Health information technology ( HIT ) is an information technology that is applied to health and health care. It supports health information management across computer systems and secure health information exchange between qualified consumers, providers, payers and monitors. Based on a frequently cited 2008 report on a small series of studies conducted in four locations providing outpatient care - three US and one medical centers in the Netherlands - the use of electronic health records (EHRs) is seen as the most promising tool for improving quality, safety and efficiency the whole of the health delivery system. According to a 2006 report by the Agency for Research and Quality of Health, HIT's extensive and consistent use will:
- Improve the quality or effectiveness of health care:
- Increase productivity or efficiency of health care;
- Prevent medical errors and improve the accuracy of health care and procedural truths;
- Reduce health care costs;
- Improve the efficiency of health care administration and work processes;
- Reduced unproductive or inactive working papers and work times;
- Extend real-time health informatics communication among health care professionals; and
- Extend access to affordable treatments.
Risk-based regulatory framework for IT health September 4, 2013 The Health IT Policy Committee (HITPC) accepts and approves the recommendations of the FDASIA Food and Drug Administration Safety and Administration Working Group (FDASIA) for a risk-based regulatory framework for health information technology. The Food and Drug Administration (FDA), the Office of the National Coordinator for Healthcare IT (ONC), and the Federal Communications Commission (FCC) initiated the FDASIA working group from HITPC to provide stakeholder input into reports on risk-based frameworks that promote safety and innovation and reduce regulatory duplication, consistent with section 618 of FDASIA. This provision allows the Secretary of Health and Human Services (HHS) to form a working group to gain broad stakeholder input from all health services, IT, patients and the spectrum of innovation. FDA, ONC, and FCC are actively participating in this discussion with stakeholders from all healthcare, IT, patient and spectrum innovations.
HIMSS Good Informatics Practices-GIP is aligned with the FDA's risk-based regulatory framework for health information technology. The development of GIP began in 2004 to develop a risk-based IT technical guideline. Currently, GIP review and published modules are widely used as a tool to educate IT Health professionals.
Interoperable HIT will enhance the care of individual patients, but will also bring many public health benefits including:
- Early detection of infectious disease outbreaks across the country;
- Improved chronic disease management tracking;
- Evaluation of health services based on the value made possible by the collection of unidentifiable price and quality information that can be compared.
According to an article published in the International Journal of Medical Informatics, sharing health information between patients and providers helps improve diagnosis, promotes self-care, and patients also know more about their health. The use of electronic medical records (EMRs) is still scarce now but is increasing in Canada, the primary care of America and the UK. The health care information in the EMR is an important source for clinical, research, and policy questions. Privacy of health information (HIP) and security has been a major concern for patients and providers. Studies in Europe that evaluate electronic health information pose a threat to electronic medical records and the exchange of personal information. In addition, the software search feature allows the hospital to collect detailed information about the preparations that are shared, establishing a database of each treatment that can be used for research purposes.
Video Health information technology
Konsep dan definisi
Health information technology (HIT) is "the application of information processing involving computer hardware and software related to the storage, retrieval, sharing and use of health care information, health data and knowledge for communication and retrieval decision ". Technology is a broad concept that deals with the use and knowledge of species of tools and crafts, and how it affects the species' ability to control and adapt to its environment. However, strict definitions are difficult to understand; "technology" can refer to material objects used for humanity, such as machinery, hardware or equipment, but can also cover a broader theme, including systems, organizational methods, and techniques. For HIT, technology represents the attributes of computers and communications that can be connected to the network to build systems for transferring health information. Informatics is yet another integral aspect of HIT.
Informatics refers to information science, information processing practices, and information systems engineering. Informatics underlies academic inquiry and application of computing and communications technology practitioners for health care, health education, and biomedical research. Health informatics refers to the intersection of information science, computer science, and health care. Health Informatics describes the use and sharing of information in the health care industry with contributions from computer science, mathematics, and psychology. It deals with the resources, tools and methods necessary to optimize the acquisition, storage, retrieval, and use of information in health and biomedicine. Health informatics tools include not only computers but also clinical guidelines, official medical terminology, and information and communication systems. Medical informatics, nursing informatics, public health informatics, pharmacy informatics, and translational bioinformatics are subdisciplines that inform health informatics from different disciplinary perspectives. Processes and people of concern or learning are the main variables.
Maps Health information technology
Implementation
The Institute of Medicine (2001) called for the use of an electronic prescribing system in all health care organizations in 2010 to increase the urgency to accelerate the adoption of CPOE systems in US hospitals. In 2004, President Bush signed an Executive Order entitled The President's Health Information Technology Plan, which sets a ten-year plan to develop and implement electronic medical records systems across the US to improve maintenance efficiency and safety. According to a study by RAND Health, the US health care system can save more than $ 81 billion annually, reduce adverse health events and improve quality care if it broadly adopts health information technology.
