Abstract
Health care provision is a significant concern in the United States; the signing of health laws by president Obama in 2010 supports this. The Patient Protection and Affordable Care Act make health care a public concern (Shi & Singh, 2012). The citizen funds in taxes flow into the implementation of various policies and improvement of the quality of; care, medication, and equipment. This occurs in a bid to improve the quality of life; it reduces mortality rates. It also reduces other challenges associated with poor health. With the onset of technology, evident changes occur in the health care system. Patient care administration embraces the use of advanced equipment and software (Friedman, 2006). With the realization of increasing health care costs, professionals realize the challenges such as; mortality and morbidity result from medical errors and situations that can be controlled through the use of technology. This paper analyzes the concept of health information technology. It explores what the roles entail; handling complex health care systems, reducing health care costs, improving the quality of patient care and other challenges. Challenges hinder the effectiveness of the use of informatics in improving administration and patient care in the system. The incorporation of informatics in the health care system still has a long way to go. Embracing informatics and other aspects of technology will boost the quality of life in the US and worldwide.
Key words: Health care provision, mortality, morbidity, informatics, information technology.
Introduction
Informatics refers to the processing, representation, and communication of information through natural or engineered systems. This occurs through the application of information technology in various fields. In relation to health care provision, health care informatics is the design, development, adoption and application of technology-based advancements in health care services delivery, management and planning (Friedman, 2006). This concept harmoniously combines the fields of health care provision and information technology thus, the development of systems useful in managing services.
This occurs through the expansion of information, advancement of clinical workflow and security of the system. Skills in information retrieval, science, computer technology and medicine, facilitate the collection, organization, and security of crucial information. The easy accessibility of health-related data depends on the use of skills in informatics.
How is this achieved? Software applications, computer hardware, and other devices professionally combine to form complex computer networks. These networks collect, analyze, and transmit medical processes. Apart from the systematic organization and storage of medical information, these systems are able to carry out several other functions. This paper analyzes the expanding role of informatics in the health care system. It gives emphasis on the various sectors of the system such as; clinical, administrative, and financial sectors. It does this with the aim of formulating a standardized approach to health care provision nationally and internationally. The role of informatics provides means of coping with challenges in the system and improving the quality of healthcare provision.
Statistics on health care in the US
In order to comprehend the role of informatics in healthcare provision, it is crucial to identify discrepancies in the system. This shows the need for technological changes that only informatics can effect. According to Liu and Robin (2012), United States faces a crisis as a result of high expenditure in the health care sector. WHO ranks the United States 37th in healthcare provision services worldwide. An improvement in health reduces the cost. The authors state informatics as an effective strategy in improving the quality and reducing costs. The American Recovery and Reinvestment Act of 2009 set aside $25 billion for investment in health care information technology and payment of incentives.
Role of healthcare informatics
Organization and accessibility of information
The main role of health care informatics is the collection, organization, and security of patient information, financial and administrative records. With the increasing number of patients visiting hospitals for medical care, it is hectic to keep track of all the paper work. The recording and storage of patients’ medical history, treatment programs, and medical expenses is close to impossible manually. The retrieval of information stored in physical files and records is time consuming and, sometimes records may get mixed up or lost. With such challenges, the incorporation of technology into the medical systems provides easy and advanced control of patient information. Feeding of patient records into the hospital’s database makes them easy to access; they are just a click away from professionals.
The large storage space enables the safe storage of records of several patients without the fear of loss or mix-ups. Furthermore, the information is available for editing and addition of more records during subsequent hospital visits. The information receives protection from the hospital’s systems; they make the information accessible to only the relevant personnel.
The incorporation of technological advancements revolutionizes record-keeping in health care facilities. Over the years, personnel with computer skills and experience help the facilities in the transition from manual to digital record-keeping. Through this, record keepers expand their knowledge and incorporate the new skills in improving their work. The electronic records provide data about conditions, health events, diseases, functional health status and wellbeing of patients. They ensure unique information about the patients remains intact and not mixed with that of other patients. This is also in reference to various segments of the health care system (Friedman, 2006).
This receives support from the administration through; the provision of in-service training, and purchase of relevant equipment; computers, digitized machines and software applications. Through the assimilation of medical information, the health care informatics systems also makes medical processes simpler through; simplification of medical jargon, easy storage, and retrieval of data, and clear communication of information.
Multi-dimensional roles of informatics
The use of health care informatics is relevant in various medical environments. Whether it is the primary care, general care, or hospital care, informatics is crucial in the effective management of health care systems. It is also crucial in other specialties within the field. It enables efficiency in operations in; administrative, clinical, and financial functions.
In managerial informatics, the management focuses on a variety of data and statistics (Norris, 2002). This includes; service planning data, performance data, demographic information, and epidemiological statistics. Administrative informatics focuses on activities such as; procurement, resource utilization, contracting data, education, and training through the incorporation of technology. In clinical informatics, the care of patients and administration of appropriate treatment plans. This is incorporated in handling diagnostic information, test data, evidence-based medicine, care pathways and procedures (Norris, 2002).
