AWERProcedia Information Technology & Computer Science

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Marjan Laal *, Tehran University of Medical Sciences, Sina Trauma & Surgery ... AWERProcedia Information Technology & Computer Science. [Online]. 2013, 3, pp 1806- ... quality, and safety of medical care delivery via making best practice ...
AWERProcedia Information Technology & Computer Science Vol 03 (2013) 1806-1811

3rd World Conference on Information Technology (WCIT-2012)

Health IT: What Does the Term Mean? Marjan Laal *, Tehran University of Medical Sciences, Sina Trauma & Surgery Research Center, Sina Hospital, Hasan-abad Square, Hafez Street, Tehran 11555/3876, Iran. Suggested Citation: Laal, M. Health IT: What Does the Term Mean?, AWERProcedia Information Technology & Computer Science. [Online]. 2013, 3, pp 1806-1811. Available from: http://www.world-education-center.org/index.php/PITCS Proceedings of 3rd World Conference on Information Technology (WCIT-2012), 14-16 November 2012, University of Barcelon, Barcelona, Spain. Received 21 March, 2013; revised 9 June, 2013; accepted 13 August, 2013. Selection and peer review under responsibility of Prof. Dr. Hafize Keser. ©2013 Academic World Education & Research Center. All rights reserved. Abstract Health information technology is the application of information technology to plan, spread, make, use and maintain of information systems for the healthcare industry. In the last century, a growth in innovations and improvements in medical science particularly in technological healthcare industry has brought about a revolution in the process of care delivery. The term refers to use of electronic applicants to manage health and medical care information of the patients. Health information technology is an umbrella term to describe the fully management of health information across the computerized systems and its secure exchange between consumers, providers, government and quality entities, and insurers. This article strives to present a generic definition of the topic, while numerating the potential benefits might follow the use of health information technology in care system. Keywords: Health information technology, definition, benefits, barriers;

* ADDRESS FOR CORRESPONDENCE: Marjan Laal, Tehran University of Medical Sciences, Sina Trauma & Surgery Research Center,

Sina Hospital, Hasan-abad Square, Hafez Street, Tehran 11555/3876, Iran, E-mail address: [email protected] / Tel.: +98-216-675-7001

Laal, M. Health IT: What Does the Term Mean?, AWERProcedia Information Technology & Computer Science. [Online]. 2013, 3, pp 18061811. Available from: http://www.world-education-center.org/index.php/P-ITCS

1. Introduction Our next generation of physicians should be technologically adroit and capable toward innovations as our societies have entered a rapid speed of change. Today, our society needs to the physicians skilled enough to adapt to these changes and progresses. Nowadays, we have to use electronic devices in our everyday lives. Medical industry has to accept and grab technological innovation and modernization to enable our physicians to build guidelines for proper use of this technology to improve quality, safety, outcomes, and efficiency that result in saving lives while reducing costs [1]. In the last century, many progresses in the health care industry purposed to expand life expectancies, improve diagnosis and treatment options as well as enhancing efficiencies and cost effectiveness in medical care [2]. These progresses include the healthcare delivery system, too [3]. In this regard, information technology (IT) has a pivotal role in healthcare system [4]. With the adoption of IT, advanced materials, imaging, nanotechnology, sophisticated modelling and simulation in medicine, physical sciences have already changed [5]. This article seeks to bring in and describe a medical technology invention, named health IT. 2. Material and method This article reviews the definition and the concept of the term. It also includes the potential advantages that might follow the wide adoption of health IT. It begins with the conception of the term and continues with the description of the main benefits thereof. Key issues were identified through review of literature on health IT, through review of literature on its advantages. 3. Results Health IT generally refers to the use of computer in the medicinal science. These applications refer to computerized entry systems for physicians’ ordering of tests or medications, support systems for clinical decision making, and electronic prescribing of medications. Information has the main role in medical care. Physicians and hospitals generate and process information as they provide care to patients [6]. Health IT is an umbrella term to describe the fully management of health information across the computerized systems and its secure exchange between consumers, providers, government and quality entities, and insurers. Generally, it is viewed as the most promising tool to enhance the quality, safety and efficiency of the health delivery system [7]. The term includes of various set of technologies to transmit and manage health information for the groups in health and health care. Generally the term consists the capture, use, storage and/or transmission of health information through electronic processes [8]. The potential for IT to have an impact on the safety, cost, and quality of medical care, has never been greater. The technology to create, transmit, store and manage peoples’ health data is rapidly growing [9]. Numerous advantages of quality and efficiency as well as limitations have been shown in the literature for the applying of health IT. Today, there is a trend toward the medical inventions that can lower or even eliminate the potential for errors, enhance the quality of healthcare delivery and save lives [7]. Evidence suggests that health IT has the potential of enhancing the efficiency, cost effectiveness, quality, and safety of medical care delivery via making best practice guidelines and evidence databases immediately available to clinicians, and by making computerized patient records available throughout a health care network [10]. 1807

