to establish the critical goal of interoperability to communicate with one another. VI. Personal Health Record (PHR) : PHR is an electronic application through which individuals can maintain and manage their health information in a private, secure, and confidential environment. The most salient feature of