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  • Electronic Health Record
  • Online access to health education
  • eHealth = health informatics + telehealth
    • telehealth - Skype guy
    • informatics: human brain + computer > human brain
      • infomatics = basic informational sciences, domain informatics, and application domain
      • tower of achievement: model formation, system development, study of effects
        • EHR: record information, recall information, share information, continuity of care data analysis, legal purposes (needs to record who changed things), sharing with patients (if they want to)

Why eHealth?

An opportunity to:

  • Improve the quality and safety of healthcare
  • Reduce waste and inefficiency
  • Improve continuity and health outcomes for patients


  • PCHR = personal child health record
  • Use IT to replace/supplement paper records

The eHealth space

  • Has a diagram of the Aussie healthcare system
  • Problem: silos of health information - disjointed records everywhere
    • Information intensive industry

Health is an information industry

  1. Clinical
    • Personal health information
    • Fully informed decision making
  2. Audit: compare with group norms
  3. Population and public health
    • Geospatial and population approaches
  4. Research and development
  5. Teaching and learning

The scope

  1. Health information exchange: EHR
    • Integrated medical records and record linkage
  2. Clinical Decision Support (CIS = EHR + EDS)
    • TeleMedicine: remote consultation, telemonitoring
    • ePrevention and eChronic Disease Management
    • Prescribing decision support
    • General information: CAPP (like Mims)
  3. Patient decision aids (Healthy.me)
    • eKnowledge Transfer and exchange
    • eChange Disease Self-Management
    • via social media & facebook

Drivers of information sharing

  1. Clinical drivers: safety and quality of care
    • Patient and carer perspectives
    • Provider perspectives
  2. Organisational/Administrative drivers
  3. Population/public health drivers
  4. Community/sociocultural drivers
  5. Legislative/policy/political drivers
  6. Other drivers?

What health informatics is not

  1. Scientists or clinicians tinkering with computers
  2. Analysis of large datasets per se
  3. Circumscribed roles related to deployment and configuration of electronic health records in pursuit of meaningful use
  4. The profession of health information management
  5. Anything done using a computer.

A fundamental confusion between a tool and a field of human endeaver

Telehealth

  • Delivery of health-related services and information via telecommunication technologies

Telehealth applications

  1. Email to communicate with patients, order prescriptions and provide other a range of health services
  2. A teleconsultation with a patient or specialist:
    • Synchronous
    • Asynchronous e.g. store and forward images
  3. USB connected otoscope
  4. The digital stethoscope
    • 185 device that plugs into the microphone port on a notebook or PC and allows remote auscultation real time with wav file that can be stored and or trasmitted to a cardiologist
    • The airstrip application for iphone/ipad is a tool for realtime monitoring of patient vital signs

Barriers to telehealth

Most common barriers include

  • Acceptance
  • Remuneration
  • Return on investment (ROI)
  • Safety
  • Quality of care


Audiences for patient information

  • Medical research, regulatory bodies, etc; look at diagram

Consumers as the aggregators

Australians can register for a record

  • Only 50000 people enrolled nationally
  • PCHR - information can leak to others; especially private, relevant to family and friends

Data quality management (DQM) and governance

  • Preventing harm: safety and quality of eHealth
  • Privacy and Autonomy
  • Justice: for patients and families
  • The right not to know (and not to do)
  • Benefits and risks of information:
    • Information affecting patient only
    • Information affecting families eg. hereditary diseases
    • Information affecting groups

Apps to connect to EHRs

  • help to solve fragmentation of information

An internet of things

  • If we had ocmputers that knew everything there was to know about things - using data they gathered without any help from us - we would be able to track and count everything.... etc

Questions

  • How do you see a PCEHR working?
  • What do you know about data quality management and information governance?
  • How do you see telehealth working?
  • Can you imagine an App Store full of things that you can use to access any clinical information system from anywhere?