Relationship: the information that is fed from one layer to anotehr moves outwardly to the research, policy, and public health layer, but each sphere is then informed through feedback, insight, and knowledge created by the work of reserach policy, and public health. Without each layer previous, research, polocy, and public health would not be able to build the knowledge necessary to better undertstand healthcare efficency and costs, effectivness and quality, understand threats to the piblic, and issues surrounding access to care. The feedback provided helps to determine the data capture needs of HIS and the workflows and processes necessary for informatics. Reliant: ex. Cannnot create an improved workflow based on inaccute or no feedback, but to get to the point of feedback, needed the layers before
1)Research goal: inform workflows and process/clinical improvement to favorably affect outcomes
2)Policy goal: with data help policy makers see what new policies need to be instilled or adjusted
*important to note, regulations can interfere, certain data functions and capabilities can be affected
3) Public Health goal: capabilities such as HIE and Mhealth allow for the collection of data from people as they go about their daily lives. Through smartphones and social media, etc. This creates an ability to gather data or conducting predictive analysis of a populations risk factors for disease. And prevention oriented programs (education)
New systems taking a Big Data approach and using flexible "cloud computing" are being developed. Analytics-oriented HIS, which allows for organizing dashboards and business intelligence/ clinical intelligence systems from a variety of data sources, is emerging with a vengeance. Digital health, cheaper, faster systems, better data, technogies, and devices; more powerful sensors, networks, security, and capacity; advancements in science and medicine such as genomics, virtual care through telehealth and telemedicine, technology-enabled training and education; personalized health care. Any personalized healthcare that gives patients more access to care, i.e. viewing provider notes on the EHR, digital membership cards on which software is running on a smartphone, digital cell phone insurance cards, taking copayment online, improving specialty scheduling delays, reduce mistakes, delays, providers are able to place greater emphasis on patient involvement, education, and group therapy help with chronic disease management. eHealth: comprises the technologies supporting an essential shift in methods, attitudes, and actions regarding health and wellness in our society today, often referred to as Health 2.0. Move to prevention, focus on health vs. sickness. People take active roles in managing and maintaining their own health. 1) delivery of health information, for health professionals and health consumers, through the Internet and telecommunications 2) using the power of information technology and e-commerce to improve public health services, such as through the education and training of health workers 3) the use of e-commerce and e-business practices in health systems management. **ultimate goal, a focus on health for people around the world, regardless of their ability to afford insurance or their geographical access to healthcare facilities. Encompasses education and training
Challenges: people's access to infrastructure such as smartphones, access to the health related programs and professionals who develop and deliver the revolutionary programs supported by these electronic means. Need good data, or else bad eHealth
mHelath: use of mobile technologies for purposes of health are, public health, and health-related activities at the individual level. Can be clinical, educational, administrative, or research related. Includes smartphones, mobile applications using tablets and smartphones, the Internet, machine to machine wireless capabilities, personal computers, patient monitoring devices, social media, personalized health dashboards. Taken geography out of the healthcare equation, removed physical barriers. Increasing availability of mobile technologies, changing demographics play a role in need for mHealth. Ex UNICEF, m track, use simple texts to track supplies of medicines and disease outbreaks electronically rather than paper based processes.
-need more access to EHR systems and other HIS and infrastructure to have more robust foundation of data for mHealth, use, tracking, and communication
Social media: Use social media can be difficult when trying to preserve patient privacy, confidentiality, security, while still being interactive and informational for patients. Good for informational, marketing, reviews, building support communities, patient education and human interest stories.
Challenges: HIPPA, practical decisions of governing social media, guiding principles not horizontally accepted, productivity can be an issue with employees, need educational training programs to really understand how to use social media properly
Telemedicine: Remote delivery of clinical services using internet, secure email, smartphones from one site to another via electronic communication to improve a person's health awareness and access to information in the broader context of health promotion and prevention of illness or harm. 1) intent to provide clinical support 2) overcome geographical barriers 3) connect users who are in different physical locations using the variety of types of modern information 4) communication technologies and improve health outcomes
Challenges: complexity of human and cultural factors (communication methods for clinicians and patients, lack of necessary technical proficiency) cost of sustaining telemedicine and telehealth initiatives, a shortage of studies evaluating costs and benefits, legal issues around crossing trans regional boundaries, technical challenges create barriers to the integration of the various types of systems