Barriers to the adoption of health information technology

Information Technology (IT) is successfully applied in a diverse range of fields. Though, the field of Medical Informatics is more than three decades old, it shows a very slow progress compared to many other fields in which the application of IT is growing rapidly. The spending on IT in health care is shooting up but the road to successful use of IT in health care has not been easy. This paper discusses about the barriers to the successful adoption of information technology in clinical environments and outlines the different approaches used by various countries and organisations to tackle the issues successfully. Investing financial and other resources to overcome the barriers for successful adoption of HIT is highly important to realise the dream of a future healthcare system with each customer having secure, private Electronic Health Record (EHR) that is available whenever and wherever needed, enabling the highest degree of coordinated medical care based on the latest medical knowledge and evidence. Arguably, the paper reviews barriers to HIT from organisations’ alignment in respect to the leadership; with their stated values when accepting or willingness to consider the HIT as a determinant factor on their decision-making processes. However, the review concludes that there are many aspects of the organisational accountability and readiness to agree to the technology implementation

Information management in healthcare organizations

The health care industry is currently experiencing numerous fundamental changes. Healthcare organizations (HCOs) are increasingly challenged to look at their operations and find new opportunities to reorganize their processes, in order to improve the efficiency and effectiveness of their services, reduce costs, be more competitive, and also provide high quality and more personalized patient care. This new business strategy requires HCOs to implement new Information and Communication Technologies, such as Internet applications, enterprise information systems, and mobile technologies, in order to achieve their desired business changes and results, mainly through better information management methods and techniques. Based on these perspectives, this article aims to initially define and discuss the key challenges and opportunities for promoting high quality and cost effective care in HCOs. It describes the fundamental and important aspects of information management, as well as the technology drivers that aim to improve the generation and flow of health information within HCOs.information technologies, management, healthcare organizations

Health Informatics for Healthcare Quality Improvement: A Literature Review of Issues, Challenges and Findings

Healthcare providers in the United States are facing increasing pressures to provide high quality healthcare at affordable prices, while being compliant with a multitude of complex laws. Recent legal developments have highlighted the role of Information Technology and related systems in providing evidence based healthcare in an efficient manner. Health Informatics has become an integral part of the rapidly advancing healthcare technology scenario, and is emerging as a key resource for healthcare quality improvement in the United States. Considering the rapid pace at which the field of health informatics is advancing, it is important for researchers and the practitioners alike to stay abreast of current literature and developments in the field. This literature review paper captures and summarizes from research literature the most significant issues, challenges and findings pertaining to the field of health informatics with a focus on healthcare quality improvement

Flexible Data Refreshing Architecture for Health Information System Integration

Background: Having a consistent and unified view of heterogeneous distributed medical information sources is an inevitable need of health informatics. Integrating medical information of patients or about a disease, a treatment or side effects of a drug, etc, is very useful to help medical education, to achieve medical research goals and to provide the computer- based decision support systems. Contribution: This article proposes a flexible incremental update method for the materialized part of the integration system. It permits us to manage the integration system according to the characteristics of the data sources which can change. Method: This paper presents a hybrid data integration approach in which the materialized part of the system in mediator is the object indexation structure based on an instance classification of the sources objects which correspond to the global schema. The object identifier of each object in the indexation structure is materialized together with the attributes which are needed for the incremental updating of this indexation (classifying attributes). Results: The main idea of this paper is to develop a hybrid data integration framework, which represents a new aspect of a hybrid method focusing on flexible data refreshing. Conclusion: This hybrid approach implements a vertical hybrid approach. It means that at the mediator level, some data of each object are materialized and others are virtual

OntoCR: A CEN/ISO-13606 clinical repository based on ontologies

Objective: To design a new semantically interoperable clinical repository, based on ontologies, conforming to CEN/ISO 13606 standard. Materials and Methods: The approach followed is to extend OntoCRF, a framework for the development of clinical repositories based on ontologies. The meta-model of OntoCRF has been extended by incorporating an OWL model integrating CEN/ISO 13606, ISO 21090 and SNOMED CT structure. Results: This approach has demonstrated a complete evaluation cycle involving the creation of the meta-model in OWL format, the creation of a simple test application, and the communication of standardized extracts to another organization. Discussion: Using a CEN/ISO 13606 based system, an indefinite number of archetypes can be merged (and reused) to build new applications. Our approach, based on the use of ontologies, maintains data storage independent of content specification. With this approach, relational technology can be used for storage, maintaining extensibility capabilities. Conclusions: The present work demonstrates that it is possible to build a native CEN/ISO 13606 repository for the storage of clinical data. We have demonstrated semantic interoperability of clinical information using CEN/ISO 13606 extracts

The e-health concept

The aim of this article is to present fundamental aspects of the concept of e-health. The article presents some e-health approaches covered in the international literature, and some examples of good practice which were developed over the years.information technologies, management, e-health

Increased Efficiency: Formulary Drug Conversion Automation Using Visual Basic-Based Macros with Attachmate Reflections in the Pharmacy Setting

Indiana University-Purdue University Indianapolis (IUPUI)Health care automation provides opportunities for health care agencies to save time, save money, and increase patient safety. The Department of Veterans Affairs medical centers use a program, Attachmate Reflections, for pharmacy medication order verification. This program is a command line interface that allows the use of macros, or programmed automated routines, that have the ability to automate repetitive tasks. Through the use of macro programming at the VISN 11 VA medical centers, this author was able to automate converting patients from Combivent MDI inhalers to its successor Combivent Respimat inhalers due to the MDI inhaler being withdrawn from the market. Usage of the macro resulted in a time savings of 649.1 hours, cost savings of $32,748.36, and increased patient safety by providing consistent medication instructions, correct dispense quantities, correct prescription day supply, and correct number of refills remaining on the prescription

On the Importance of Intellectual Property Rights for E-science and the Integrated Health Record

An integrated health record (IHR) that enables clinical data to be shared at a national level has profound implications for medical research. Data that have been useful primarily within a single clinic will instead be free to move rapidly around a national network infrastructure. This raises challenges for technologists, clinical practice, and for the governance of these data. This article considers one specific issue that is currently poorly understood: how intellectual property (IP) relates to the sharing of medical data for research on large-scale electronic networks. Based on an understanding of current practices, this article presents recommendations for the governance of IP in an integrated health record

Towards Open Information Management in Health Care

The utilization of information technology as tool in health care is increasing. The main benefits stem from the fact that information in electronic form can be transferred to different locations rapidly and from the possibility to automate certain information management tasks. The current technological approach for this automation relies on structured, formally coded representation of information. We discuss the limitations of the current technological approach and present a viewpoint, grounded on previous research and the authors’ own experiences, on how to progress. We present that a bottleneck in the automation of the management of constantly evolving clinical information is caused by the fact that the current technological approach requires the formal coding of information to be static in nature. This inherently hinders the expandability of the information case space to be managed. We present a new paradigm entitled open information management targeting unlimited case spaces. We also present a conceptual example from clinical medicine demonstrating open information management principles and mechanisms