Information Technology Reference
In-Depth Information
care, the CDSS's close the gap between evidence and clinical practice [2]. Some of
the scientific developments related with IT were implemented with success, however
with very specific target. For instance METABO [3] is a data mining system for
predicting the glucose in diabetic patients and ASPREN [4] is a surveillance system
related with the Influenza virus. Nevertheless, the daily use of IT with data mining
models capable of helping efficiently the clinic decision is not truly robust.
Furthermore, the fact that throughout this process the patient was not involved, that is,
these systems are fed with clinical and demographic data related to health, but not
with the quality of life of patients.
2
Information Technologies in Health
The United States Institute of Medicine has recognized the existence of problems with
the quality of health care and for more than a decade suggests the use of IT in health
care, including CDSS to improve the quality of care [5]. Since 2004 the adoption of
IT in healthcare has grown slowly. Such IT has been a mean to improve the quality of
health care, however the interaction and participation of all partners in health care,
including patients, is critical to the successful implementation of IT.
A CDSS is a program designed to help health professionals in decision making.
These systems have been the subject of intense study over the past decades in the field
of health informatics. The progressive increase in the amount of data, information and
knowledge to medical practice has been the main reason for the development of these
systems. The expectation is that by providing relevant data and knowledge in the
health care, the CDSS will close the gap between evidence and clinical practice. The
Electronic Medical Record (EMR) is growing in Europe and the United States. Since
2004 the U.S. federal government promotes the importance of EMR, warning
however that although the EMR can improve the accessibility and readability of
information, it is unlikely that there are significant improvements in the quality of
services without proper use of the Knowledge Management (KM) system containing
the CDSS [5]. Some suggested areas of intervention are: prevention, for example in
immunization; diagnosis, when there is need to compare patients with signs and
similar symptoms; treatment used in drug interactions alert. The main issue in KM is
to manage and evaluate the knowledge establishing strategies that allow the
organization to be aware of their knowledge. The KM aims to share, store, create and
apply existing knowledge to organizational processes, thus representing a greater
capacity for organizational response to fluctuations of its internal and external
environment, providing a mechanism favoring the relationships between the different
partners of the organizations and at the same time promoting responsiveness and
adaptation to the environment. However, this is a relatively new concept in Health,
and despite its acceptance, its use has been introduced slowly [6]. Since the 90's a
pressure on the health sector with regard to accountability, transparency, equal access
to health care and optimization of the efficiency/effectiveness related to services has
been made. In this context, various world political entities have promoted the
development of Quality Management Systems and external evaluations.
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