Healthcare and Information Technology

Andrew Peck, Matthew Johnson, Logan Fehrenbach

Meagan Christian

History of Healthcare and IT Integration in

the 1960sThe main healthcare drivers in this era were Medicare and Medicaid.

The IT drivers were expensive mainframes and storage.

Because computers and storage were so large and expensive, hospitals typically shared a mainframe.

The principal applications arising in this

environment were shared hospital accounting systems.

IBM 360 Mainframe

Introduced in 1964

Clinical Computing

Early work in medical informatics focused on Clinical Computing with a clear goal.

That is to improve clinical decisions and to reduce medical errors essentially through electronic access to procedure results, faster access to relevant medical information, and decision support functions such as reminders and alerts.

It had been widely hypothesized that physicians' errors of omission and commission were at least as frequently related to their lack of information about the patient as they were to lack of medical knowledge.

History of Healthcare and IT Integration in

the 1970sPROMIS

Taking advantage of third generation computers, in 1968 development of the PRoblem Oriented Medical Information System (PROMIS*) was begun by Dr. Lawrence Weed at the University Medical Center in Burlington, VT (McNeill, 1979). The importance of this system lies in the fact that it was the first attempt to provide a total, integrated system that included all aspects of health care including patient treatment.

The PROMIS system also made it possible to see the relationship between conditions, treatments, costs, and outcomes.

Apple’s Arrival 1977 - The first Apple II is delivered. Although weak by today's standards, it had the ability to do color graphics and shipped with a form of the Basic Programming language as part of the computer. It used the Motorola 6502 chip. The original had 4 K of RAM and an 8 bit bus.

In the late 1970's, hospital information systems other than large teaching medical centers started to use online data communications technology to provide instant access to computerized data base

The 80sIBM realizes that they need to build a smaller, stand alone computer. Bill Gates convinces them to use a larger chip (16 bit) and more RAM than originally planned (64 K instead of 16 K).

He also convinces them to license the Microsoft Operating System (the famous DOS, rhymes with boss) as the operating system and contracts to write software for this machine.

The price of PCs drops as "clones" appear on the scene. Although the term clone is used, these computers were not an exact duplicate of the IBM PC. In computers, the term clone means that a computer allows one to run the same programs, or software.

80s ContinuedANA House of Delegates adopts a resolution identifying the need for nurses to use information systems to collect essential data for clinical practice, management of nursing care and nursing resources, education, administration, and research (Milholland, 1997).

Healthcare drivers were heavily tied to DRGs and reimbursement. For the first time, hospitals needed to pull significant information for both clinical and financial systems in order to be reimbursed. At the same time, personal computers, and widespread, non-traditional software applications had entered the market, as had emerging network solutions

The result was that hospitals began to integrate applications so that financial and clinical systems could talk to each other in a limited way.

IT and HC in the 90s

In this decade, competition and consolidation drove healthcare, along with the need to integrate hospitals, providers, and managed care. From an IT perspective, hospitals now had access to broad, distributed computing systems and robust networks. And so we created integrated delivery network (IDN)-like integration, including the impetus to integrate data and reporting.

Integrated hospital, provider, and managed care offering

2000 – PresentThe main healthcare drivers were more integration and the beginnings of outcomes-based reimbursement. We now had enough technology and bedside clinical applications installed to make a serious run at commercial, real-time clinical decision support.

More integration within Healthcare Providers.

IT DriversMore of Patient, Medical, and Financial information, Mobility, Emerging Cloud Computers.

2000s Cont.

Emerging, broad-based clinical decision support

Broad operational departmental systems with EMR integration

Emerging data warehousing and analytics solutions

Technological Progress

StorageMass storage is no

longer a issue. There are now enterprise

storage systems providing large

amounts of storage for less than $1 per

gigabyte.

Graphical Images

There as been a technological improvement in the presentation of graphical images. This improvement has discontinued the use of X-ray films and instead the image is stored digitally. It is easier to distribute the pictures to all care providers.

