Leadership Commitments to Improve Value in Health Care Finding Common Ground: Workshop Summary (2009) / Chapter Skim
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13 Information Technology
13 Information Technology
Pages 309-320
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From page 309... ...
Information systems that were initially developed by gathering limited patient demographic and financial data have, in many cases, expanded to include volumes of complex clinical findings, laboratory data, and images. With the significant increase in patient data volume and complexity, healthcare data management is increasingly more challenging.
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From page 310... ...
Despite the significant advances in healthcare IT, work remains to be done to meet the needs of a learning healthcare system. Focused efforts in data warehousing and the development of data analysis tools will enhance the healthcare system's ability to work with large data volumes and images.
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From page 311... ...
IT consumers, such as healthcare organizations and providers, will increasingly demand intraoperability between systems as the digitization of clinical information and the use of electronic media in medical offices increases. Beyond individual patient care and data transferability, the accumulating public and population data efficiently necessitate interoperable systems that are suitable for a single-physician practice as well as large multispecialty academic organizations.
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From page 312... ...
IT can supply relevant aggregated clinical and experiential evidence data to guide clinicians faced with clinical and biological data from individual patients. Clinical decision support rules are complex and require the flexibility to respond to changing clinical evidence and learning.
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From page 313... ...
Similar to clinical decision support, alert functions correspondingly require integration with provider work flow and clinical systems. Flexible Data Views As the complexity and volume of data increase, simple tables and statistics will not provide an adequate view of the available information.
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From page 314... ...
However, if the key word is "chest pain," these tools will also pick up "no chest pain" and the results will include patients who did not have chest pain or who denied having chest pain. In light of these gaps, transformation will require an impetus for rectifying deficiencies to create a foundational medical informatics ecosystem.
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From page 315... ...
In fact, some hospitals have four and five full-time employees who just walk around collecting all these data on paper. The proposed IT Core Measures Initiative could help transform health care by promoting the implementation of an important information infrastructure that would encourage the development of additional measures.
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From page 316... ...
How can systems currently deemed impossible be developed? How can systems that guide clinical decisions on the basis of individual clinical and biological data with relevant clinical evidence and experiential information gathered from the mining of data on previous patients with similar conditions be developed?
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From page 317... ...
As the clinical standards are developed and adopted, feedback on the standards will increase and the standards can adjust to meet the needs of the users. The virtuous cycle -- one that continually feeds outputs back into the cycle as inputs -- inherently leads to equilibrium within the medical informatics ecosystem, as seen with eBay, Flickr, and YouTube, and the technology works in harmony with the community.
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From page 318... ...
Patients and Consumers Representatives from patient and consumer stakeholder groups encourage healthcare IT to increase their access to patient-controlled information sources, including medical records, clinicians, and clinical data, as well as an ability to use IT as a means of communicating and participating in the planning of their care. Specific IT enhancements might include secure data sharing and protection, access to multiple data sources, an ability to access personal medical information, a standardized healthcare data vocabulary, tools for communicating with healthcare professionals, and IT cost containment.
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From page 319... ...
Healthcare Providers and Healthcare Delivery Organizations Healthcare providers and healthcare delivery organizations suggest that the healthcare IT sector develop systems that are user-friendly, highly integrated, and interconnected and that allow clinicians to spend more time with patients and access the aggregated clinical information. Specific IT enhancements might include the provision of access to all clinical data sources; a standardized healthcare data vocabulary; tools for communicating with other healthcare professionals; and increased ease of system use, training in system use, user interface development, and system upgrades.
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From page 320... ...
Specific IT enhancements might include information from data collected concurrently during the routine delivery of care to assess outcomes, prevention strategies, and treatments; tools designed to aggregate and analyze data efficiently; patient outcomes reporting to empower patients to enter treatment outcomes data; and biobanking initiatives to improve the collection and storage of tissue samples and genetic data. Support for the development of database architectures and governance procedures addressing privacy needs and proprietary interests could support the application of evidence in the research setting.
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