The Future of Computer Applications in Biomedicine

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The Future of Computer Applications in Biomedicine

• HIM 3000
• Ch 24

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Looking back?

• Computerized records 1980s 1990s
• Electronic records 2000
• National Research Council 1997 We envision the
  day when citizens no longer will have multiple
  records of their health care encounters scattered
  throughout the offices of numerous physicians
  hospitals. Instead their records will be linked
  electronically over the Internet so that each
  person has a single virtual health record
  distributed, but unified, summary of all the
  health care they have received in their lives.

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How Do We Bridge The Gap And Deliver The Promise?
Metrics/Measurement Systems How do we collect
and share data between stakeholders?
Agreement On Healthcare Goals What
results/outcomes are valued?
Compensation Plans How do we align incentives to
secure delivery of the outcomes we value?
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Health Information Technology

• Its About The Information, Not The Technology
• The enhanced use of healthcare information
  technology is a means to an enda critical tool
  to
• Collect data and provide decision support tools,
  especially at the point of care
• Share data between healthcare providers, payers,
  policy makers, and consumers
• The end is more effective and more efficient
  healthcare purchased on the basis of value and
  outcomes rather than just unit cost

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The Critical Importance Of HIT

• As healthcare starts to shift from an input
  driven to an output driven model, outcomes
  assessment tools become critical to drive
  meaningful changes in provider compensation
  systems
• If empowered consumers dont have quality/value
  information readily available, it is likely that
  they will buy healthcare services solely on a
  price basis

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Emerging Federal Approach To Nurturing HIT

• Focus on improving patient safety and
  biopreparedness
• Legislative and executive-branch efforts underway
• Federal Health Architecture (FHA)
• Consolidated Health Initiative (CHI)
• National Health Information Infrastructure (NHII)
• EHR functional model (in conjunction with private
  sector)
• e-Prescribing

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Telemedicine

• Using computers and telecommunications equipment
  to deliver medical care at a distance.
• -telepsychiatry
• -Teleoncology
• -Teledermatology
• -Teleradiology

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Remote Patient Monitoring Technologies Are
Beginning To Mature
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So What?

• New technologies will allow HIT to go places it
  has seldom/never been before
• Exam rooms
• Patients homes
• More information means we have a movie instead
  of a photograph on how patients are doing,
  thereby improving quality of care by detecting
  changes in health status early

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Where HIT Needs To Be
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Balancing Cost and Value
RESULT Coordinated care Collaborative
relationships
RESULT Uncoordinated care Adversarial
relationships
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Forces affecting the Future of Medical Computing

• Legal considerations
• Health care financing
• Changes in the background of health professionals

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Assignment question 2.

• Answer question 2 in text.
• Imagine that you are a patient visiting a health
  care facility at which the physicians have made a
  major commitment to computer-based tools. How
  would you react to the following situations?

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• (A)Before you are ushered into the examining
  room, the nurse takes your blood pressure and
  pulse in a work area and then enters the
  information into a computer terminal located in
  the nursing station adjacent to the waiting room.

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• (B)While the physician interviews you, he or she
  occassionally types information into a computer
  workstation that is facing the physician you
  cannot see the screen

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• (C)While the physician interviews you, he or she
  occasionally uses a mouse-pointing device to
  enter information into a computer workstation
  located such that, when facing the physician, you
  cannot see the screen.

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• (D)While the physician interviews you, he or she
  occasionally uses a mouse-pointing device to
  enter information into a computer workstation
  located such that you both can see. While doing
  so, the physician explains the data being
  reviewed and entered.

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• (E)While the physician interviews you, he or she
  enters information into a clipboard sized
  computer terminal that responds to finger touch
  and requires no keyboard typing.

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• (F)While the physician interviews you, he or she
  occasionally stops to dictate a phrase. A
  speech-understanding interface processes what is
  being said and stores the information in a
  medical record system.

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• (G)There is no computer in the examining room,
  but you notice that between visits the physician
  uses a workstation in the office to review and
  enter patient data.

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2.

• Now imagine that you are the physician in each
  situation. How would you react in each case?
  What do your answers to these questions tell you
  about the potential effect of computers on a
  patient-physician rapport? What insight have you
  gained regarding how interactive technologies
  could affect the patient-physician encounter? Did
  you have different reactions to scenarios c d?
  Do you believe that most people would respond to
  these two situations as you did?