Emerging Trends of IT in Healthcare Sector Chandan Kalra School of Electrical & Computer Engineering, RMIT University, Melbourne, Australia
[email protected] ABSTRACT IT has played an impacting role in clinical medicine, disease management, treatment strategies and in remote health monitoring to support prevention and early diagnosis. Of the numerous IT applications currently pursued, the use of telemedicine is a major source in addressing the health care delivery issues. Remote health monitoring could lead to significant reduction of total cost in healthcare by avoiding unnecessary hospitalizations and ensuring those who need urgent care get it sooner. Latest developments in micro and nano-technologies as well as in information processing and wireless communication offer, today, the possibility for smart miniaturization and non-invasive biomedical measurement as well as wearable sensing, processing and communication .The new 3G mobile communications system strive to overcome the technical limitations like increased equipment cost of satellite based systems and the limited band width of current generation of cellular telecommunication system. In recent years with the explosive consumer use of digital cellular technologies networks, there have been a powerful impact on the way the different health care organization are delivering health care to their customers. Emerging technologies on transmission of wireless images, and video include the UMTS, WIMAX, Sensor Networks and many more. Sensor Networks help in data gathering and computation in the physical environment by allowing the vital signs to be automatically collected and integrated into the patient care record and use for real time correlation with hospital records and long term observations.. Information technology is developing at very fast rate and it is trying very hard to merge up the gaps existing in technology by providing different solutions for the existing problems. INTRODUCTION The underway evolution in healthcare and health delivery world-wide is driven, mainly, by societal changes e.g. increase of, ageing population, chronic diseases and need for further integration of handicapped (through rehabilitation ,monitoring, homecare etc) and by remarkable progress in information technologies where IT has played an impacting and powerful role. People become more “health conscious” and patients become “health consumers” asking for better health and life style management, including healthcare, rehabilitation, fitness sport etc. The classical “hospital centred health” is shifting towards “patient centred health” and from “diagnosis
and treatment” practice, the effort is put more and more in prevention and early risk detection. Telemedicine is not a new or unique concept and is defined as the use of telecommunication and computer technologies for the purpose of delivering health care to patients. It is the way to diagnose, monitor, assess, intervene and communicate with patients who are graphically remote from provider[8]. It provides for two way transmission of data, voice and images between the patient in the home and the health care provider in the home care agency. The emergence of telemedicine as an acceptable mode of health care delivery creates opportunities and challenges for home care provider. Just as the healthcare community came to embrace and feel comfortable with telemedicine technology, a new player home telemedicine surfaced as one of the fastest growing areas with in telemedicine community. HOME TELEMEDICINE Telemedicine in home health care is a relatively new area of interest. The phrase “tele-homecare” describes telemedicine application that is specific to home care. Using personal computers and video equipment that transmit data over ordinary telephone lines, home health care providers are now able to monitor patients and provide care at much lower cost than technologies that use wider bandwidth telephone lines and more complex equipment. Home Telemedicine technology works over plain old telephone service (POTS) which is used to transmit two-way interactive voice, data, graphics, and video between the home and UHC. Once the patient and healthcare professional are “connected” via video and audio, the patient can see, hear and even take picture of the patient. In the long term, it may be less about providing log distance care to people who are unwell, and more about monitoring people using implanted sensors in an effort to spot diseases at an early stage. While observing and interacting with patient, home health nurses use medical devices attached to the patient’s monitoring unit to assess clinical problems and health status. Foe example, blood pressure measurement is accomplished with a cuff and sphygmomanometer, and an electronic stethoscope enables the nurse to listen to the patient’s heart and lungs. Measurement and transmission of temperature, weight, blood glucose levels and pulse oximetry are all possible with the newest generation of models.
In addition to providing care to patients with chronic diseases, tele-homecare creates opportunities for home care providers to monitor high-risk patients cared for in the hospital. Using video visits and medical sensors, nurses and other health professionals can interact with the patients several times a day, if needed [10]. Tele homecare can empower disabled persons, connect socially individuals to their care providers and support caregivers. HOW TELE HOME CARE AFFECTS PATIENTS If health care planners will know more about patient’s health related performances, care would most likely be cheaper, more effective, and closer to individual’s desires. 1) It assesses patient attitudes towards technology. 2) It assess home environment for adequacy for electricity and safety. 3) It reviews benefits and risks with patient. 4) It provides training and opportunities for patients to gain experience and confidence with the equipment. 5 It provides technical support either online or in person. 6). It provides feedback to patients regarding improvements in health status and clinical measures etc. Placing this technology into patient’s hand allow the patient and the caregiver to participate actively in the plan of care. The presence of equipment and the ability to monitor health parameters, even in the absence of healthcare provider, promotes self care and responsibility [4]. This emphasis will shift from acute to chronic conditions and from treatment to prevention. So the shift to tele-health reflects the broader shift from diagnosis and treatment to wellness. Also it’s moving from telemedicine to tele-health and tele-prevention. And this is all possible because of IT. It is time for the informatics community to turn their attention toward building computer based applications that support clinicians in complex process of integrating patient preference with scientific knowledge, guidelines and realities of health care.
