This document discusses advances in health care technology and information systems. It focuses on how electronic health records, mobile medical devices, and health applications have improved patient care and health outcomes. While technology has increased access and quality of care, it has also contributed to rising healthcare costs in the US that must be addressed. The document examines several examples of new technologies, such as blood pressure monitors, sleep apnea devices, and smartphone applications that give patients a more active role in their health.

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Abstract
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Introduction
The development of health information in the healthcare field
has proven to significantly improve the efficiency of healthcare
workers, improved the quality of life for patients through the
reduction of preventable deaths and provided valuable research
data in the scientific field for development of pharmaceutical
drugs and medical treatments. Although technology
developments and improvements in healthcare are profound,
there are significant disadvantages of electronic health care
records that must be addressed for the protection of patients in
the United States healthcare system.
Advances in Health Care Information Technology
The United States health care system is classified as unique,
massive, and a consistently expanding system and yet lacks
coordination and universal coverage for all residents in the
United States (Shi & Singh, 2019, p. 2). The vast amount of
organizations, individuals and government agencies that are
involved in the US health care system include nearly twelve
million people working in health care delivery, public and
private agencies providing insurance to over five-thousand
hospitals, fifteen-thousand nursing homes, two-thousand mental

2. health facilities, hospice and home-health agencies and over
twelve-thousand programs providing basic health support to
migrant workers, low-income and the homeless populations (Shi
& Singh, 2019, p. 2). With a health care system that stands
above all the other developed countries, one would expect that
technology would provide a plethora of affordable care and
services to the population.
Technological developments and improvements in health care
have made significant impacts on patient care and quality of life
through improved communication, implementation of Electronic
Health Records, and more efficient processes and practices of
health care professionals (Banova, 2019). Technology in the
health care field leads to high quality resources, improves
communication and the collection of information that is
necessary in health care to ensure that potential mistakes are
caught quickly, and patient harm is prevented. Technology is
also responsible for the implementation of health care systems
that improve the quality of care and drives advancements in the
health care system (Chen & Department of Hospital and Health
Care Administration, 2019). The advances in health technology
and science have played a significant role in shaping the health
care delivery system in the United States over the past one-
hundred years, evolving from primitive practices to the largest
industry in the world known as health informatics driven by the
advances we see today (Shi & Singh, 2019, p. 72).
Technology in health care is responsible for copious benefits
and has contributed to life extension, medical cures, advanced
diagnostic procedures, development of new drugs, and
improving the quality of life to many who suffer from chronic
conditions (Shi & Singh, 2019, p. 101). The implementation of
health informatics in the healthcare field also has multiple
benefits which include reducing healthcare costs through the
development of a standardized health IT system and providing
clinical researchers with advanced medical knowledge for such
things as developing treatments for viral outbreaks and
preventative measures such as development of the flu shot

3. (Banova, 2019). This technology is fundamental to the
management of information being used in the delivery of patient
care, quality improvement, billing and collections, and various
other facets involving the operation of health care organizations
(Shi & Singh, 2019, p. 103). For example, health informatics
was the foundation for the HIPAA program which was
established by the US Department of Health and Human
Services (HHS) as a federal law that required the creation of
national patient privacy rules to protect sensitive health
information from being disclosed without patient consent or
knowledge (HIPAA, 2018).
Since the establishment of the United States Health Insurance
Portability and Accountability Act (HIPAA) of 1996 to ensure
safeguards are in place to protect patient information, health
informatics has demonstrated consistent growth (Simoes, 2015).
Electronic health records (EHRs) were developed in response to
the establishment of HIPAA in an effort to replace the
traditional paper medical records, providing secure storage of
confidential patient health records, and giving patients the
ability to obtain electronic access while enhancing the quality,
efficiency and safety of patient care through health informatics
(Shi & Singh, 2019). It is disappointing that the adoption of
universal health information technology such as electronic
health records (EHRs) has been a slow and problematic process
resulting in communication breakdowns between health care
organizations and negatively impacting patient trust, data
accuracy and patients ability to obtain immediate, accurate
knowledge regarding their health care (Byrne et al., 2014).
Technological breakthroughs are more prominent in the United
States than any other developing country with electronic
wearable devices, telemedicine utilized for medical diagnosis
and patient care utilized when the physician and patient are
separated by distance, and at home monitoring systems
receiving the most attention due to their ability to protect
patient safety for chronically ill patients (Loncar-Turukalo et
al., 2019). Wolff, Darer, & Larsen demonstrated that a lack of

