Computerized information systems have replaced the use of paper-based records and allowed for a greater degree of data standardization.
In order to be fully effective, computerized tools require standardization not only in what is being collected but also in how it is done so that different subsystems can communicate back and forth. In addition, software must be designed with the end user in mind to ensure that it is accessible and can be adapted to a wide variety of workflows.
There are many benefits to using computerized information systems, including the ability to produce reports in a timely manner, provide real-time data on patients’ status, allow for more effective communication between doctors and hospitals, and automate basic tasks for medical professionals.
A new and relatively untapped resource for care management is the use of mobile apps and smartphones to provide health-related information directly to patients. This approach has been adopted by a few studies that aim to reduce the number of patients with chronic disease who end up in emergency rooms or present as outpatients at the hospital.
By providing information via applications that are downloaded to mobile devices, patients can access health-related background information or specific advice for their conditions on demand. On the provider side, digital care records allow physicians and other caregivers to send reminders about important events such as medication dosings and appointments over short message services (SMS). Smartphone apps may also allow patients to calculate their medication dosings and arrange for delivery of prescriptions to pharmacies.
There is less scientific evidence than needed to show that mHealth improves clinical and health outcomes, and there are not yet any clear guidelines on how these technologies can best be employed. Further research will be necessary before it is possible to advocate the use of mobile apps and other mobile devices for improving care management.
A significant area of mHealth research is focused on the use of IT systems to improve patient safety during medical procedures, with a specific interest in minimizing human error.
When it comes to preventing surgical errors, electronic checklists have been shown to be more effective than paper-format checklists. In some cases, the use of electronic devices has been shown to reduce complications and improve outcomes over traditional methods of delivery, as well as the costs associated with providing care.
Inpatient IT systems can help medical staff identify patients who have undergone surgery at another hospital without being notified by their primary care physician. They may also flag patients who are scheduled for duplicate procedures at the same time, which is a factor in one-third of adverse drug events.
While these efforts are promising, there are some obstacles that may limit how widespread the use of mHealth will become. For example, it has been found that surgeons often do not have enough time to sanitize their hands and don their surgical masks before a procedure begins, making the use of electronic devices for checklists less effective.
There are also issues such as patient safety and connectivity that pose potential barriers to the broader adoption of mHealth in hospitals. For example, it has been found that some patients may not be able to access certain apps due to security restrictions on their devices.
In terms of connectivity, some hospitals and clinics may not have wireless networks that meet the capacity required to support an increased use of mobile devices. This can be made worse by the fact that some physicians and nurses may not be technologically savvy enough to input information about patients into their smartphones or tablets. A lack of training in the use of mobile apps may also allow patient data to be inadvertently lost or compromised.
Some providers are skeptical about the benefit of using smartphones and other mobile devices for managing patients, which can create resistance to the adoption of these technologies. The cybersecurity risks associated with mobile devices have also been cited as a reason to limit their use in hospitals.