Guest Post by Brent Whitfield, CEO, DCG Technical Solutions Inc.
- The digitization of healthcare is driving the need for systems to manage and organize large amounts of personal health data in order to drive more comprehensive care for patients across the healthcare continuum.
- As more systems continue to be built, there is a large push for strong system interoperability to connect health data from disparate systems and care providers into a central location for better patient and provider access to information.
- To encourage proper information management, new data standards and regulations are being enforced to ensure the protection of information and the use of standard processes.
- The focus on health information management (HIM) skills for employees will continue to grow in coming years as disparate systems continue to generate large amounts of patient data that is critical for successful healthcare delivery.
It has been 15 years since the US Department of Health and Human Services first revealed their plans for a patient digital health record that accompanied every citizen from cradle to grave. Over that time, information management within healthcare, including the design and development of databases, has grown in importance. Progress was slow at first but has accelerated over recent years with the advance of communications technology.
Although some healthcare providers still rely upon paper-based information systems, the drive towards digital healthcare continues apace and most now utilize either digital or hybrid systems. For example, in 2015, around 86 percent of office-based physicians had some form of EHR system in place (the figure was around 24 percent in 2005).
This article explores the benefits of effective information management in healthcare and what needs to happen to ensure this technology continues to move in the right direction.
A myriad of computer systems
Due to the many different branches and specialisms within the healthcare system, a huge number of mission-specific computer systems have been developed. These include systems for digital imaging, laboratory information management (e.g. blood testing), electronic handover, clinical safety (blood product tracking, infection control, etc.), incident management and monitoring vital signs. There has also been an increase in the implementation of electronic record systems for patient information (EHR and EMR systems) and hospital administration (HIS systems). Preventative technology, such as patient monitoring devices are becoming steadily more popular and are likely to proliferate as the Internet of Things expands towards its expected volume of around 30 billion devices by 2020.
The big challenge with all of this data is, of course, collating it so that health professionals and patients can draw accurate conclusions and implement successful health outcomes.
Why databases are integral to healthcare
Patients within the healthcare system may be seen by multiple healthcare providers (physicians, specialists, surgeons, etc.), receive several diagnoses, undergo many different procedures and be prescribed various drugs and other interventions. Throughout their journey through the health system (and even outside it, in some cases), health data will be recorded, manipulated and stored. Together with their demographic information, this adds up to a significant amount of information.
It is only through using powerful, well-designed databases that this data can be accessed by those who need it. Just as importantly, the data can be pre-processed so that it arrives in the form required.
As an example, a doctor in a cardiac unit can spend a lot more time actually looking after his or her patients if their personal details and relevant health history is pre-populated in the systems he or she uses. This can only happen if the patient’s existing information is queried, filtered and retrieved using database technology.
Transporting data between institutions (hospitals, laboratories, pharmacies, medical centers, clinics, etc.) requires function integration. This can be realized via web services such as data registry, patient identification, healthcare resource access control and order management services.
Of course, in order to manage the flow of information into, through and out of such a vast system a set of workflow standards are needed. This has led to the introduction of standard sets such as HL7 (Health Level 7) which is aimed at the application layer (layer 7) of the OSI stack. HL7 includes a combination of documentation and communication standards. For example, the Clinical Context Object Workgroup (CCOW) is designed to ensure disparate applications are synchronized in real time and presented in a unified way. Single Sign-on (SSO) access control technology also speeds up access to data by reducing the number of individual passwords a healthcare provider needs to remember.
Prioritizing cyber protection
In addition to being developed, databases and systems need to be secured to avoid data being stolen or lost during transit or storage.
Healthcare systems are a high profile target for cybercriminals, as revealed by the WannaCry Ransomware attack on the NHS in the United Kingdom. The costs of a data breach are increased when such sensitive data is involved and healthcare providers must ensure staff are adequately trained on Cybersecurity.
In-house IT support personnel should also be given the tools and the training to recognize when databases have been compromised so that an immediate response can be activated.
As healthcare systems move into the cloud, the challenge to remain compliant with data protection laws presents another headache for health care providers to deal with. Migrating databases and applications to the cloud is no mean task and usually benefits from the involvement of professional IT consulting firms. For example, removing data from in-house data centers and storing it across a distributed network raises numerous questions about the role of the cloud service provider and the geographical location of data.
Educating the next generation
Since 1928 and the formation of AHIMA, there has been a drive to standardize the health information field by laying out the competencies required for achieving certification in Health Information Management (HIM).
The changing face of healthcare to a more digitally connected service has increased the need for highly skilled information management and database development personnel. Higher education courses clearly need to keep up with technological developments if the right calibre of graduates is to be hired.
Following a 2004 study involving database experts, PMC magazine revealed a list of 20 top skills, split into three categories, which all HIM professionals should have if they are to effectively develop and manage the relational databases at the heart of 21st Century healthcare. Unsurprisingly, fluency in the SQL language was rated highest overall as this is the language used in the most popular databases.
According to the report’s conclusion, “an improperly designed database could lead to the generation of inaccurate results, redundancy of data, wasted time and effort, and perpetuation of medical errors.” The experts involved also voiced their concerns that employees transitioning from a business environment into healthcare would struggle as their skills were not necessarily transferable.
This suggests that the demand for specifically health-focused database and information management courses will only grow over the coming years. Accordingly, some institutions are now providing courses specifically on information management in healthcare.
Keeping pace with technological advancement will be the challenge of up and coming generations of HIM professionals and the institutions training them.
Brent Whitfield is the CEO of DCG Technical Solutions Inc. DCG provides the specialist advice and IT Support Los Angeles area businesses need to remain competitive and productive, while being sensitive to limited IT budgets. Brent has been featured in Fast Company, CNBC, Network Computing, Reuters, and Yahoo Business. https://www.dcgla.com was recognized among the Top 10 Fastest Growing MSPs in North America by MSP mentor. Twitter: @DCGCloud
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