Research paper Sample: Healthcare Information Technology

Publication Date: 17 Jan 2020

Abstract

In modern conditions, information and communication technologies (ICT) are a significant factor determining the dynamics of the socio-economic development of the state, including the development of the public health system. The introduction and widespread use of modern ICTs and the development of telemedicine should be an integral part of measures to modernize healthcare, ensure accessibility and improve the quality of medical care, and implement national priorities in the field of public health. The relevance of the development of information technology with the use of modern computer technology and communications is now no one in doubt. This is the basis for the development of all socio-economic sectors of the country. Healthcare is not an exception – many hopes for improving the quality and accessibility of medical care, for improving management efficiency and using available resources are associated with the widespread introduction of information and computer technologies in health care. We have previously formed a systematic view of the main factors, leading principles and key conditions for the successful computerization of health care. Subsequently, the problems that exist in the implementation of each of the main factors – organizational, technical, program, information and personnel were formulated. Unfortunately, it is necessary to state that almost none of the problems listed above have seen any tangible positive developments. Despite the obviousness of such an approach to the question, this problem has tended to increase in recent years.

 Introduction

Health care is an area where the requirements for accuracy and timeliness of information are particularly high. Information technologies are able to fill the existing gaps and optimize the processes of obtaining, storing and providing medical data, i.e., significantly facilitate the work of medical personnel and improve the quality of service.

Therefore, the main task of information and communication technologies (ICT) in health care is to ensure patient safety. On this basis, informatization of health care in the countries of the European Union is on the way of creating support systems for medical solutions, creating a new information environment for its activities, allowing access to professional information resources (information reference systems and thematic forums), to navigate between professional associations and recognized experts. This creates an environment of continuous education of doctors through regular monitoring of the latest achievements in the field of medicine and pharmaceuticals.

Computer support systems for medical appointments can reduce the number of medical errors in prescribing drugs by almost 80% and reduce adverse reactions by 55% (Bates, 2015). In some countries, a doctor cannot obtain licenses for professional activities without appropriate knowledge in the field of information technology (for example, in the Netherlands).

The increasing volumes of information, its reliability, methods of receiving and transmitting, dictate the use of modern information technologies in healthcare. The process of computerization of health care in our country is gaining momentum with each passing year and with this the number of medical institutions introducing and using medical information systems is increasing (Gensinger, 2010). Modern information technologies, including those in the field of health care, help to rationalize the work of medical workers, increase the effectiveness of treatment-and-prophylactic institutions and bring the health care system to a new level, both in terms of the services provided and in quality. Therefore, it is necessary to improve the regulatory framework for the use of information systems in health care, increase the confidence of doctors and management personnel in the computerization of the industry, create training centers for doctors, and highlight positive results (Coplan, 2011). The return on the introduction of medical information systems is expressed in qualitative indicators, such as improving the quality of medical care, facilitating the work of medical personnel, and improving the health of patients. Moreover, to measure the economic benefits, it is necessary to apply the methods of measuring the economic effect, which are currently not sufficiently developed.

Benefits of MIT

The return on the introduction of medical information technologies (MIT) as a whole is made up of savings in certain areas of their use, so estimates of the economic effect achieved can be obtained by identifying the fullest possible range of benefits provided by information systems. The most tangible benefits of introducing medical information systems are:

1) The benefits of reducing the number of actions with medical records, the possibility of copying records;

2) Savings on drug costs;

3) Savings on laboratory and radiological studies;

4) The benefits of shortening hospitalization;

5) The benefits of the administration obtained when working with payment documents.

The priority task in the implementation of ICT is the organization of a unified industry system of legally significant electronic document management (EDM) based on the use of public telecommunications networks, certified means of cryptographic information protection and electronic digital signature (Bower, 2005). As a basis for such a network, it is advisable to use the EDM infrastructure, which is created in the system, technically compatible with the EDM networks used in the Pension Fund and the Social Insurance Fund. This, firstly, will allow to cover practically all health care and social institutions with a single EDM network, and, secondly, to significantly reduce the time and total expenses for its construction and operation.

Areas of Implementation and Use of ICT

The most important and promising areas of implementation and use of ICT in the context of the development of domestic health care are:

