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The Importance of Informatics for Health Care Industry

September 2016
Acta Medica Anatolia 4(3):124-125

DOI:10.5505/actamedica.2016.81300

License
CC BY 4.0

Authors:

Düzce University

There is no industry that does not benefit from the advantages of information technology (IT). Health care industry is no different from them. IT solutions are used to minimize the human resource required for labor-intensive or time consuming tasks by automating them, benefit from the intelligent software solutions that not just store the data in electronic format but also ease the decision making process, accelerate the business processes by providing services simultaneously, and provide maintainable and consistent services. Despite all of these advantages, health care industry spends only 2% of its revenues on technology, which is very limited when it is compared to other industries that spend around 10%.

Available via license: CC BY 4.0

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124

Acta Medica Anatolia

Correspondence: Abdullah Talha Kabakuş, IT Center, Abant Izzet Baysal University, Turkey

Conict of Interest: None

E-mail: talhakabakus@gmail.com

Volume 4 Issue 3 2016

doi: 10.15824/actamedica.2016.81300

Anatolian Medicine History

1 IT Center, Abant Izzet Baysal University, Turkey

2 Department of Computer Engineering, Duzce University, Faculty of Engineering, Turkey

Abdullah Talha Kabakus1, Resul Kara2

The importance of informatics for health care industry

There is no industry that does not benefit from the

advantages of information technology (IT). Health

care industry is no different from them. IT solutions

are used to (1) minimize the human resource

required for labor-intensive or time consuming tasks

by automating them, (2) benefit from the intelligent

software solutions that not just store the data in

electronic format but also ease the decision making

process, (3) accelerate the business processes by

providing services simultaneously, and (4) provide

maintainable and consistent services. Despite all

of these advantages, health care industry spends

only 2% of its revenues on technology, which is

very limited when it is compared to other industries

that spend around 10% (1). According to the report

published by University of Illinois at Chicago’s Online

Health Informatics Program, 50,000 health care

informatics professionals will be needed in the next

5-7 years which means 21% projected increase in

health care informatics jobs between 2010 and 2020

(2). The advantages of IT solutions for health care

industry can be listed as:

• Clinical decision support systems (CDSSs) are

equipped with various software technologies such

as artificial intelligent, fuzzy logic, artificial neural

networks, and data mining to evaluate existing

patients’ data to make a deduction about the

patient’s diagnosis and make recommendations

for the treatment.

• Electronic health record (EHR) refers to

systematized collection of patient in a digital

format (3). This record contains detailed

information about the patient such as medical

history, medication and allergies, immunization

status, laboratory test results, radiology images,

vital signs, personal stats like age and weight

(4). Since this data is stored in digital format, it

is accessible from anywhere and anytime when

the access is granted. EHR lets patients to be

informed about their laboratory test results and

treatment processes. Also, storing the data in

digital format makes it possible to backup the

whole data easily thanks to the state-of-the-

art digital backup solutions. Storing the patient

data in a central server is necessary in order to

construct a knowledge base for the diseases and

regarding treatments.

• Telemedicine is the use of communication

technology based on the internet to provide health

and social care directly to the patient located in a

remote area (5). Telemedicine lets patients who

may not be able to drive to meet physicians face-

to-face such as patients with advanced level of

muscle diseases, respiratory system diseases, and

diabetes (6–8), to have a chance to communicate

with their physicians through the internet.

Another necessity for the use of Telemedicine

is that underdeveloped countries are in need

of large number of physicians as it is reported

that in sub-Saharan Africa, on average, there are

fewer than ten physicians per 100,000 people

and 14 countries do not have radiologists (9).

Telemedicine currently is widely used in different

medical specialties such as psychiatry, neurology,

cardiology, surgery, ophthalmology, genetics,

pathology, microbiology, oncology, dermatology,

dentistry, geriatrics (10). Telesurgery is one of

telemedicine applications that lets physicians

to operate patients with using manageable

robots. The communication channel is in need

of high bandwidth in order to provide a lag

free synchronous communication between the

surgeon and the robot.

It is evident that health care industry is in need of

IT solutions more than any other industries due to

three major reasons: (1) It is necessary to store and

process large amount of patient data, (2) physicians

need to use intelligent systems to make better

diagnosis and arrange patient’s treatment with

taking the advantage of being able to review arranged

Received: 17.05.2016 Accepted: 07.06.2016

125

Kabakus et al.

Acta Med Anatol 2016;4(3):124-125

Anatolian Medicine History

treatments for similar patients and their courses

of disease, (3) physicians need to communicate

with patients located in remote places. Informatics

will not only ease the things for patients by letting

them to drive the whole health care processes by

online, but also will help physicians to make better

decision for the patients’ treatments with using

intelligent software systems and will let physicians

to monitor their patients closely. We experiment

that telemedicine is not commonly used by the

health care industry in Turkey especially when it is

compared to overdeveloped countries. Despite that

we think that the technological requirements for

telemedicine are ready to popularize it in Turkey

thanks to the latest developments in the information

technology.

