(HealthTech Wire / Interview) - Software is ubiquitous in modern medical institutions. The availability of medical data in digital form, it seems, is no longer an issue. However, challenges remain: since more patient data is available, proper information management and better patient involvement are becoming ever more important. Arto Ryymin, Executive Vice President of Tieto’s healthcare and welfare business, talks to HealthTech Wire about how to achieve these goals in an increasingly mobile and interconnected healthcare IT universe.
A world without healthcare IT is unthinkable for most hospitals these days because many, if not all, have IT systems of varying degrees of sophistication in place. Have healthcare-IT companies fulfilled their mission? Or are there further challenges that still need to be addressed?
Information management in healthcare IT is an extremely important issue that will occupy us for years to come. The trend is toward smart user interfaces with context-relevant data, depending on the role of the user and on the phase of the care process. Context relevance also means that clients increasingly expect us to provide treatment guidance and even decision-support tools that are tailored to specific doctors, processes, and patients. Another big issue is patient centricity. For healthcare IT, this means that we have to think more about processes and solutions that allow patients to be at the center of all the operations regardless of the service provider’s organizations. What we also see is that more and more hospitals and other healthcare organizations are interested in moving the patient closer to the care process. We are certainly witnessing a trend toward more open information exchange and interoperability. A related issue is mobility, which has already been in focus for awhile, and which will provide even more opportunities for enhanced patient-institution interaction in the future.
With the recent presentation of the iPad 2, everybody is talking about tablet PCs. Do you think that the tablet PC is the ultimate answer to mobility issues in hospitals?
Modern tablet PCs are a revolution, but I don’t think they fit all hospital situations. The office or ward workstation will still be with us for the foreseeable future, though I’m quite certain that some doctors might be inclined to use smaller and more portable devices like smartphones in their mobile routine. We have recently implemented a smartphone-based mobile-access solution in Germany at the Bundesknappschaft Hospital in Bottrop. Doctors can take and use a smartphone everywhere. This is not necessarily true for a tablet PC simply because it is bigger. Tablet PCs are great devices for some specific situations: for example ward rounds or nurses’ documentation. What they also do is that they force healthcare-IT providers to think even more about usability. A doctor who knows how easy the use of an iPad application can be will be less ready to accept a clumsy interface on his office PC. And finally, tablet PCs are nearly ideal tools for accessing data in homecare scenarios.
Will homecare really be relevant for hospital IT providers in the future?
Involving the patient more closely is an issue whose significance is obvious, and we have had good experience with SMS reminder services for quite awhile now. This is a simple but very effective way of connecting patients with hospital information systems that has benefits for both the individual and the institution. Digitally supported homecare scenarios are a step or two further down the road. At the World of Health-IT Conference in Budapest in May 2011, we will present a case study from the city of Espoo, Finland. Digital self-care in Espoo provides chronically ill patients with the chance to be part of a care team via the internet that consists of doctors and nurses. It gives chronically ill patients an opportunity to take care of their health and play a more active role in their treatment. The digital self-care IT system is integrated into the EPR and HIS system. Diagnoses, medications, and care plans are published directly from EPR to Personal Health Records, which patients can access. They can also send questions and requests for prescription refills and get quick responses. This is really a paradigm shift, and it again illustrates the increasing importance of information management. The patients see data from their own health record, but they do not see all data, of course. They are presented a selected view of relevant documents that are displayed in a form that a patient can understand.
Earlier, you mentioned that hospitals were becoming more interested in tools for treatment guidance and for clinical-decision support. Is there a role for IT solutions as tools to increase patient safety?
There certainly is. Clinical pathways we are now implementing in many hospitals are the first step in this direction. A pathway gives the user guidance on what to do next in a process. Working with a user interface that adapts to the clinical situation and to the user’s role is the second step. And the third is offering medical guidance, for example by including alerts in order-entry software; by offering information on standard treatment options; or by displaying relevant study results. We currently have a promising decision-support tool in development, and we are receiving positive feedback.
Can a healthcare IT company provide credible medical expertise?
We cannot and do not want to provide medical expertise on our own. Decision-support solutions can only be successful when they are co-developed and indeed maintained by partners with appropriate medical expertise. These partners can be our customers when we are talking about in-house decision support. They can also comprise professional bodies like physicians’ or pharmacists’ associations. For the content, we also need external expertise, but usability is our job. Our clients need integrated systems that automatically provide information and guidance - and might even have the ability to learn about the individual user’s preferences. Working with separate solutions is a huge waste of efficiency.
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