Its ability to facilitate multi-purpose operations helps professionals in performing their activities effectively and efficiently. According to Friedman (2006), apart from clinical care, the data acquired through informatics record storage is useful for various purposes. These include; health risk detection, intervention, and monitoring of the provision of health care. The information ensures data quality and completeness. It ensures the data meets the professional standards of reliability and validity. It increases the integration of health data from various states according to Friedman (2006). This also increases the burden health care providers have in responding to and collecting mandates from federal and state health agencies. It increases the use of collected data for productive activities due to easy access.
Medical decisions
Through the storage and easy accessibility of massive information on various patients’ histories, treatment programs and effectiveness, the medical practitioners can refer back when making decisions. The professionals take advantage of the constantly increasing knowledge on; the optional treatment programs available, possible results, and medications. There are computer systems known as Clinical Decision Support Systems (CDSS).
These are software applications helping with the choice of medication and treatment programs used; they consider the pros and cons of using each option. This increases the probability of effective medical services; it avoids medical errors that may result in death and worse patient conditions. Before the presentation of the possible options, the software considers all information on medical history and previous treatment plans.
Subsequently, there are electronic prescribing systems. These software applications carry out prescription writing for all treatment plans according to the reviewed medical history and current patient complications. The software improves the system by eliminating the need for hand-written prescriptions; these are always prone to errors.
In order to make appropriate prescriptions, information on various drugs is crucial. This should be considered before selection. The use of informatics facilitates data mining on information relevant to various drugs; cost, previous effectiveness, and side effects. This helps in the reduction of the cost of treatment and probability of mistakes. It improves the quality of healthcare provision for patients with varying complications.
Development of Clinical Decision Support Systems
Decision support systems are tools incorporating informatics skills in health care provision. This help in making appropriate decisions regarding clinical matters as described earlier (Liu & Rubin, 2012). In radiology, for instance, there are two types of decision support systems.
- Computerized Physician Order Entry- Decision Support (CPOE-DS)
This system is useful in the selection of the most appropriate imaging procedures for particular clinical indications. The expenditure of the US between 2000 and 2006 rose up to 17% annually. This focused on the purchase of imaging equipment for; computed tomography, nuclear medicine, and magnetic resonance imaging. These include guidelines; they help in the selection of appropriate treatments.
- Computer-Assisted Diagnosis (CAD)
This is a software application used in the provision of second opinions in radiology and other fields. In radiology, it improves the interpretation of the images. It detects and interprets the medical significance of the images; this is effective in the detection of cases of breast cancer, pulmonary nodules and colon polyps.
Data mining
Records of previous health cases are important in influencing future cases of disease and other health issues. Health records should be carefully and systematically stored. Through informatics, electronic health records provide a source of quality clinical information. This exists in the form of; progress notes, imaging reports, consultant notes, laboratory results, and discharge summaries.
Natural Language Processing automatically extracts data from unstructured documents. This makes data mining and retrieval easy. Most patient data exist according to the medical conditions; this allows focus on the elimination of challenges, quality improvement and research.
Globalization of medical care
Technological advancement changes the world into a global village; through improved communication and transport, fields such as; education, governance and trade improve. The health care system has not been left behind either. The incorporation of health informatics into the systems worldwide standardizes the approaches to healthcare in various countries worldwide. The United States and other developed countries worldwide such as Japan, Russia and Britain adopt similar technological advancements in the provision of health services to patients. Informatics techniques, tools, protocols, and concepts are useful to researchers, patients, and health care providers. They transform the delivery system and promote the best practices.
Legal requirements vary in various states; this forces the use of health care informatics to comply with the requirements of the law. As legal aspects in health change, the use of informatics in the US must comply with the changes. Its provisions must cater for ethical principles, operational practices, and various patient and administrative concerns. For instance, the American Recovery and Reinvestment Act of 2009 cater for the adoption and meaningful use of information to health care provision. This is according to Liu and Rubin (2012), who explore the contributions of informatics to health care. This is especially in the field of radiology. Various states and local regulations control informatics use and quality initiatives (Shi & Singh, 2012).
Controlling terminologies and structured reporting
As stated earlier, one of the challenges of health care provision is the understanding of jargon and medical terminologies used in addressing varied situations. Information exchange is crucial in the provision of medical care; if affected, this may pose a risk to the care of patients. Progress notes, imaging reports, and consultation notes exist in pre-text (Liu & Rubin, 2012).
Variability in the use of medical terms leads to confusion and misinterpretation of the intended information. Informatics systems such as the; Breast Imaging Reporting and Data System reduce variability in the vocabulary choice in mammography reports. RadLex is a lexicon improving the clarity of clinical communication in radiology. It does this by associating medical terms with alternative words. These alternatives have similar meanings, which boost the quality and consistency, of medical records.