1. Clark C. Healthcare information systems. In: e-Health-

care. Aspen; 1995. p. 300–1.

2. The Intersection of Healthcare and IT [Internet]. Uni-

versity of Illinois at Chicago Program Online Health In-

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http://healthinformatics.uic.edu/resources/info-

graphics/the-intersection-of-healthcare-and-it/

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Medical Internet Research. 2005.

4. Dinya E. Health Informatics: eHEALTH and TELEMEDI-

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Background The use of telemedicine has grown across several medical fields, due to the increasing number of “e-patients”. Objective This narrative review gives an overview of the growing use of telemedicine in different medical specialties, showing how its use can improve medical care. Methods A PubMed/Medline, Embase, Web of Science, and Scopus search was performed using the following keywords: telemedicine, teleconsultation, telehealth, e-health, and e-medicine. Selected papers from 1996 to 2014 were chosen on the basis of their content (quality and novelty). Results Telemedicine has already been applied to different areas of medical practice, and it is as effective as face-to-face medical care, at least for the diagnosis and treatment of some pathological conditions. Conclusion Telemedicine is time- and cost-effective for both patients and health care professionals, encouraging its use on a larger scale. Telemedicine provides specialist medical care to patients who have poor access to hospitals, and ensures continuity of care and optimal use of available health resources. The use of telemedicine opens new perspectives for patients seeking a medical second opinion for their pathology, since they can have remote access to medical resources that would otherwise require enormous costs and time.

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Many developing countries have an acute shortage of doctors, particularly specialists. Sub-Saharan Africa has, on average, fewer than 10 doctors per 100 000 people, and 14 countries do not have a single radiologist.1 The specialists and services that are available are concentrated in cities. Workers in rural health care, who serve most of the population, are isolated from specialist support and up to date information by poor roads, scarce and expensive telephones, and a lack of library facilities.2 Can information technology offer solutions? If so, what technologies are likely to be most effective and economical? The internet is making inroads into Africa: whereas three years ago only 12 countries in Africa had internet access, it is now available, at least in the capital city, in 53 out of 54 African countries.3 Free online resources include journals,4 research databases, and training courses.5 Email has many advantages …

The Emergence of National Electronic Health Record Architectures in the United States and Australia: Models, Costs, and Questions

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Full-text available

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Emerging electronic health record models present numerous challenges to health care systems, physicians, and regulators. This article provides explanation of some of the reasons driving the development of the electronic health record, describes two national electronic health record models (currently developing in the United States and Australia) and one distributed, personal model. The US and Australian models are contrasted in their different architectures ("pull" versus "push") and their different approaches to patient autonomy, privacy, and confidentiality. The article also discusses some of the professional, practical, and legal challenges that health care providers potentially face both during and after electronic health record implementation.

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We have conducted a systematic review of home telecare for frail elderly people and for patients with chronic conditions. We searched 17 electronic databases, the reference lists of identified studies, conference proceedings and Websites for studies available in January 2006. We identified summaries of 8666 studies, which were assessed independently for relevance by two reviewers. Randomized controlled trials of any size and observational studies with 80 or more participants were eligible for inclusion if they examined the effects of using telecommunications technology to (a) monitor vital signs or safety and security in the home, or (b) provide information and support. The review included 68 randomized controlled trials (69%) and 30 observational studies with 80 or more participants (31%). Most studies focused on people with diabetes (31%) or heart failure (29%). Almost two-thirds (64%) of the studies originated in the US; more than half (55%) had been published within the previous three years. Based on the evidence reviewed, the most effective telecare interventions appear to be automated vital signs monitoring (for reducing health service use) and telephone follow-up by nurses (for improving clinical indicators and reducing health service use). The cost-effectiveness of these interventions was less certain. There is insufficient evidence about the effects of home safety and security alert systems. It is important to note that just because there is insufficient evidence about some interventions, this does not mean that those interventions have no effect.

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Healthcare reform arising from the consumer’s demand for cost-effective health access, services, and quality requires a new, previously unimagined health delivery system. The healthcare industry, administrators, and care providers are challenging traditional approaches, structures, roles, practices, and information system technology. Healthcare organizations are exploring such avenues as continuous quality improvement, managed care, patient-centered reengineering, integrated health networks, and a computer-based patient record. The traditional hospital information system is changing to provide for the management and processing of patient-centered data, information, and knowledge across the healthcare continuum, patient’s life span, windows of time, and diffuse organizational and geographical boundaries. The traditional hospital information system has now become a healthcare information system.

