Impact of IT on Healthcare - Case Study Example

Impact of IT on healthcare (Name) (Institution) (Course) (Instructor’s Name) Date of submission Part 1 The healthcare industry The healthcare industry has undergone a lot of transformation in Australia in recent times, one major change being adapting IT to improve healthcare services. IT has been largely employed to improve on medical information recording and storage. Rapid changes in demography and shifting disease patterns among Australians have necessitated more efficient and high capacity record keeping capabilities. This requires that players in the healthcare industry must adapt to these new developments by incorporation of technological advancements in the provision of healthcare services health information being one of them (Marshall 2003). There is a need to invest more technology wise to mitigate the challenges triggered by changes in demographic factors such as an aging population and changing disease patterns. Governments, especially in the OECD have continuously increased spending in healthcare. As of 2003, OECD governments had an average of 8.5% of their GDP dedicated to healthcare. Podger and Hagan (1999) estimated that Australia dedicates 8-9% of its GDP to healthcare. The US and Canada have relatively higher healthcare budgetary allocation at 13.7% and 9.5% of their GDP respectively (Murray and Pollard 2004). There is an observable general pattern which indicates that healthcare spending has been growing at a faster rate than GDP growth. This increase budgetary allocation is basically aimed at improving quality. Wrobel (2003) say that Patients’ history or medical information is fundamental to improving quality of healthcare. This has created the need for proper records keeping and patient health information recording and sharing. IT comes in handy in simplifying information recording and sharing. The Labour government has proposed an ambitious plan of electronic medical information recording that will assist in provision of quality healthcare. The proposed plan headed by the Federal Health Minister Nicola Roxon, is estimated to cost the taxpayer $466.7 million as provided for in this year’s federal budget (Crozier 2010). The proposed plan is expected to change how clinicians treat their patients. Such a plan comes on the backdrop of numerous cases of misinformed treatment and poor quality healthcare worldwide. Westhuizen and Pottas (2010) provide appalling figures that highlight the importance of such a project. They say that 7000 patients die annually due to careless handwriting by medical/clinical staff; and 7.5 million unnecessary medical and surgical procedures are performed annually worldwide. These have lowered the quality of healthcare while increasing the costs. The current Medicare program, which is funded by the taxpayer, caters for entire costs in public hospitals and makes calculated reimbursements to patients upon visiting private hospitals. The government provides a fee schedule for use by these private hospitals. Private hospitals may either bill the patient directly or bill the Health Insurance Commission (HIC) which is the government’s insurance authority. The HIC reimburses 75% of the total for in-hospital expenses and 85% for out-of-hospital expenses using the government set fee for the services (Hopkins n.d.; HealthConnect programme office 2002). The nature of Australia’s healthcare industry is dynamic and to implement such a project requires extreme caution. First and foremost, the fact that healthcare provision falls under two major categories, public and private presents a challenge (Kelly et al 2010; Murray and Pollard 2004). Public healthcare is also categorized under federal/commonwealth government and the state governments. However, there is debate on the feasibility on this project as many stakeholders question the feasibility of the existing technology in handling such a complex project. Part 2- option 2 Health information systems (HIS) The healthcare industry produces a lot of data on a day to day basis. According to Fernando (2004), the healthcare industry is the most demanding in terms of information. He says that some researchers in this field estimate that healthcare personnel use up between 35% and 60% of their working hours managing clinical data. To put this into perspective, an acute care hospital can generate up to five terabytes of data annually. In most cases, such information is placed in scattered repositories while some is duplicated and repetitive. Time and resources are wasted in processing such data. As such, there is a need to provide and share information among healthcare professional frequently and in an organized manner to increase the efficiency of the whole healthcare system. This is where IT comes in through health information systems. The Better Medication Management System (BMMS) is one of the major projects developed by the Australia health department from which other comprehensive HIS have been developed. Nonetheless, this project was itself a culmination of earlier attempts to organize health information electronically. This system was launched in 2003 as a brainchild of the HealthConnect initiative by the National Electronic Health Records Taskforce which released its first project proposal paper titled A health Information Network for Australia in July 2000. This proposal stated that patients would give consent to the electronic storage of their data in the system while the data would be limited to only the patients/consumers, authorized healthcare providers and research and health planning managers. The proposed draft of The Better Medication Management System Bill of 2001 was forwarded to a select taskforce comprising of stakeholders in the industry in May 2001 for further review (HealthConnect Programme Office. 