Digital health
electronically connects the points of care so that health information can be
shared securely to help deliver safer, better quality healthcare.
The broad scope
of Digital Health includes
categories such as mobile health (mHealth), health information technology (IT),
wearable devices, telehealth and telemedicine, and personalized medicine.
Digital health is about electronically connecting the points of care so that
health information can be shared securely. This is the first step to
understanding how digital health can help deliver safer, better quality
healthcare.
Health
Information Management (HIM) professionals are well trained in the latest
information management technology applications and understand the workflow in
any health care provider organization. Health Information Managers are vital to
the daily operations management of health information and electronic health
records (EHRs). They ensure that Data Quality is maintained, by applying the
principles of Change Management and continuous capacity building through
education and training. They ensure that the health information and records of
a patient are complete, accurate, protected and meet the desired and stipulated
medical, legal and ethical standards. Therefore, it must be made mandatory to
appoint an adequate number of health information managers, according to the
size of the healthcare organization, to ensure safe and smooth adoption of
digital health in India, leading to informed healthcare delivery.
These
professionals affect the quality of patient information and patient care at
every point in the health care delivery cycle. They work on the classification
of diseases and treatments to ensure they are standardized for clinical,
financial, and legal uses in health care. HIM professionals care for patients
by caring for their medical data. This, in turn, leads to informed healthcare
delivery, especially when and where the information is translated into
actionable outputs.
I
have been tracing the evolution of health informatics and health information
managers in making healthcare delivery more informed. Further they also show
the role of unlearning and relearning in effectively assimilating information
for better healthcare delivery.
As
the Indian government aims for Universal Health Coverage (UHC), the lack of
skilled human resource may prove to be the biggest impediment in its path to
achieve targeted goals. Therefore, the model curriculum handbook on health
information management has been designed with a focus on performance-based
outcomes pertaining to different levels. The learning goals and objectives of
the undergraduate and graduate education program are based on the performance
expectations. These are articulated as learning goals and learning objectives.
Using this framework, students will learn to integrate their knowledge, skills
and abilities in a hands-on manner in a professional healthcare setting. These
learning goals are divided into nine key areas, though the degree of required
involvement may differ across various levels of qualification and professional
cadres:
1. Clinical care
2. Communication
3. Membership of a
multidisciplinary health team
4. Ethics and
accountability at all levels (clinical, professional, personal and social)
5. Commitment to
professional excellence
6. Leadership and
mentorship
7. Social
accountability and responsibility
8. Scientific attitude
and scholarship (only at higher level- PhD)
9. Lifelong learning
Among
these nine core competencies, the third one (Membership
of a multidisciplinary health team) is perhaps the most important. The student will learn to put a high value on effective
communication within the team, including transparency about aims, decisions,
uncertainty and mistakes. Team-based health care is the provision of health
services to individuals, families, and/or their communities by at least two
health providers who work collaboratively to accomplish shared goals within and
across settings to achieve coordinated, high quality care. Program objectives
will aim at making the students being able to:
Ø Recognize,
clearly articulate, understand and support shared goals in the team that
reflect patient and family priorities
Ø Possess
distinct roles within the team; to have clear expectations for each member’s
functions, responsibilities, and accountabilities, which in turn optimizes the
team’s efficiency and makes it possible for them to use division of labor
advantageously, and accomplish more than the sum of its parts
Ø Develop
mutual trust within the team to create strong norms of reciprocity and greater
opportunities for shared achievement
Ø Communicate
effectively so that the team prioritizes and continuously refines its communication
channels creating an environment of general and specific understanding
Ø Recognize
measurable processes and outcomes, so that the individual and team can agree on
and implement reliable and timely feedback on successes and failures in both
the team’s functioning and the achievement of their goals. These can then be
used to track and improve performance immediately and over time.
As
this model curriculum is competency-based, it connects the dots between the
‘know what’ and ‘do how’ for HIM professionals.
The
National
Health Policy-2017 advocates extensive deployment of digital tools for
improving the efficiency and outcome of the healthcare system. The policy aims
at an integrated health information platform or system which serves the needs
of all stake-holders and improves efficiency, transparency, and citizen
experience. Delivery of better health outcomes in terms of access, quality,
affordability, lowering of disease burden and efficient monitoring of health
entitlements to citizens, is the goal. Establishing federated national health
information architecture, to roll-out and link systems across public and
private health providers at State and national levels consistent with Metadata
and Data Standards (MDDS) and Electronic Health Record (EHR) Standards, will be
supported by this policy. The policy suggests exploring the use of “Aadhaar”
(Unique ID or UID) for identification. Creation of registries (i.e. patients,
provider, service, diseases, document and event) for enhanced public health/big
data analytics, creation of health information exchange platform and national
health information network, use of National Optical Fiber Network (NOFN), use
of smart phones/tablets for capturing real time data, are key strategies of the
National Health Information Architecture. The policy advocates scaling of
various initiatives in the area of tele-consultation which will entail linking
tertiary care institutions (medical colleges) to District and Sub-district
hospitals which provide secondary care facilities, for the purpose of
specialist consultations. The policy will promote utilization of National
Knowledge Network (NKN) for Tele-education, Tele-CME, Tele-consultations and
access to digital library.
The
National Health Policy 2017 of India states that recognizing the integral role
of technology (eHealth, mHealth, Cloud, Internet of Things or IoT, wearables)
in the healthcare delivery, a National Digital Health Authority (NDHA) will be
set up to regulate, develop and deploy digital health across the continuum of
care.
Currently,
in the International Institute of Health
Management Research, New Delhi, I am
involved in training such professionals through a regular 2-year PGDHM (Post Graduate Diploma
in Health and Hospital Management) course that is equivalent to MBA, as per
the Association of Indian Universities (AIU), and also through short-term
Management Development Programs (MDP) for in-service professionals.
To conclude, HIM
professionals are very well trained and suited to ensure that the health
information and records (EHRs) of a patient are complete, accurate, protected
and meet the desired and stipulated medical, legal and ethical standards.
Therefore, it must be made mandatory to appoint an adequate number of health
information managers, according to the size of the healthcare organization, to
ensure safe and smooth adoption of digital health in India, leading to informed
and safer healthcare delivery.