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Chronic respiratory patients requiring oxygen or home mechanical ventilation experience frequent exacerbations and hospitalisations with related costs. Strict monitoring and care have been recommended. The aim of the present study was to primarily evaluate reduction in hospitalisations and, secondly, exacerbations, general practitioner (GP) calls and related cost-effectiveness of tele-assistance (TA) for these patients. A total of 240 patients (101 with chronic obstructive pulmonary disease (COPD)) were randomised to two groups: an intervention group entered a 1-yr TA programme while controls received traditional care. No anthropometric and clinical differences were found between groups both in baseline and in mortality (18% for TA, 23% for controls). Compared with controls, the TA group experienced significantly fewer hospitalisations (-36%), urgent GP calls (-65%) and acute exacerbations (-71%). Only COPD patients, as a separate group, had fewer hospitalisations, emergency room admissions, urgent GP calls or exacerbations. Each patient referred to staff a mean± sd 36±25 times. After deduction of TA costs, the average overall cost for each patient was 33% less than that for usual care. In chronic respiratory failure patients on oxygen or home mechanical ventilation, a nurse-centred tele-assistance prevents hospitalisations while it is cost-effective. The chronic obstructive pulmonary disease group seems to have a greater advantage from tele-assistance.

Diabetes Disease Management Program for an Indigent Population Empowered by Telemedicine Technology

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Mercy Health Center in Laredo, Texas implemented a Telemedicine Diabetes Disease Management Program to determine the impact of a web-based patient interface technology as part of a diabetes disease management program. The program featured the use of the Health Hero iCare Desktop and the Health Buddy appliance. The Mercy Health Center outcomes study aimed to assess the effect of telemedicine technology on the health of indigent border residents with diabetes. The study was conducted in calendar year 2000-2001 using comparative cohort data from calendar year 1999. Using the technology, patients were monitored daily at home, and to ensure early intervention, nurses were alerted if patients reported abnormalities. The goals of the program were to decrease hospital-based resource utilization, improve patient compliance with treatment plans, improve the level of patient satisfaction with healthcare services, and improve patients' perceived quality of life. Objective outcomes, including inpatient admissions, emergency room visits, postdischarge care visits, and outpatient visits, as well as charges for healthcare services, were all measured on a per patient per year basis. Subjective outcomes, including quality of life and patient satisfaction, were estimated from surveys conducted before, quarterly for two quarters within the program, and at the end of the study period. For each measure except for quality of life, comparisons were made between the year just prior to and the year of Health Buddy utilization. Quality of life was compared for the year just prior to Health Buddy utilization and at the end of the second quarter. After 1 year, reductions in overall utilization and charges, as well as improvements in quality of life, were demonstrated. Patients in the program showed reduced overall charges of 747 dollars per patient per year. Inpatient admissions were reduced 32% (p < 0.07), emergency room encounters were reduced 34% (p < 0.06), postdischarge care visits were reduced 44% (p < 0.28), and outpatient visits were reduced 49% (p < 0.001). Quality of life was assessed using the Medical Outcomes Study 12-item Short Form health survey. The mean improvement in the mental component after 6 months in the program was 2.8, from 45.1 preprogram to 47.9 within the program (p < 0.0264). The mean improvement in the physical component after 6 months in the program was 2.1, from 41.7 preprogram to 43.8 within the program (p < 0.0518). The reductions in utilization and improvement in quality of life can likely be attributed to the patient's enhanced self-management behaviors and the nurse's ability to intervene in a timely manner when warranted. Without technology and daily remote monitoring, standard patient care is based on episodic encounters between patients and their care providers, which does not allow for prevention, education, or early intervention. This program bridged the gap between office visits for the patients. The early intervention ultimately reduced the cost of care.

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We have used telemedicine at the Seattle Veterans Administration Medical Center to deliver follow-up care to patients with Parkinson's disease (PD). Patients were located at eight facilities which were 67-2400 km from the medical centre. Each facility had videoconferencing equipment (connected by Internet Protocol at 384 kbit/s), and computer terminals that could access the patient's electronic medical record. Over a three-year period, we used telemedicine for 100 follow-up visits on 34 PD patients. Visits lasted 30-60 min. Patients and providers were satisfied with the use of the technology. Savings amounted to approximately 1500 attendant travel hours, 100,000 travel kilometres, and US 37,000 dollars in travel and lodging costs. For the first 82 telemedicine visits, the video quality was inadequate for scoring all components of the motor Unified Parkinson Disease Rating Scale (UPDRS). For the last 18 visits, a different videoconferencing unit produced better video quality, which was satisfactory for motor UPDRS measurements, except for components that required physical contact with the patient (rigidity and retropulsion testing). Our experience shows that telemedicine can be used effectively for follow-up visits with selected PD patients who are unable to travel.

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E Dinya

Dinya E. Health Informatics: eHEALTH and TELEMEDI-CINE. 2013.

The Importance of Informatics for Health Care Industry

Abstract

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