The Promise of Information and Communication Technology In Health Care: Extracting Value from the Chaos

Healthcare is an information business with expanding use of information and communication technologies (ICTs). Current ICT tools are immature, but a brighter future looms. We examine 7 areas of ICT in healthcare: electronic health records (EHRs), health information exchange (HIE), patient portals, telemedicine, social media, mobile devices and wearable sensors and monitors, and privacy and security. In each of these areas, we examine the current status and future promise, highlighting how each might reach its promise. Steps to better EHRs include a universal programming interface, universal patient identifiers, improved documentation and improved data analysis. HIEs require federal subsidies for sustainability and support from EHR vendors, targeting seamless sharing of EHR data. Patient portals must bring patients into the EHR with better design and training, greater provider engagement and leveraging HIEs. Telemedicine needs sustainable payment models, clear rules of engagement, quality measures and monitoring. Social media needs consensus on rules of engagement for providers, better data mining tools and approaches to counter disinformation. Mobile and wearable devices benefit from a universal programming interface, improved infrastructure, more rigorous research and integration with EHRs and HIEs. Laws for privacy and security need updating to match current technologies, and data stewards should share information on breaches and standardize best practices. ICT tools are evolving quickly in healthcare and require a rational and well-funded national agenda for development, use and assessment

Canadian Patient Perceptions of Electronic Personal Health Records: An Empirical Investigation

Electronic personal health records (PHRs) have significant promise in helping to empower patients and consumers in general to take more responsibility for managing their own health, with lower costs for the healthcare system. However, few empirical studies have been undertaken to understand patient perspectives on the benefits of PHRs. This article describes an empirical study that proposes a theoretical model on PHR adoption and validates that model using the views of 389 Canadian patients. We found that perceived usefulness, security, privacy, and trust in PHRs, together with personal information technology innovativeness, are significant motivators of adoption, while computer anxiety may be an important deterrent. Overall, this study is a step toward understanding patient views that are key to the success of electronic PHRs. Growing adoption of this novel e-health approach is of importance as it may improve benefits for both patients and society

Health information technology and digital innovation for national learning health and care systems

Health information technology can support the development of national learning health and care systems, which can be defined as health and care systems that continuously use data-enabled infrastructure to support policy and planning, public health, and personalisation of care. The COVID-19 pandemic has offered an opportunity to assess how well equipped the UK is to leverage health information technology and apply the principles of a national learning health and care system in response to a major public health shock. With the experience acquired during the pandemic, each country within the UK should now re-evaluate their digital health and care strategies. After leaving the EU, UK countries now need to decide to what extent they wish to engage with European efforts to promote interoperability between electronic health records. Major priorities for strengthening health information technology in the UK include achieving the optimal balance between top-down and bottom-up implementation, improving usability and interoperability, developing capacity for handling, processing, and analysing data, addressing privacy and security concerns, and encouraging digital inclusivity. Current and future opportunities include integrating electronic health records across health and care providers, investing in health data science research, generating real-world data, developing artificial intelligence and robotics, and facilitating public–private partnerships. Many ethical challenges and unintended consequences of implementation of health information technology exist. To address these, there is a need to develop regulatory frameworks for the development, management, and procurement of artificial intelligence and health information technology systems, create public–private partnerships, and ethically and safely apply artificial intelligence in the National Health Service

Is There an App for That? Electronic Health Records (EHRs) and a New Environment of Conflict Prevention and Resolution

Katsh discusses the new problems that are a consequence of a new technological environment in healthcare, one that has an array of elements that makes the emergence of disputes likely. Novel uses of technology have already addressed both the problem and its source in other contexts, such as e-commerce, where large numbers of transactions have generated large numbers of disputes. If technology-supported healthcare is to improve the field of medicine, a similar effort at dispute prevention and resolution will be necessary

Health on a Cloud: Modeling Digital Flows in an E-health Ecosystem

A unified and well-knit e-health network is one that provides a common platform to its key stakeholders to facilitate a sharing of information with a view to promoting cooperation and maximizing benefits. A promising candidate worthy of being considered for this ponderous job is the emerging "cloud technology" with its offer of computing as a utility, which seems well-suited to foster such a network bringing together diverse players who would otherwise remain fragmented and be unable to reap benefits that accrue from cooperation. The e-health network serves to provide added value to its various stakeholders through syndication, aggregation and distribution of this health information, thereby reducing costs and improving efficiencies. Because such a network is in fact an interconnected "network of network" that delivers a product or service through both competition and cooperation, it can be thought of as a business ecosystem. . This study attempts to model the digital information flows in an e-health ecosystem and analyze the resulting strategic implications for the key players for whom the rules of the game are bound to change given their interdependent added-values. The ADVISOR framework is deployed to examine the values created and captured in the ecosystem. Based on this analysis, some critical questions that must be addressed as necessary preconditions for an e-Health Cloud, are derived. The paper concludes with the conjecture that "collaboration for value" will replace "competition for revenue" as the new axiom in the health care business that could ideally usher in a fair, efficient and sustainable ecosystem

Alcuni abstract di articoli che trattano argomenti relativi all'eHealth

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A prototypical Skin Cancer Information System

Skin cancer is a common problem in Australia and indeed around the world. Within the domain of eHealth, there appears to be no satisfactory clinical software that follows the flow of a normal skin cancer examination. This paper introduces a system that was specifically designed, coded and implemented to store patient health records as a means of registering the diagnoses of skin cancer along with the treatment. The information system was intended to be web-based, and connect to remote database servers. The implemented system was designed to incorporate features such as inserting procedural details, generating forms and reports with interactive interfaces, yet be relatively unsophisticated to use. We expect the system once fully implemented and on line, will aid in Australia’s eHealth industry, delivering more accurate information to doctors and patients in an effort to combat issues involving skin cancer. Other parameters discussed are the need for data encryption of medical records and the role such a system can play in medical information

Health Information Technology in the United States, 2008

Provides updated survey data on health information technology (HIT) and electronic health records adoption, with a focus on providers serving vulnerable populations. Examines assessments of HIT's effect on the cost and quality of care and emerging issues