2002). The BMMS was introduced to provide a complete patient medication record, linking information about a patient’s medication held by doctors, pharmacists and hospitals. This is administered by the Health Insurance Commission (HIC). Consumers’ Medicare number would be used as the form of identification throughout the system. Doctors and pharmacists would be needed to add information about prescription mediations while consumers would request non-prescription medication to be added. Such information is stored in a central database and is available to doctors and healthcare workers serving such clients in future. Clients could also retain some confidential information between he himself and the particular doctor or pharmacist who prescribed the medication (Nesbitt 2001). The system received mixed reviews with the greatest criticism being its inability to ascertain the security of the system and guarantee user confidentiality. This threat of security is constant in all IT fields. To confirm this, Fernando (2004) says that “no HIS can ever be completely secure, regardless of whether all the threats currently envisaged are controlled. A security plan is not a static entity in time; it evolves and changes, as do technologies and potential vulnerabilities” (p. 314). From this argument, it is there is no HIS that can guarantee 100% security for patient information (Kelly et al 2010). On the other hand, it is the responsibility of the HIS developers to ensure the highest level of security and privacy of patient information in order to gain public acceptance and ensure the success of the whole project in the long run. Timeline of major events in the healthcare industry Timing Description Mandate 1960 Problem Oriented Medical Information System) 1999 National Electronic Health Records Task Force Implementation of IT systems in healthcare 1999 Electronic Health Records Taskforce was created taskforce is to create a plan for the "development and utilization of electronic health records (EHR) in the state in order to improve the quality of patient care, increase the efficiency of health care practice, improve safety, and reduce health care errors 2003 the Commonwealth HealthConnect project Overseeing Better Medication Management System May 2004 Better Medication Management System Voluntary recording and storage of patient health information electronically 2008 National Ehealth Transition Authority Electronically collecting and securely exchanging health information. 2010 Plans for Integrated health information system Part 3- option 1 Ethical issues and challenges Patient privacy and confidentiality are the greatest ethical concerns for BMMS. Patient confidentiality is a very sensitive issue in healthcare which is covered in the Privacy Act by the Commonwealth government (Win 2005). It stipulates that patients’ personal information obtained in the course of consultation and treatment should not be revealed to a third party without the consent of the patient (Wagner 2001). The idea of storing such information electronically increases the risk of that information being illegally accessed by third parties (Anderson 2006). Researchers and healthcare planners who access patient information increase this risk and breaching patient privacy and confidentiality. The BMMS led to increased practitioners use of computers which changed the perception of healthcare and medication. In a research among Australian patients indicated that patients had observed increased use of computers by general practitioners but 77% the patients have not been explained to what is the necessity of storing patient records electronically. Nonetheless, 63% of the respondents agreed that computer use would somehow improve delivery of healthcare services (Cesnik n.d.). The government agencies in the healthcare provision should thus ride on this optimism on IT adoption to implement further technologic advances, which the Gartner (2010) technology cycle calls the high technology expectations phase. Another study by the Privacy Commissioner indicated that 84% of Australian trusted the health system to use patient information responsibly (Conrick 2006). This therefore indicates that there is need to reconsider patient doctor relationship in order to build trust in the system and ensure its success (Kelly et al 2010). If patients cannot trust the storage of their health record electronically, then they may be inclined to give false information to the doctor thereby increasing the risk of wrong treatment. The use of consumer information from the BMMS database is very useful for pharmaceutical companies for research purposes. Research ethics propose that participants/respondents in any given research should be informed about the research findings. In some cases, the promise of the research report is given in order obtain the consent of the participants. Unfortunately, in this case, the actual involvement of the research participants is not necessary and actual contact between the participants and the researchers is very minimal creating a possibility that the participants will not be informed of the research findings (Podger & Hagan 1999). In cases where researchers are tracking the effects of a particular drug on users, it is possible that if the effects are harmful, the researchers might not disclose such finding to the participants to avoid creating a panic and legal battles. Part 4 Future of IT in health There is general agreement across a number of authors that a fully integrated HIS carries a lot potential in improving healthcare delivery worldwide. In fact, such systems have a great potential in tracking the effects of certain drugs on patients. Namazi (2010) says that recent developments in nano-technology could also be utilized for these purposes where nano-devices are implanted on patients and transmit data automatically to the HIS database. While this would simplify outpatient care delivery, patient monitoring and early detection of illnesses, not many patients would be willing to have devices implanted in their bodies. The current BMMS which basically tracks medication is poised to benefit from recent discoveries by Microsoft. The discovery by Microsoft also relates to nano-devices. However, the already tested device is specifically implanted in the brain and detects reactions to drugs only (Shipley 2009). This technology can simply research on drugs to replace the usual empirical observation of reaction to drugs on patients. Another idea being tested in the healthcare field is robot surgeons. Last year, doctors in Canada successfully used a robotic arm controlled by a doctor to remove a brain tumor. This allows doctor to operate and the same time track the progress using an MRI scanner. The same doctors are also assessing the possibility of remotely controlling the robot duping such operations where the patient and doctor need not be in the same room. However, patients are yet to accept the idea of a machine operating them as people would ordinarily trust a human arm more than a robotic one. IT