4. communication exists between medical providers, family and
caregivers that has a negative impact on the safety and quality
of care that chronically ill, elderly and terminally ill patients
receive as a result of the caregivers lack of ability to access and
monitor the patients electronic health records demonstrating
that technology does not improve a patients overall satisfaction
or their quality of life (2016).
It is important to understand that advances in technology
although important to the quality of care, has been the largest
factor in the continued rising costs of medical care in the United
States (Shi & Singh, 2019). Technology is exciting, new,
constantly evolving, brings hope to the individuals who may
benefit from these advances, and in some cases can be
inspirational to medical professionals. There are several factors
that contribute to the correlation between technological
advances, the continuous rising health care costs, and the
impact this has on advances in health care today.
There was a time when certain conditions equated to no hope of
survival. Shi & Singh demonstrated that as a result of major
technological advances, physicians now have the ability to help
patients suffering from such illnesses as diabetes, end-stage
renal disease, heart disease and HIV/AIDS and due to modern
technology, these conditions are no longer fatal (2019, p. 117).
Various surgical procedures have been reduced to minimally
invasive providing patients with less impact and allowing for
quicker healing times (Shi & Singh, 2019, p. 117). These
technological innovations although profound and an incredible
improvement to quality of life for patients, has contributed to
the negative impact on health care costs.
Medical technology has had a positive impact on health care
accessibility such as utilizing communication technology to
allow patients remote access to their health care providers, or
providing rural hospitals the ability to coordinate care through
video communication (Shi & Singh, 2019, p. 119). Large urban
hospitals and medical clinics have been transformed into state
of the art facilities with newly developed technologies, modern

5. medicine, and the latest diagnostic and therapeutic remedies
being offered to patients not only allowing for access to modern
treatments but reducing costs to patients as these services are
often offered on an outpatient basis where previously only
available in the hospitals (Shi & Singh, 2019, p. 117).
As previously discussed, the United States is responsible for the
highest spending in the world in the development of new
medical technology and the cost of health care (Shi & Singh,
2019, p. 119). As Shi & Singh demonstrated, the actions of the
United States benefits the other developing countries as they
essentially get a free ride in the technological field by waiting
for the United States to develop the technology and then utilize
this technology in the European and other economies at a
fraction of the cost (Shi & Singh, 2019, p. 119). The United
States would benefit through the establishment and
implementation of a centralized health technology assessment to
evaluate ethical and legal dilemmas, efficacy, safety, and cost-
effectiveness of newly developed medical technology (Shi &
Singh, 2019, p. 120).
Essentially, medical technology is only beneficial when it helps
a patient and is beneficial to their care. In the United States,
the Federal Drug Administration (FDA) is responsible for
regulating the introduction of new medications, biologics and
medical devices based on performed medical trials and the
ability to demonstrate their efficacy and safety however, the
FDA does not evaluate cost-effectiveness thus demonstrating a
lack of monitoring rising health care costs, excessive spending
and wasteful practices in the health care field (Shi & Singh,
2019, p. 123). Americans have demonstrated a desire to have
access to the newest and the latest technology although, there
are significant disadvantages of technological advances that
must be addressed for the protection of patients in the United
States healthcare system. The good should outweigh the
negative and be beneficial not only medically but cost
effectively as well.
Mobile Medical Technology

6. The future of technology is being ushered in with exponentially
better performance in smaller and more compact devices. As
such, the advancements in smartphones and wearable devices
has allowed the medical industry to capitalize on this trend by
developing new microsystems, wearable devices, and apps
designed for smartphones, tablets, and watches. According to a
recent article, “Technology advancements in recent years have
caused an explosion of smart and highly connected computing
devices that are in a small form factor” (Qureshi & Krishnan,
2018). From new blood pressure cuffs, sleep apnea diagnosis
devices, and health applications to patient education, these new
mobile technologies are increasing quality of care and providing
a more patient-centered healthcare model.
Blood Pressure Monitoring
New micro technology and computing is making advancements
in blood pressure monitoring. It is making it easier and more
cost efficient for patients to check their blood pressure and keep
an electronic log. This log can be digitally transmitted to the
patient’s healthcare provider for analysis and medication
adjustments. Factors, such as stress and exertion, will have a
negative effect on blood pressure. Patient’s blood pressure
taken in a hospital setting do not tend to be an accurate measure
because this environment is stressful and frightening to the
patient causing blood pressure to spike. A more accurate
reading can be taken at home when the patient is in a less
stressful, more comfortable setting. Not every patient is able to
take their own blood pressure and the equipment used in a
hospital setting is too cumbersome and expensive for patients to
have them at home. The new blood pressure cuff that connect
to a smartphone via Bluetooth technology alleviates this
problem by having a small compact cuff that can be carried
around easily. According to a recent study, “95% of the health
personnel on whom the device was tested agreed that the device
can be useful in terms of medical cost, distant health services
and obtaining useful reference data” (Ilhan, Yıldız, & Kayrak,
2016).

