One of my lectures on Medical informatics, information systems and evaluation perspectives.

1. The role of IS/IT in healthcare
Session 1: Seminar Medical
Informatics
Rogier van de Wetering, PhD
1Dept.of Information and Computing Sciences, Utrecht University,
The Netherlands
Utrecht, April 29, 2011
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2. Outline
 Key developments in healthcare
 Types of systems
 Trends and developments
 Benefits of IS/IT
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3. Vision Microsoft on the Future of
healthcare
“We always
overestimate the
change that will occur
in the next two years
and underestimate the
change that will occur
in the next ten.”
--Bill Gates Jr.
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4. Key developments in healthcare from an
international context
Ageing Growing costs
population of healthcare Individuals
more engaged
in decisions
and purchases
E-prevention Providers Providers
programs will develop develop new
reduce future management services to
healthcare information of clients (product
and quality
spending performance information)
Development
of service
innovations to
enhance care
and cure
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5. Current healthcare systems
 Inefficient
 Fragmented
 Quality issues
 Expensive
What about IT?
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6. International Comparison of Spending on
Health, 1980–2007
Source: Davis et al., How the performance of the U.S.
health care system compares internationally. The common
wealth fund (2010). See also OECD.org
6

7. 7
14
10
12
16
18
0
6
8
2
4
% GDP
United States 16,0
France 11,2
Switzerland 10,7
Austria 10,5
Germany 10,5
Canada 10,4
Belgium 1 10,2
Netherlands 9,9
Portugal 9,9
New Zealand 1 9,8
Denmark 9,7
Greece 9,7
1. Current expenditure. Source: OECD Health Data 2010.
Sweden 9,4
Iceland 9,1
Italy 9,1
Public expenditure on health
Spain 9,0
OECD 9,0
Ireland 8,7
United Kingdom 8,7
Australia 8,5
Norway 8,5
Finland 8,4
Japan 8,1
Private expenditure on health
Slovak Republic 7,8
Hungary 7,3
Luxembourg 7,2
Czech Republic 7,1
Poland 7,0
other OECD country on healthcare
Chile 6,9
Korea 6,5
Turkey 6,0
The United States spends more than any
Mexico 5,9

8. Health reform legislation should improve
the affordability of insurance and access to
care in the US
Source: Davis et al., How the performance of the U.S. health
care system compares internationally. The common wealth fund
(2010). See also OECD.org
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9. Overview of various types of IS/IT
 Electronic health records (ePR/eMR)
 Computerized provider order entry (CPOE)
 Decision and diagnostic support (e.g. CAD/CAR)
 Advanced visualization tools
 Enterprise-wide image management systems (i.e. PACS)
 Prescribing systems
 E-Health / consumer informatics / educational
 Surgical simulation and modeling
 Mobile computing
 Tele-medicine
 Administration
 Data exchange networks (e.g. XDS-i, IHE)
 Knowledge discovery/mining and retrieval systems
(Cf. Haux, 2010; Chaundry, 2006; Huang, 2010)
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10. Extracted clusters from 16 medical informatics
journals, appearing between 2005 and 2008
Organization, application,
and evaluation of health IS
Signal and data analysis
Medical knowledge representa -
tion
Source: M. J. Schuemie1 et al., Mapping the Domain of
Medical Informatics. Methods Inf Med 2009; 48: 76–83
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11. Hype Cycle for Healthcare Provider
Applications and Systems
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12. There are many possible benefits and
costs of implementing health information
technology
 Effects of health IS/IT (Cf. Chaundry, 2006):
 Quality
 Efficiency
 Costs
 Challenges for the future:
 Interoperability of medical data
 Adoption rates of IS/IT
 Misalignment of incentives for its use
Key question remains: How to apply IT effectively?
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13. X–Ray Exam without PACS: an inefficient
process
GEYM
S
CT
Patient Previous Exams Patient Data
Registered hung in Reading Re–Entered Exam Performed
Room at Acq Device
Develop Quality Hang Radiologist Read Un–Hang Films
Film Assurance Films Dictate & Approve & Attach Report
Send Films & Retrieve Films &
Re–assemble Return Films
Report to Referring Report to Referring
Film Jacket to File Room
Physician Physician
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14. X–Ray Exam with PACS: an efficient
process
GEYM
S
CT
Patient
Registered Exam Performed
Radiologist Read
Dictate & Approve
Referring Physician
Accesses Report
and Films
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15. Final remarks
 Need for IS/IT in healthcare
 Classifications of systems
 Broad impact of IS/IT
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