Healthcare information technology (HCIT) has the potential to enable better care for patients, and to help clinicians achieve continual improvements in the quality of care in primary care settings.
However, simply implementing current health IT tools will not bring about these results. To generate substantial and ongoing improvements in care, health IT adoption must go hand in hand with the implementation of a robust care model and the routine use of solid improvement methods by clinicians and other staff.
What is Health Care Information Technology?
In general, IT allows health care providers to collect, store, retrieve, and transfer information electronically. However, more specific discussion of IT in health care is challenging due to the lack of precise definitions, the volume of applications, and a rapid pace of change in technology. Similar terms can be used to define different products, and
the exact functions of a system will depend on the specifics of its implementation in a given setting. Both the terms and the functions also change over time.
For example, computerized provider order entry (CPOE), which can minimize handwriting or other communication errors by having physicians or other providers enter orders into a computer system, can apply only to prescription drugs, or may also include additional physician orders, such as x-rays or other images, consultations, and transfers.
For electronic health records (EHRs, also known as electronic medical records, automated medical records, and computer-based patient records, among other names), multiple definitions exist, depending on the constellation of functions that are included (Brailler and Tarasawa 2003).
They can be used simply as a passive tool to store patient information or can include multiple decision support functions, such as individualized patient reminders and prescribing alerts. When purchasing IT, providers must consider multiple
functions and literally hundreds of applications offered by numerous vendors. In general, the various IT applications fall into three categories:
• Administrative and financial systems that facilitate billing, accounting, and other administrative tasks;
• Clinical systems that facilitate or provide input into the care process; and
• Infrastructure that supports both the administrative and clinical applications.
Some terms which are used frequently in discussions of Information Technology in Health Care:
Electronic health record (EHR): EHRs were originally envisioned as an electronic file cabinet for patient data from various sources (eventually integrating text, voice, images, handwritten notes, etc.). Now they are generally viewed as part of an automated order-entry and patient-tracking system providing real-time access to patient data, as well as a continuous longitudinal record of their care.
Computerized provider order entry (CPOE): CPOE in its basic form is typically a medication ordering and fulfillment system. More advanced CPOE will also include lab orders, radiology studies, procedures, discharges, transfers, and referrals.
Bar coding: Bar coding in a health care environment is similar to bar code scanning in other environments: An optical scanner is used to electronically capture information encoded on a product. Initially, it will be used for medication (for example, matching drugs to patients by using bar codes on both the medications and patients’ arm bracelets), but other applications may be pursued, such as medical devices, lab, and radiology.
Clinical decision support system (CDSS): CDSS provides physicians and nurses with real-time diagnostic and treatment recommendations. The term covers a variety of technologies ranging from simple alerts and prescription drug interaction warnings to full clinical pathways and protocols. CDSS may be used as part of CPOE and EHR.
Radio frequency identification (RFID): This technology tracks patients throughout the hospital, and links lab and medication tracking through a wireless communications system. It is neither mature nor widely available, but may be an alternative to bar coding.
Picture archiving and communications system (PACS): This technology captures and integrates diagnostic and radiological images from various devices (e.g., x-ray, MRI, computed topography scan), stores them, and disseminates them to a medical record, a clinical data repository, or other points of care.
Electronic materials management (EMM): Health care organizations use EMM to track and manage inventory of medical supplies, pharmaceuticals, and other materials. This technology is similar to enterprise resource planning systems used outside of health care.
Interoperability: This concept refers to electronic communication among organizations so that the data in one IT system can be incorporated into another. Discussions of interoperability focus on development of standards for content and messaging, among other areas, and development of adequate security and privacy safeguards.
How it is impacting the healthcare?
The future of healthcare in the complex 21st century depends on technology and our response to it. Physicians today are standing at the forefront of a radical shift in the delivery of medicine. We are at the dawn of an advance that can significantly improve clinical care for the patients. Medicine is becoming more and more complex.
Each year brings more guidelines and more medications with more potential side effects and interactions. The population is aging and more patients are presenting with multiple chronic problems. It will soon be impossible to deliver the standard of care without an electronic record.
Need of Health Care Information Technology:
The paper-based techniques for record-keeping served caregivers and their patients well in earlier eras, when most people had a single physician over many years and much of their medical history resided in that physician’s memory.
In the modern era, however, the enormous complexity and sophistication of medical practice involving multiple care providers, the geographic mobility of citizens, and the critical requirement for adequate patient information in medical decision-making have stressed the traditional modes to the breaking point. Indicators of distress in the health care delivery system have been visible for some time. Some examples:
1. Medical errors have been found in one of every five doses given in typical hospitals and skilled nursing facilities, and 7 percent of those errors (more than 40 per day in a typical 300-patient facility) were potentially life threatening.( Barker, Flynn , Pepper)
2. From 17 percent to 49 percent of diagnostic laboratory tests are performed needlessly because medical history and results of earlier tests are not available when new tests are ordered.(HIMS,2006)