Health care information system refers to the broad range of issues in the management and use of biomedical information, including medical computing and the study of nature of medical information itself.
The health care system forms a major building block of health care industry. The basics of health care systems remain the same-national coverage for medically necessary health care service provided based on need and quality rather than ability to pay.
Health information systems are important support tools in the management of health care services. An adequate health information system is vital not only for assessing the health needs of population and groups but also for planning and for implementation of health interventions. It is equally important in the evaluation of programmes from both the perspectives and coverage.
Potential causes of problems in Health care information systems
The health care organizational structure ought to be naturally distributed. In order to improve the quality of care, the adoption of standards to allow the effective and robust networking of the various centers for clinical, epidemiological, administrative information management purpose is a strategic and urgent measure in health care.
Health care is experiencing rapid improvements due to its changing focus and tremendous achievements in computing and communication technology. The patient information is widely dispersed; therefore, ubiquitous patient information may be obtained from any location and be effectively integrated (Khosrowpour, 2001).
The adoption of them allows the effective and robust networking of various centres for clinical, epidemiological and administrative information management purposes. However, this is far from been reality because of several challenges (Khosrowpour, 2001).
These problems in effective health care systems include among others: size/scalability, representation heterogeneity-some patient information may be represented in disparate ways within different systems, which sets barrier for data integration (Khosrowpour, 2001).
There is no consensus in data formats. Platform and programming language heterogeneity-individual health care systems are often platform dependent. They are developed using different programming languages on heterogeneous platforms, which causes incompatibility problems.
Lack of computing interoperability-hospitals uses assorted devices, instruments and systems that collect and maintain patient information. Another cause of problem in healthcare information system is real time capabilities gathering and integrating distributed patient information is not quick enough to be useful for diagnosis treatment.
In addition, security challenge forms today are healthcare challenge in collecting relevant patient information from multiple resources (Khosrowpour, 2001). The security and data limitation on data access and disclosure should be taken into consideration during patient information sharing.
Evidence since the early efforts of establishing data interchange standards and designing distributed system architecture for health care, such as Health Level 7 (HL7), Digital Imaging and communications in Medicine (DICOM), electrical Data interchange for administration, Commerce and transport (EDIFACT).
Evidence shows that though these standards are widely used, most of them focus on health data exchange and only support part of patient information. This standards or protocols neither provide truly open systems that enable users to select best of applications, nor exchange data in meaningful way. In order, to achieve an open plug and play environment, industry standard middleware architectures and interfaces should be well defined and adopted.
Ethical and cost concern of information and communication technology tools in health care (ICT)
While the trends and developments of ICT in health care have given rise to many positive developments public concerns have been raised over the many issues. First the pervasiveness of the technology that people do not understand, lack of transparency of work of healthcare professionals and its effects on the doctor patient relationship, difficulty of respecting the privacy and confidentiality of the patients especially when getting access to electronically recorded and stored health data.
The difficulty of ensuring the security of shared personal health data.Finally, lack of adequate infrastructure in certain regions and the absence of computer literacy in certain sections of the population, which may reinforce existing inequalities.
Ethical aspects of ICT use in healthcare systems are vast. They include:
Effectiveness versus confidentiality-The need to know and share patient personal health data, in order to provide good quality of care, it creates a situation of shared secrecy which may compromise confidentiality (Khosrowpour, 2001).
Privacy may be traded for certain collective goods (research, administration, planning, prevention etc) that benefit the community or population at large. In addition, the use of ICT in health care system may bring professional fear that quality assurance standards (protocols, clinical guidelines, clinical pathways etc) may restrict or diminish professional autonomy (Khosrowpour, 2001).
Though the ICT use in health care system indicates giving the best possible care to every patient, this may be very expensive and not feasibly. In the context of limited resources, to give a patient expensive care could deprive another patient of much needed basic treatment.
Ethical principles may be used to address such conflicts. This is by using the ICT as the basis of serving and preserving the basis of human dignity-privacy, confidentiality and medical secrecy. Another is by allowing autonomy serving as basis of self-determination and participation.
Ensuring justice-through equitable distribution of limited resources. Finally, by ensuring solidarity; serving as a basis of the right for everyone to the protection of healthcare, with special concern for vulnerable groups in the society (Khosrowpour, 2001).
Khosrowpour, M. (2001) managing information technology in a global environment: 2001 Information Resources Management Association, Hershey, PA, United States: Idea Group Inc (IGI)