has potential in aiding decision making and providing artificial intelligence i.e. health informatics. Cesnik (n.d.) says that in the same manner that decision making models have been developed in business, health informatics using the same technology could be applied to aid practitioners in decision making and delivery of healthcare. While research in this filed was very strong in the 1980’s, research and implementation in this direction has slowed hence the potential benefits of such systems still unrealized. Automation of certain tests and healthcare services is a potential inclusion in the future. Doctors have argued that tests such as blood pressure and temperature should be automated in order to improve workflow. This however, again is challenged by patients desire for the doctor’s/nurse’s arm and presence during healthcare delivery (Hicks 2010). The main challenge facing adoption of IT in healthcare is patient doctor interaction on a personal level. While IT improves healthcare, it may take a while before patients can embrace it. Accessibility of patient medical information is very vital for delivery of healthcare on the side of patients. They can obtain healthcare services from wherever they are without the luggage of paperwork. This is very critical in times of emergencies where response time by medical personnel is greatly reduced and unnecessary tests such as blood group tests are omitted. Some patients are limited to travel by their medical conditions but where in mild cases, patients can travel without worry of their medical records as they can access them online. General lowered cost of healthcare as a result of increased efficiency in delivery of healthcare services. Experts in this field have noted that elimination of paperwork in record keeping implies that the personnel and amount of resources required in delivering healthcare is reduced significantly hence bringing down the cost of healthcare (Crozier 2010). However, complex technologic devices introduced in healthcare such as nano-devices have the potential of increasing the cost of healthcare in the short run but lowering it on the long run (Shipley 2009). As such, healthcare consumers should brace for higher costs in the short run. References Anderson, G. (2006). “Social, ethical and legal barriers to E-health.” International journal of medical informatics. 76(2007), 480–483 Cesnik, B. (n.d.). History of health informatics. Retrieved online on 27/09/10 from, http://www.achi.org.au/docs/HNI_Book/Chapter_02.pdf Conrick, M. (2006). Health informatics: transforming healthcare with technology. Sydney: Cengage Learning Australia Crozier, R. (2010). Budget 2010: Feds move on e-health records. Retrieved online on 27/09/10 from, http://www.healthissuescentre.org.au/documents/items/2008/05/206763-upload-00001.pdf Fernando, J. (2004). “Factors that have contributed to a lack of integration in health information system security.” The Journal on Information Technology in Healthcare. 2(5), 313–328 Gartner, (2010). Research methodologies. Retrieved online on 27/09/10 from, http://www.gartner.com/technology/research/methodologies/hype-cycle.jsp HealtConnect Programme Office. (2002). Consent and Electronic Health Records A discussion paper. Retrieved online on 27/09/10 from, http://www.health.gov.au/internet/hconnect/publishing.nsf/content/e250bd83358d3a56ca257128007b7ec9/$file/cons_dp.pdf Hicks, R. 2009. How will technology change the future of healthcare? Retrieved online on 27/09/10 from, http://www.futuregov.asia/articles/2009/sep/01/how-will-technology-change-future-healthcare/ Hopkins, H. (n.d.) Consumers and the Better Medication Management System. Retrieved online on 27/09/10 from, http://www.healthissuescentre.org.au/documents/items/2008/05/206763-upload-00001.pdf Kelly, M., J. Richardson, B. Corbitt & J. Lenarcic. (2010). The Impact of Context on the Adoption of Health Informatics in Australia. 23rd Bled eConference eTrust: Implications for the Individual, Enterprises and Society. Retrieved online on 27/09/10 from, http://www.bledconference.org/proceedings.nsf/0/c87cec8cd7416174c1257757003e4ce7/$FILE/38_Kelly.pdf Marshall, S. (2003). Closing the digital divide: transforming regional economies and communities with information technology. London: Greenwood Publishing Group, 2003 McKenzie, G. Medical legal issues. Retrieved online on 27/09/10 from, http://www.achi.org.au/docs/HNI_Book/Chapter_22.pdf Namazi, N. 2010. Advances in Nanotechnology could produce new devices. Retrieved online on 27/09/10 from, http://www.healthcare-digital.com/industry-focus/healthcare-technology/advances-nanotechnology-could-produce-new-devices Nesbitt, J. (2001). Australian medical association submission to the commonwealth department of health and aged care the better medication management system draft exposure legislation. Retrieved online on 27/09/10 from, http://ama.com.au/node/3747 Ortega A, C. Figueroa and G. Ruz (2005). Medical Claim Fraud/Abuse Detection System based on Data Mining: A Case Study in Chile. Retrieved online from citeseer database Podger, A. and P. Hagan (1999). Reforming the Australian health care system: the role of government. Issue 1 of Department of Health and Aged Care occasional papers series. Perth: Commonwealth of Australia Shipley, D. (2009). Hi-tech health care 's future. Retrieved online on 27/09/10 from, http://www.telegraph.co.uk/technology/4947958/Hi-tech-health-cares-future.html Wagner, I. (1999). Ethical issues of healthcare in the information society. Opinion of the European group on ethics in science and new technologies to the European commission. Retrieved online on 27/09/10 from, http://ec.europa.eu/european_group_ethics/docs/avis13_en.pdf Westhuizen, E. & D. Pottas (2010). “Towards Characteristics of lifelong health records” In Takeda, H. (ed). E-Health: First IMIA/IFIP Joint Symposium, E-Health 2010, Held as Part of WCC 2010, Brisbane, Australia, September 20-23, 2010, Proceedings. Brisbane: Springer Win, K. (2005). “A review of security of electronic health records.” Health Information Management. 34 (1), 13-16 Retrieved online on 27/09/10 from, http://www.mja.com.au/public/journal/34_1_2005/pdf/contents34_1.pdf#page=14 Wrobel, J. (2003). Are we ready for the Better Medication Management System? The Medical Journal of Australia. 178 (9): 448-450. Retrieved online on 27/09/10 from, http://www.mja.com.au/public/issues/178_09_050503/wro10348_fm.html Read More