SMART WEARABLES FOR HEALTH MONITORING The new generation of biomedical sensors presents a large spectrum bandwidth allowing new measurements on human and new approaches for diagnosis, ambulatory health care, care at home and at the point of need, any time. These days wearable sensors are used for home tele-monitoring for chronic patients, blood composition monitoring and drug delivery for diabetic patients. Non-invasive sensors are the most challenging and advantaged to monitor physiological functions but also daily activities and individual behavior offering painless measurement, comfort and prevention from infections and contamination [11]. These sensors can be applied in contact with or near to body and measure an impressive number of body parameters such as vital signs as ECG, pulse,
blood oxygen saturation, respiration, skin temperature, blood pressure .BodyTel is one of the several firms to have developed sensors based on Bluetooth wireless technology which can measure glucose levels, blood pressure and weight and upload the data to a secure web server [6]. The patients keep their independence and get to stay at home, and it costs less to treat them. Using sensors on doors and mattresses, smart pill boxes that can tell when they are being opened, heart-monitors and a location –sensing wristwatch-the system allows carers to keep tabs on elderly people. Although developing specific systems and applications to address specific user needs, research and industrial community faces a number of critical issues like data security and confidentiality, risk analysis, user interface and acceptance and awareness and exploitation. WIRELESS TECHNOLOGY IN HEALTH CARE Wireless information technologies is used as an umbrella term that include mobile and hand held computers, personal digital assistant, mobile phones, pagers, wireless computer networks and mobile and wireless communications.. They offer greater flexibility and mobility, besides other benefits as they provide better access to data from anywhere at any time. The benefits of these features have prompted health care organizations to consider wireless solutions in their information technology development and deployment. There are two basic approaches to wireless networks each using a different base technology. One is used to create a wireless LAN and other to establish wireless connectivity to the internet. Both infrastructures can be accessed by means of portable, mobile-computing devices. The main wireless technologies that have been used are: GSM, satellite, and WLAN.GSM is a system currently in use and it is 2G of mobile communication networks [1]. There is an evolution of mobile telecommunication systems from 2Gto 2.5G and subsequently to 3G, wideband code division multiple access[7] .This will facilitate the provision of faster data transfer rates ,thus enabling the development of telemedicine systems that require high data transfer rates and that are currently only feasible on wired communication networks. Satellite systems are able to provide a variety of data rates. WLAN is a flexible data communication systems, implemented as an extension or as an alternative for a wired LAN. Using radio frequency technology, WLANs transmit and receive data over the air. It combines data connectivity with user mobility. They are becoming very popular in a healthcare, retail, manufacturing, warehousing and academia [3]. 3G mobile networks like UMTS are currently installed and operating which provide bandwidth up to 2Mbps.WiMax is currently being standardized, with some commercial applications installed already [2]. The use of such networks will be very important because health care providers will have
immediate and high speed telemedicine access from anywhere in the area of city[9]. Use of GPS, GIS, and intelligent graphics control systems would also immensely contribute to improvement of health care services. The future needs of signal and image processing applications in e-health will involve different signals such as ECG to real time color video signals. There will be strong demand to move more and more services to smaller, low power, compact computing devices. 3G advances will provide both mobile patients and normal working end users the choices that will fit their lifestyles and make easier for them to interact medical attention and advice [3]. IMPROVING SAFETY TECHNOLOGY
WITH
INFORMATION
Information technology has made possible what has been called "mass customization" — the efficient and reliable production of goods and services according to the highly personalized needs of individual customers. Health care is, of course, more complex and clinicians have always strived to provide carefully individualized care. However, safe care now requires a degree of individualization that is becoming unimaginable without computerized decision support. Information technology can reduce the rates of errors by preventing errors and adverse events by facilitating more rapid response after an adverse event has occurred and by tracking and providing feedback about adverse events 1) IMPROVING COMMUNICATION: Failure of communication result from clinician remains along the most common factors contributing occurrence of adverse events. But new technology like PDAs and wireless access to electronic medical records may improve the exchange of information. A wide range of textbooks, reference on drugs, and access to medline data base are already available for desktops and hand – held computers. 2) MONITORING: Monitoring is inherently boring and is not performed well by humans. Moreover, so many data are collected now that it can be hard to sift through them to detect problems. However, if the monitoring of information is computerized, it can permit clinicians to intervene before an adverse outcome occurs. For example smart monitoring in an intensive care unit can be carried out by triggering alert when heart rate crosses high or low limit.
