Health information and communication technology has become an essential part of a doctor’s work – and it is a strategic tool for change. “We are on the brink of the third wave of digitalization of healthcare which will make the medicine more precise,” says Jarmo Reponen MD, PhD, Professor of Health Information Systems at the Faculty of Medicine, University of Oulu, Finland.
Professor Reponen, what is the status quo of the eHealth professionals‘ tools?
Researching the software tools professionals have been using in healthcare information and communication since the middle of this millennium in Finland and also in collaboration with our Nordic partners, we can see three different waves of digitalization in healthcare.
The first wave supplied us with electronic medical records (EMR), digital image archives (PACS) and networks in imaging and laboratory aspects. So that all the medical data is transformed to and available in digital format in hospitals and primary care institutions. In Finland and in other Nordic countries those tools have reached practically 100% availability already 10 years ago. For example, we don’t have paper records or film images anymore.
Today, we are in the middle of the second wave of digitalization in healthcare which has given us more connectivity through national health information exchanges (HIE) and tools for interacting with patients and citizens. The core of the second wave is the patient empowerment. These are essential for healthcare reform with freedom of choice and patient mobility.
While the second wave is going on, we are in the first steps into the third wave of digitalization which will empower the patients and citizen even more. It is based on the first two waves and will add artificial intelligence to the professional tools through, for example through machine learning. Within the medical record systems, the picture archives and communication systems we will see more and more intelligent tools and different support systems. For example, in many medical even today you can have instant warnings of interactions of different medicines which are not compatible with each other.
What, if any effects, will those developments have for the patients?
Health information systems are entering the second and third wave digitalization, which will give the professionals more connectivity, more interactions with citizens and more intelligent tools. This requires a new generation of software but also awareness of the new roles of physicians and nurses. Citizens´ own role in their health will increase with the new eHealth and mHealth tools.
What advances in intelligent computing will have the greatest effect on the healthcare system?
There are plenty of effects because so many things are changing. Some of those changes will make the workflow more effective. The use of certain treatment orientated softwares will make the treatment more precise. Combined they will hopefully make hospitals work more efficiently. On the other hand artificial intelligences are coming to certain areas as a helping tool. It will help the professionals in the differential diagnosis to personalize the treatment of certain patients. The medicine is becoming more precise.
How will those changes transform diagnosis, treatment and workflow?
We get more information of the patient to the point-of-care. With the availability of the archives of previous data, patient data from other areas of the health information exchanges, physicians can make better diagnoses. It also means that they can make more precise diagnoses and more accurate decisions on patient treatment.
Of course, it is not enough that the systems store and deliver medical data to support the efficiency of medical treatment. We need more workflow orientated software for professionals that could give us guidance in our work. So that if we have a certain kind of patient in our consultation, the software automatically list me the tools I need to diagnose and treat that patient. These kind of software are emerging already.
When we talk about the various intelligent and augmented tools, I would say that the vendors should look more for standardization in their software. They need to have application programming interfaces (API) and connectivity in their add-on tools because there will be always new kinds of inventions. Those vendors who can rapidly react to those innovations have the edge. I really am looking forward to software vendors that can have standardizes interfaces for these news kind of tools to be connected to the core software. That is my message to the healthcare industry.
You say that you want more decision support tools. Don’t you think there is a probability that physicians will rely too much on those tools and not enough on their own brain?
Of course, using those decision support tools will have implications on the education and teaching area. We must educate a new generation of physicians and nurses who are aware of those tools and can utilize them to see what is possible or not possible with these tools. I come from an university and therefore like to emphasize the importance of education and teaching of these subjects. Most younger professionals use social media channels like YouTube of Facebook. But that doesn’t help them in the professional usage of the new decision support or other eHealth tools. That is my message to universities and nursing schools: make those tools a part of your curriculums so that the new generation of professionals can better save the patients in the future.
Jarmo Reponen, MD, PhD, radiologist, serves as a professor of Health Information Systems at the Faculty of Medicine, University of Oulu, Finland. He is past president of FSTeH and EuroPACS. He has more than 25 years of experience in the development, implementation and evaluation of hospital information systems, especially in the field of electronic patient record and radiology systems. His group co-developed the world’s first mobile app for smartphones 20 years ago. Currently their research focuses on the effects of digitization in healthcare, with target areas of availability, use and usability of the information systems.