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Informatics, Informatics, Communications & Communications & Access to Health Access to Health Care Information Care Information Nora Oliveri, MD Fundación de Informática Médica (Medical Informatics Foundation) [email protected] / [email protected]

Informatics, Communications Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

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…The New Digital Structure  The flow of information is the main differentiating feature in organizations in the digital era. Once informatics is incorporated to our activity all processes are easier and swifter. By using informatics we have access to the information that we need, and this allows us to make proper and timely decisions.

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Page 1: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Informatics, Informatics, Communications & Communications &

Access to Health Care Access to Health Care InformationInformation

Nora Oliveri, MDFundación de

Informática Médica (Medical Informatics

Foundation)[email protected] /

[email protected]

Page 2: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

The New Digital Structure…

The incorporation of informatics to medicine allows us to go from an infrastructure based on pencil to a digital infrastructure. Then, we enter the digital era, the information era.

Page 3: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

…The New Digital Structure

The flow of information is the main differentiating feature in organizations in the digital era. Once informatics is incorporated to our activity all processes are easier and swifter. By using informatics we have access to the information that we need, and this allows us to make proper and timely decisions.

Page 4: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Significance of the Internet in Access to Information

The value of the Internet as a quick, efficient & economic means to access information is still more important in countries where high costs in communication and low economic resources make it impossible sometimes, to obtain available information at the right time.

Page 5: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Kofi A Annan, General Secretary of the United Nations says…

“The quantity and quality of the available information is changing each day, in each country, in each corner of the world. Access is crucial. The capability to receive, send, and share information through computer nets, the possibility of publishing works without censorship or restrictions, the freedom to communicate at will beyond frontiers, will be the basic rights for everyone.

Page 6: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

…Kofi A Annan, General Secretary of the United Nations says

For a long time, economic inequality and fear to freedom has prevented most men and women in the planet from making the most of the knowledge the information revolution has provided to us.”

Page 7: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Internet is….

Internet is a Metanet, is a network of networks, global, worldwide, planetary, made up by multiple computers connected among themselves and that communicate with each other using the same language.Besides, is a model of Information Systems.

Page 8: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Internet presents the fastest growth of any media in history

To reach 50 MM of users it took: Radio 38 years

TV 13 years Cable 10 years Internet 5 years

Page 9: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

E-mail

The e-mail is the digital version of our traditional mail

It is the most popular service in the Internet Tens of millions of e-mail messages

circulate daily through the net all over the world

There is no relation between geographical distance and time

Page 10: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

WWW or Web

WWW was created in 1989, 20 years after the creation of the Internet

A system that allows to interconnect the information that will be available through the Internet.

Page 11: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Internet # Web Internet:

MEDIA by which access is obtained to information.It is the computer net that allows to access the information stored on the WWW

Web: It is the information contained in the net, which can be presented as text, images, audio, video

Page 12: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Search EnginesSome of the most useful search engines specialized in locating information regarding a given topic of the health care field

Medhunt: [www.hon.ch/MedHunt] Medexplorer: [www.medexplorer.com] Medscape: [www.medscape.com] HealthAtoZ: [www.healthatoz.com] Medical World Search: [www.mwsearch.com] Yahoo Health: [dir.yahoo.com/Health]

Page 13: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Telemedicine &Telehealth

“Telemedicine is the use of telecommunications & informatics with medical purposes”

J. Preston, 1993

Page 14: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Telemedicine &Telehealth…

“Telehealth: Is a compound term that includes activities related to health, services and methods, which are carried out in the distance with the help of information & telecommunications technology.”Definition by the Experts Group of the WHO, Geneva, 1997

Page 15: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

…Telemedicine &Telehealth Its goal is to improve the population’s

health, the control of diseases and medical care, as well as education, administration & research in the health area.

Telehealth policies must be addressed to all countries and regions within each country, to identify the key issues in introduction of Telehealth, and to provide a strategy for this introduction.

Page 16: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

…Telemedicine &Telehealth

The most important benefits are related to cost saving, extension of health cover for everyone and improvements in population health indexes.

Page 17: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Telehealth includes

TelemedicineTele-educationTele-research

Tele-administration

Page 18: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Telemedicine It is the supply of health care services by

professionals, in places where distance is a critical factor, using information and telecommunication technology for exchanging reliable information for diagnosis, treatment, and prevention of diseases, research, evaluation and continuing medical education, with the goal of improving individuals’ and peoples’ health.