7. Sleep Apnea
It is estimated that 5 to 20 percent of the adult population in the
US have varying degrees of obstructive sleep apnea (National
Sleep Foundation, 2020). Obstructive sleep apnea has many
risk factors that cause serious problems including death.
Causes of these deaths range from lack of breathing while
asleep to vehicle wrecks causes by drowsiness. In the past, the
only way to test for sleep apnea was through long studies where
the patient would come to a hospital, be connected by diodes to
machines that would record body movement, breathing, and
oxygen levels. However, with the advancements in medical
technology, new mobile devices are available that allow patients
to take home the device and test for obstructive sleep apnea at
home. “Improvements in computational capacity combined with
increased availability of training datasets are likely to foster
improved algorithm performance that will simultaneously
benefit consumer and clinical sleep devices alike” (Bianchi,
2017). These devices allow for automation to occur in scoring
for sleep apnea markers. “Whether this occurs in a clinical
context or not, there is little doubt it will continue to dominate
the analysis of portable devices, if only because of the scale and
desire for rapid/immediate results” (Bianchi, 2017).
Applications
Smartphones are being used by more and more people daily.
The Obama administration made it possible for even low-
income family to have a phone. These phones started out being
basic flip phones but have since become lower-end smart
phones. With the increasing growth of smartphone use comes
opportunity for application developers and healthcare provider
to team up and create apps that will make the flow of medical
information easier and more secure. This will allow patients to
have a more active role in their healthcare decisions and
activity. “Medical applications make smartphones useful tools
in the practice of evidence-based medicine at the point of care,
in addition to their use in mobile clinical communication.
Medical applications can range from education, news, reference

8. guides, and database to electronic health records. Popular
medical applications include:
· Micromedex – Pharmaceutical reference apps
· UpToDate – Medical news and advancements app
· John’s Hopkins ABX Guide – Comprehensive reference app
· Red Cross First Aid – Instructional guide app for everyday
first aid.
· My Chart – Electronic medical records (Schiola, 2016).
Patient Education
Health Literacy is particularly important. Having a patient
being involved and active in their healthcare decision can be the
difference between a patient making an informed decision on
treatment or blindly trusting a healthcare care provider. Also,
patients are more likely to follow through with treatment plans
if they are educated on why they need the treatment plan and
how the plan is going to help them successfully recover from
their illness. Advancements in medical technology makes it
possible for patient education to be more streamlined and
acceptable to all patients. Wearable devices are communicating
with smartphones and giving patients dashboards that can show
them an overview of their scores and test results. Applications
like MyChart allows patients to communicate with their
healthcare provider and get answers to questions without having
to leave home. Biomedical wearables are allowing patients to
send data to physicians in real-time so that feedback can be
given quickly. The quicker that a diagnosis is given; the
quicker a patient can decide on a chosen treatment plan.
Advancement of Care Through Information Technology
The healthcare system is increasingly complex because it is
marked by multiple hand-offs between primary care and
specialty providers, inadequate communication among
providers, and lack of clarity about a care provider for patients
with life-limiting illness. Patients and families often cite such
difficulties as information deficits, uncoordinated care, and
insufficient psychosocial support. Studies have shown that
information enabled healthcare has the potential to reduce

9. disintegration of needed information which ensures high quality
and safer care (Clauser et al., 2011). In the face of prevailing
challenges of delivering well-coordinated, patient-centered care
in a complex modern healthcare system, this section will
examine the potential role of information technology (IT)
advances to help both providers and patients. As such, it will
also take cognizance of these challenges and opportunities to
advance understanding of how patient data, provider and patient
involvement, and informatics innovations can support high-
quality healthcare. Given the advances in electronics, the
Internet and telecommunication which have pushed the field of
health care to embrace information technology (IT); this section
of the research article will also focus on the use of information
technology in health promotion and its evolving impact on the
healthcare system in the USA (Roberts et al., 2020).
For the purpose of better understanding, we shall narrow the
technological care coordination advancement by using a known
ailment of cancer. Hence, cancer care is characterized by three
important facets. One is state-of-the-art clinical medicine,
which may include evidence-based and sophisticated therapies
targeted to patients' tumor and biological characteristics.
Second, an approach to care that is attentive to the spectrum of
patients' needs (i.e., physical, psychosocial, functional,
spiritual). Third, the use of systems solutions, both human and
machine, that support organizations in achieving their clinical
medicine and patient-centered care delivery goals (Roberts et
al., 2020). Therefore, enhancing these delivery features for a
disease as complicated and diverse as cancer often entails
complex decision making as outlined earlier on the opening
paragraph of this section. Studies have also shown how to
marshal information technology (IT) to effectively measure,
monitor, and proactively intervene when necessary across all
these dimensions to continually improve performance and build
an effective system of cancer care. As such, reports have shown
that these attributes of care delivery for modern healthcare and
for cancer care delivery, have few efforts being made to