Laal, M. Health IT: What Does the Term Mean?, AWERProcedia Information Technology & Computer Science. [Online]. 2013, 3, pp 18061811. Available from: http://www.world-education-center.org/index.php/P-ITCS

Nowadays, modern medicine is incredible without application of computers. Computer-based information and communication technologies continue to change radically the delivery of health care, the scientific understanding of the human body and its diseases [11]. One of the main objectives of the application of health IT, is to reduce medical errors. Medical mistakes due to a former physician's poor hand writing would be prevented by using this system, as information of constant patient's health would get stored in readable form. Doctor can follow required treatments or medications needed for a patient through prompt and timely access to a patient's health history documents. These documents are stored as part of a patient's personal health record. The record also hold any information about family health which could be approperiate for further medical situations in future. The objectives of the application of health IT, are mainly to improve the patient's treatment and decrease medical errors. In many conditions, errors can occur due to the treatments prescribed to a patient which may have a negative outcome. The doctor would be able to decide which medications are appropriate to prescribe via clear and accurate information being presented about the patient's reactions to past administrations of certain medications. It allows physicians to have information about medications that are covered by the patient's insurance [12-13]. Better information, enabling those interested in promoting or considering health IT adoption, to arbitrate what benefits to expect from application of it, how best to use the system for enhancing the value derived from their investment, or how to direct policy planned to increase the quality and efficiency delivered by the medical care sector as a whole. 4. Discussion Health IT is applying information processing including both computer hardware and software for the storage, retrieval and sharing of health care information, and using this data and knowledge for communication and decision making [14]. It includes of a vast variable set of technologies to transmit and manage health information for use by consumers, payers, providers, insurers and other groups dealing with health and health care. Health IT contains the capture, storage, use and/or transmission of health information through electronic processes [8]. Generally, the term refers to computer applications for medical care. Those applications may include computerized entry systems for physicians’ ordering of tests or medications, support systems for clinical decision making, and electronic prescribing of medications. Information plays a key role in health care. Providers such as physicians and hospitals generate and process information as they provide care to patients [6]. Information which is based on computer and communication technologies proceed to change fundamentally the delivery of health care and the conception and scientific understanding of the human body and the diseases that afflict it. Today, modern medicine has become almost incomprehensible without applying computers [11]. Mekhjian, et al. [15] noted in their article that health IT have the potential of reducing the hospital stay by 5 percent or more via speeding up certain hospital functions; like ordering and completing tests, ordering and administering medications, and collecting information and preparing for patients’ discharge, and also by preventing costly errors; such as adverse drug reactions that in turn result in lengthening of hospital stay and some delay in discharge. Research has shown that serious errors which occur in the medications of patients in hospitals are both common and potentially expensive . These mistakes could be substantially minimized through greater application of health IT. Some studies have shown the potential reductions in error rates of between 50 percent and over 90 percent [12-13, 16-17].

