For medical informatics the concept of standardization has become commonplace. E-Health Reporter Latin America talked to the medical informatics expert Don Newsham, who has spent the last 35 years working to implement ICTs in Healthcare, about the accelerating development of standards and the need to apply them.
In this interview, the recent former CEO of Canada’s Health Informatics Association (COACH) describes the skills that every national health system needs to achieve standardization, from political plans to human resources.
What are the priorities facing the global eHealth industry today?
I think it’s quite interesting that in large parts of the world a good health technology infrastructure is already in place: progress has been made in mHealth, telemedicine, electronic patient records and digital information storage facilities in many countries and they are functioning well.
With regard to what must be worked on, I think there are four priorities:
1. To use electronic health records in hospitals and implement security standards.
2. To make use of these records to achieve personalized treatment with the patient’s full involvement.
3. To link the different nodes in the national health system and ensure the exchange of patient information both nationally and internationally.
4. To develop the concept of big data, i.e.: to have an enormous clinical database that supports systems, the personalized nature of medicine and the application of genomic information.
To link the different nodes in healthcare systems, everyone must speak the same language. So, how can a healthcare system be standardized?
It requires a lot of work and really it’s down to our field: medical informatics. If you want to standardize a healthcare system, you must first consider standardizing the information content, the terminology of the data and the technological infrastructure to move, share and communicate this information. And around all this, you need rules about privacy, security and confidentiality to accompany the exchange of data.
What impact will a standardized system have on the daily activities of a health center?
Standards give institutions the ability to be continually at the patients’ service. But that’s not all; they also imbue confidence and security that the right patient information is being used for the right patient and the right diagnosis. There are various standards in an electronic record: for the name, the document, the gender, etc. When the patient comes back to the hospital, standards allow them to be found properly, quickly and exactly.
You often use the concept of “basic skills”, what are they?
Basic skills in standardization are very similar to the skills needed in medical informatics. Above all, it is really necessary to understand healthcare, to understand how to apply knowledge of it and to understand the technology. Then one must have business and project management skills. Medical informatics professionals must have these basic skills; it’s the basis of their field.
For standards, skill at the definition and development of standards is required – especially the ability to develop consensuses. Standards are agreements between countries, communities and businesses that define what a standard is and how to adopt and use it.
What would an effective political plan to incorporate all these technologies within a health system look like?
First of all, the will and political commitment are necessary to adapt and make the necessary changes for the application of medical informatics. Then a very strong strategic plan to efficiently use healthcare technology is required. Thirdly, the abilities must be there in the human resources, i.e.: people with knowledge and experience. Fourthly, an effective economic capacity must be in place. And finally effective partnerships between the government, the private sector, the public sector, businesses and consultants are required.
Do you think that there is resistance among the medical community to adopting these technologies?
I don’t know if I would call it resistance. I think that the challenge is to adopt the changes that technologies offer to the medical community, among other sectors, and to provide the necessary training and use eHealth effectively. I don’t believe that doctors are resistant to the value and improvements that the technology provides. Perhaps they just need to be sure that the technology is effective and will assist them rather than getting in their way.
In your judgment, which countries provide a model for medical informatics?
Some of the Scandinavian countries such as Denmark and Sweden have made tremendous progress, as has the Netherlands. Major powers such as the United States, Canada, Australia and Great Britain have implemented excellent Health ICT initiatives. Some of the Latin American countries such as Brazil, Mexico and Argentina are also working on some very interesting projects.
What are the tangible benefits of the progress of eHealth in developed countries?
The majority of developed countries are making excellent progress with telemedicine and mHealth via smartphones, using them to exchange data or generate reminders and alerts. The vigorous growth of cellphones has allowed and supported eHealth and we can see that in telemedicine, for example.
Many countries have also implemented very good developments with regard to electronic health records. In Canada, for example, over ninety percent of citizens have access to their electronic health record and over seventy percent of doctors use them. For instance, thanks to the technology we have carried out over 478 thousand individual patient interactions through telehealth in one year alone.
What are your expectations for the eHealth industry in the next five years?
I think that the next area in which we’re going to see a lot of change, regardless of the country, is in the use that patients and doctors will make of the technology. I think that we will see an increase in the use of mobile applications, which are cheap and effective, so that patients can participate in their healthcare and professionals can use the technological tools in a simple and constructive manner.
