Future Development of Medical Informatics from the Viewpoint of Health Telematics

2009 ◽  
Vol 48 (01) ◽  
pp. 55-61 ◽  
Author(s):  
K. P. Pfeiffer

Summary Objectives: The transformation process of the health care systems in most countries in direction of integrated care needs the support of information and communication technology. The central element of this development is the electronic health care record. But there are many other applications around this record and the functionality and usability of these systems has to be improved and extended. Methods: A system-analytic approach to integrated care is used to analyze the possibilities and the role of information and communication technology in current and future health and social care systems. Results: The key elements of the improvements in the next years are the integration of evidence-based knowledge in the care process, the improvement of the usability for patients and health care providers, the development of pro-active systems for decision support, the support of the mobility of patients and the activities of daily living, the integration of data form molecular biology, semantic interoperability and last but not least the processing and analysis of these data. In a series of tables requirements of the functionality of eHealth applications are summarized. Conclusion: Research in medical informatics has to focus on strategic concepts and how to transform the demands of a modern integrated health and social care system into user-friendly, secure and efficient ICT solutions and to support the citizen’s responsibility for her/his own healthcare. But there is also a high demand for research to improve the technology of ICT systems in health and social care.

10.2196/20938 ◽  
2020 ◽  
Vol 8 (10) ◽  
pp. e20938
Author(s):  
Jordi Piera-Jiménez ◽  
Signe Daugbjerg ◽  
Panagiotis Stafylas ◽  
Ingo Meyer ◽  
Sonja Müller ◽  
...  

Background Information and communication technology may provide domiciliary care programs with continuity of care. However, evidence about the effectiveness and cost-effectiveness of information and communication technology in the context of integrated care models is relatively scarce. Objective The objective of our study was to provide evidence on the clinical effectiveness and cost-effectiveness of the BeyondSilos project for patients enrolled in the Badalona city pilot site in Spain. Methods A quasi-experimental study was used to assess the cost-effectiveness of information and communication technology–enhanced integration of health and social care, including the third sector (intervention), compared to basic health and social care coordination (comparator). The study was conducted in Badalona between 2015 and 2016. Participants were followed for 8 months. Results The study included 198 patients: 98 in the intervention group and 100 in the comparator group. The mean Barthel index remained unchanged in the intervention group (mean change 0.14, 95% CI –4.51 to 4.78; P=.95) but decreased in the comparator group (mean change –3.23, 95% CI –5.34 to –1.11; P=.003). Instrumental Activities of Daily Living significantly decreased in both groups: mean changes of –0.23 (95% CI –0.44 to –0.02; P=.03) and –0.33 (95% CI –0.46 to –0.20; P<.001) in the intervention and comparator groups, respectively. No differences were found in the Geriatric Depression Scale (intervention: mean change 0.28, 95% CI –0.44 to 1.01, P=.44; comparator: mean change –0.29, 95% CI –0.59 to 0.01, P=.06). The intervention showed cost-effectiveness (incremental cost-effectiveness ratio €6505.52, approximately US $7582). Conclusions The information and communication technology–enhanced integrated domiciliary care program was cost-effective. The beneficial effects of this approach strongly rely upon the commitment of the professional staff involved. Trial Registration ClinicalTrials.gov NCT03111004; http://clinicaltrials.gov/ct2/show/ NCT03111004


2020 ◽  
Author(s):  
Jordi Piera-Jiménez ◽  
Signe Daugbjerg ◽  
Panagiotis Stafylas ◽  
Ingo Meyer ◽  
Sonja Müller ◽  
...  