1. The widespread introduction of a single social card of a citizen based on smart card technology. This card can perform the functions of a machine readable policy, an electronic prescription, a personal carrier of vital and other medical data, and also be used as a means of identifying a patient and a health professional to control access to confidential information — electronic medical records of patients, etc. – including a “citizen’s electronic health passport”. Multifunctional card will reduce the total cost of creating and operating a unified infrastructure.
2. Development of unified, federal standards and creation of infrastructure for the phased introduction of the “citizen’s electronic health passport”. The implementation of this concept, which received the name “Life Long Personal Health Record” abroad, suggests that:
3. a) when providing medical care, an electronic medical record of the patient is kept; ideally, data in an EHR accumulate throughout its life;
4. b) technical solutions are used and the infrastructure is in place to ensure quick access from any medical institution (or even an ambulance car) to all medical data of the patient, which in this case are recorded in several EHRs in different medical institutions; integrated patient data can be stored both centrally and in geographically distributed data sets;
5. c) to organize authorized access to personal data, special technical means are used to identify the patient and the medical worker, for example, on the basis of smart cards.
6. Improving information and analytical support for industry management. Phased creation of a single multi-level sectoral information-analytical system, based on the transition to the technologies of formation, maintenance and presentation of statistical reporting in electronic form across the industry, the use of modern analytical OLAP-technologies (Gartee, 2011). It is necessary to systematize, streamline, unify the statistical reporting system, and make it more informative and adequate to the real needs of health care authorities at all levels.
7. Creation of territorial (regional, municipal) integrated medical centers for data collection and processing based on the IT centers of the territorial funds of the MLA and MIAC health authorities of the subjects. Streamlining and unification of information flows between the subjects of the health care system. The transition to the implementation of the principle of “one window” in the external information exchange of medical institutions – through the IDC (Revels, 2012). These centers, in addition to solving traditional tasks for the OMS funds and health authorities, could become centers for organizing support for the introduction of ICT in hospitals, their IT services, IT consulting, personnel training, etc. In addition, ICOD could the outsourcing regime to provide medical institutions with database maintenance and preparation of reporting forms of state and departmental statistical observation (given the acute problems with the staff of medical statistics, this seems to be quite relevant and claimed). It should be noted that a similar organizational model used in Germany and the Netherlands, begins to be implemented in France. In addition, in almost all countries of the European Union, competence centers are being created in the field of ICT use in healthcare.
8. Development, active introduction and use of telemedicine technologies, especially when organizing the provision of specialized and high-tech medical care, in disaster medicine, in rural health care, in sparsely populated and remote areas, as well as in “homemade” Internet medicine – for doctor-patient communication and remote monitoring of its condition. It is necessary to use more actively modern channels and means of communication – e-mail, the Internet, a mobile phone – to transfer medical documents and provide the population with “medical reference” and “remote registry” services (Tan, 2013). Today, for the development of telemedicine, we need first a regulatory and methodological framework, which is now virtually absent. This is the main problem today. The creation of ICT telemedicine infrastructure is a task of a lower order of complexity.
9. Creating a unified automated system for registering and recording medical errors (medical personnel errors) as a necessary element of the quality management system of medical care. First, you need to develop a single classifier, forms and methods of their accounting (registration) (Tuohy, 2017). Without this, it is impossible to effectively plan and organize measures to improve the quality and safety of medical care. For example, in the USA there is a special federal agency, Agency for Healthcare Research and Quality, which collects and analyzes data on the quality of medical care, medical errors and their consequences (using ICT), maintains an appropriate database, publishes analytical materials, organizes the development of methodological guidelines, quality management manuals for medical care.
10. The organization of continuous distance education of medical workers using ICT, resources and Internet services. Medicine today is one of the most dynamically developing areas of human activity. Therefore, constant updating of the professional knowledge of doctors and nurses is necessary (Gensinger, 2010). There are quite effective standard technological solutions and products in the field of e-Learning, tools for creating multimedia information educational resources. However, for their practical application, special training programs, teaching materials, regulatory documents, etc. are needed. Now they have begun to pay considerable attention to this. In addition, the issue of amending the state educational standards and curricula for postgraduate training of medical and pharmaceutical workers in the study and development of ICT is being considered in order to bring them in line with modern requirements.

The state should stimulate the introduction of ICT in medical institutions, subsidize work on the creation and implementation of computer support systems for medical prescriptions, advisory and expert diagnostic systems, as well as scientific research in the field of medical informatics, based on competitions, grants, etc. create a competent authority to coordinate these works and studies.

Possible Problems of Implementation

The most difficult for computer implementation, obviously, is the diagnosis. The solution of this problem is the most complicated scientific and engineering problem. It is too early to talk about the widespread introduction into the practice of computer diagnostic support tools. At the same time, a significant proportion of medical errors associated with improper prescription of drugs. At the same time, the methods of formalizing the rules of their appointment and control today are largely developed, tested and proved effective. For their wide practical implementation, it is necessary to organize the work on the formalization of clinical pharmacological articles of medicines, to form and officially distribute relevant databases that are necessary for IT systems for supporting medical prescriptions, monitoring the implementation of clinical standards and examining medical care. The introduction of modern ICT in health care practice is associated with significant organizational and methodological work at all levels. The more than fifty-year history of the use of computer technology in medicine in our country has convincingly proved their high efficiency. Modern medical practice and health care are becoming more and more “ICT-dependent”.

