Presentasjon om: "Healthcare informatics towards 2020"— Utskrift av presentasjonen:
1 Healthcare informatics towards 2020 Øystein NytrøIDI and Program for healthcare informaticsPaper with contributions from Arild Faxvaag
2 Nerd alert: Health with an IT perspective! I don’t know anything…
3 What am I talking about? Health is: Subjective Individual Basic for livingMedicine is:Multidisciplinary, based on the natural sciences in studying diseases, engineering in developing tools and therapy, and based on understanding and treating individuals with a wide range of physiological, social and psychological problems.Healthcare is:Knowledge intensive: About diseases, phenomena, treatments etc.Information intensive: About patients, individual history, population, epidemiology etc.About: Diagnosing, Intervening and Nursing
4 Healthcare informatics (CEN251) A scientific discipline that concerns itself with the cognitive, information processing and communication tasks of health care practice, education and research, including the information science and technology to support these tasks.
5 Challenges of healthcare Increased cost of healthcare spendingUS: 15% of GDP in 2003OECD average: 9%Expected to rise with 3-4 %points next 5 yearsIncreased cost of treatmentFocus on development of high-cost procedures, tools and medicineDubious cost-effectiveness both nationally and globallyThe 90% rule:10% of the population uses 90% of the resourcesGlobal discrepancy – 8 physicians/Mpers in Angola, 530/Mpers in CubaAgingConsumerism - healthcare as statusTechnology – always more knowledge and more diseases and tools
6 World health variables, 2000 source: UN Population Division
8 Why be application specific? Having a common goalShaping the future by interacting with realityCross-disciplinary workGood ideas come from hard problemsTechnology does only exist in a context!It is used by humans, in a society, for a purpose.Better remember that!
9 Challenges for informatics - applied A host of unconnected legacy systems:AccountingPlanning and logisticsConnected to tools (X-ray, laboratory…)Little information flow between services:A patient wanders from one organization to the next, from one physician to another one, with different problems and diseases.Do they communicate efficiently?Relevant clinical information is not available to the right person at the right time in the right placeRelevant clinical knowledge is not integrated in the information systemsInformation quality: Inconsistencies and errorsThe patient is left out of the loop
10 Some methodological questions: For what purpose and whom is a system designed?Does the system work as intended, - and designed?Is the system used as anticipated?What is the cost/effect?Does the system produce the desired results?How does systems impact the organization of services?Does increased complexity of technology help or hinder?
11 Ways to go:Patient-centered recording and use of medical data for cooperative careProcess-integrated decision support through current medical knowledgeComprehensive use of patient data for research and health care reportingCombining bio-information and health-informationStructured and knowledge-rich patient recordsArchitectures that support cooperative care across organizations and care layers: Distribution, roles, access, safety and security.Patient-directed information and knowledgePathways of care and care processes
12 IME, NTNU, you and me and health Let’s do something worthwhile before the North-Atlantic freezes over.Let’s start with doing technologically advanced, conceptually simple and cheap things of global value.We’ve potentially got the worlds most unique laboratory: The norwegian healthcare system
13 Arbeid med å ”oppdatere arkiv” Tre muligheterHare i hue: Trenger ikke å dokumentereSe behovet: Informasjon som vitalt i prosessen, ikke bare for journalen og framtidenInformasjon har verdiNTNU framsyngruppe i bioinformatikkBioinformatikkNorges konkurransefortrinn knyttet tilBofasthetHelsevesenets enkelhet, homogenitet og tilgjengelighetEtt spørsmål som stadig dukker opp: Hvordan bringe resultatene tilbake i klinikken:Moralsk forpliktelse: Gjør noe som er relevant for dem som betaler
14 GlobaliseringDet kreves enorme løft internasjonalt for å oppgradere basis helsetjenesteBehov for globalisering av NorgeBehov for relevans av IME/NTNURekrutterende og appellerende
15 NTNU-strategiVi kan ikke drive mer ”ikt-industri” enn det er flinke kandidaterTiltrekk de flinkeste studenteneVed synlig og relevant forskningVed høy kvalitetFlerfaglighetForskningsbasert undervisningNorge er forskningsfiendtligFordi vi har lav profilFordi vi ikke synliggjør kopling mellom samfunn-teknologi-forskningFordi vi har teite politikereFordi vi ikke synliggjør forskningen i undervisningenForskningen må organiseresDisiplinorientertProsjektbasert, enkel organisering av prosjekterOverordnete visjoner:Ting vi skal gjøre!Dra til Mars. eMelhus.IKT with a missionJEG MÅ FORSKE PÅ NOE!Jeg forsker både med hode og hjerteHva som skjer underveis, ikke hvor vi kommerSom en metode, ikke som en måloppfyllelse
16 User-centered methods: Challenges Field studies:How to make use of observation data and interviews for the design?Drama workshops and lo-fi prototyping:How to involve the users as active participants in the design process?Prototyping and prototyping tools:How much needs to be prototyped? (”Just-enough prototyping”)Usability testing:How do we evaluate the usability of mobile systems for health workers?
17 Requirements analysis Drama workshopsAnalysis & Scenario buildingRequirements analysisRequirementsDesign andPrototypingScenarios & personasVideo, mock-upsand notesPaper prototype/running prototypeEvaluationImages, Video, InterviewsBy developerIn the field or in a labField studiesUsability testingDrama workshops
18 New technologyMobile wireless computing (PDAs, Tablets, WLAN, GPRS og 3G terminals, Bluetooth, ID Tags,,).
19 DHL vs. a hospital DHL Hospital Work The work is procedure driven The work is problem drivenWorkersThe workers follow proceduresThe workers solve problemsControlThe system is in controlThe workers are in controlInformation flowThe computer system needs information from the workersThe workers need information from the computer systemWork processesThe process is simple and predictableThe process is complex and less predictableKnowledgeThe knowledge can easily be externalized “in the world”.The knowledge and competence is to a large extent tacit.
20 Mobile computing: some issues Desktop computersMobile and wirelessForeground/BackgroundComputer use is the main activity.The computer is integrated with other activities.Hardware and ergonomicsThe PC fits many purposesHardware matters (size, weight, shape, battery,,)Mind/BodySymbol manipulation (mind)Physical and mental (body-mind)Environment dataPhysical position is irrelevant (cyber space)Location and data from environment can be usedScreen sizeLarge screensSmall screens, sunlightInputKeyboard and mouseStylus and buttons, but often need for one-handed input.
21 Drama workshop One day workshop in a full-scale model 6-8 health workers in two teams1-2 facilitators (drama instructors)Lo-fi mockups (foam models, Post-its,,)Recording to video (1-2 persons)2-3 developers as observers.
24 ResultsDrama and improvised prototyping works well with health workers.Drama workshops give developers deep understanding of ”context-of-use”.Health workers are creative and clear given the right setting, methods and prototyping materials.Health workers, like the rest of us, have a good implicit knowledge of technology.
25 Future workConstruction of a usability lab for mobile health ICT, supported by Norwegian Research Council (NFR).Integration with new Electronic Patient Record center at NTNU. (EPJ).Further research on methods and tools.Cooperation with developers and IT researchers.Integration of UCD with existing Software Engineering methods (e.g. RUP).