The American Recovery and Reinvestment Act, signed into law in 2009 under the Obama Administration, has provided about $ 19 billion in incentives for hospitals to switch from paper to electronic medical records. Meaningful Use, as part of the 2009 Health Information Technology for Economic and Clinical Health (HITECH) is an incentive that covers more than $ 20 billion for HIT implementation alone, and provides further indications of the growing consensus on the potential beneficial effects of HIT. The American Recovery and Reinvestment Act has set aside $ 2 billion to be used for programs developed by National Coordinators and Secretaries to help healthcare providers implement HIT and provide technical assistance through regional centers. The other $ 17 billion incentive comes from Medicare and Medicaid funds for those who adopt HIT by 2015. Healthcare providers applying electronic records can receive up to $ 44,000 over four years in Medicare funding and $ 63,750 for six years in Medicaid funding. The sooner the health care provider adopts the system, the more funds they receive. Those who do not adopt electronic health records systems before 2015 do not receive federal funds.
While electronic health records have many potential advantages in terms of providing efficient and safe care, recent reports have uncovered some of the challenges of applying electronic health records. The most rapid barrier to adoption of this technology is the high initial cost of applying new technology and the time it takes for physicians to train and adapt to new systems. There are also allegations of billing fraud cases, in which hospitals inflate their bills to Medicare. Given that healthcare providers have not reached the deadline (2015) to adopt electronic health records, it is unclear what effect this policy will have on long term.
One approach to reducing costs and promoting wider use is to develop open standards associated with EHR. In 2014 there is a broad interest in the design of the new HL7 standard, Fast Healthcare Interoperability Resources (FHIR), designed to be open, expanded, and easier to implement, benefiting from modern web technologies.
Tech type
In a 2008 study on technology adoption in the United States, Furukawa and colleagues classified applications to prescribe to include electronic medical records (EMR), clinical decision support (CDS), and computerized physician order entries (CPOE). They further define applications for dispensing to include bar-coding in drug dispensing (BarD), robot for drug delivery (ROBOT), and automated discharge machines (ADM). They define applications for administration to include electronic drug administration records (eMAR) and bar-coding in drug administration (BarA or BCMA).
Electronic health record (EHR)
Although electronic health records (EHR), formerly known as electronic medical records (EMR), are often cited in the literature, there is no consensus on the definition. However, there is a consensus that EMR may reduce some types of errors, including those associated with prescription drugs, for preventive care, and for tests and procedures. Recurring signs alert doctors of intervals for preventive care and track referrals and test results. Clinical guidelines for disease management have demonstrated benefits when accessible in electronic records during the patient care process. Advances in health informatics and the widespread adoption of operable electronic health records promise access to patient records in every health care setting. The 2005 report notes that medical practice in the United States faces obstacles to adopting EHR systems, such as training, cost and complexity, but adoption rates continue to increase (see chart to right). Since 2002, the National Health Service of the United Kingdom has stressed on introducing computers into health care. In 2005, one of the largest projects for the national EHR was by the National Health Service (NHS) in the UK. The goal of the NHS is to have 60,000,000 patients with centralized electronic health records in 2010. The plan involves a phased rollout starting in May 2006, providing a common practice in the UK access to the National Program for IT (NPfIT), the NHS component known as "Connecting for the Health Program ". However, recent surveys show a shortage of doctors in understanding the patient's safety features of NPfIT-approved software. The main problem in HIT adoption is primarily seen by doctors, stakeholders essential to the EHR process. The Thorn et al. article, raises that emergency physicians notice that the exchange of health information interferes with the workflow and is less desirable to use, although the main goal of EHR is to improve coordination of care. The problem is that exchange does not address end-user needs, e.g. simplicity, easy-to-use interface, and system speed. The same findings seen in previous articles focusing on CPOE and physician resistance to their use, Bhattacherjee et al.
Technology of clinical point care
Computerized service provider (physician)
Error writing is the largest preventable source of errors in hospital. A 2006 report by the Institute of Medicine estimates that hospitalized patients are exposed to treatment errors daily from their stay. Computerized commission order (CPOE) entries, also called computerized doctor order entries, can reduce the total drug error rate by up to 80%, and 55% serious harm (serious harm to patients). A 2004 survey found that 16% of US clinics, hospitals, and medical practices are expected to use CPOE within 2 years. In addition to prescribing electronics, a standard barcode system for removing drugs can prevent a medication error of one quarter. Consumer information about the risks of improved drug and drug packaging (clear labeling, avoidance of drug names and similar dosage reminders) are other remedial measures. Despite much evidence of the potential for reducing treatment errors, competing systems from barcodes and electronic prescribing have slowed the adoption of this technology by doctors and hospitals in the United States, due to concerns with interoperability and compliance with future national standards. Such concerns are not unimportant; standards for electronic prescribing for Medicare Part D conflict with regulations in many US states. And, regardless of regulatory issues, for small practice physicians, utilizing CPOE requires major changes in the practice workflow and additional time investment. Many doctors are not full-time hospital staff; inserting orders for hospitalized patients means taking time away from scheduled patients.