Challenges affecting the role of informatics in health care provision
Informatics has a variety of roles in the health care system. It improves the system by ensuring the effective performance of the roles. However, the implementation of informatics in the system faces a variety of challenges; these slow down the productivity rates and provision of quality medical care. According to most experts, dealing with these challenges goes a long way in ensuring quality health care. According to Norris (2002), many nations, including the US, experience challenges in delivering quality health care services to its citizens. The use of information is a vital step in eliminating these challenges. They include;
- Stakeholder involvement in the implementation process
The success of the incorporation of informatics into the health care system depends on the contribution of all stakeholders to its implementation. Stakeholders have not been comprehensively involved in the process. Norris (2002), states that the support of stakeholders goes a long way in medical progress. They include; patients, doctors, nurses, support staff, researchers, professional bodies, staff and unions, management, government departments, and the community at large. United effort leads to the provision of funds and support in incorporating informatics into the various health care institutions. According to Shi and Singh (2012), over 20% of the US citizens will require long-term medical care by 2020. Ensuring this requires the development and use of costly new medical technology through collective effort.
- Cooperation from employees
The workplace environment faces challenges in adapting to changes; this is especially in cases where the changes relate to technology use. Most employees experience difficulty in adjusting to the use of new computer hardware and software applications in carrying out their daily activities. Challenge is evident in making medical providers adjust and commit to the implementation of varied information technology components.
This should be averted by motivating professionals; they thus embrace the changes. Through in-service training and workshops, they understand the effect informatics healthcare has on their individual performance and the excellence of the entire institution. They develop interest in change when they realize that informatics is productive and beneficial to their work.
- Health Information Networks
The incorporation of information technology may result in some unethical practices. Many individuals, for instance, may take advantage of the internet to make their own prescriptions instead of consulting the health care professionals; they risk making wrong prescriptions, which may be hazardous. Data storage may have poor security systems; this increases the risk of privacy and confidentiality breach on vital patient informative and administrative records. Medical errors may occur in cases where electronic storage is unavailable or faulty. The storage if vital information in this form puts it at a risk of unethically use by insurance and other organizations.
- Quality and standards of care
The use of technology in diagnosis and medical procedures faces a possibility of errors. Computer-generated images are of poor quality and make diagnosis difficult. For instance, dermatological and X-ray images have poor diagnostic qualities. Errors occur due to the lack of adequate protocols for new technology-assisted medical practices. Incorrect use of systems such as the Clinical Decision Support result in law suits for malpractice. Medical errors may also arise due to the undefined delegation of duties between the machines and humans, failed technology, poorly constructed computerized pathways, inadequate staff training, and low medical supplies through e-commerce. The change also leads to the loss of jobs by professionals whose work is done by machines; machines are capable of working for longer hours. Further research on the performance of technology imposes its roles to reduce the challenges through new innovations.
Conclusion
Health care informatics revolutionizes the performance of health care facilities worldwide. It improves the process of diagnosis and prescription of treatment for patients. This depends on the patient records safely stored and easily accessed. Technology improves the processes of identifying diseases, conditions, and medical cases early enough so they can be dealt with appropriately. The use of technology is, however, not foolproof. Just like the use of other technological concepts, a variety of risks occur in relation to; data storage, retrieval, data security, efficiency of machines, cost and availability. It faces several challenges that may prove hazardous if not dealt with by the professionals. The research studies carried out by professionals in various sectors of the medical sector aim at discovering innovative ways of eliminating the challenges associated with informatics use. Elimination of the current challenges is a great step in medical care and reduction of mortality rates. Health care depends on technological advancements in ensuring the quality of life improves in the US and other countries worldwide.
Reference
Friedman, D. J. (2006). Assessing the Potential of National Strategies for Electronic Health Records for Population Health Monitoring and Research. Vital and Health Statistics, Series 2(143), Retrieved May 4, 2013 from http://www.cdc.gov/nchs/data/series/sr_02/sr02_143.pdf
Liu, Y. I. and Rubin, D. L. (2012). The Role of Informatics in Health Care Reform. Academic Radiology, Vol. 19(9), Retrieved May 4, 2013 from http://www.intersystems.com/healthshare/WhitePapers/AccountableCare- InterSystemsWP.pdf
Norris, A. C. (2002). Current Trends and Challenges in Health Informatics. Health Informatics Journal, Retrieved May 4, 2013 from http://.jhi.sagepub.com/cgi/content/abstract/8/4/205
Shi, L., and Singh, D. A. (2012). Delivering Health Care in America: A systems approach (5th ed.). Burlington, MA: Jones & Bartlett Learning, Retrieved May 4, 2013 from http://www.books.google.co.ke/books?id=3H0mMeLIHp8C&printsec=frontcover&dq=D elivering+Health+Care+America:+A+systems+
