“IT enables improvements in health care processes; can engage patients and stakeholders; and provide infrastructure to share clinical and financial information more efficiently. All of these things help to make the health care system run more smoothly and cost-effectively,” says Dr. Fay Cobb Payton, associate professor of information systems in the Department of Business Management at NC State’s Poole College of Management and co-author of the paper.
“But technology alone is not a panacea that will solve the overarching problems facing the health care system, such as difficulties in sharing medical data and ballooning health care costs,” Payton says. “For example, IT can streamline processes, such as medical record-keeping, but interorganizational data sharing among clinical stakeholders is lacking and hence stands to impact clinical assessments and outcomes as well as medical decision-making.”
To ensure that the IT developed for the health care system actually meets the system’s needs, the authors of the paper say the IT community needs to adopt a more interdisciplinary approach to product development, design, implementation and research. The authors say bringing in interdisciplinary experts would also help ensure that IT products and applications are implemented in a way that maximizes utility for all of the stakeholders involved: patients, researchers, health care providers, public health agencies and insures, among others. To that end, Payton says IT development and implementation teams may want to include doctors, nurses, social workers and other end users – not just IT professionals.
“The IT industry needs to solicit outside expertise continually throughout the product and application development process,” Payton says. “Interdisciplinary approaches are further needed to address critical issues, such as clinical outcomes, health disparities and treatment management. IT expertise alone does not ensure the best possible product. Feedback from end users in the health care field is critical.”
The paper, “Health Care IT: Process, People, Patients and Interdisciplinary Considerations,” is published in a special issue of the Journal of the Association for Information Systems.
Research abstract | “Health Care IT: Process, People, Patients and Interdisciplinary Considerations”
- Authors: Fay Cobb Payton, North Carolina State University; Guy Pare, HEC Montreal; Cynthia LeRouge, Saint Louis University; Madhu Reddy, Pennsylvania State University
- Published: February 2011, Journal of the Association for Information Systems
Abstract: “Despite this great promise, the impact of IT on healthcare over the past decade has so far been modest. Currently, almost 80 percent of physicians—the majority in small, independent practices—lack even rudimentary digital records. Where electronic records do exist, they are typically limited in functionality and poor in interoperability. As a result, the ability to integrate electronic health information about a patient and exchange it among clinical providers remains the exception rather than the rule.
Compared to other industrialized nations, the United States lags far behind in the use of electronic health records” and global economies can and have benefited from the implementation of information technology in the health care domain. While IT advantages have enabled social networks, instant messaging and blogging, PCAST (2010, p 25-26) determined that four separate identifiable barriers in the healthcare system exists.
First among these barriers are proprietary applications which typically support fragmentation in patient, people and process data and workflow aggregation. Second, electronic health records (EHRs) are largely seen and used for internal organizational purposes with limited connections to external constituents, such as patients, external providers and public health agencies and researchers. Third, patient privacy concerns abound and consequently hinder content for public health and research initiatives. Lastly, given the fee-for-service health delivery model, much of health care IT has focused on financial (administrative) rather than clinical functions. These barriers highlight the hurdles that both healthcare and IT must address and overcome in order to provide and deliver effective and efficient care.
One notable, yet, absent obstacle from the PCAST list is the need for interdisciplinary approaches to healthcare and health IT. In its 2003 report, Health Professions Education: A Bridge to Quality, the National Academy of Sciences concluded that all health professionals should be trained to deliver patient-centered care as members of an interdisciplinary team emphasizing evident-based practice, quality improvement approaches and informatics (p 121). This imperative not only calls for interdisciplinary methodologies and theoretical foundations needed to address clinical outcomes, health disparities, evidence-based practices, treatment management (Payton, 2009) but implies the need for integration among people, patients and processes among healthcare stakeholders.