Informatics, Communications & Access to Health Care Information

Informatics, Communications & Access to Health Care Information Nora Oliveri, MD Fundación de Informática Médica (Medical Informatics Foundation) norao@fim.org.ar / oliverinora@aol.com

The New Digital Structure… • The incorporation of informatics to medicine allows us to go from an infrastructure based on pencil to a digital infrastructure. Then, we enter the digital era, the information era.

…The New Digital Structure • The flow of information is the main differentiating feature in organizations in the digital era. Once informatics is incorporated to our activity all processes are easier and swifter. By using informatics we have access to the information that we need, and this allows us to make proper and timely decisions.

Significance of the Internet in Access to Information • The value of the Internet as a quick, efficient & economic means to access information is still more important in countries where high costs in communication and low economic resources make it impossible sometimes, to obtain available information at the right time.

Kofi A Annan, General Secretary of the United Nations says… “The quantity and quality of the available information is changing each day, in each country, in each corner of the world. Access is crucial. The capability to receive, send, and share information through computer nets, the possibility of publishing works without censorship or restrictions, the freedom to communicate at will beyond frontiers, will be the basic rights for everyone.

…Kofi A Annan, General Secretary of the United Nations says For a long time, economic inequality and fear to freedom has prevented most men and women in the planet from making the most of the knowledge the information revolution has provided to us.”

Internet is…. Internet is a Metanet, is a network of networks, global, worldwide, planetary, made up by multiple computers connected among themselves and that communicate with each other using the same language. Besides, is a model of Information Systems.

Internet presents the fastest growth of any media in history To reach 50 MM of users it took: Radio 38 years TV 13 years Cable 10 years Internet 5 years

E-mail • The e-mail is the digital version of our traditional mail • It is the most popular service in the Internet • Tens of millions of e-mail messages circulate daily through the net all over the world • There is no relation between geographical distance and time

WWW or Web • WWW was created in 1989, 20 years after the creation of the Internet • A system that allows to interconnect the information that will be available through the Internet.

Internet # Web • Internet: MEDIA by which access is obtained to information. It is the computer net that allows to access the information stored on the WWW • Web: It is the information contained in the net, which can be presented as text, images, audio, video

Search Engines Some of the most useful search engines specialized in locating information regarding a given topic of the health care field • Medhunt: [www.hon.ch/MedHunt] • Medexplorer: [www.medexplorer.com] • Medscape: [www.medscape.com] • HealthAtoZ: [www.healthatoz.com] • Medical World Search: [www.mwsearch.com] • Yahoo Health: [dir.yahoo.com/Health]

Telemedicine &Telehealth • “Telemedicine is the use of telecommunications & informatics with medical purposes” J. Preston, 1993

Telemedicine &Telehealth… • “Telehealth: Is a compound term that includes activities related to health, services and methods, which are carried out in the distance with the help of information & telecommunications technology.” Definition by the Experts Group of the WHO, Geneva, 1997

…Telemedicine &Telehealth • Its goal is to improve the population’s health, the control of diseases and medical care, as well as education, administration & research in the health area. • Telehealth policies must be addressed to all countries and regions within each country, to identify the key issues in introduction of Telehealth, and to provide a strategy for this introduction.

…Telemedicine &Telehealth • The most important benefits are related to cost saving, extension of health cover for everyone and improvements in population health indexes.

Telehealth includes • Telemedicine • Tele-education • Tele-research • Tele-administration

Telemedicine It is the supply of health care services by professionals, in places where distance is a critical factor, using information and telecommunication technology for exchanging reliable information for diagnosis, treatment, and prevention of diseases, research, evaluation and continuing medical education, with the goal of improving individuals’ and peoples’ health.

Tele-education… • It is a dynamic process by which changes can be transformed in attitudes, knowledge, information and training through information and communication technologies to and for the patients, health care professionals and communities with the purpose of encouraging health improvement.

