Special section on healthcare information systems

摘要

The cost of healthcare is growing in almost every country, driven by our aging population and advances in medical science. At the same time, in the current economic climate, many countries are struggling to reduce public spending on all kinds of service provision, and healthcare is no exception to this. With this tension between burgeoning costs and tightening budgets, many countries are seeking to identify ways to use Information Technology (IT) to improve efficiencies while not reducing, or possibly even improving, healthcare and healthcare service delivery. For example, the American Recovery and Reinvestment Act of 2009 provided $36 Billion USD for health IT in the USA. This focus on the potential of IT is not surprising since research has demonstrated how communication and coordination inefficiencies in healthcare systems contribute substantially to healthcare costs. For example, Agarwal and colleagues (2010) estimated that in US hospitals alone (i.e., not considering costs across the multiplex of healthcare providers), over $12 billion USD were wasted due to communication inefficiencies among care providers. Thus, many healthcare providers continue to rely on antiquated methods to communicate across the healthcare specialisms involved. Doctor to nurse communications, for example, often rely on hand-written (often illegible) notes or verbal instructions hurriedly communicated in a busy working environment. Similar miscommunications can occur between healthcare professionals and their patients. Such communication practices can result in medical errors (otherwise known as adverse events) as when the nurse misinterprets the scribbled note or hurried verbal instruction from the doctor. Even in those contexts, where healthcare providers have adopted IT, for example in relation to managing patient records, the systems are often standalone and not interoperable across the healthcare system - even in the local or regional context. Thus, it is most often the case that when a patient is referred by a primary care physician to a specialist in a hospital, the specialist does not have access to the medical record and so has to reconstruct the patient history.