Growing Digital Health, Increasing Challenges for Public Administrators (Part I)

 

Information Communications Technologies (ICTs) are becoming a core part of the healthcare landscape, challenging public administrators to understand, participate and guide this rapidly evolving area. The 2009 Health Information Technology for Economic and Clinical Care Act (HITECH Act) introduced policy to guide the further the implementation of digital health initiatives. In this column, we discuss some of the ways digital health is currently being used, the possible directions we can expect to see in the near future.  In the second part of this article, we’ll discuss considerations that public administrators need to keep in mind regarding these technologies.

Internet-based technologies used in healthcare, broadly known as eHealth, have become essential components of the healthcare landscape. These technologies are now a primary avenue through which the public, consumers and providers access health information and manage healthcare. In 2012, Crutzen and Gao noted that the ubiquity of eHealth has led to a fundamental shift in how we conceptualize health and health care. Health Information Technology (Health IT) has allowed for an unprecedented democratization of health information by encouraging consumers to be more active participants in managing their health information. This also reflects a powerful meme that increased accessibility and availability of health information will result in better and more economical health for all. However, health IT researchers suggest that realization of health IT’s potential depends on effective public policy to guide the use of these innovations. These effective public policies are currently under development with the federal government providing leadership and state associations engaging in active innovations.

 

Electronic health records

Electronic Health records (EHR) are individual digital patient records that potentially contain a longitudinal record of a patient’s medical and health records. EHR have the potential to maintain a comprehensive and life-long record of health and health care data. It is likely that children born in the past decade will be able to have a near-complete digital health record, available to them at the push of a button, no matter where they are seeking treatment. In principle, EHR can be transported across healthcare institutions giving providers a clearer picture of health across a lifespan. The potential ramifications in this longitudinal view in the care are staggering; data can potentially be mined to facilitate individualized disease prevention and health promotion plans, create tailored yet comprehensive treatment and care plans, as well as provide a platform for routine public health surveillance and monitoring public health emergencies. Additionally, EHRs may be harnessed to inform cost-effective care options.

Government has been strongly invested in facilitating the development of EHRs. The Federal HITECH Act established the Office of the National Coordinator for Health Information Technology (ONCHIT), a division of the US Department of Health and Human Services, to promote the development of a national health information technology infrastructure. ONCHIT has been particularly invested in developing and informing policy regarding Electronic Health Records (EHRs). To date, one challenge to widespread institutionalization of EHRs is the lack of a standard, cross-system compatible and sustainable technology framework. Currently private and public EHR technologies operate throughout the country using a menagerie of different operating systems and technology platforms. Open source technologies, available and adaptable for little or no cost by users, are gaining in number of users and are supported by federal, state and local health service agencies. For more information about open source electronic health records go to www.osehra.org.

 

Look for the second part of our recommendations on growing digital health in next week’s PA TIMES online.

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Authors: Christopher J. Godfrey, Ph.D., Director, Web 2.0 Interdisciplinary Informatics Institute Department of Psychology, Pace University; Hillary J. Knepper, Ph.D., Assistant Professor, Department of Public Administration, Pace University; Camila Bernal and Danica Spence, Undergraduate Research Assistants, Pace University Web 2.0  Interdisciplinary Informatics Institute.  Contact: [email protected]

 

 

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