Innovations, opportunities, and technology challenges
One area of ​​rapidly growing health care innovation lies in the continued use of data science and machine learning. The main opportunities here are:
- Health Monitoring and Diagnosis;
- Medical Treatment and Patient Care;
- Pharmaceutical Research and Development;
- Clinical Performance Optimization.
Handwritten reports or notes, manual order entries, non-standard abbreviations, and poor readability lead to substantial errors and injuries, according to the Institute of Medicine (2000) report. IOM's follow-up report (2004), Crossing the quality gap: The new health system for the 21st century , suggests the rapid adoption of electronic patient records, electronic drug ordering, with computer and internet-based information systems to support clinical decisions. However, many system implementations have experienced costly failures. In addition, there is evidence that CPOE actually contributes to some types of side effects and other medical errors. For example, the period immediately after the implementation of CPOE resulted in a significant increase in adverse drug events reported in at least one study, and other evidence of error has been reported. Collectively, these reported side effects illustrate the phenomena associated with complex adaptation system disorders resulting from poorly or poorly planned technological innovations.
iatrogenesis technology
Technology can introduce a new source of errors. Technology-induced errors are significant and increasingly apparent in the maintenance delivery system. The term to describe a new area of ​​production of this error includes the label of iatrogenesis technology for the process and e-iatrogenic for individual faults. Sources for this error include:
- Prescriber and inexperienced staff can cause the wrong security; that when technology suggests action, mistakes are avoided.
- The shortcut or default option may replace non-standard treatment regimens for elderly or underweight patients, resulting in toxic doses.
- CPOE and automatic drug expenditure were identified as the cause of errors by 84% of the over 500 health care facilities participating in the surveillance system by the United States Pharmacopoeia.
- Warnings are irrelevant or can often interfere with the workflow.
Health information technology can also produce iatrogenesis if the design and engineering is below standard, as illustrated in a 14-part detailed analysis conducted at the University of Sydney.
HIT Revenue Cycle
Income Generation HIMSS Income Task Force was formed to prepare for IT changes in the US (eg American Recovery and Reinvestment Act of 2009 (HITECH), Affordable Care Act, 5010 (electronic exchange), ICD-10). An important change in the income cycle is the international classification of illness (ICD) code 9-10. The ICD-9 code is set to use three to five alphanumeric codes that represent 4,000 different types of procedures, while ICD-10 uses three to seven alphanumeric codes that increase the procedural code to 70,000. ICD-9 is outdated because there are more codes than the available procedures, and to document procedures without ICD-9 code, unused code is used that does not fully capture the procedure or the work involved in turn affects the replacement. Therefore, ICD-10 was introduced to simplify procedures with unknown code and unify the standards closer to world standards (ICD-11). One of the major parts of the HIT Revenue Cycle is the collection of bills, it uses codes to capture replacement costs from different payers, such as CMS.
International comparison via HIT
Comparison of the performance of international health systems is important to understand the complexity of the health system and find better opportunities, which can be done through health information technology. This provides an opportunity for policy makers to compare and differentiate systems through established indicators of health information technology, because inaccurate comparison can lead to adverse policy.
See also
References
Further reading
- Ash, J. S., Sittig, D. F., Poon, E. G., Guappone, K., Campbell, E., & amp; Dykstra, R. H. (2007). The degree and importance of undesirable consequences associated with the computer provider's order entry. "Journal of the American Association of Medical Informatics, 14 (4): 415-423.
- Edmunds M, Peddicord D, Detmer DE, Shortliffe E. IT Policies and Politics Health: Primary on Policies Moving Into Action. Main Session, Annual Symposium of the American Medical Association (2009). Available as a webinar at https://www.amia.org/amia-policy-101.
- Holden, Richard J., Brown, Roger L., Alper, Samuel J., Scanlon, Matthew C., Patel, Neal R., Karsh, Ben-Tzion (July 2011). That's good, but what does IT do? Evaluate the impact of drug administration with bar codes by measuring changes in the treatment process. International Journal of Industrial Ergonomics, 41 (4), 370-379.
- Mettler T (2016). "Anticipating the incompatibility of HIT investments: Developing a viable model for e-health services". International Journal of Medical Informatics . 85 (1): 104-115. doi: 10.1016/j.ijmedinf.2015.10.002.
- Moore, An'nita & amp; Fisher, Kathleen (2012, March). Medical Information Technology and Medical Nurse-Surgery: The Emergence of New Care Partnership. CIN: Computer, Informatics, Nursing, 30 (3), 157-163.
- Milstein, Julia A. & amp; Bates, David W. (2010, March-April). Paperless health: Progress and challenges of health care systems that support IT. Business Horizons, 53 (2), 119-130.
- Sidrov, J. (2006). This is not always the case: Electronic health records and prospects are unlikely to reduce health care costs. Health Affairs, 25 (4): 1079-1085.
External links
- Resource and Health Services Administration (HRSA)
- Health Information Technology at US Department of Health & amp; Human Services
Source of the article : Wikipedia
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