By Elizabeth Zborek

The past decade has seen a rise in the use of electronic health records (EHR), electronic referrals to specialists, and e-prescriptions to pharmacies. This transition towards a more electronically-focused approach to health care demonstrates the growing influence of health information technology (HIT). HIT encompasses any technological advancement that is employed to collect, store, analyze, and share health information.1 HIT has manifested through many technological innovations, such as the digitalization of medical diagnostics and the advent of mobile health applications.

The HIT era emerged as a means to address the issues of health care costs, medical errors, and the disconnect between health care providers.2 Its growth can be traced to the 1960s when the Medicaid and Medicare programs were enacted, and the need for an organized billing process was met with mainframe computers and centralized processing.3 Smaller and more affordable microcomputers (PCs) emerged in the 1980s, and became increasingly used for clinical in- formation systems and for maintaining billing information.3 The 1990s saw the dawn of the Internet, and health care workers took advantage of it as a potential form of communication between providers.3

More recently, The American Recovery and Reinvestment Act and The Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009 introduced financial incentives for professionals who demonstrated proficiency in a certified EHR program.5 These incentives were offered in hopes of achieving improvements in care delivery, enabling patients to be engaged in the health care process, and helping providers avoid preventable medical errors.9 Consequently, many clinics and hospitals have made the transition from paper health records to electronic health records. The transition can be laborious, but once health care workers learn how to operate the EHR systems, they can appreciate the benefits that modernizing offers.

Moreover, the implementation of
 electronic health records directly benefits patients in addition to providers by
assisting patients with their own health
management. Patient portals, secure on-
line websites
that allow patients to access their personal health
records, have
become commonplace. These portals provide patients with more control and a better understanding of health care process overall by allowing them to manage their appointments and medications all in one place. Most importantly, these sites improve patients’ health literacy by providing them with more information about their diagnoses and treatments.

The transition to EHR programs is reflective of a larger shift towards technology in the field of medicine. More creative and accessible ways to improve patient health are constantly being in- vented, and the next phase of the HIT era will likely entail the widespread implementation of health care apps.

New health care apps are being de- signed to help physicians provide better care and increase patients’ involvement in the health care process. Such apps include iTriage, HealthTap, Doctor on Demand, palmEM, and InQuicker. The iTriage, HealthTap, and Doctor on Demand apps connect patients with information about local doctors and clinics, while also providing patients with more information about their symptoms. Doctors and residents employ palmEM as a quick reference for clinical decision making; InQuicker helps patients and doctors save time in the emergency room by allowing those with non-life threatening illnesses to check into the emergency room from their homes. Although these apps have already improved the care patients receive, there are still opportunities for further development.

The HIT era has also led to the creation of the telemedicine industry. Tele- medicine is the utilization of telecommunications technology such as email, Skype, and smartphones to assist in improving a patient’s health.7 A combination of health information technology and electronic communications, telemedicine is increasing health care cover- age in underserved areas. For example, the residents of the Chakrajmal village in India were able to consult with a doctor via telecommunications technology in 2008.6

Telemedicine is already being employed to transmit diagnostic images
amongst providers, share medical data
between providers and patients, monitor patient vital signs from various locations, and educate patients remotely.4
As of now, most of these transmissions
are taking place via computer, but in the
future, we will see them occur via apps on
mobile devices,
thus streamlining the patient
and provider communication process.6

Despite all of the potential benefits of fusing medicine with technology, there are also drawbacks. As observed with EHRs, adoption implementation and maintenance costs exist.10 Furthermore, failure to learn how to correctly utilize the technologies can lead to interrupted workflow, reduced productivity, and increased medical errors.10 Another op- posing argument to health information technology is the risk for patient privacy violations.10 Technology users face sophisticated malware and hackers, who can attempt to access personal health information.11 While these issues must be addressed, the potential that health information technologies have to revolutionize and improve the health care system will very likely outweigh these costs.

Health information technology has greatly influenced health care during its short existence, and new ways to utilize it are constantly being invented. The US electronic medical record market alone is predicted to grow from $2.177 billion in 2009 to $6.054 billion in 2015, illustrating the rising demand for health information technology.8 Though there will always be an adjustment period when new technologies are being standardized, advanced health information technologies can increase both quality and efficiency of health care. With this immense potential comes a responsibility for the next generation of health care professionals to invent, implement, and utilize technology in ways that improve patient experience.

