Professional Documents
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Dr. Mona Al-Achkar Jabbour Maj_aj@hotmail.com Professor of Law President of the Lebanese Information Technology Association (LITA) Nancy Abi Karam LITA member
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Added value
For:
citizens governments business sctor Online prescribing, information patients portals interactive communication Extended service times Decision support systems Order clinicians entry online training Clinical databases communication Workflow planning systems budgetary systems
"Medical Informatics
"Medical Informatics studies:
the organization of medical information the effective management of information using computer technology and the impact of such technology on medical research, education, and patient care.
assessing current information practices, determining the information needs of health care providers and patients, developing interventions using computer technology, and evaluating the impact of those interventions.
Objectives
optimize the use of information in order to improve: the quality of health care, reduce cost, provide better education for providers and patients, and to conduct medical research more effectively."
Health informatics
the study of: resources and methods for the management of health information.
systems such as electronic health records (EHR) electronic medical records (EMR) health information exchange standards medical terminologies Clinical Terms and portable medical devices for the collection of data.
It involves:
health informatics
The first use in the 1950s with dental data collected by the National Bureau of Standards, now known as the National Institute of Standards and Technology (NIST). Accelerated usage with development of the Massachusetts General Hospital Utility Multi-Programming System (MUMPS), which provided a standard programming language for clinical applications. Today,International Medical Informatics Association (IMIA) oversees member organizations involved in health informatics worldwide.
Scope - 1
It deals with:
- the resources -devices - required methods to optimize: - the acquisition, storage, retrieval, and use of information in health and biomedicine.
Scope -2
Scope -3
nursing clinical care dentistry pharmacy public health occupational therapy physical therapy (bio)medical research alternative medicine
The term "medical informatics", refered to the processing of medical data by computers.
Health applications then became known as "health telematics" or "telemedicine", and now "e health". the value of these applications lies not in the technology itself or even in the exchange of data but in the ability to develop human networks of competence and expertise in the field of health.
Tele-health surveillance, health promotion and public health functions. It is broader in definition than tele-medicine as it includes computerassisted telecommunications to support management, surveillance, literature and access to medical knowledge.
Tele-medicine is the use of telecommunications to diagnose and treat disease and ill-health.
Telematics for health is a WHO composite term for both telemedicine and telehealth, or any healthrelated activities carried out over distance by means of information communication technologies.
Nursing Informatics
Planning care Delivering care Nursing informatics refers to:
informatics within all areas of nursing practice informatics designed for and relevant to nurses
information management,
E-health
Barely in use before 1999
the term has already entered the scientific literature (today, 76 Medline-indexed articles contain the term "e-health" in the title or abstract).
E-health :
More than a technological developement
"stamping a definition on something like e-health is somewhat like stamping a definition on 'the Internet': It is defined how it is used - the definition cannot be pinned down, as it is a dynamic environment, constantly moving."
It characterizes:
a technical development a state-of-mind a way of thinking an attitude a commitment for networked, global thinking, to improve health care locally, regionally, and worldwide by using information and communication technology.
E-Health
E-health is the transfer of health resources and health care by electronic means. It encompasses three main areas:
The delivery of health information, for health professionals and health consumers, through the Internet and telecommunications. Using the power of IT and e-commerce to improve public health services, e.g. through the education and training of health workers. The use of e-commerce and e-business practices in health systems management.
Defining E- Health
- public health which is the responsibility of States (preventing and responding to disease in populations) and healthcarewhich is the responsibility of professional and hospitals toward individual patients and the treatment of disease. - products, such as instruments to ensure the constant monitoring of blood pressure in ambulatory patients, - systems, such as computer-assisted surgery systems, and services, such as: - operating surgical and intensive care units, with interconnected instruments and surveillance services ensuring continuous patient monitoring; - computer-assisted prescription services, where the software checks for incompatible drugs, contraindications and dosage levels; - information services for patients and consumers, including individual electronic health records.