3) DECISION SUPPORT SYSTEM: Information systems can assist in the flow of care by computerized algorithms and neural networks which are developed in order to reduce diagnostic and treatment errors in clinical settings. 4) RAPID RESPONSE TO AND TRACKING EVENTS: Computerized tools can also be used with electronic medical records to identify, intervene and track the frequency of adverse events which is a major gap in the current safetyrelated environment to improve processes and to measure the
outcomes as these tools are useful for both improvement of care as well as for research purpose. LIMITATIONS IMPROVEMENT
AND
DIRECTION
FOR
1) Appropriate development methodology which enables proper integration of new wireless solutions with the existing solutions is on the slower side which needs to be motivated a lot with financial help. 2) Data access and communication and synchronization issues between the mobile devices and existing databases needs to be resolved. 3) Suitable user interfaces in order to capture and access data which is done accurately and timely is required as they also pose a number of limitations with regard to the code, integration and transmission. 4) Management issues of wireless in health care in terms of wireless capacity in rural areas, implementation and methodologies for quality of services is very much needed as there is lack of knowledge by developers in terms of available technologies and proper planning of the development and deployment. [5] Although wireless and mobile computing has made significant progress and is gaining widespread adoption there are some obstacles to realizing their full potential 5) There are device limitations such as screen size, memory and storage capabilities constrain the amount and types of data that can be displayed at a time. 6) The most significant limitations of wireless networks are the slow data transfer rate and the lack of a single connectivity standard that enables devices to communicate with one another and to exchange data. 7) Wireless devices are still in their infancy stages and slower in speed compared with desktop computers. 8) There is lack of real-time connectivity due to mobility of the device, the size of the screen and hence the problem to display for high quality graphic display. Studies in tele-health reveal that technical solutions alone will not provide expected benefits. In addition to deploying innovative solutions providing appropriate access to these new services and actual use of these services are important [5]. The technology alone will not solve the problems encountered in this domain but proper management of technology is the key to success. Organization-wide initiatives and plans should be there to implement wireless health care solutions which are identified as a major factor contributing to the failure of successful deployment of IT in health care.
CONCLUSION This paper presents the impact of IT in the evolution of health care sector. It discusses the various emerging technologies for the purpose of delivering health care services to the patient’s home. Tele Health is an upcoming Technology which moves away from telemedicine to tele-health to tele-prevention. Patients get complete independence by getting to stay at home and at the same time being cured too at lesser cost. Providing reliable, efficient, individualized care requires a degree of mastery of data and coordination that will be achievable only with the increased use of information technology. Information technology can substantially improve the safety of medical care by structuring actions, catching errors, and bringing evidence-based, patient-centered decision support to the point of care to allow necessary customization. Wireless technology is playing a big role by involving the exploitation of mobile telecommunication and multimedia technologies to provide better access in health care sector by providing solutions that can be integrated with already existing methods and expert care by overcoming the boundaries of separation that exist today between different users of such medical information.
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FUTURE SCOPE Just as the health care community came to embrace and feel comfortable with telemedicine technology, a new player- home telemedicine is one the fastest growing areas within the telemedicine community. Shift to tele-health reflects the broader shift from diagnosis and treatment to wellness. In the long term it may be less about providing long distance care to people who are unwell and more about monitoring people using wearable or implanted sensors in an effort to spot disease at an early stage. This emphasis will shift from acute to chronic conditions and from treatment to prevention. But for this to happen , management issues of wireless in healthcare in terms of wireless capacity in rural areas ,implementation process and methodologies for QOS should be discussed which also opens up the issues associated with security and privacy of patient data. Patients should have complete awareness and should be motivated towards using technology so that they can make use of IT with free hand and become independent. Communication efficiency in terms of network Infrastructure, user interfaces to accommodate different types of users, configuration of wireless LAN and speed should also be considered. REFERENCES [1]
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