BACKGROUND Information and communication technology may provide domiciliary care programs with continuity of care. However, evidence about the effectiveness and cost-effectiveness of information and communication technology in the context of integrated care models is relatively scarce. OBJECTIVE The objective of our study was to provide evidence on the clinical effectiveness and cost-effectiveness of the BeyondSilos project for patients enrolled in the Badalona city pilot site in Spain. METHODS A quasi-experimental study was used to assess the cost-effectiveness of information and communication technology–enhanced integration of health and social care, including the third sector (intervention), compared to basic health and social care coordination (comparator). The study was conducted in Badalona between 2015 and 2016. Participants were followed for 8 months. RESULTS The study included 198 patients: 98 in the intervention group and 100 in the comparator group. The mean Barthel index remained unchanged in the intervention group (mean change 0.14, 95% CI –4.51 to 4.78; <i>P</i>=.95) but decreased in the comparator group (mean change –3.23, 95% CI –5.34 to –1.11; <i>P</i>=.003). Instrumental Activities of Daily Living significantly decreased in both groups: mean changes of –0.23 (95% CI –0.44 to –0.02; <i>P</i>=.03) and –0.33 (95% CI –0.46 to –0.20; <i>P</i>&lt;.001) in the intervention and comparator groups, respectively. No differences were found in the Geriatric Depression Scale (intervention: mean change 0.28, 95% CI –0.44 to 1.01, <i>P</i>=.44; comparator: mean change –0.29, 95% CI –0.59 to 0.01, <i>P</i>=.06). The intervention showed cost-effectiveness (incremental cost-effectiveness ratio €6505.52, approximately US $7582). CONCLUSIONS The information and communication technology–enhanced integrated domiciliary care program was cost-effective. The beneficial effects of this approach strongly rely upon the commitment of the professional staff involved. CLINICALTRIAL ClinicalTrials.gov NCT03111004; http://clinicaltrials.gov/ct2/show/ NCT03111004


Author(s):  
Susanna Nordin ◽  
Jodi Sturge ◽  
Maria Ayoub ◽  
Allyson Jones ◽  
Kevin McKee ◽  
...  

Information and communication technology (ICT) can potentially support older adults in making decisions and increase their involvement in decision-making processes. Although the range of technical products has expanded in various areas of society, knowledge is lacking on the influence that ICT has on older adults’ decision-making in everyday situations. Based on the literature, we aimed to provide an overview of the role of ICT in home-dwelling older adults’ decision-making in relation to health, and health and social care services. A scoping review of articles published between 2010 and 2020 was undertaken by searching five electronic databases. Finally, 12 articles using qualitative, quantitative, and mixed-method designs were included. The articles were published in journals representing biology and medicine, nursing, informatics, and computer science. A majority of the articles were published in the last five years, and most articles came from European countries. The results are presented in three categories: (i) form and function of ICT for decision-making, (ii) perceived value and effect of ICT for decision-making, and (iii) factors influencing ICT use for decision-making. According to our findings, ICT for decision-making in relation to health, and health and social care services was more implicitly described than explicitly described, and we conclude that more research on this topic is needed. Future research should engage older adults and health professionals in developing technology based on their needs. Further, factors that influence older adults’ use of ICT should be evaluated to ensure that it is successfully integrated into their daily lives.


2018 ◽  
Vol 159 (8) ◽  
pp. 312-319
Author(s):  
Anett Mária Tróbert ◽  
Zsuzsanna Széman

Abstract: According to statistical data, the number of healthy life years is not increasing in proportion with the longer average life expectancy. In the ageing societies, the long-term care systems are increasingly overburdened; cost-efficient operation and the related coordination of services is one of the key questions for their sustainability. The present separation of the health care and social care systems causes numerous difficulties. One aim of the online research by questionnaire was to survey the attitude of general practitioners – who play a very important part in care for the elderly – towards their elder patients, the patients’ family members, and social workers providing eldercare. The other aim was to gather information on shortcomings experienced by doctors in the care system and on what possibilities general practitioners see for the improvement of eldercare. Semi-structured questionnaires were applied and analysed by descriptive and content methodology. The questionnaires were sent out to 5060 addresses around the country: a total of 145 were returned filled in. The respondents made many recommendations for the improvement of eldercare in the categories of development of social services, family support, development of health services, and societal cooperation. The areas in need of development named by the general practitioners are closely interrelated: the reform of social care would support the health care system and vice versa. More effective operation of the health and social care systems would ease the burdens of families, and at the same time encourage more active participation of families in the care process. And the systematic education of society and communities is a long-term investment that would strengthen a positive attitude towards old age and a value-oriented view of the ageing process that is one of the basic conditions for successful social integration of the elderly. Orv Hetil. 2018; 159(8): 312–319.


