¶ … Information Technology on the Healthcare sector Healthcare systems serve to perform the very important function of preserving human capital. In modern society, health care assumes significance not just in terms of the expenditure it generates, but also because it is a large-scale consumer of goods and services, important employer and contributes in research and development. From the perspective of countries, maintaining and improving health care services require significant investments. Consequently governments and the private sector consistently strive to improve the productivity levels of this sector by controlling costs. It is in this context that information and communication technology can play a key role in making both ends meet - ensure adequate health care for people at affordable costs. (Murphy, p. 12)

There is considerable criticism that health sector is markedly lagging in adopting information technology practices, thus preventing the benefits that can reach the patients and practitioners of the profession. This trend is noticed even in advanced countries like the U.S. And Europe. In the U.S., it is estimated that more than 90% of about 30 billion health transactions still continue to be managed through telephone, fax and the mail modes. A survey by the non-profit organization eHealth Initiative revealed that as much as 40% of health care establishments reported IT budget allocations of a measly 1.5% or less of their total operating expenses budgets. (Murphy, p. 12)

While the induction of IT is healthcare has still some way to go, there have been some significant changes in working practices in some areas. Perhaps the most important development is the availability of current and reliable health information to anyone with internet connection facility. This means that patients can play a greater role in the health care process by finding more information about healthy living, diseases, medical treatment, advances in surgery and so forth. Since internet technology is independent of distances, patients living in different can consult with doctors living elsewhere. In fact, doctors performing complex surgeries resort to online expert's advice and assistance right at the operation theater. For patients living and working in remote and far-flung areas, IT-enabled medical services are a boon as the number of times they need to visit expert medical practitioners can be drastically reduced. The doctors can follow the progress of their patients by exchanging information online and this reduces time and costs for both the parties involved.

IT offers tremendous advantage for medical professionals as well. Medical journals from different parts of the world are now available online and there are several websites offering information and advice. The main benefits include avoiding physical movement of patients or medical staff from locations where adequate expertise is not available, by relying on direct electronic transfer of information; increasing response time of medical institutions, and reducing wastage by monitoring available resources. Integration of electronics, communications and medical technology provide citizens many options from which they can choose the type and extent of health care they need.

National governments are waking up to the reality that IT can play a major role in improving healthcare services. The European Union (EU) proposed the eHealth scheme in 2002, which is an integral part of its EU health strategy covering EU's information system policies and activities for healthcare sector. The strategies under this scheme include developing a comprehensive database on personal health information and medical emergency data, developing health information networks for quick and easy access to health information across the healthcare system and enabling online health services.

The online health services would maintain electronic health records and provide ready information on illness prevention, tele-consultation and e-reimbursement. In April 2004, the EU formulated an action plan for providing better healthcare to European citizens. The plan was aimed at achieving two main objectives: speedy adoption of latest information and communication technologies in the health sector and integration of the entire spectrum of e-Health policies and activities. With this initiative, EU policymakers believe that, by 2010, e-Health would become an essential service available to every citizen and will be adequately budgeted in the national expenditure. (Europa Information Society)

Task 1- External Environment

Technological innovations in the Health sector:

From an overall perspective, an IS/IT strategy for the health sector would center on data communication. In the current scenario, several types of information systems exist to meet different kinds of needs. However, all systems would fall under three broad categories - strategic, tactical and operational. Strategic systems are implemented for achieving the long-term goals of the organization and generally dealt by decision and policy makers. Tactical activities are those that are carried out by personnel and collectively, these activities should lead the organization...

The operational systems deal with technical and data-based systems required for managing day-to-day operations.
Operational information systems:

Typically, these information systems help manage transactions in the health care system. They provide historical records of past transactions and perform routine record management functions. Data collection, input validation, information processing and output generation are the tasks of operational information systems. Order entry, accounts payable and receivable, inventory control, payroll and general ledger are some of the functions done by these systems.

Management information systems:

Given the dynamic and complex nature of the health sector, managers need information to take quick decisions which may have far reaching consequences such as saving lives and controlling health degradation. Management information systems are prepared with inputs from the operating managers and presented in a form that could be easily assimilated and understood by decision makers. This helps decision making in various key activities such as planning, finance, marketing, logistics, human resources and project management.

Decision support systems:

For solving unstructured management problems, interactive information systems or decision support systems are used. The main advantage of this system is that it can provide multiple solutions for a problem and allow the users to take the best decision. In health care sector, decision support systems allows medical professionals and administrators to devise quality and cost control projects that can eventually lead to affordable healthcare. (Shapleigh, p. 24) Transition and Trendstar are some examples of decision support systems that are finding increasing applications, especially in large hospitals. Group decision support systems allow combining communications from different sources, interaction of computer networks and access to multiple databases, thus providing the platform for effective group decision-making in complex situations (Dennis et al., p. 602). Medical practitioners can use these systems while performing complicated surgeries.

Expert systems:

They are knowledge-based systems, used to make decisions or solve problems in a particular field. An expert system incorporates the technical and analytical knowledge and rules accepted in the professional and provide decisions based on these inputs. A popular expert system in healthcare is MYCIN, which enables diagnosis of infectious diseases and suggest possible therapies. Another example is the widespread use of casemix systems for hospital information systems management (Smith, p. 63). Expert systems are believed to have great potential applications in future health care management.

Future innovations:

Expert systems and decision support systems are still in its early stages in health care management. Advances in computer modeling and artificial intelligence are expected to result in more advanced and better expert systems in future that will make problem solving easier and quicker. Artificial intelligence systems, like humans, have the capacity to learn and develop new knowledge from existing data and interactions. Since computers have the innate ability to analyze large amounts of data, an artificial intelligence system can possibly link up seemingly disparate data and information and come up with new and innovative solutions. It an also perform the important function of alerting a medical practitioner when there is data to suggest that the patient's condition has changed or could change. Artificial neural networks, based on the model of the human neuron, are emerging as a potential technology that would enable accurate decision making even in the absence of information and data. Neural computing could find immense use in the design of National Health Information Systems and Public Health Care Systems.

It is evident that IT can have a positive and result oriented impact on the management of health care. But in practice, there are many issues that prevent easy integration of IT and medical systems. Some deep-rooted problems that inhibit adoption of IT relate to costs, competition, human resources, and infrastructure and so on. One of the greatest impediments is the huge investment that is required for setting up computer networks, data base management, training and hiring skilled personnel, maintenance and upgrading hardware and software. Small and medium sizes health care centers may not be able to set up full-fledged systems. The intense competition in health care prevents free sharing of information on patients, population and medical advances. This is perhaps one reason why even large medical centers still depend on traditional methods for handling patients and do not have a complete IT strategy. Another problem is the lack of technology infrastructure such as networking capacity, bandwidth, data transfer systems, power and connectivity, which prevent integration of IT in medical centers.

Impact of non-technical issues on IT strategy:

There are various non-technical issues that impact the IT/IS strategy in health…