Page 19: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Tele-education…

It is a dynamic process by which changes can be transformed in attitudes, knowledge, information and training through information and communication technologies to and for the patients, health care professionals and communities with the purpose of encouraging health improvement.

Page 20: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

…Tele-education

The most important ideas in Tele-education include:

Learning throughout life Health improvement

Participatory Education Education without frontiers

Page 21: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Tele-research…

It includes a variety of scientific activities addressed to solve health care problems including:

Connection & collaboration among individuals and centers to share ideas, results and to access the core of competence, information and knowledge bases

Page 22: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

…Tele-research

Development of new telematics and application technologies

Assessment and validation of telematics applied to health care and its effects on individuals, societies and disciplines related to health care.

Page 23: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Tele-administration

It is the use of information and communications technology for planning, implementation, funding, and assessment of disease control, quality, efficiency and effectiveness in service supply.This also includes epidemiological surveillance and control, and administration of human & technical resources.

Page 24: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Obstacles in incorporation of Telehealth…

A. Political / Economic• Expectation - Failure in demand• Political support based in Health Care

for Everyone

Page 25: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

…Obstacles in incorporation of Telehealth

B. Social / Cultural• Attitude & training for health care

professionals• Existence of flow of traditional

information

Page 26: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

…Obstacles in incorporation of Telehealth

C. Ethical / Legal• Data confidentiality & protection • Transaction malpractice• Professional credential

Page 27: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Obstacles for incorporation of Telehealth

D. Technical / Financial• Regulation and training framework• Telecommunication networks• Help for the user• Tele-diagnosis can increase costs• Costs policy• Data and method assessment

Page 28: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Applications in Computerized Health Care

Access to Databases Electronic Medical Records Distance Training Operation Monitoring Tele-ambulance Home Care Epidemiological Surveillance & Prevention Health Care Services Planning Mobile Applications

Page 29: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Prospect in Latin-America for the next 5 years

Improvements in communication infrastructure associated to decrease in costs of services will allow the development and implementation of health care networks.

A better access to information will allow medical services to be addressed more specifically to prevention.

Page 30: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Prospect in Latin-America for the next 5 years …

Systems of Epidemiological Surveillance and Disease Monitoring will allow a careful control in the whole population.

Family physicians will be the first link of a health care system interconnected that will allow to make references, counter-references, requests for studies, results receipt, control and treatment alert.

Page 31: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Prospect in Latin-America for the next 5 years …

Distance medical education through the Internet will allow that all professionals interested in keeping updated can do so with a low cost, accessing highly qualified programs and self-regulating the time to be able to follow their own pace.

Page 32: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Prospect in Latin-America for the next 5 years …

Institutions will carry out massive training of staff through Intranets, which will allow a significant saving of costs and permanent control of individual and general training level with highly standardized information.

Page 33: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Prospect in Latin-America for the next 5 years …

The implementation of applications for mobile devices will allow to perform a better control and follow up of patients with chronic pathologies, such as diabetes or hypertension, as well as elder patients.

Page 34: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Prospect in Latin-America for the next 5 years …

Professionals will enrich the medical relationship with patients by establishing a bilateral computer link that will allow them not only to provide medical information, but to educate the population, too.

In turn, the patients will be able to know the degree of training and updating before choosing a professional in directories available from institutions authorized for professional certification and re-certification.

Page 35: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Prospect in Latin-America for the next 5 years …

Computerization of administrative processes will allow a better control of transactions and clearness in purchases.

The analysis of transactions will allow billing to be transmitted without mistakes, thus making collection of services swifter, and detecting any attempt of fraud or abuse.

Page 36: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Now, let us imagine that… We could add to our health care system the

elements described here. All actors of the system are connected between

themselves We have an urgency system that allows for

incorporation of all information and taking data from the hospital central system

The computers are very friendly and can be managed by a tactile screen, optic pencil or voice recognition

Page 37: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

…Now, let us imagine that Billings and administrative procedures are

carried out automatically The information remains recorded on line so

that it can be consulted by any other professional that may need it from a remote place

All the information about treatments and administered drugs is evaluated automatically to help preventing adverse and secondary reactions

Page 38: Informatics, Communications  Access to Health Care Information Nora Oliveri, MD Fundacin de Informtica Mdica (Medical Informatics Foundation)

Conclusions

Undoubtedly, many changes will have to be done to reach a health care system that may operate thus.

This will be a challenge that will be worthy to face to have a better quality of life and to get increasingly closer to health care principles for everyone.