The role of IS/IT in Healthcare

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The role of IS/IT in Healthcare

Seminar Medical Informatics

dr. Rogier van de Wetering

1Dept. of Information and Computing Sciences, Utrecht University, The Netherlands

Utrecht, May 16, 2012

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Outline lecture

Developments in Healthcare

Types of Information Systems and IT-architectures

Assignment 1

Break

Key benefits of IS/IT

Case: implementation of patient ID-card

Assignment 2

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Key developments in healthcare from an international context

Individuals more engaged

in decisions and purchases

Providers develop new services to

clients (product

and quality information)

Innovations to improve

efficiency & transparency

Growing costs of healthcare

Ageing population

E-prevention programs will reduce future

healthcare spending

Providers develop

management information of performance

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International Comparison of Spending on Health, 1980–2007

Source: Davis et al., How the performance of the U.S.

health care system compares internationally. The common

wealth fund (2010). See also OECD.org

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What is driving health care costs?

Spending on healthcare in all OECD countries are rising faster than economic growth, especially within the U.S.

Advances in medical technologies improve diagnosis and patient treatment. However, they also increase health spending

This can be clearly seen from the rapid growth and use of computed tomography (CT) scanners and magnetic resonance imaging (MRI) units used for diagnostic purposes

Factors include:

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Medical

technology

Population

expectations

Population

ageing

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The U.S. and Greece show a big difference in their use per capita as

opposed to the Netherlands

98,191,2

72,3

62,8

53,748,5 47,7

38,8 37,831,2

27,824,2 21,4

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MRI exams per 1 000 population

Data include only exams for out-patients and private in-

patients (excluding exams in public hospitals).

Number of MRI exams per 1 000 population, 2008 (or latest year available)

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Developments in healthcare from a hospital CXO perspective

Hospital CXO Chain care

Governance, risk &

compliance

Horizontal /vertical

integration

Reimburse

ments

M&A Alliances

Order mngt Lean (logistic)

operations

Tele-medicine / eHealth

Patient

influence

Cloud solutions / SaaS

Mobile

apps

Information

Management

Patient

engagement /

empowerment

Shared

Services

Integrated

supporting

processes

Information

Security

Medical

Imaging

Technology

Minimal

Invasive

surgery

RFID / Track

& Trace

Regulations

Virtualization

Big Data/

Analytics

Mobility

outpatient

clinic

Business

Intelligence

Customized

care EHR/EPR

Business

IT

Healthcare

Lean

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Hype Cycle for Healthcare Provider Applications and Systems

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Outline





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Overview of various types of IS/IT

Electronic health records (ePR/eMR)

Computerized provider order entry (CPOE)

Decision and diagnostic support (e.g. CAD/CAR)

Advanced visualization tools

Surgical simulation and modeling

Knowledge discovery/mining and retrieval systems

Enterprise-wide image management systems (i.e. PACS)

Data exchange networks (e.g. XDS-i, IHE)

Prescribing systems

E-Health / consumer informatics / educational

Tele-medicine

Mobile computing

Administration

(Cf. Haux, 2010; Chaundry, 2006; Huang, 2010; Van de Wetering, 2011)

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Extracted medical informatics clusters/classifications appearing between

2005 and 2008 Organization, application,

and evaluation of health IS

Medical knowledge representa -

tion

Signal and data analysis

Source: M. J. Schuemie1 et al., Mapping the Domain of

Medical Informatics. Methods Inf Med 2009; 48: 76–83

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The healthcare provider solution map shows six broad solution areas, as well as the high-

level solutions contained in each

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Break!!

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Outline





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There are many possible benefits and costs of implementing health information

technology

Effects of health IS/IT (Cf. Chaundry, 2006):

Quality

Efficiency

Costs

Challenges for the future:

Interoperability of medical data

Adoption rates of IS/IT

Misalignment of incentives for its use

Key question remains: How to apply IT effectively?

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A typical IT-implementation method including various phases and value

streams

Support

Project Management

Value

People, change management and education

Process and systems

Business Intelligence

Information Technology

Security and Controls

1 Vision

4 Build

Implementation

cycle

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Outline





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Case: patient ID-card at Amsterdam Medical Center (AMC)

Main goals:

Efficiency improvement (e.g., no re-coding of patient numbers etc.);

Less patients losing their card;

Improvement patient identification;

Cost efficient, what’s the business case?

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Menigte

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21

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A design/blueprint and associated IT-architecture gave alignment with the

final solution

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A simplified IT-architecture

Server

(Email, tel., VeCoZo, adress, huisarts en foto)

Front-Office Balies

Self-service Client

software

Webcam

ZIS

Synchronisation

VECOZO

SBV-Z

Synchronisation

Cloverleaf

Pass printer

EHR

Scanner

X/Care

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The AMC solution at the registration desks in the outpatient clinic

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Ideal process

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Final remarks

Need for IS/IT in healthcare

Classifications of systems and architectural design

Broad impact of IS/IT

Case example on how IS/IT impacts hospital operations