The HIC reimburses 75% of the total for in-hospital expenses and 85% for out-of-hospital expenses using the government set fee for the services (Hopkins n.d.; HealthConnect programme office 2002). The nature of Australia’s healthcare industry is dynamic and to implement such a project requires extreme caution. First and foremost, the fact that healthcare provision falls under two major categories, public and private presents a challenge (Kelly et al 2010; Murray and Pollard 2004). Public healthcare is also categorized under federal/commonwealth government and the state governments.

However, there is debate on the feasibility on this project as many stakeholders question the feasibility of the existing technology in handling such a complex project. Part 2- option 2 Health information systems (HIS) The healthcare industry produces a lot of data on a day to day basis. According to Fernando (2004), the healthcare industry is the most demanding in terms of information. He says that some researchers in this field estimate that healthcare personnel use up between 35% and 60% of their working hours managing clinical data.

To put this into perspective, an acute care hospital can generate up to five terabytes of data annually. In most cases, such information is placed in scattered repositories while some is duplicated and repetitive. Time and resources are wasted in processing such data. As such, there is a need to provide and share information among healthcare professional frequently and in an organized manner to increase the efficiency of the whole healthcare system. This is where IT comes in through health information systems.

The Better Medication Management System (BMMS) is one of the major projects developed by the Australia health department from which other comprehensive HIS have been developed. Nonetheless, this project was itself a culmination of earlier attempts to organize health information electronically. This system was launched in 2003 as a brainchild of the HealthConnect initiative by the National Electronic Health Records Taskforce which released its first project proposal paper titled A health Information Network for Australia in July 2000.

This proposal stated that patients would give consent to the electronic storage of their data in the system while the data would be limited to only the patients/consumers, authorized healthcare providers and research and health planning managers. The proposed draft of The Better Medication Management System Bill of 2001 was forwarded to a select taskforce comprising of stakeholders in the industry in May 2001 for further review (HealthConnect Programme Office. 2002). The BMMS was introduced to provide a complete patient medication record, linking information about a patient’s medication held by doctors, pharmacists and hospitals.

This is administered by the Health Insurance Commission (HIC). Consumers’ Medicare number would be used as the form of identification throughout the system. Doctors and pharmacists would be needed to add information about prescription mediations while consumers would request non-prescription medication to be added. Such information is stored in a central database and is available to doctors and healthcare workers serving such clients in future. Clients could also retain some confidential information between he himself and the particular doctor or pharmacist who prescribed the medication (Nesbitt 2001).

The system received mixed reviews with the greatest criticism being its inability to ascertain the security of the system and guarantee user confidentiality. This threat of security is constant in all IT fields. To confirm this, Fernando (2004) says that “no HIS can ever be completely secure, regardless of whether all the threats currently envisaged are controlled. A security plan is not a static entity in time; it evolves and changes, as do technologies and potential vulnerabilities” (p. 314). From this argument, it is there is no HIS that can guarantee 100% security for patient information (Kelly et al 2010).

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