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Laal, M. Health IT: What Does the Term Mean?, AWERProcedia Information Technology & Computer Science. [Online]. 2013, 3, pp 18061811. Available from: http://www.world-education-center.org/index.php/P-ITCS

Jha, et al. [18] noted that adverse drug events resulted in 1.4 percent of hospital admissions and 28 percent of those were considered preventable. One study showed adverse drug reactions that occured through medical care at an outpatient facility and required hospitalization, happenned annually in a rate of 3.4 for every 1,000 patients. Significant savings occur if preventing even a fraction of the errors now occurring in inpatient and outpatient settings [19]. In the field of pediatrics, many studies have reported the frequency of medication mistakes and adverse drug reactions in both the inpatient and outpatient situations [20-23]. One study showed that informing physicians about a patient’s previous lab work and reminding them of the date of the patient’s last test when they planned to order a test, reduced the volume of tests ordered by about 6 percent [24]. Another study found that providers cancelled 69 percent of lab tests when alerted by an electronic notice that a test appeared to be redundant. This issue, together with a related estimate that 9 percent of all lab tests appeared to be redundant [25], suggests that health IT with a notice of redundancy could reduce the number of laboratory tests by about 6 percent; 69 percent of 9 percent [26]. In regard to imaging studies, Harpole and his colleagues [27] showed that by the use of health IT and providing a clinical decision support system, there was no significant effect on whether or not a test was ordered but did influence the types of radiological images that were taken. 5. Conclusion Health IT generally refers to the use of computer in medicine, to the extent that fully management of health information across the computerized systems and its secure exchange between consumers, providers, government and quality entities, and insurers, take place. The term includes the capture, use, storage and/or transmission of health information through electronic processes. Numerous studies have been done to evaluate the adoption of health IT and the added value in medical care system. The results come in the consequence that applying computer-based information about the patients’ medical history; in other words adoption of health IT has the potential of enhancing quality and efficiency of medical care, while reducing the cost rises from the redundancy of lab tests and medication errors. References [1] Alliance (2008, April 28). Defining key health information technology terms. Report to the Office of the National Coordinator for Health Information Technology, the National Alliance for Health Information Technology: Publishing. USA. Retrieved Nov. 5, 2012 from http://www.10_2_hit_terms [1].pdf. [2] Varkey, P., Horne, A. & Bennet, K. E. (2008). Innovation in Health Care: A Primer. American Journal of Medical Quality; 23(5), 382-388. [3] Varkey, P., & Athyal, V. P. (2005). Service delivery innovations at Mayo Clinic. Journal of Minnesota Medical, 88(12), 39-42. [4] Omachonu, V. K. & Einspruch, N. G. (2010). Innovation in healthcare delivery systems: a conceptual framework. The Innovation Journal: The Public Sector Innovation Journal; 15(1), Article 2. [5] Economist (2009, April 16). Medicine goes digital. Special report on health care and technology. London, UK. Retrieved Nov.5 2012 from www.economist.com/node/13437990. [6] CBO (2008, May 18). Evidence of the costs and benefits of health information technology, A Congressional Budget Office (CBO) paper, USA; Retrieved 2012 Nov.5, from: http://www.cbo.gov/ftpdocs/91xx/doc9168/05-20-healthit.pdf

