There has been significant progress in developing
and evaluating computer applications aimed at improving personal health and
healthcare and this often referred to as “medical informatics”: the
intersection of information technology (IT) and medicine. By focusing on
healthcare that is predictive, preventive, personalized and participatory (P4
medicine) new frontiers in Healthcare Information Technology (HIT) are emerging.
However, the road to successful implementation of IT has been challenging, with
strong factors pushing it up the path of progress while simultaneously pulling
it down.
The Push for HIT
“Prevention is Quality. Prevention lowers cost”.
The healthcare sector will save trillions of dollars if healthcare is made
convenient while simultaneously improving quality and lowering cost. While this
sounds difficult, it is not an impossible task. According to Robert Pearl
during his speech at the 8th Annual American Health Care Congress, sending
secure email to physicians and getting almost immediate diagnosis increases
productivity by $28,000/year. Only a few minutes are required to make initial medical
assessment and there is no need to meet the physician in person. In areas such
as dermatology, 70% of the patients received care almost immediately because of
sending information safely and securely via internet.Another emerging sector in HIT is mobile apps. This sector aims to better connect medical professionals with patients and decrease the divide between patient, doctors and nurses. The technology also aims to improve the flow of information among the medical community by allowing doctors and nurses in the same health institution to communicate efficiently and provide the right medical treatment at the right time.
Hurdles faced by HIT
The barriers to shifting healthcare to a predictive
and preventive system includes costs, technical issues, system
interoperability, concerns about privacy and confidentiality, and lack of a
well-trained clinical informatics workforce to lead the process.
While there is an increased demand for HIT, its development has been rather slow. Evaluation by means of randomized controlled trials (RCT) has not yet provided any major indications of improved patient outcomes or cost effectiveness. The evaluation technique adopted has a severely negative impact on the progress of information as clinical information technology is not comparable to a drug and cannot be evaluated using randomized controls. The major drawbacks to using RCT is cost and difficulty related to external validity. Further, a negative result from such trails do not provide any constructive feedback as it does not help us understand the effects of the clinical system or help us build better ones in the future.
In conclusion, HIT is a disruptive technology that has the potential to steer the healthcare system towards the path of success if IT and healthcare are able to more easily merge to form one cohesive sector.
References:
Dr. Robert Pearl's speech at the 8th Annual American Health Care Congress
http://www.bmj.com/content/316/7149/1959
The
article “Evaluating information technology in health care: barriers and
challenges” evaluates the issues faced by clinical informatics
http://medicalcenter.osu.edu/about
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