(1) Development and promotion of industry-wide standards;
(2) Funding of research for investigation of the impact of IT on quality;
(3) Provision of incentives that provide encouragement of investment in IT;
(4) Giving grants to investors in IT; and (5) Development of strategies to improve the flow of information across providers. (Report to Congress, June, 2004, p.159)
Stated additionally in the Report to Congress is that there are multiple functions that must be considered when purchase IT and hundreds of applications that various vendors offer. The various IT applications are stated to be within three categories including those of:
(1) Administrative and financial systems that facilitate billing, accounting and other administrative tasks;
(2) Clinical systems that facilitate or provide input into the care process; and (3) Infrastructure that supports both the administrative and clinical applications. (Report to Congress, June 2004, p.160)
The work published by The Royal Society entitled: "Digital Healthcare: The Impact of Information and Communication Technologies on Health and Healthcare" states: "The single most important factor in realizing the potential of healthcare ICTs is the people who use them. The end users of any new technology must be involved at all stages of the design, development and implementation, taking into account how people work together and how patients, carers and healthcare professionals interact." (2006, p.1) It is additionally stated that it should be recognized by all healthcare professionals that ICTs hold great potential value in the health care workplace. It is important that healthcare managers "ensure sufficient time for healthcare professionals to be involved properly in the design, development and implementation of new technologies. This includes local and national health authorities ensuring that funding and time are allocated for initial training and ongoing support when new systems are introduced." (The Royal Society, 2006, p.1) The Royal Society additionally states that higher education institutions and professional bodies "…must ensure that both basic training and continuing professional development include the use and understanding of ICTs as an integral part of healthcare professionals' everyday role." (2006, p.1)
The Royal Society states the belief that "Healthcare ICTs will change the roles of patients, carers and healthcare professionals in the delivery of healthcare. For example, more healthcare-related material is available now for patients via the worldwide web, leading to a new role for healthcare professionals in guiding patients through the various information sources. Continued research into the socio-cultural impact of healthcare ICTs is required." (2006, p.1) The Royal Society states that data access is both a complex as well as a controversial issue since it is "…technically possible to establish systems that allow different levels of access to an individual's electronic health records. However, it is not clear what a sensible access policy would be because there is an unresolved conflict between privacy and sharing healthcare data for both individual and public benefit." (2006, p.2) In order that a resolution be found to this conflict "…there needs to be further engagement with patients, carers and the wider public to determine where a workable balance lies between privacy issues and data sharing." (The Royal Society, 2006, p.2) The health policy of future government is stated to be presented with a need to "…be informed by the findings of this engagement." (The Royal Society, 2006, p.2)
The Royal Society states that it advocates strongly for "an incremental and iterative approach to the design, implementation and evaluation of healthcare ICTs. This involves engaging the end users at all appropriate stages from determining the specifications through to training and ongoing support once the system is introduced." (2006, p.2) Stated to be a major part of this approach is the design and development since this includes good or bad elements of systems. Particular attention should be paid to the "impact of the speed and scale of the different programs and the varying levels of user-engagement." (The Royal Society, 2006, p.3)
The criteria for evaluating the technical and financial performance should be establishing in the beginning of the development process as should user satisfaction. There is a requirement that "…local, regional, national and international systems must be able to operate together and share information, which requires national and international standards. We encourage the Government to build on its ongoing work to achieve connectivity as quickly as possible between the different national and international standards being developed. It will not be possible to establish fully interoperable systems until these standards are agreed." (The Royal Society, 2006, p.3)
The following figure lists examples of health information technology for hospitals and physicians.
Examples of Health Information and Technology for Hospitals and Physicians
Source: Report to Congress (June, 2004)
SUMMARY AND CONCLUSION
This work has identified the primary barriers and drivers of information technology in the health care environment and as well has noted the various challenges that are presented in implementation of electronic medical record systems and other information technology applications in the health care workplace.
Barriers have been noted to include the immaturity of software and training issues accompanied by concerns over privacy. Cost and complexity have also been noted in this study to present specific challenges to implementation of IT. Interfaces are noted in this study as a particular problem in electronic medical record system implementation. That which serves to drive information technology investment are two factors: (1) the promise of quality and (2) gains in efficiency.
The effort should be specifically driven by management in the health care sector and by higher educational institutions and professional bodies through making sure that basic training as well as ongoing professional development are inclusive of the understanding of the use of the information technology as being integral in the role of the healthcare professional daily. Concerns of patients over privacy will have to be effectively addressed as well as issues relating to integration of systems on local, regional, national and international levels.
While information technology implementation in health care has not progressed at the expected rate, it is likely that as health care professionals become more attuned to and informed of the capacity and potential of information technology applications in the health care workplace that information technology will be implemented widely across the health care sector.
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