Challenges and Opportunities -- The Growing Importance of Information Technology in Healthcare

1. Challenges and Opportunities -- The Growing Importance of Information Technology in Healthcare Stephen M. Foxman, Esq. Philadelphia December, 2005

2. Major Technology Issues for Healthcare Institutions • Computer systems with different functions operate separately, and don’t share information • Data is spread throughout healthcare institution, in various departments and in different computer systems • Mandatory compliance with new legal requirements, such as security and privacy requirements of U.S. Health Insurance Portability and Accountability Act of 1996

3. Management of Supplies and Equipment • Advanced information technology (IT) systems are needed for ordering, inventory control, finding and distributing supplies • Cost control and avoidance of theft and waste • Use of Radio Frequency Identification Tags (RFID) and bar coding for locating and keeping track of supplies and equipment • Business Process Improvement systems; improvement of quality of delivery of services

4. EMR and Patient Information • Electronic Medical Records (EMR) • Importance of access and accuracy of medical history of patients • Privacy issues regarding storage and access to information • Diagnosis, treatment and potentially detrimental other information being accessed by patient or others (e.g., sexually transmitted disease, genetic disease or DNA disease susceptibility analysis information)

5. Patient Information • Clinical Information Systems for patient charting • Use of wireless personal digital assistant devices (PDA) for access to and updating of EMR • Potential for patients to have personal card, RFID device, implanted device containing blood type, disease, and other EMR information • Treatment information to be generated and stored for later reference in EMR • Tie in of EMR treatment and prescription information to pharmacy for providing appropriate medicines and dosages for patients

6. Prescriptions and Medications • Computerized generation of prescription to avoid errors • Computerized generation of labels; drug ingestion or use instructions; warnings • Computerized cross checking of prescription against patient information on allergic reactions, drug interactions, appropriate dosage levels

7. Management of Patient Treatment • Specialized information technology systems to manage appropriate treatment tied into diagnostic databases, patient personal information and diagnosed condition • Use of IT systems to manage and avoid errors in special care environments such as operating rooms, emergency rooms, pediatric care and intensive care wards • Use of IT systems to aid nurses in providing proper treatment (Nursing Informatic Systems), monitoring patients with sensory equipment for vital signs

8. Management of Patient Treatment • Use of local robotic delivery systems to provide equipment, medications, and nutrition • Wireless communication for doctors and nurses to avoid pagers and delays in providing information regarding patients and treatment • Use of distance diagnosis and treatment with high speed digital communications links; transmission of charts, monitoring information, x-rays and scans • Patient access to doctors and medical information over Internet

9. Staff Development and Training • Use of Internet based training to maintain best practices and skills for hospital or other healthcare institutional staff

10. Billing and Collection Information • Particular importance in US because of lack of national healthcare delivery and insurance system • Computerized monitoring of use of proper medications, medical equipment, treatment procedures for cost control • Determination of proper codes for treatment and billing for services – used by private insurers to make payments to providers of care • Development of national databases for tracking illnesses, treatment methods and effectiveness of medications and treatments used

11. Medical Research • Tracking of methodologies used, compliance with government reporting and safety requirements • Specialized IT systems to track information and provide reports in form necessary for government approval of new drugs • Potential exposure to liability from electronic storage of field reports and emails between pharmaceutical company employees and researchers (e.g., recent Vioxx case against Merck)