The changing perspectives about health information technology over the last ten years

By Dr Adam CHEE

The year 2011 holds many promises for healthcare information technology professionals around the world as governments of various countries issue budget and mandates to implement national-wide healthcare information technology initiatives.

The talk of the town is, without doubt, the electronic medical records (EHR). From the meaningful use of EHR in the United States of America to the eHealth Programme in Hong Kong, the EHR initiatives in Taiwan and Singapore to the Personal Health Record initiative down in Australia”these are just some of the multi-million (if not billion) programmes that are taking place as we speak. While the quest towards the intended is still a long arduous journey ahead, the healthcare information technology industry has come a long way.

The need for effective health informatics

So what happened during the last decade that fuelled the current demand for adoption of nation-wide eHealth or EHR programmes? These initiatives are by any standards, neither cheap nor easy to achieve and no government will devote to such causes if it does not benefit their people and nation. The drivers point to a common indicator”a rising demand for healthcare services but an inability to meet these demands. Further, looking at things to come, there will be a continual increase in demand due to rising affluence and changes in diet, life style leading to increase in the aging population, changes in disease patterns as well as epidemiological changes.

Enabler in the past decade

Health information technology can serve as an enabler by bridging the gap arising from healthcare systems due to an inability to keep pace with the increasing demands but this only made sense if the cost of the enabling technology is kept affordable.

While the cost of the average workstation 10 years ago was relatively affordable (as compared to 15 years ago), the cost of broadband and storage was not. It is only during the last 10 years that faster and cheaper broadband and storage were made available and this served as an important catalyst in enabling the adoption of health information technology.

The other important catalysts are the convergence of standards within the healthcare information technology industry, which enables interoperability between the disparate silos of data to converge and utilisation of data, which transforms them into usable information to enable better diagnosis and patient care. The consolidation of data also allows research and trending to take place, which further fuels the acceptance and demand for healthcare information technology.

Most important, is the improvement of communication between both clinical professionals and IT professionals, the ability to work hand in glove with clinicians understanding the underlying need and the ability to fulfil those individual needs (clinical specific) while keeping focus on the grand scheme of things. Great improvements have been made during the last decade with the emergence of healthcare information technology professionals.

Formula for success

From understanding the role technology in healthcare (as an enabler) to cheaper but technologically superior workstations, servers, broadband and storage, healthcare enterprises were able to obtain a Return on Investment (ROI) from their healthcare information technology initiatives. These ROI range from operational efficiency, workflow improvement, lower operating cost, manpower reduction to most importantly, increased patient safety and quality of care.

However, the process in convincing clinicians to adopt healthcare information technology has been an uphill task, mainly due to unfamiliarity with computers and expectation management. When the concept of healthcare information technology was first introduced to clinicians, it was held as the ‘holy grail’ of healthcare, the final answer in resolving all problems that ever existed. Unfortunately, most of these solution providers come from the financial or logistic industry and lack the inability to understand clinicians’ needs. Further, with the limitations of technology at that time, the faith placed in this discipline plummet.

Effective expectations and change management by experienced healthcare information technology professionals are crucial in accelerating the re-embracement of healthcare informatics in the healthcare enterprise, especially among clinicians. In order for technologies to be implemented and used meaningfully in the healthcare enterprise, they need to become transparent to the intended end-user and associated workflow.

Picture a duck swimming; it looks graceful on the surface but a lot of paddling is happening under the water. That’s exactly how effective healthcare information technology is and this concept took healthcare information technology professionals a long time to figure out.

What will change this industry?

The introduction of new enabling technology and devices will definitely redefine the rules and boundaries that presently exist; these include:

New generation tablets: This will change access of patient information by clinicians, nurses and supporting paramedical staff and redefine point-of-care.

Cloud computing: This will change the business model adopted by healthcare enterprise as well as how they offer health services to their patients.

If you look at the examples above, mobility is the trend. The ability to break the barrier of patient care and treatment, taking place only when the patient and healthcare professionals meet physically, by providing remote monitoring and patient care is the key. Effective telemedicine at low cost are some of the trends of things to come.  In addition, we need to focus on lowering healthcare cost by looking at public health and primary care. Prevention is better than cure and spending money on tertiary care is not sustainable and many governments have started to realise that and more importantly, they also understand that effective utilisation of healthcare information technology can help smoothen the bumps due to high cost and lack of qualified manpower, as well as the fact that some things are done better by computers.

Advancements in the past decade

Looking back at the past decade and reflecting on the success and failure factors, it is evidential that in the adoption of healthcare information technology, it is not the latest or greatest technology that matters but rather, the technology that brings benefits and value to the clinicians and patients.

It is important to always seek in understanding the underlying paint-points and then develop the solution to address the needs by utilising the most affordable technology that will deliver the greatest benefits while having minimal impact on the end-users. Remember, technology serves as an enabler and not as the end goal, let us learn from the experience gained in the past decade while we embrace the exciting journey ahead.

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