Recently Developed Apps

iTriage

iTriage helps patients narrow down the cause of their symptoms, identify local providers, clinics, and hospitals, and stay up to-date-with latest health news.

HealthTap

This app helps doctors and clinics attract and educate new patients while improving the quality of health information online. Additionally, it connects patients with doctors to give them the best health information.

palmEM

palmEM covers hundreds of the most commonly encountered
conditions in emergency medicine. The app contains quick medication references and helps doctors with clinical decision-making. Many similar apps have appeared on the market, in order to
help physicians and residents quickly and efficiently give a patient a diagnosis.

InQuicker

Not exactly a typical mobile app, InQuicker is a site that can be used on all mobile devices, much like Patient Portal. It reduces the time that hospital personnel spend on data input by allowing patients with non-life threatening illnesses to check into the emergency room from home. Patients can wait at home instead of a crowded waiting room until they are called in to be seen by a health care provider.

Doctor on Demand

Patients utilize this app in order to get in contact with board-certified doctors for non-emergency medical purposes. They pay a $40 fee for each video visit, and doctors are able to diagnose patients and prescribe medications when clinically appropriate. ■ MD

References

  1. “Basics of Health IT” 15 Jan. 2013. Web. 30 June 2014. http://www.healthit.gov/patientsfamilies/ba- sics-health-it
  2. Bates, D., Cohen, M., Leape, L., Overhage, J. M., Shabot, M. M., & Sheridan, T. (2001). Web. 27 Jun. 2014. Reducing the frequency of errors in medicine using information technology. Journal of the Amer- ican Medical Informatics Association, 8(4), 299 -308. http://www.ncbi.nlm.nih.gov/pubmed/11418536
  3. “History and Evolution of Health Care Information Systems” Web. 30 Jun. 2014. instructional1. calstatela.edu/prosent/CIS%20581/chapter4.pptx
  4. Puskin, D. Johnston, B. Speedie, S. May. 2006. Web. 30 June 2014. http://www.americantelemed.org/ docs/default-source/policy/telemedicine-telehealth-and-health-information-technology.pdf ?sfvrsn=8
  5. “EHR Incentive Payment Timeline” 4 Mar. 2014. Web. 30 June 2014.http://www.healthit.gov/provid- ers-professionals/ehr-incentive-payment-timeline
  6. “Can Telemedicine alleviate India’s Health Care Problems?” 08 Mar. 2012. Web. 30 Jun. 2014. http:// knowledge.wharton.upenn.edu/article/can-telemedicine-alleviate-indias-health-care-problems/
  7. “What is Telemedicine?” Web. 28 Aug. 2014. http://www.americantelemed.org/about-telemedicine/ what-is-telemedicine#.VATVLPldUS4
  8. “U.S. Electronic Medical Records (EMR- Physician Office & Hospital Market- Emerging Trends (Smart Cards, Speech Enabled EMR), Market Share, Winning Strategies, Adoption & Forecasts till 2015” June 2011. Web. 28 Aug. 2014. http://www.marketsandmarkets.com/Market-Reports/us-emr- market-401.html
  9. Blumenthal, D., Tavenner, M. 05 Aug. 2010. The “Meaningful Use” Regulation for Electronic Health Records. Web. 28 Aug. 2014. http://www.nejm.org/doi/pdf/10.1056/NEJMp1006114
  10. Menachemi, N., Collum, T. 11 May 2011. Web. 28 Aug. 2014. “Benefits and drawbacks of electronic health record systems”. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3270933/
  11. Halamka, J. 01 Sept. 2011. Web. 28 Aug. 2014. “The Rise of Electronic Medicine” http://www.technol- ogyreview.com/news/425298/the-rise-of-electronic-medicine/

Images gathered from: iTriage –Accessed 8/15/14 https://www.itriagehealth.com/facilities/il/chicago;

HealthTap – Accessed 8/15/14 https://www.healthtap.com/what_we_make/overview;

PalmEM – Accessed 8/15/14 https://itunes.apple.com/us/app/palmem-emergency-medicine/ id481034047?mt=8;

InQuicker – Accessed 8/15/14 https://inquicker.com/;

Doctor on Demand – Accessed 8/31/14 http://www.doctorondemand.com/

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