Further Development

The underlying sections of the plan support the government’s information policy and its strategy for modernizing public administration. The plan aims to consolidate and further develop e-collaboration between health institutions, GPs and the national insurance system, which was launched during the previous document. One of the main tasks is to connect new members to the network. National information services, such as free choice of hospitals, population registers, medical personnel registries, will increasingly spread across networks (Davis, 2014). The plan focuses on cooperation with municipal health and social work systems, as well as within them. Municipal structures should play a more important role in ensuring a holistic approach to patients and users of health services. The number of elderly people in need of care is growing (Bates, 2015). There is also a growing need for cooperation between institutions providing specialized medical services, primary care and care services. Challenges for the municipal level are reducing the time spent by patients in hospital departments, increasing the volume and simultaneously increasing the responsibility for requiring care users with co-morbidities.

Applied IT is critical to ensuring quality and efficiency, fast and reliable information sharing between collaborating units within the health sector. Therefore, it is necessary to consider the development of IT in connection with changes in organizational and work processes throughout the health care system (Bower, 2005). Application of IT requires that all sections are interconnected and have a common goal. The plan follows European IT initiatives and implies that investments should be a strong support for the mainstream health and social work policies.

Therefore, the strategy focuses on two main sections:

1. Strengthening information activities: further development of infrastructure; work with information structures and security, electronic medical history, information sharing, access to professional support. Events are chosen because they are crucial prerequisites for electronic collaboration between various performers. It is also necessary to ensure the viability of solutions common to the whole country, which are already at the implementation stage.
2. Inclusion of new “actors” in the electronic collaboration. So far, e-collaboration has been developed mainly between healthcare institutions, GPs and the insurance system. The cooperation should include patients, users, their relatives, pharmacies, municipal services. They are named on the basis that IT is already fairly well spread in society and there is a need for more intensive electronic collaboration.

Ways of implementation are known. There are many methods of transmitting information: a common database, e-mail, collaboration in telemedicine. IT makes it possible to transfer healthcare services to a level closer to their consumer. At the same time, it is assumed that collaborating agencies should have access to constantly updated information on tests performed, medication use, diagnostic methods, and treatment initiated.

The main growth driver for the sector has been the unprecedented proliferation of mobile technologies, as well as new ways of using such solutions (for example, mobile phones, portable devices for patient monitoring, personal electronic assistants (PDAs), etc.) for medical purposes (Revels, 2012). The technologies have the greatest prospects in the following areas: wireless patient monitoring, location-based tele-monitoring systems, and Bluetooth-equipped medical sensors. These technologies will open up a host of new growth opportunities in the healthcare industry. Thanks to them, the medical staff and the patients themselves will have at their disposal a number of innovative solutions.

As new IT solutions are introduced and patients are monitored, each health facility will be forced to purchase a wireless communications platform. Those mobile solutions that more than others will meet the specific requirements of the healthcare industry will become the benchmark for this sector.

In the future, cloud technologies and the benefits they provide may change the very dynamics of the development of the “medical IT” industry. In particular, the need for effective and synchronized information sharing can be a key driver for the growth of the cloud technology sector for medicine. Regarding regulations, recent health sector reforms and new policies in this area, adopted in many countries, have highlighted the quality of medical services in the first place. In the absence of reliable evidence of the effectiveness of medical care, obtaining state subsidies by medical institutions may be difficult.

Conclusion

Summing up, the three main forecasts can be formulated as follows:

– in the context of the transition to a personalized service model, diagnostic aids can fundamentally change the process of drug development and commercialization. The combination of biomarkers and drugs will increase the effectiveness and safety of treatment;

– in this decade, we will witness a further convergence of the healthcare industry and medical science; many companies will look for alternatives to popular brands of drugs;

• the proliferation of new technologies to combine previously scattered medical devices into a single platform will help expand the functionality of devices, reduce the workload of staff and reduce the number of errors to a minimum.

The Ministry of Health announced a competition to create a special mobile application for mobile phones, with the help of which citizens will be able to verify the authenticity of the drug without leaving their homes. A mobile phone application that will read bar codes on packages of drugs will be available for download on the official portal of the agency. It is assumed that the mobile application will work on two operating systems – iOS and Android. To get all the necessary information about the medicine (expiration date, information about the manufacturer, instructions for use, it will be enough for a person to point the camera of the mobile phone at the bar code on the package.

References

Bates, D. 2015. Information Technology for Patient Empowerment in Healthcare. Walter de Gruyter GmbH & Co KG.

Bower, A. 2005. The Diffusion and Value of Healthcare Information Technology. Rand Corporation.

Coplan, S. 2011. Project Management for Healthcare Information Technology. McGraw Hill Professional.

Davis, N. 2014. Health Information Technology. Elsevier Health Sciences.

Gartee, R. 2011. Health Information Technology and Management. Pearson.

Gensinger, R. 2010. Introduction to Healthcare Information Enabling Technologies. HIMSS.

Revels, M. 2012. Introduction to Healthcare Information Technology. Cengage Learning.

Tan, J. 2013. Healthcare Information Technology Innovation and Sustainability: Frontiers and Adoption. IGI Global.

Tuohy, T. 2017. Healthcare Information Technology Integrated Project Delivery. Lulu.com.