Healthcare Information Systems and Technology

Abstract

This paper defines and explains medical technologies and how they have advanced health organizations in recent years. A background in medical technologies such as electronic health records, smart cards, and clinical information systems is included, and cost-effective analyses, technology diffusion, access to technology, and quality-adjusted life years are investigated as well. Finally, these medical technologies are examined to determine their contribution to the medical field, in general.

Healthcare Information Systems and Technology

Medical technology is any technology used to save lives in individuals suffering from a wide range of conditions. In its many forms, medical technology is already diagnosing, monitoring, and treating virtually every disease or condition that affects humans. Medical technology ranges from band aids to hearing aids, and has lately become much more advanced, stretching into the realms of what may have been considered science fiction a few decades ago. New medical technologies include MRI machines, heart monitor implants, and joint replacements. All medical technologies are intended to benefit health and quality of life, not least by employing hundreds of thousands of people and contributing to a successful economy (“Medical Technology” 2013).

The European Commission defines a medical device as “any instrument, apparatus, appliance, software, material or other article, whether used alone or in combination, including the software intended by its manufacturer to be used specifically for diagnostic and/or therapeutic purposes and necessary for its proper application, intended by the manufacturer to be used for human beings” (“Medical Technology” 2013). These devices may be used for any of the following: diagnosis, prevention, monitoring, treatment or alleviation of a disease, injury, or handicap, as well as conception control.

In this paper, the following medical technologies will be discussed: electronic health records, cost-effective analysis, cost efficiency, clinical information systems, information technology, technological imperative, technology diffusion, and quality-adjusted life years.

Literature Review

According to the NCBI 2009 report on Medical Technology, new medical support systems such as electronic medical records, clinical information systems, and telemedicine -- or “the use of technology to remotely diagnose and treat conditions” (“Health, United States, Special Feature: Medical Technology, Introduction and Timeline,” 2009) -- help organize the vast amount of new procedures and practices that have come onto the medical market in recent years. Health informatics systems attempt to prevent medical errors such as drug interactions.

Medical technologies have now diffused into standard medical practice, raising concerns about cost-effectiveness for all providers and patients using them. (It is important to note that, once technologies diffuse into common practice in clinics and other healthcare locations, they are difficult to dislodge even if they are proven to be ineffective or non-cost-effective. Technology diffusion often differs depending on factors such as race/ethnicity, gender, urbanization, or age, which causes differences in the quality of treatment for individuals and groups.)

Cost for a certain technology is determined by use and cost, thus cheaper technologies can be more expensive than infrequently-used, more expensive technologies. For example, annual flu vaccines can be cost-saving in the child population, while drugs and therapies that increase life-expectancy in the adult population can result in higher lifetime medical care costs in the long term. Thus, the cost-efficiency of medical technology relies on many different aspects of the healthcare industry and can only be determined by a complete understanding of all factors involved. Cost-effective analysis of medical technology is difficult to quantify because “…The cumulative contribution of all new technologies to rising medical expenditures…is a subject of much debate” (“Health, United States, Special Feature: Medical Technology, Introduction and Timeline,” 2009).

The “technological imperative” is a subject of much discussion in the healthcare community and is defined in different ways by different industries. The PCMag Encyclopedia defines it as “The concept that new technologies are inevitable and essential and that they must be developed and accepted for the good of society” (“Technology Imperative,” 2014). B. Hofmann dissects the imperative at length in his article “Is there a technological imperative in health care?” (Hofmann, 2002). Hofmann believes there is no conception of the imperative that allows displacement of responsibility for human actions; that is, whether or not a computer glitch caused an error, healthcare professionals are still responsible for the outcome of a medical intervention. We cannot blame machines for loss of life or quality of life at any point.

In any discussion of the technological imperative, an examination of quality-adjusted life years must be undertaken. A quality-adjusted life year (QALY) is a measurement of disease burden on the quality of a patient’s life vs. the cost of a healthcare intervention. According to NCBI, “The QALY calculation is simple: the change in utility value induced by the treatment is multiplied by the duration of the treatment effect to provide the number of QALYs gained. QALYs can then be incorporated with medical costs to arrive at a final common denominator of cost/QALY. This parameter can be used to compare the cost-effectiveness of any treatment” (Prieto and Sacristán, 2002).

Medical technology has affected, advanced, and helped define healthcare in many different ways with the advent of the technologies examined in this article, but the cost-effectiveness and quality of life provided by the technologies has yet to be quantified in an acceptable manner. Hofmann’s definition of the technological imperative insists that further examination of the effects of technology on both the economy and the patients themselves remain at the forefront of the healthcare community’s ethical concerns.

References

Medical technology contributing to Europe's health, innovation and economy. (2013). Retrieved from http://www.eucomed.be/uploads/Modules/Publications/medtech-medicaltechnology_broch_v05_pbp.pdf

Health, United States, 2009: with special feature on medical technology. (2009). Available from http://www.ncbi.nlm.nih.gov/books/NBK44737/

Hofmann, B. (2002). Is there a technological imperative in health care? [Abstract]. International Journal of Technology Assessment in Health Care. Summer 18(3):675-89. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/12391958

Technology Imperative. (n.d.) PCMag Encyclopedia. Retrieved from http://www.pcmag.com/encyclopedia/term/64252/technology-imperative

Prieto, L., and Sacristán, JA. (2003). Problems and solutions in calculating quality-adjusted life years (QALYs). Health Qual Life Outcomes. 1: 80. Doi: 10.1186/1477-7525-1-80