Health informatics: the future of healthcare?
When applied correctly ICTs can serve as a useful tool to achieve national and global health / social objectives allowing countries to work together in bridging the digital and health divide.
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Health informatics provides the opportunity to deliver a truly global and holistic approach to health by tackling the issue of geographical barriers to healthcare, and allowing for greater collaboration and better management in the health sector. Limited resources can also be more efficiently utilised, and access to and the quality of services improved. Caution must be exercised and best-practice policies and procedures established to encourage innovation and development in this area as well as to promote acceptance of the new methods and standards by practitioners and patients alike. There has been a recent strong movement toward the use of health informatics globally. The idea however, has been around for a few decades. Telemedicine emerged in 1967 after the development of a two-way audiovisual microwave circuit by Dr Kenneth Bird which was used by physicians at the Massachusetts General Hospital in Boston to treat patients located 2.7 miles away.
It is often debated whether investing in health informatics initiatives is a wise decision, particularly for developing countries where scarce resources may be better directed to provide basic and essential services such as food, clean water, housing and education. It is also a commonly accepted view that access to healthcare, which in turn leads to better health outcomes, can affect an individuals and their familys socio-economic status. For example, health affects the ability to work, school and earn money. Providing access to better health services and information is often identified as one of the means to empower an individual to break out of the poverty cycle and foster inclusive growth.
The World Health Organisation (WHO) describes health as:
…a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
This indicates a holistic approach to health which health informatics could address. For example not only can ICTs (information and communications technologies) assist in the delivery of clinical services to enhance an individuals physical or mental well-being, ICTs can also foster social well-being by connecting people to wider global and local networks of friends, family and the community.
The World Summit on the Information Society (WSIS) identified specific ICT-related goals for health including connecting health centres and hospitals with ICTs and developing eHealth. WSIS goals were identified as a means of achieving Millennium Development Goals (MDGs) including those of improving child and maternal health. A 2007 report by Lord Crisp commissioned by the United Kingdom government concluded however that health-related MDGs could not be achieved without:
- developing countries taking the lead while supported by international, national and local partnerships
- developed countries supporting training, education and employment of health workers in developing countries
- rigorous research and evaluation
- applying good practice systematically
- the use of ICT and biomedical technologies
- links with economic development
- reducing wasted effort.
The University of Auckland describes health informatics as the:
…assimilation and application of computing, information and telecommunication technologies to facilitate the planning, delivery and evaluation of high quality, cost effective healthcare.
This can encompass a range of concepts such as eHealth (electronic health), mHealth (mobile health) and telehealth (remote provision of health services). A pioneering study being carried out at an Auckland retirement village by the University of Auckland and a cluster of South Korean companies involves the use of robotics to assist in the care of elderly people. Tasks performed by the robots include recording blood pressure / heart rates, contacting help if a resident falls and reminding residents to take their medication.
A systematic review of eHealth initiatives in developing countries found that there were promising benefits that could be derived from eHealth. However, the study also concluded that evaluations of these services were lacking and an increased focus needed to be placed on evaluating eHealth programmes. A study on the impact of eHealth commissioned by the European Commission Information Society and Media Director General concluded that the lack of reliable evidence on positive impacts of eHealth services has prevented uptake of them.
The benefits of increasing access to health care and health education through the use of health informatics include:
- The ability to extend services across geographically remote populations without the need for unnecessary travel, thereby saving costs and increasing efficiency. Similar benefits can be derived from distance-learning. Even when patients are not residing in geographically remote areas, costs can be cut and efficiency improved by ubiquitously providing certain services such as monitoring.
- Increasing the national talent pool through training in both health and the use of ICT.
- The introduction of better information management systems allowing for better collaboration between different health care providers (nationally and trans-nationally), better continuity of care and increased efficiency.
- Overall provision of a better quality of care.
- The increased ability to shift the focus from a treatment to a preventative health care system through the provision of timely and empowering information to individuals using mediums such as the Internet and mobile services as well as health-lines .
- Increasing access to emergency services and information through health-lines and through disaster management applications for rescue and emergency services.
According to the European Commission:
Investing in digital technologies related to healthcare, known as eHealth, can dramatically improve the range and quality of care available to Europes patients and medical specialists. …. eHealth can minimise the risk of medical errors and help the early detection of health problems. Home telemonitoring of heart patients can improve survival rates by 15%, reduce hospital days by 25% and save 10% in nursing costs … ePrescriptions can reduce errors in drugs dosage by 15%. eHealth will be critical to keep health care affordable and accessible to all in the ageing societies of Europe.
One of the goals of Europes Digital Agenda is to provide secure access to online medical health records by 2015. This is in line with the goal of creating a single digital market across member states.
Some limitations and concerns associated with the use of health informatics include:
- privacy issues surrounding the electronic storage of patient information
- the possible lack of infrastructure and basic reliable ICT and telecommunications services affecting the ability to introduce health informatics initiatives in developing countries. This includes an investigation into the affordability of services as well
- the need to change the attitude and behaviour of both health care professionals and patients to accept and use the new methods
- sustainability issues and the need for ongoing funding for such initiatives to endure
- the quality of information delivered through sources such as the Internet.
New technology and practices can now provide a unique, global approach to holistic health and well-being. When applied correctly ICTs can serve as a useful tool to achieve national and global health / social objectives allowing countries to work together in bridging the digital and health divide.
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