Lecture on the role of IS/IT in the healthcare domain. Various types of IS/IT are introduced. Also, the benefits of IS/IT in healthcare are outlined. Various developments in healthcare from a hospital CXO perspective are specified. Finally, I will also presentbenefits and costs associated with the implementation of health information technology.

1. 1
The role of IS/IT in Healthcare
Seminar Medical Informatics
dr. Rogier van de Wetering
1Dept. of Information and Computing Sciences, Utrecht University,
The Netherlands
Utrecht, May 16, 2012

2. 2
Outline lecture
 Developments in Healthcare
 Types of Information Systems and IT-
architectures
 Assignment 1
 Break
 Key benefits of IS/IT
 Case: implementation of patient ID-card
 Assignment 2

3. 3
Key developments in healthcare from an
international context
Individuals
more engaged
in decisions
and purchases
Providers
develop new
services to
clients (product
and quality
information)
Innovations to
improve
efficiency &
transparency
Growing costs
of healthcare
Ageing
population
E-prevention
programs will
reduce future
healthcare
spending
Providers
develop
management
information of
performance

4. 4
International Comparison of Spending on
Health, 1980–2007
Source: Davis et al., How the performance of the U.S.
health care system compares internationally. The common
wealth fund (2010). See also OECD.org

5. 5
What is driving health care costs?
 Spending on healthcare in all OECD countries are rising
faster than economic growth, especially within the U.S.
 Advances in medical technologies improve diagnosis and
patient treatment. However, they also increase health
spending
 This can be clearly seen from the rapid growth and use of
computed tomography (CT) scanners and magnetic
resonance imaging (MRI) units used for diagnostic purposes
 Factors include:
5
Medical
technology
Population
expectations
Population
ageing

6. 6
The U.S. and Greece show a big
difference in their use per capita as
opposed to the Netherlands
98,1
91,2
72,3
62,8
53,7
48,5 47,7
38,8 37,8
31,2
27,8
24,2 21,4
12,7
0
20
40
60
80
100 Greece
UnitedStates
Iceland
Luxembourg
Belgium
France
OECD
Netherlands
Denmark
Canada
CzechRepublic
SlovakRepublic
Australia1
Korea
MRI exams per 1 000 population
Data include only exams for out-patients and private in-
patients (excluding exams in public hospitals).
Number of MRI exams per 1 000 population, 2008 (or latest year available)

7. 7
Developments in healthcare from a
hospital CXO perspective
Hospital CXO Chain care
Governance, risk &
compliance
Horizontal /vertical
integration
Reimburse
ments
M&A Alliances
Order mngtLean (logistic)
operations
Tele-medicine / eHealth
Patient
influence
Cloud solutions / SaaS
Mobile
apps
Information
Management
Patient
engagement /
empowerment
Shared
Services
Integrated
supporting
processes
Information
Security
Medical
Imaging
Technology
Minimal
Invasive
surgery
RFID / Track
& Trace
Regulations
Virtualization
Big Data/
Analytics
Mobility
outpatient
clinic
Business
Intelligence
Customized
care
EHR/EPR
Business
IT
Healthcare
Lean

8. 8
Hype Cycle for Healthcare Provider
Applications and Systems

9. 9
Outline
 Developments in Healthcare
 Types of Information Systems and IT-
architectures
 Key benefits of IS/IT
 Case: implementation of patient ID-card

10. 10
Overview of various types of IS/IT
 Electronic health records (ePR/eMR)
 Computerized provider order entry (CPOE)
 Decision and diagnostic support (e.g. CAD/CAR)
 Advanced visualization tools
 Surgical simulation and modeling
 Knowledge discovery/mining and retrieval systems
 Enterprise-wide image management systems (i.e. PACS)
 Data exchange networks (e.g. XDS-i, IHE)
 Prescribing systems
 E-Health / consumer informatics / educational
 Tele-medicine
 Mobile computing
 Administration
(Cf. Haux, 2010; Chaundry, 2006; Huang, 2010; Van de Wetering,
2011)

11. 11
Extracted medical informatics
clusters/classifications appearing between
2005 and 2008
Organization, application,
and evaluation of health IS
Medical knowledge representa -
tion
Signal and data analysis
Source: M. J. Schuemie1 et al., Mapping the Domain of
Medical Informatics. Methods Inf Med 2009; 48: 76–83

12. 12
The healthcare provider solution map shows
six broad solution areas, as well as the high-
level solutions contained in each

13. 13
Break!!

14. 14
Outline
 Developments in Healthcare
 Types of Information Systems and IT-
architectures
 Key benefits of IS/IT
 Case: implementation of patient ID-card

15. 15
There are many possible benefits and
costs of implementing health information
technology
 Effects of health IS/IT (Cf. Chaundry, 2006):
 Quality
 Efficiency
 Costs
 Challenges for the future:
 Interoperability of medical data
 Adoption rates of IS/IT
 Misalignment of incentives for its use
Key question remains: How to apply IT effectively?

16. 16
A typical IT-implementation method
including various phases and value
streams
Support
Project Management
Value
People, change management and education
Process and systems
Business Intelligence
Information Technology
Security and Controls
1Vision
4Build
Implementation
cycle

17. 17
Outline
 Developments in Healthcare
 Types of Information Systems and IT-
architectures
 Key benefits of IS/IT
 Case: implementation of patient ID-card

18. 18
Case: patient ID-card at Amsterdam
Medical Center (AMC)
 Main goals:
 Efficiency improvement (e.g., no re-coding of patient numbers
etc.);
 Less patients losing their card;
 Improvement patient identification;
 Cost efficient, what’s the business case?

19. 19
Menigte

20. 20

21. 21

22. 22
A design/blueprint and associated IT-
architecture gave alignment with the
final solution

23. 23
A simplified IT-architecture
Server
(Email, tel., VeCoZo, adress, huisarts en foto)
Front-Office Balies
Self-service Client
software
Webcam
ZIS
Synchronisation
VECOZO
SBV-Z
Synchronisation
Cloverleaf
Pass printer
EHR
Scanner
X/Care

24. 24
The AMC solution at the registration
desks in the outpatient clinic

25. 25

26. 26
Ideal process

27. 27
Final remarks
 Need for IS/IT in healthcare
 Classifications of systems and architectural design
 Broad impact of IS/IT
 Case example on how IS/IT impacts hospital operations