…Tele-education • The most important ideas in Tele-education include: • Learning throughout life • Health improvement • Participatory Education • Education without frontiers

Tele-research… It includes a variety of scientific activities addressed to solve health care problems including: • Connection & collaboration among individuals and centers to share ideas, results and to access the core of competence, information and knowledge bases

…Tele-research • Development of new telematics and application technologies • Assessment and validation of telematics applied to health care and its effects on individuals, societies and disciplines related to health care.

Tele-administration It is the use of information and communications technology for planning, implementation, funding, and assessment of disease control, quality, efficiency and effectiveness in service supply. This also includes epidemiological surveillance and control, and administration of human & technical resources.

Obstacles in incorporation of Telehealth… A. Political / Economic • Expectation - Failure in demand • Political support based in Health Care for Everyone

…Obstacles in incorporation of Telehealth B. Social / Cultural • Attitude & training for health care professionals • Existence of flow of traditional information

…Obstacles in incorporation of Telehealth C. Ethical / Legal • Data confidentiality & protection • Transaction malpractice • Professional credential

Obstacles for incorporation of Telehealth D. Technical / Financial • Regulation and training framework • Telecommunication networks • Help for the user • Tele-diagnosis can increase costs • Costs policy • Data and method assessment

Applications in Computerized Health Care • Access to Databases • Electronic Medical Records • Distance Training • Operation Monitoring • Tele-ambulance • Home Care • Epidemiological Surveillance & Prevention • Health Care Services Planning • Mobile Applications

Prospect in Latin-America for the next 5 years • Improvements in communication infrastructure associated to decrease in costs of services will allow the development and implementation of health care networks. • A better access to information will allow medical services to be addressed more specifically to prevention.

Prospect in Latin-America for the next 5 years … • Systems of Epidemiological Surveillance and Disease Monitoring will allow a careful control in the whole population. • Family physicians will be the first link of a health care system interconnected that will allow to make references, counter-references, requests for studies, results receipt, control and treatment alert.

Prospect in Latin-America for the next 5 years … • Distance medical education through the Internet will allow that all professionals interested in keeping updated can do so with a low cost, accessing highly qualified programs and self-regulating the time to be able to follow their own pace.

Prospect in Latin-America for the next 5 years … • Institutions will carry out massive training of staff through Intranets, which will allow a significant saving of costs and permanent control of individual and general training level with highly standardized information.

Prospect in Latin-America for the next 5 years … • The implementation of applications for mobile devices will allow to perform a better control and follow up of patients with chronic pathologies, such as diabetes or hypertension, as well as elder patients.

Prospect in Latin-America for the next 5 years … • Professionals will enrich the medical relationship with patients by establishing a bilateral computer link that will allow them not only to provide medical information, but to educate the population, too. • In turn, the patients will be able to know the degree of training and updating before choosing a professional in directories available from institutions authorized for professional certification and re-certification.

Prospect in Latin-America for the next 5 years … • Computerization of administrative processes will allow a better control of transactions and clearness in purchases. • The analysis of transactions will allow billing to be transmitted without mistakes, thus making collection of services swifter, and detecting any attempt of fraud or abuse.

Now, let us imagine that… • We could add to our health care system the elements described here. • All actors of the system are connected between themselves • We have an urgency system that allows for incorporation of all information and taking data from the hospital central system • The computers are very friendly and can be managed by a tactile screen, optic pencil or voice recognition

…Now, let us imagine that • Billings and administrative procedures are carried out automatically • The information remains recorded on line so that it can be consulted by any other professional that may need it from a remote place • All the information about treatments and administered drugs is evaluated automatically to help preventing adverse and secondary reactions

Conclusions Undoubtedly, many changes will have to be done to reach a health care system that may operate thus. This will be a challenge that will be worthy to face to have a better quality of life and to get increasingly closer to health care principles for everyone.

Informatics, Communications & Access to Health Care Information