How can health information systems and EMRs facilitate patient care
Professor Steven BoyagesThe University of Sydney
18th June, 2015, Elounda CreteThe Athena Society
The nature of patient care is a constantTO RECHON him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look up his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according the law of medicine, but to none others. (Hippocrates 460-370 BC)
Health is a knowledge based profession
• Research• Development
Generate Knowledge
• Education• Training
Impart Knowledge • Care
• Prevention
ApplyKnowledge
15/04/2023 7
Objectives of Investment in IT
• Improve patient experience• Improve patient safety• Improve provider experience• Create value for money
Investing In Health IT perceived as a solution to some of the
challengesBenefits
– Improved automation– Improved productivity– Reduced duplication– Improved safety– Improved patient and
staff experience– Improved reach of
information and service
Risks– Financial investment not
realised– Poor connectivity– Lack of common standards– Increased risk to patients– Increased staff frustration
and lower morale– Staff expectations not
realised– Poor execution and
implementation due to inadequate training
8
The Two Hype Cycle Viewsof the Electronic Health Record
Technology Trigger
Peak ofInflated Expectations
Trough of Disillusionment Slope of Enlightenment Plateau of
Productivity
time
expectations
PositiveHype
NegativeHype
UsabilityValue
Source: Gartner, 2013
FunctionImpact
Minimal
Full
Availability of Products2020+2012200519981993
Generation 1:The Collector
Generation 2:The Documentor
Generation 3:The Helper
Generation 4:The Colleague
Generation 5:The Mentor
Electronic Health Records:Generations Model
Today
Source: Gartner, 2013
The Internet of Things….And Everything
13
Location of equipment
Availability & location of
staff
Location and condition
data on the patient
Source: Gartner, 2013
What’s Next?:Patient-Facing ICT Explodes
Source: Gartner, 2013
Care Coordination Applications
“Quantified Self” Applications
Patient Engagement/Portals
Predictive, planning analytics
Visualization
Level of Business Impact
BI/Analytics Shifts GearsJust as Clinical Data Emerges
Ad hoc query,OLAP, data mining
Skill Levels
Required
Reporting, dashboards
Prescriptive process
optimization
Information Patterns
Adapt and Evolve
What will happen?
Why did it happen?
What happened?
What should happen?
Retrospective Concurrent Prognostic
Source: Gartner, 2013
Performance transparency, clinical effectiveness research
Patients “Quantified Self”
Genomics and collaborativeclinical research and discovery
Population health analytics: Lifestyle/social norm, persuasion and prevention researchAdvanced sensor
technologies
EHRs with real-time clinical decision support and interoperability
"The Nexus" Net-mediated
business, clinical, researchand social processes
Complex Data, New Discoveries, Fast Translation
Mobile technologies
Provider carecoordination applications
Social networks
Major medical breakthroughsE.g., nanomedicine, 3D bioprinters
New Technology TriggersThe Nexus of IT Forces:
Social, Mobile, Cloud & Big Data/Information
Source: Gartner, 2013
Annual benefit paid by Medicare for 25-hydroxyvitamin D testing and percentage increase since 2000
Year Annual Benefit ($) % Increase
2000 1,021,784 100%2001 1,670,597 163%2002 2,318,770 227%2003 3,216,543 315%2004 5,269,951 516%2005 7,592,467 743%2006 12,149,112 1189%2007 22,621,733 2214%2008 42,358,509 4146%2009 67,643,016 6620%2010 96,746,203 9468%
Vitamin D Test Medicare Benefit ($m) per annum: Australia
1994 1999 2004 2009 20140
20,000,000
40,000,000
60,000,000
80,000,000
100,000,000
120,000,000
140,000,000
160,000,000
Medicare Benefit ($m)
Year
$ m
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