Future of Healthcare and IT

Man and MachineIn the health arena, wireless devices were first adopted in the fitness space. When a sensor communicates by Bluetooth to a mobile device, such as one embedded in the sole of a shoe, a body area network is formed. Combined with a variety of wireless scales and accelerometers, these devices quantify data on exercise and activity and can be used clinically to encourage individuals to be more physically fit.

Fitbit

Fitbit Inc. is a company headquartered in San Francisco. Founded and managed by James Park and Eric Friedman, the company is known for its products of the same name, which are activity trackers, wireless-enabled wearable devices that measure data such as the number of steps walked, quality of sleep, and other personal metrics. The first of these was the Fitbit Tracker.

Just one aspect of this Life/health-improving gadget (Sleeping Patterns)[Shown Below]. Information like this as well as many other health data gathering information such as (Calories burned, Calorie Intake, steps taken, goals, etc.) Is possible and affordable to people for $100 to $250.

Wearable technology is going to play a huge role in health care in years to come. The Consumer Electronics Association reports that sales of fitness trackers and smart watches will reach $1 billion this year. But monitoring fitness is only the beginning. For instance, Intel teamed up with the Michael J. Fox Foundation to use wearables to find certain characteristics of Parkinson's disease.

Digital Diagnostics

Making health care more accessible includes providing digital diagnostics options for people who need it, especially those who can't get to a doctor's office. This is one of the main themes of digital health.

One example of digital diagnostics is “Neurotrack” a software-based Alzheimer's diagnostic test that can detect impairments on the hippocampus (the first area of the brain to be affected by the disease) by evaluating eye movement.

Brilliant Minds are affected by Alzheimer’s. Healthcare and IT are collaborating to hopefully resolve

diseases such as this.

Ultra-Fast Scans

GE Showcased it’s ultra-fast CT scanner earlier this year, which can capture a still image of a heart in one beat. The company said that according to research, about 60% of patients have heart rates of higher than 60 beats per minute and are turned away from scans because their heart beats too fast to scan. With this Revolution CT, doctors can see specific areas of the heart that they could not before.

Digital TherapyDigital therapy is important for patients who need at-home care, can't afford to travel to a clinic, or have no way to get to a clinic for therapy. Wellframe is a platform that combines mobile technology with artificial intelligence to provide patients with care after they've returned home from the hospital or doctor's office. It's been described as a "GPS navigation system for patients." There is a daily to-do list for the patient and a tracker for diet and exercise, but an advanced algorithm adapts the content based on the information from patient and healthcare provider. The company has performed trials with cardiovascular, pulmonary, and mental health patients.

Example of Digital Therapy

Barriers in HITHealthcare Culture: In healthcare, they stick to what they have learned. If healthcare workers have to learn a new system, or new method, day-to-day patient care would take a backseat.

Medical efficacy review: To have a successful innovation in healthcare, you must not harm any patients and meet the standards. But finding a medical professionals to determine medical efficacy can be hard.

High-Stress environment: Healthcare worker have very stressful work place. There main goal is to have great patient care. So it is hard for innovative thinking for better healthcare products.

Infographic

Resourceshttps://www.healthcatalyst.com/healthcare-information-systems-past-present-future

http://mthink.com/article/health-care-technology-history-clinical-care-innovation/

https://www.himss.org/files/HIMSSorg/content/files/HistoryHIMSS_January2013.pdf

http://dlthede.net/informatics/chap01introni/healthcare_computers.html

http://healthit.gov/patients-families/better-information-means-safer-health-care

Resources Continued

http://www.forbes.com/sites/robertszczerba/2014/11/23/tech-trends-shaping-the-future-of-medicine-part-1/

https://www.roswellpark.org/partners-practice/white-papers/future-healthcare

http://www.techrepublic.com/article/10-technologies-changing-the-future-of-healthcare/

http://venturebeat.com/2013/06/23/7-predictions-for-the-future-of-health-care-technology/

http://cacm.acm.org/magazines/2010/9/98032-computers-in-patient-care-the-promise-and-the-challenge/fulltext