2014 ◽  
Vol 3 (6) ◽  
pp. 8 ◽  
Author(s):  
Israel R Kabashiki ◽  
Ngozi I Moneke

Background: Health Information and Communication Technology (HICT) has the potential to reduce patient wait time and improves patient satisfaction. The Long wait times for patients to receive medical services are a big issue in Canada. The Canadian government has invested in Information and Communication Technology (ICT) to shorten patient referral wait times for medical services. Little was known about the association between ICT investments and the quality of health care delivery, and particularly between the use of ICT and referral wait times in the Manitoba Health System (MHS). Methods: The purpose of this quantitative correlational study was to determine if a relationship existed between the use of HICT and the quality of health care delivery in the MHS. The quality of health care delivery was measured in terms of referral wait time, health information sharing effectiveness, physicians’ satisfaction, and patients’ satisfaction. Conclusion: Findings indicated the absence of a significant association between HICT use and referral wait times. Significant correlations were found to exist between (1) HICT use and health information sharing effectiveness, (2) HICT use and physician’s satisfaction, and (3) HICT use and patient’s satisfaction. Four recommendations emerged from this study: First, patient satisfaction should be used as an indicator of the quality of health care delivery. Second, health knowledge repository and expert systems should be integrated into health ICT systems to minimize unnecessary referrals. Third, a mixed health system should be implemented to shorten wait times. Fourth, the portability of the Canadian Medicare should be enhanced to allow Manitobans in particular and Canadians in general to seek medical services abroad. This study was intended to contribute to the existing body of knowledge associated with ICT investments’ outcomes and health care delivery in the MHS.  


2006 ◽  
Vol 5 ◽  
pp. 2-5
Author(s):  
Georg Marckmann ◽  
Kenneth W Goodman

Computer-based information and communication technologies continue to transform the delivery of health care and the conception and scientific understanding of the human body and the diseases that afflict it. While information technology has the potential to improve the quality and efficiency of patient care, it also raises important ethical and social issues. This IRIE theme issue seeks to provide a forum to identify, analyse and discuss the ethical and social issues raised by various applications of information and communication technology in medicine and health care. The contributions give a flavour of the extraordinarily broad landscape shaped by the intersection of medicine, computing and ethics. In fact, their diversity suggests that much more work is needed to clarify issues and approaches, and to provide practical tools for clinicians.


2020 ◽  
Vol 33 (4) ◽  
pp. 351-363
Author(s):  
John Duncan Edmonstone

Purpose This paper aims to make the case that there is a need to move beyond a focus on an approach to leadership development which is confined to health care only. It argues that, given the economic, financial, social and organisational context within which health and social care organisations in the UK operate, there is a need to develop leadership within health and social care systems, rather than within the existing “siloed” sectors. Design/methodology/approach The paper considers the context within which health and social care organisations in the UK operate; examines the nature of those organisations; makes the case for focusing on the health and social car system through systems leadership; and identifies the need for leadership, rather than leader development. Findings There is a danger of health and social care organisations “walking backwards into the future” with eyes fixed on the past. The future lies with treating health and social care as a system, rather than focusing on organisations. The current model is individual leader focused, but the emerging model is one of collective multi-agency teams. Originality/value The paper seeks to go beyond a health-care-only focus, by asserting that there is a need to regard health and social care as a single system, delivered by a multiplicity of different organisations. This has implications for the kind of leadership involved and for how this might be developed.


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