10 e's in "e-health" Efficiency Enhancing quality Encouragement Education Enabling Extending Ethics Evidence based Empowerment Equity
The goals
increasing efficiency in health care Improving quality of care increasing commitment to evidence-based medicine empowering patients and consumers developing new relationships between patients and health professionals
Some applications
system making patient information accessible for all healthcare units at a district, county, or even national level. patient portal, a system for patient Internet access to medical record. use of Internet as a source of medical information, a means for medical consultation and for marketing of drugs.
e-Business
includes online procurement processing between health care providers and suppliers, online electronic claims processing, eligibility authorization from insurance companies, and consumer purchase of prescription drugs and health insurance.
Consumer marketing
includes the use of Web sites to showcase organizational information to attract new patients and provide wellness information and disease-specific information to existing patients.
Organizational management
includes patient access to medical information via electronic health records allowing them to conduct risk assessments of their own health and include patientphysician interaction using e-mail.
Going digital
- data sharing
Implications in practice
The standards and regulations that have hitherto served to protect individuals in such a vitally important area of life can no longer be guaranteed when healthcare moves into the public arena.
At a more local level, the introduction of computermediated healthcare changes the processes and practices of the care professionals not least in learning to operate and manage ICTs, individually and as part of a team.
Multi-layers stakeholders
Patients: individuals, family, carers Management, owners, shareholders
professions allied to health: Researchers, academics and students Vendors and consultants
Multidisciplinary
computer science information science medicine
law
philosophy social sciences
Contain the standard medical and clinical data gathered in one providers office.
1- go beyond the data collected in the providers office and include a more comprehensive patient history.
ex: EHRs are designed to contain and share information from all providers involved in a patients care.
2- EHR data can be created, managed, and consulted by authorized providers and staff from across more than one health care organization.
Legal Challenges
The critical, legal challenge for MEdical informatics is how to maximize the opportunities and benefits afforded whilst minimizing the risks and liabilities arising from new technology and practices.
Sensitive Data
Technical and legal Protection Norms & Standards Private Application
Sensitive data
Personal health data: Sensitive patient health data can include insurancerelated data, actual medical information, and personal data about patients, such as social security numbers, addresses, and other sensitive information, which should not be publicly available.
Risks
Reliability
- The storing and exchange of medical images is crucial to providing a knowledge base for practitioners, and clearly it is also crucial that the images from which judgments are made are reliable.
Data Loss
Data Leakage The movement of a data asset from an intended state to an unintended, inappropriate, or unauthorized state, representing a risk or a potentially negative impact to the company. Locate all sensitive information A key challenge is being able to accurately identify relevant data at all key locations (stored data, laptops, network, message server). Control and protect all sensitive information There are many ways to misuse and lose sensitive data. Hospitals/physicians and companies must control and protect sensitive data in order to meet legal, regulatory and company policy compliance obligations.
Variations:
several legislations may hold liability for costs associated with breaches of pd data
Increasing risks
According to a 2012 Department of Homeland Security bulletin, attacks against healthcare organizations are expected to increase.
Two areas of the law that most involve healthcare leaders and managers are :
employment law
mal practice
Minimizing Risks
With the changing legal landscape and the areas of potential risk, physicians can :
Openly discuss with their medical liability carriers the advantages and pitfalls in using ICTs Reach out to professionals within their organizations, networks, or communities for support in Ensure that their systems meet their legal, business, and records management needs Ask in-depth questions of potential vendors to ensure that their products address medico-legal issues demand the functionality that supports both their clinical and business needs.
Lebanon
Lebanon
We are on the net! The citizen at the heart of the Government concern!?
HIPPA and HITECH in the USA set national standard for the privacy Convention on PDP in Europe Varieties of legislations in Europe Observation of technical standards of secure data communication, or to provisions ensuring high quality of handling, collecting, storing, transmitting and manipulating, etc. of health care data
Appropriate administrative, legislative and regulatory frameworks are essential to the implementation of a national or regional e-health project. This wide-ranging subject has a bearing on the fundamental rights of the citizen, e-commerce, health and a large number of international regulations governing the technical and economic spheres.
- The exchange of medical records can legitimately take place where a similar level of personal data protection prevails in each of the countries
- conducting clinical trials - Regional cooperation can be facilitated by partnerships with international bodies to guarantee codes of good conduct and credibility
FOCUS SCOPE
PENALTIES