As a result of this prolonged underinvestment, little overall progress has been made toward meeting the information needs of patients, providers, hospitals, clinics, and the broad regulatory, financial, and research environment in which they operate. Moreover, most health care-related information/communications technologies investments to date have been concentrated on the administrative side of the business, rather than on clinical care. The Information Technology Deficit and Its Proximate CausesĪlthough information gathering, processing, communication, and management are essential to health care delivery, the health care sector as a whole has historically trailed far behind most other industries in investments in information/ communications technologies ( DOC, 1999).
At the environmental level, federal/state funding and regulatory agencies and research institutions need information on the health status of populations and the quality and productivity/performance of care providers and organizations to execute regulatory oversight, protect and advance the public health (surveillance/monitoring), evaluate new forms of care, accelerate research, and disseminate new medical knowledge/evidence.Īs discussed in Chapter 3, information and information exchange are also critical to the tactical and strategic applications of systems-engineering tools at all four levels of the system, especially for strategic applications of enterprise-management tools and risk analysis and management tools at the organizational and environmental levels. For individual patients to participate as informed, “controlling” partners in the design and administration of their own care, they must also have access to much the same kind of information and education, decision-support, and communications tools-in a “patient-accessible/usable” form.Īt the organizational level, hospitals and clinics need clinical, financial, and administrative data/information to measure, assess, control, and improve the quality and productivity of their operations. To integrate these critical information streams, they will also need training/education, decision-support, information-management, and communications tools. In addition, they need information on patient preferences and values and important administrative information, such as the status and availability of supporting resources (personnel, hospital beds, etc.). To diagnose and treat individual patients effectively, individual care providers and care teams must have access to at least three major types of clinical information-the patient's health record, the rapidly changing medical-evidence base, and provider orders guiding the process of patient care. Information and information exchange are crucial to the delivery of care on all levels of the health care delivery system-the patient, the care team, the health care organization, and the encompassing political-economic environment.
THE CENTRALITY OF INFORMATION TO HEALTH CARE DELIVERY