INFORMATICS LITERACY FOR HEALTHCARE WORKFORCE Sukhen Dey, PhD Indiana Univerity Southeast, USA sdey@ius.edu Mensura Kudumovic, PhD University of Sarajevo, Sarajevo, Bosnia and Herzegovina mensura.kudumovic@eibios.mf.unsa.ba
A simple definition of informatics in healthcare is the application of computing and telecommunication technology to improve physical, psychological and physiological welfare of a patient. Why we need to raise the awareness of Information Technology in? The cost of healthcare is skyrocketing all over the world. The healthcare workforce from doctors to nurses are in great shortage all over the world. We need to do things cost effectively, efficiently, accurately and with lesser probability of errors. We need more technologically aware (literate) healthcare workforce even in developed nations like the U.S, U.K and Australia to take care of patients.
Healthcare is in a state of Crisis globally: Chronic disease oriented patients account for 65% - 75% of the deaths in the world. By 2020-25 the 65+ aging population will almost double. Over one billion people in the world are suffering obesity related problems, both physically and psychologically. This is approaching a 2.2 billion figure in a few years. Almost 35% of the world population. In the U.S alone the total healthcare spending is going to reach around $4.1 trillion dollars by 2015. Yes, $4.1 trillion dollars.
An estimated 250,000 patients die or get seriously affected in the U.S. hospitals every year because of medical errors. What about the world? Public health risk factors are increasing because of: Increased density of population facing natural disasters. Threats of terrorism. Man made so called technology which are unreliable, poorly maintained and a total ignorance of potential mass epidemic such as the Oil Spill in the gulf. We can spend $500 billion; but do we have enough trained healthcare professionals to handle the job?
In order to take care of the 6.8 billion people, we estimate 300-400 million healthcare workers globally. There is an average of three physicians per 1000 population in the world and in some developed countries like U.S, U.K, Japan and Canada, it is around two. Thus, we need more healthcare professionals in the upcoming years. Global population is growing. People are aging. We are facing new forms of health complications. Educational institutions are not producing enough graduates to take care of the growing demand for healthcare professionals. Healthcare Informatics has not been incorporated adequately into most medical curriculum. Patient safety is being violated at every corner of the global healthcare community as a result of the lack of training in electronic communication, documentation, order entry and automated systems.
The fallacy remains; many nations are welcoming patients from affluent countries because of the rising healthcare cost under the banner of healthcare outsourcing. However, we fail to see any noticeable initiative by either the domicile healthcare providers or the host countries to expose nurses, physicians and allied health professionals to basic medical informatics literacy applicable to patient care and safety.
In the U.S and probably in many countries major problems related to the increasing healthcare cost and patient safety (or unsafely) center around: Paper based records and hand written orders. Manual communications. Manual documentation of important medical procedures and protocols. Non-electronic drug prescribing. Duplication of patient records and inconsistency in legacy databases. Lack of data standards. Serious healthcare labor shortages. Poor training. Lack of almost any healthcare based information technology exposure to students at the two year or one year diploma level. We do not have the world statistics. However, in the U.S alone, Almost 80% of the healthcare workforce jobs require a two-year college degree or even a one-year diploma.
Objectives of Healthcare Informatics include: Improving the channel of communication to aid mission critical decisions. Increasing the use of electronic communication. Electronic communication automatically creates searchable documentation which can be used for future references. To provide better bedside care to patients using systems, networks and devices such as barcoding, RFID and PDAs.
Reducing medical and medication error rates. Information Technology applications have significant impact on reducing medical errors with accurate patient identification and medical history. Reducing cost of healthcare delivery. The skyrocketing cost of healthcare throughout the world can be controlled by deploying appropriate information technology infrastructure. Reducing burden on individual nurses, physicians and allied health workforce so that they can spend more time with the patient. They are now submerged with manual paperwork.
The benefits of the applications of informatics are far greater than what we have listed. The problems remain: Healthcare workforce are not properly trained in the use of medical informatics. In the academic level we find limited exposure to healthcare based Information Technology applications. There is a serious lack of simply composed textbooks and appropriate materials for lower level healthcare students in this area. There is a serious shortage of qualified informatics instructors to accommodate at a lower level health education programs. The field is new. The demand for healthcare informatics instructors are high. Lower level healthcare programs are not willing to pay attractive salaries; Yet 70%-80% of the healthcare workforce jobs require a two-year college degree or even a one-year diploma.
While, Many programs are just starting to adopt Health Information Technology concepts and practices, the existing workforce is far from a general literacy of Information Technology use in healthcare. Even at the medical schools, the future doctors are not getting enough exposure to Information Technology based concepts practices such as Bedside Technologies, Online Real-time reference, e-prescribing and hands on Electronic Health Record systems. In a high tech medical community such as in the U.S, some 65% of patient documentations, prescribing and orders are still hand written. The medical error rates and malpractice suits are all time high and we are sure the legal community welcomes that. We assume that the ethics and legal boundaries of medical practices are well emphasized in the medical education; However, are we providing enough hands on training to the electronic tools to prevent errors?
An Interim Solution We are in the process of designing a lifelong learning oriented certification program that can be deployed through an online platform. The program is created to offer Continuing Education certifications in the areas of Medical Informatics and Health Information Technology. The courses are online, non-instructor oriented Continuing Medical Education and Professional Education offerings. The online platform will reach a global audience with an ecommerce platform. It is important to recognize that the program is not intended as an academic endeavor.
Lifelong learning is a self-directed exercise to learn more about a subject either to upgrade skills or simply to know more about something. All courses will award CEUs. (Continuing Education Credit). Each course will qualify for a course completion certificate with four CEUs. A group of four or five courses will qualify for 16-20 CEUs and a Subject certificate, such as Introduction to Medical Informatics and Introduction to Health Information Technology. The contents are lectures, readings, videos and quizzes.
The Overall program structure looks as follows
Group* HI HI HI, HIT HIT HIT HIT HIT HI HI, HIT Four-Week Courses Under Design Healthcare Informatics - Basic Foundations. Healthcare Informatics - Systems and Applications. Scope of Information Technology in Healthcare. Medical Errors, Patient Safety and Technology based Solutions: An Overview. An introduction to Health Information Technology. An Introduction to Electronic Health Record. Information Technology Infrastructure in Public Health System. Business intelligence (bi) models in healthcare. Healthcare Reform Act of 2009: An Overview. HI = Introduction to Healthcare Informatics HIT= Introduction to Health Information Technology As stated before: A student can achieve a course certification or a Subject certification with a group of courses.
Based on the immediate training need of healthcare workforce in the application of Information Technology, the program discussed has the potential: To fulfill the application of Information Technology literacy requirements at various levels of healthcare professionals. Implant genesis of appreciating automation and electronic communications for any healthcare workforce. Provide opportunities to a large group of health sciences students to get exposed to an important topic which may or may not be embedded in their course of study. Last but not least, there might be interest from common population (patients) to know more about the global healthcare scene and how any healthcare system can be more efficient with the aid of existing and emerging Information Technology applications.
INFORMATICS LITERACY FOR HEALTHCARE WORKFORCE Sukhen Dey, PhD Indiana Univerity Southeast, USA sdey@ius.edu Mensura Kudumovic, PhD University of Sarajevo, Sarajevo, Bosnia and Herzegovina mensura.kudumovic@eibios.mf.unsa.ba