10. describe this IT improvement in managing general healthcare.
Some studies have discussed the potential for IT to improve
cancer care from both the patient's perspective and as part of an
overall system-improvement strategy. With the advent of HIT,
patients have been empowered to become more involved in their
cancer/health care. Therefore, the internet has become a useful
tool as all Americans have sought cancer-related information on
the web. Beyond information seeking, IT provides resources for
social and emotional support to cancer patients and their
caregivers. Given the distress and uncertainty that inevitably
accompanies a cancer diagnosis, virtual social support groups
are a way for patients to find coping strategies and share
experiences (Roberts et al., 2020). Indeed, there has been an
improved cancer management through IT which has been
propagated through shared decision making, symptom
management, and treatment adherence literature. Additionally,
there has been confirmed delivery of tailored advice about
chemotherapy symptoms through handheld computers which has
been reported that patients and providers found this strategy
feasible and acceptable.
For the advancement of healthcare promotion through
information technology; there are different applications of
health IT in health care and health education. As such, health
providers and patients are accepting and even crediting health
IT for providing patients with resources to educate themselves
on their health status and actively participate in their health
care by enabling them easy access to health information
(Nimkar, 2016). Among all healthcare applications of
technology, the use of IT has evolved as a revolutionary and
rapidly emerging trend in health care. Self-management patient
portals, electronic medical records, interactive preventive health
records, personal health records, online peer support groups and
social media are some of the latest trends in health IT (Nimkar,
2016). Consequently, the U.S healthcare system has always
sought to improve the quality of health care. According to
Nimkar (2016); this can only be achieved if medical and other

11. health personnel (e.g. doctors, nurses, therapists, and health
educators), administrators and patients collaborate at different
levels to assimilate complex information. Health IT has
enabled this assimilation of information from various sources
and hence emerged as a growing phenomenon in the field of
health care. It has a wide range of applications in educational,
administrative, clinical and research areas of health.
No doubt, there are challenges associated with technological
advancements and the health IT is facing its share of challenges,
however, it is still evolving to be one of the fastest growing
trends in the US healthcare system. Indeed, health-related IT
can facilitate a paradigm shift from a system-centered disease
prevention model of care to a more patient-centered health
promotion approach.
Healthcare Information Technology
Healthcare information technology refers to the application of
technology to health care. This is in terms of healthcare
professionals and patients storing, sharing, and analyzing health
information in electronic systems (Zhang et al., 2015). The
method of technology aims at providing better care to patients
as well as achieving health equity.
History of healthcare information technology in the USA
The 1920s was the time healthcare technology in the USA
got its roots. Health care practitioners commenced using
medical records to file details, patient care outcomes, and
complications (O’Malley et al., 2015). In 1928, establishment
of the Association of Record Librarians of North America
(ARLNA) was done to regulate medical records. Paper records
were active up to the 1970s, use of computers, contributed to
the commencement of new styles of healthcare system
technology. The adjustment was made possible by Dr.
Lawrence Weed, who generated the first medical record: which
was problem oriented. The system not only allowed access of
patient’s whole medical history by Clinicians but also
verification of diagnoses by third-party facilities. In 1965,
Medicare and Medicaid branches were founded, and the two

12. health care systems are being used today. The foundation of the
two branches led to healthcare information systems
development, as electronic medical records were growing.
Unfortunately, the healthcare system was expensive.
For medical keeping, only the most significant providers could
dedicate the resources to weigh technology. This was as a
result of the computer were big mainframes. Technological
advancement in computers inspired the development of
numerous systems for managing well-being of patients in the
1970s. For instance, Computer Stored Ambulatory Record
(COSTAR) and Registries Medical Record System were created.
Computers became prominent in the 1980s, and the development
of the voice recognition model by Dragon Systems was done
(Ajami, 2016). Personal computers and window software
became predominant though they were not primarily used for
medical recording.
Electronic Health Records (EHR)
Increased awareness and importance of EHR was in the late
20th century. The Institute of Medicine (IOM) made a study on
healthcare records as well as the welfares of medical records.
This study established obstacles to the embracement of
electronic health records, such as high cost and lack of
standards. The report, fortunately, set the expected standards of
EHR. To keep track of patients’ medical care, systems such as
the Healthcare Information Exchange (HIE) and Master Patient
Index (MPI) were introduced (Evans, 2016). World Wide Web
technology paved its way in 1990, establishing how to access,
share, and direct information though there were no immediate
effects on healthcare. In 1994, a new standard, ICD-10 coding
standard was introduced, the amount of codes that could be
employed in medical records was expanded by the rule.
In a study by IOM, the government of President George W.
Bush supported the statistics of IOM; that hospitalized patient
lost their lives due to preventable medical errors. He obligated
computerized health records, and President Obama, in year
2009, signed the Health Information Technology for Economic

