Informatics, Communications

1
Informatics, Communications Access to Health
Care Information

• Nora Oliveri, MD
• Fundación de Informática Médica (Medical
  Informatics Foundation)
• norao_at_fim.org.ar / oliverinora_at_aol.com

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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.

3
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.

4
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.

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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.

6
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.

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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.

8
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

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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

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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.

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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

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Search Engines

• Some 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

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Telemedicine Telehealth

• Telemedicine is the use of telecommunications
  informatics with medical purposes
• J. Preston, 1993

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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

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Telemedicine Telehealth

• Its goal is to improve the populations 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.

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Telemedicine Telehealth

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

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Telehealth includes

• Telemedicine
• Tele-education
• Tele-research
• Tele-administration

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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.

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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.

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Tele-education

• The most important ideas in Tele-education
  include
• Learning throughout life
• Health improvement
• Participatory Education
• Education without frontiers

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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

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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.

23
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.

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Obstacles in incorporation of Telehealth

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

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Obstacles in incorporation of Telehealth

• B. Social / Cultural
• Attitude training for health care professionals
• Existence of flow of traditional information

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Obstacles in incorporation of Telehealth

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

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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

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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

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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

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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

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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.