1

The role of IS/IT in healthcare

Session 1: Seminar Medical Informatics

Rogier van de Wetering, PhD

1Dept. of Information and Computing Sciences, Utrecht University, The Netherlands

Utrecht, April 29, 2011

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Outline

Key developments in healthcare

Types of systems

Trends and developments

Benefits of IS/IT

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Vision Microsoft on the Future of healthcare

“We always

overestimate the

change that will occur

in the next two years

and underestimate the

change that will occur

in the next ten.”

--Bill Gates Jr.

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Key developments in healthcare from an international context

Individuals more engaged

in decisions and purchases

Providers develop new services to

clients (product

and quality information)

Development of service

innovations to enhance care

and cure

Growing costs of healthcare

Ageing population

E-prevention programs will reduce future

healthcare spending

Providers develop

management information of performance

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Current healthcare systems

Inefficient

Fragmented

Quality issues

Expensive

What about IT?

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International Comparison of Spending on Health, 1980–2007

Source: Davis et al., How the performance of the U.S.

health care system compares internationally. The common

wealth fund (2010). See also OECD.org

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The United States spends more than any other OECD country on healthcare

1

6,0

11

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10

,7

10

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10

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10

,4

10

,2

9,9

9,9

9,8

9,7

9,7

9,4

9,1

9,1

9,0

9,0

8,7

8,7

8,5

8,5

8,4

8,1

7,8

7,3

7,2

7,1

7,0

6,9

6,5

6,0

5,9

0

2

4

6

8

10

12

14

16

18

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% GDP

Public expenditure on health Private expenditure on health

1. Current expenditure. Source: OECD Health Data 2010.

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Health reform legislation should improve the affordability of insurance and access to

care in the US

Source: Davis et al., How the performance of the U.S. health

care system compares internationally. The common wealth fund

(2010). See also OECD.org

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Overview of various types of IS/IT

Electronic health records (ePR/eMR)

Computerized provider order entry (CPOE)

Decision and diagnostic support (e.g. CAD/CAR)

Advanced visualization tools

Enterprise-wide image management systems (i.e. PACS)

Prescribing systems

E-Health / consumer informatics / educational

Surgical simulation and modeling

Mobile computing

Tele-medicine

Administration

Data exchange networks (e.g. XDS-i, IHE)

Knowledge discovery/mining and retrieval systems

(Cf. Haux, 2010; Chaundry, 2006; Huang, 2010)

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Extracted clusters from 16 medical informatics journals, appearing between 2005 and 2008

Organization, application,

and evaluation of health IS

Medical knowledge representa -

tion

Signal and data analysis

Source: M. J. Schuemie1 et al., Mapping the Domain of

Medical Informatics. Methods Inf Med 2009; 48: 76–83

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Hype Cycle for Healthcare Provider Applications and Systems

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There are many possible benefits and costs of implementing health information

technology

Effects of health IS/IT (Cf. Chaundry, 2006):

Quality

Efficiency

Costs

Challenges for the future:

Interoperability of medical data

Adoption rates of IS/IT

Misalignment of incentives for its use

Key question remains: How to apply IT effectively?

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X–Ray Exam without PACS: an inefficient process

Un–Hang Films

& Attach Report

Patient

Registered Exam Performed

Patient Data

Re–Entered

at Acq Device

Previous Exams

hung in Reading

Room

GEYMS

CT

Return Films

to File Room Re–assemble

Film Jacket

Send Films &

Report to Referring

Physician

Retrieve Films &

Report to Referring

Physician

Radiologist Read

Dictate & Approve

Develop

Film Quality

Assurance

Hang

Films

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X–Ray Exam with PACS: an efficient

process

Patient

Registered Exam Performed

GEYMS

CT

Radiologist Read

Dictate & Approve

Referring Physician

Accesses Report

and Films

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Final remarks

Need for IS/IT in healthcare

Classifications of systems

Broad impact of IS/IT