13. and Clinical Health (HITECH) to embrace electronic health
records. By the year 2010, EHR was widespread, and efforts to
help healthcare practitioners migrate to the system (Cifuentes,
2015). The number of EHR users continued increasing, and by
the year 2015, the number had doubled. Up to date, the theme
of flawless information sharing amid healthcare providers,
products, as well as systems are being adopted. Today, users
can freely interact with applications, systems can communicate
with each other, and consumer devices integrate.
Impacts of Technological Advancement in Healthcare System
Costs Savings: Technological advancement from paper health
records to electronic records has reduced the cost of casualty.
Healthcare practitioners monitor a patient in real-time when
using advanced medical devices and devices (Zhang et al.,
2015). This reduces the unnecessary visits of patients to their
doctors. Readmission and hospital stray significantly reduce.
Reduction in unnecessary tests reduces spending money on
hospital bills. The savings per patient, therefore, increase.
Reduced Paperwork: The advanced software helps healthcare
providers in tracking procedures as well as using numerous
methods, which reduces paperwork. When entering data into a
system that is computerized, it is more quickly compared to
paperwork methods. Also, the risk of error in both patient’s
data, as well as financial details, reduces (Baker et al., 2015).
This helps in improved quality care for patients. Moreover,
efficiency is improved.
Rapid Information Sharing: Due to wireless communication,
instant messaging is possible in hospitals. These technologies
offer users a platform that they can send messages and other
secure information. For instance, a health practitioner can send
a lab test to another practitioner; therefore, necessitating
comparing patient data with other patients’ data. This system of
messaging can accelerate the communication process,
efficiently securing information safety.
For a consultation, patients can practically get in touch with
healthcare providers from any part of the world, it is a result of

14. the possibility of using smartphones or web-based consultation.
For medical coding experts, it is possible to digitally access
patient records while working at home. Productivity and
efficiency, therefore, increases.
Reduced Unnecessary Test: Before EHR, scenarios of repeating
medical tests were common. This was because of, for instance,
the unavailability of a patient test to another different doctor.
Repeating tests were not only costly but also were inconvenient
and uncomfortable. Fortunately, with EHRs, health care
practitioners can easily access patients’ test results, thus
recording immediately. Unnecessarily repeated tests are
therefore reduced.
Challenges with the Use of Information Technology in
Healthcare System
There have been several challenges caused using health
informatics in healthcare.Challenges has been associated with
collaboration in the daily healthcare work practice, among
professionals in different healthcare organizations as well as the
patients themselves and their relatives, researchers and
practitioners are still trying to find solutions to these challenges
associated with using IT systems to share information and
knowledge in healthcare (Svensson, 2019).
Safety and Security: Although EHR aims at safeguarding and
ensuring that data security is maxima, there exist security
challenge, unfortunately. This is as a result of the increase in
use of modern mobile healthcare technology, significantly
increasing data breaching. An increase in malware has become
a threat to healthcare data.
Identity theft, physical harm to patients, and financial harm to
the individuals as well as the public at large are some of the
emerging threats (Martínez et al., 2015). The weakness of data
encryption and inadequate access control, for instance,
increases the inability to protect data, thereby paving the way to
a cybercriminal who hacks and tamper with sensitive
information. Individuals using health technologies may lack
knowledge of how their data is used and disclosed to third

15. parties.
Regulatory Burden: in the process of enhancing the safety of
healthcare data and patients, technological, regulatory Burden,
however, is currently insignificant. Comparing the regulatory
Burden to the severities of the development of pharmaceuticals,
strengthening regulation could help gain much. There are
emerging issues today on regulating the technology of the
computer. The issue debates on whether to frequently regulate
mobile apps (Baker et al., 2015) or strict protocols.
Since technology advances day by day, the field of healthcare
system technology will grow alongside technology. The …