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[7] Chaudhry, B., Wang, J., Wu, S., Maglione, M., Mojica, W., Roth, . . . Shekelle , P. G. (2006). Systematic review: Impact of health information technology on quality, efficiency, and costs of medical care. Annals of Internal Medicine, 144(10), 742–752. [8] Lardiere, M. R. (2008, April 8). An introduction to health information technology (HIT) and best practices for implementation. Washington DC, USA: National Association of Community Health Centers (NACHC) Publishing. Retrieved Nov.5 2012 from An Introduction to Health Information Technology_8_4_08. Doc. [9] Alliance (2008 April 28). Defining Key Health Information Technology Terms (p.4, p.7). Report to the Office of the National Coordinator for Health Information Technology, the National Alliance for Health Information Technology, USA; Retrieved 2012 Nov. 5, from: http://www.10_2_hit_terms [1].pdf. [10] Shekelle, P. G., Morton, S. C., & Keeler, E. B. (2006, April). Costs and benefits of health information technology. Evidence Report/Technology Assessment No. 132, Southern California Evidence-based Practice Center, Santa Monica, CA, USA. Rockville, MD: Agency for Healthcare Research and Quality (AHRQ) Publishing. [11] Marckmann, G., & Goodman, K. W. (2006). Introduction: Ethics of Information Technology in Health Care. Journal of International review of information technology, 5 (Sep), 2-5. *12+ Bates, D. W., Teich, J. M., Lee, J., Seger, D. L., Kuperman, G. J., Ma’luf, N., . . . Leape, L. (1999). The impact of computerized physician order entry on medication error prevention. Journal of the American Medical Informatics Association, 6(4), 313–321. [13] Bates, D. W., Leape, L. L., Cullen, D. J., Laird, N., Petersen, L. A., Teich, J. M., . . . Seger, D. L. (1998). Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. JAMA, 280(15), 1311-16. [14] Brailer, D. & Thompson, T. (2004). Health IT strategic framework. Washington, DC, USA. Department of Health and Human Services. [15] Mekhjian, H. S., Kumar, R. R., Kuehn, L., Bentley, T. D., Teater, P., Thomas, A., . . . Ahmad, A. (2002). Immediate Benefits Realized following Implementation of Physician Order Entry at an Academic Medical Center. Journal of the American Medical Informatics Association, 9(5), 529–539. [16] Potts A. L., Barr F. E., Gregory D. F., Wright L. & Patel N. R. (2004). Computerized physician order entry and medication errors in a pediatric critical care unit. Journal of Pediatrics, 113 (1), 59-63. [17] Evans, R. S., Pestotnik, S.L., Classen, D. C., Clemmer, T. P., Weaver, L. K., Orme, J. F., . . . Burke, J. P. (1998). A computer-assisted management program for antibiotics and other antiinfective agents. N Engl J Med, 338(4), 232-8. [18] Jha, A. K., Kuperman, G. J., Rittenberg, E., Teich, J. M., & Bates, D. W. (2001). Identifying hospital admissions due to adverse drug events using a computer-based monitor. Journal of Pharmacoepidemiology and Drug Safety, 10(2), 113–9. [19] Honigman, B., Lee, J., Rothschild, J., Light, P., Pulling, R. M., Yu, T., & Bates, D. W. (2001). Using computerized data to identify adverse drug events in outpatients. Journal of the American Medical Informatics Association, 8(3), 254–66. [20] Kaushal, R., Bates, D. W., Landrigan, C., McKenna, K. J., Clapp, M. D., Federico, F., & Goldmann, D. A. (2001). Medication errors and adverse drug events in pediatric inpatients. JAMA, 285(16), 2114-20. [21] Folli, H. L., Poole, R. L., Benitz, W. E. & Russo, J. C. (1987). Medication error prevention by clinical pharmacists in two children's hospitals. Journal of Pediatrics, 79(5), 718-22. [22] Jonville, A. P., Autret, E., Bavoux, F., Bertrand, P. P., Barbier, P., & Gauchez, A. S. (1991). Characteristics of medication errors in pediatrics. The Annals of Pharmacotherapy, 25(10), 1113-8. [23] Holdsworth, M. T., Fichtl, R. E., Behta, M., Raisch, D. W., Mendez-Rico, E., Adams, A., . . . Greenwald, B. M. (2003). Incidence and impact of adverse drug events in pediatric inpatients. Arch Pediatr Adolesc Med, 157(1), 60-5. [24] Tierney, W. M., McDonald, C. J., Martin, D. K., Hui, S. L., & Rogers, M. P. (1987). Computerized display of past test results: Effect on outpatient testing. Annals of Internal Medicine, 107(4), 569–574. [25] Bates, D. W., Boyle, D. L., Rittenberg, E., Kuperman, G. J., Ma’luf, N., Menkin, V., . . . Tanasijevic, M. J. (1998). What proportion of common diagnostic tests appear redundant? American Journal of Medicine, 104(4), 361–368.

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[26] Bates, D. W., Kuperman, G. J., Rittenberg, E., Teich, J. M., Fiskio, J., Ma’luf, N., . . . Tanasijevic, M. J. (1999). A randomized trial of a computer-based intervention to reduce utilization of redundant laboratory tests. American Journal of Medicine, 106(2), 144–150. [27] Harpole, L. H., Khorasani, R., Fiskio, J., Kuperman, G. J. & Bates, D. W. (1997). Automated evidence-based critiquing of orders for abdominal radiographs: Impact on utilization and appropriateness. Journal of the American Medical Informatics Association, 4(6), 511–521.

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