Technology - KRC
Why are Urban Indian programs better suited for Health Information Technologies; and why is this a great opportunity for us?
Traditionally, the government has fostered the use of information technologies as great alternatives for getting rural and isolated areas connected to regional and national systems. Under this general notion, urban communities were greatly overlooked, regardless of the fact that cities offered the advantage of services agglomeration. That is, the series of services that can be found in urban settings- such as technology providers, cheaper broadband access, skilled personnel, transportation options, etc.
A recent survey carried out by NCUIH (responded by approximately 60% of the UIHPs) shows that the basics for e-readiness are indeed in place. For instance, 100 % of the Urban Indian Health Programs report having access to Internet in their facilities (and their own server); of those, over 90 % have broadband connection. The same survey shows that an average of 95 % of the personnel uses internet at work. UIHP leaders estimate that nearly sixty percent of their served community has access to Internet and Email (59% and 57%, respectively).
The last administration made only shy attempts to fund and foment HIT initiatives at the national level. The Obama administration, though, has publicly declared that the use of Health Information Technology is not only beneficial but extremely necessary for all health facilities. E-Health initiatives are to be implemented for the country to have a functioning health system, regardless of the reforms to be made as technologies are neutral to politics. The American Recovery and Reinvestment Act takes a two-pronged approach to advanced education relating to the use of health information technology, providing support both for health informatics programs and for clinical education programs that integrate HITs. [1]
What exactly is Health Information Technology?
In plain English, it is the use of electronic means to carry out an operation related to a health care or to a medical management task*. HITs therefore, range from purely administrative operations, to task-specific tools for management systems; to highly specialized, patient-customized solutions.
How HITs are tools for Sustainable development in my organization?
HITs can foster sustainable development in three main ways:
a) Freeing up Resources: although the initial investment can be expensive funding and training wise, Information technologies have proven to lower fixed costs through significantly faster operations and increased efficiency.[2] These resources can be used for improving or expanding services.
b) Knowledge Transfer and Foundation: once the technology has been ingrained in the health facility, it creates a technological foundation that can be used by managers to find customized solutions according to the challenges they are facing- which can expand capabilities without much investment.
c) Standardized Systems: the technology to be provided through this government initiative would be standard for all facilities, which reduces costs as well as it eases both management and IT personnel recruitment.
How does it affect me and my Clinic?
The most common notion about the use of information technologies for health is the use of Electronic Health Record (EHR) systems. These systems bring about a great deal of benefits to any implementing clinic by making information: quickly available, customizable, shareable and searchable in a quick fashion (in addition to greatly lowering the costs and making management more efficient). However, there are many other e-health-based systems and applications that once implemented can help our health programs expand services, improve existing ones and/or leapfrog stages of development and catch up with national trends. According to international expert, Dr. Per-Gunnar Svennsson, e-Health Care Management can be divided according to their type of user: a) Consumers informatics, Clinical Informatics and Biomedics [1].
A recent report of the Health Information Management Systems Society (HIMSS) stresses the potential for HITs to help clinics provide better, more customized and efficient care for their patients: Today much of the driving clinical need centers around efforts at enhancing patient safety, patient satisfaction, throughout, and the demand for quick and accurate access to clinical information in order to provide not only quality patient care, but also access real time information for crucial leadership decision making [2] . In general terms, there are three crosscutting themes where HITs can improve health care facilities and practitioners performance: a) Administrative Tasks, b) Clinical Support; and c) Infrastructure Efficiency. Some examples of specific areas where HITs can positively impact performance are:
Clinical decision making- generating case-specific advice
Chronic Care
Managing clinical competency
Maintaining cost control
Monitoring medication orders
avoiding duplicate or unnecessary tests
Support of patient safety
Clinical research
Education of future caregivers[3]
As technologies evolve, it is expected that HITs will be embedded in many more specific tasks and supportive areas of health care. The more practitioners get used to working with e-health systems, the more customized solutions will arise*[4].
What if we do not join these efforts?
The technological and medical gap will increase considerably. As health care providers, UIHPs would not only be missing the opportunity to take advantage of the funds and efforts this administration is putting into creating the basis for a sustainable health care system for all (including minorities and the Indian Health Service); but we would also be thwarting our own way to get further government funding in the future-- as federal and local initiatives and grants will most likely require the utilization of these systems. Lastly, our population would suffer from not getting the improved and expanded health care services that could potentially be provided with HIT systems.
Where can I find more information on HITs?
There is plenty of literature available depending on the specific topic you would like to research on. You may also contact your regional I.H.S Office for information on the initiatives to be implemented.
{1] Svennsson, Pre-Gunnar. eHealth Applications in Health Care management. E-health International journal.2002.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=135526
[2] To Learn more about the use and impact of HITs go to: http://www.himss.org/content/files/ClinicalPerspectives_whitepaper_052907.pdf
[3] Idem.
[4] For a list of HITs applications please visit http://www.medpac.gov/publications\congressional_reports\June04_ch7.pdf
