By Abdul Roudsari, BSc, MSc, PhD

The few, large and standard package providers, keeping paper records in isolation with minimal web support, was yesterday. Tomorrow promises the flexibility of
multiple providers, integrated records, personalized services, the interactive web, mobile and smart phones. Today is the transition period, moving to tomorrow’s promises from yesterday’s starting point. Summarizing challenges are common to all countries – big or small, rich or poor – expecting improved health at lower cost.

Individual patients at the centre. A focus on the individual implies better and safer care through personalization. Coordination, continuity and quality across services, based on good record keeping, would logically follow. Changing processes and behaviour through innovation. Sharing information between providers would tend to promote greater understanding between providers themselves and opportunities for wider change. Innovation might lead to redesigned existing services, new services not previously practicable, and behaviour change by staff and organizations in line with whole process re-engineering.

TeleCare promoting TeleHealth. Panic buttons and environmental alarms are already in place as TeleCare for many older and “at risk” social care clients. Simplified medical monitoring devices, following a similar social care connectivity model, begins the shift of health services closer to home. Family access to the same records allows additional support at home, perhaps by remote links.

Well-being and public health on the move. Tailoring advice to individuals at home extends to patients away on business, holiday or unforeseen travel. Mobile devices provide the vehicle. Messages could cover services, hazards and precautions specific to locations.

Records and advanced informatics. Special algorithms have potential to predict service demand as well as individual risk factors. They are likely to develop with improving record data quality and record integration across services. The fundamental warning of disruptive technologies. Much is possible with new technologies. Services are redesigned, new services are emerging, and patients are in the “driving seat”. But several factors advocate caution. Not all patients have the funds or IT-literacy for internet use. Those that do may have unrealistic expectations. Multiple systems replacing established human services may lead to fragmentation and greater alienation. This is the message of a truly disruptive technology. The web on various platforms is a pervasive medium in all countries, even in poorer countries. Learning what works best for which individuals and which organizations marks the important transition period for all in health Information and Communication Technologies (ICT) today.

Abdul Roudsari is a Professor and the Director of the University of Victoria’s School of Health Information Science.

From the 2012 Spring Communiqué — Informatics