Health is a state of complete physical, mental and social well being, and not merely the absence of disease or infirmity. World Health Organization
Many people do not realize the importance of good health, and even if they do, they may still disregard it. Whether we work at home or in an office, we need good health in order to perform our duties well. Contrary to what most people believe, health does not merely mean being free from physical pain or the symptoms of any disease. In addition to physical fitness, the fitness of mind is also of crucial consideration in the overall assessment of wellbeing. One of the basic requirements for good health is to live in a clean and healthy environment which is almost impossible today. Be it the water we drink or food we consume, the air we breathe or the land we live upon, everything is polluted. Our cities, towns and rivers have become dumping grounds of wastes and breeding grounds of dangerous microbes. Due to all these our chances of acquiring good health may remain a distant dream. This has made a demand to move in new dimension of medical science and that is, by associating engineering with medical science.
This association not only improves the living standards and general health of people, but it also saves countless lives all over the world. In the past 50 years, advancement in medicine has mostly been due to technological advancements made possible by biomedical engineering activities. Biomedical engineering or â€œEngineering for Healthâ€ is one of the fastest growing fields of research and technological advancement. It is defined as the use of principles and techniques of engineering to solve problems in medical and biological sciences in order to advance the healthcare treatment. It includes the advancement of fundamental concepts of engineering, biology and medicine to develop new devices and innovative approaches to solve health issues. This biomedical engineering has resulted in development of platform shoes, wooden teeth and limb prostheses, pacemakers, heart-lung machinea, dialysis machines, diagnostic equipment and imaging technologies of every kind, artificial organs, implants and advanced prosthetics.
ICT Based Framework for Improving Healthcare Workflow
Information and communication technologies (ICT) have become inevitable and almost inseparable parts of our lives. They have also penetrated many application areas including healthcare.
Workflow in healthcare is a term for expressing the work in a computerized format processes which represent the flow of task in particular healthcare procedures. Healthcare procedures can be related to admission and discharge, health monitoring and advice, operation procedure, diagnostics procedure, preventive health, home health monitor, healthcare reporting and documentation, hospitalization, nursing, healthcare data management, etc. Few examples of healthcare workflow are, monitoring a remote patient and advising the treatment for him/her, standardization of patient healthcare data (e.g., diagnostics report, admission and discharge summary), management of appointment calendar and health data for clinicians and patient over cloud, operation theatre management, e-Health services etc.
The integration of healthcare with ICT has led to increased accessibility to healthcare providers, more efficient processes and better quality of healthcare services. Technologies such as cloud computing, mobile technology, intelligent and decision support software, internet and web services, wireless communication etc are being used in different areas of healthcare such as hospital network, clinical services, diagnostics services, personal health, remote monitoring, tele-health, ambulatory and emergency services, health data management, etc. Use of ICT based services in healthcare has helped the user (patient or doctors) in achieving better operational efficiency related to healthcare work flow. There are many areas in healthcare like hospital interoperability, healthcare/hospital document workflow, home healthcare, remote health monitoring, e-Health, m-Health etc which need use of advanced ICT to improve work flow related operational efficiency. ICT is being used in some of these areas; however it is still not matured much.
Research Issues & Challenges
Cloud computing is the delivery of computing as a service rather than a product, whereby shared resources, software, and information are provided to computers and other devices as a utility over a network/Internet. If used together with other technologies such as mobile, wireless/Wi-Fi, web services, it may just be the right technology for healthcare infrastructure. However, several serious issues concerning security, data storage, protection and ownership, quality of services, and mobility need to be resolved before Cloud computing can be widely adopted in healthcare. MoCAsH is one of such example which uses mobile and cloud connectivity of healthcare.
Interoperability is the ability of two or more systems or components (e.g. two or more healthcare information systems) to exchange information and use the information that has been exchanged. This information exchange can be based on some health standards like HL7 and Clinical Document Architecture. Handling interoperability issue in medical systems is a mandatory requirement, as they support existing legacy system in healthcare. Electronic health record (EHR) system plays a bigger role in health data interoperability.
In the last five years, a lot of research results have appeared on various topics of healthcare ICT, that includes - ICT based connected health services and healthcare service interoperability, ICT readiness of e-Health services, integration of cloud with sensor data, device to service oriented healthcare approach on cloud, technology for tele healthcare. Availability of electronic health record system and clinical healthcare software in the leading hospitals in many of the developed and developing country clearly indicates the result of research and advancement in this area. Some of the hospital centric commercial services related to clinical side are being offered on web and mobile by the hospitals and diagnostics laboratories. Considering the infant stage of ICT application in healthcare, increased cost of healthcare services, aging population of developed country, healthcare domain will see a quantum jump in the use of technology in near future.
Healthcare Visualization of Future
Future healthcare will have multi dimensional technology enabler to focus on patient health. The social, information, mobile and cloud enabler will help in better diagnosis and treatment of patient. Now, people are talking about Digital and Paperless Hospital System where in they want to use smart devices, mobile and communication technology for improved healthcare response. The use of technology has improved the overall treatment process in terms of time and quality. The healthcare industry will continue to grow in importance around the world. New technologies, in particular, will play a key role in dramatically changing the practice of medicine and improving peopleâ€™s health. Government in developed and developing country are planning to focus on meeting long term healthcare objective throughout the world.
Many countries and technology companies have their vision and mission planned for futuristic healthcare. Information technology has made significant contributions to our world, namely in the medical industry. With the increased use of electronic medical records (EMR), tele-health services, and mobile technologies like tablets and smart phones, physicians and patients are both seeing the benefits that these new medical technologies are bringing. In personal and remote health care, there will be a great upliftment due to new wearable body sensors that capture continuous physiological data streams during daily routines - as opposed to discrete data captured at isolated moments in time - will provide clinicians with greater context and enable them to diagnose based on robust evidence.
Future medical IT system will be more focused towards analytics and decision system and will integrate different aspect of engineering infrastructure and cross industries like banking and insurance to ensure better quality of treatment. So, the paradigm shift in healthcare in next 40 years will be how technology empowers patients to take control of their healthcare. Internet-informed patients will become partners in the promotion of their health in partnership with their health care providers. The growing use of Electronic Health Records (EHR), Personal Health Records (PHR), Health Information Exchange (HIE) Networks and other health information technologies will have a tremendous effect on the business of health care and people's health. Information technology will help patients to access the health care system on a 24x7 basis, at their convenience making them a partner in their health along with the health care providers.
Following diagram shows the technology focus in healthcare and how it will shape up in future.
Current usage of technology is limited to application of technology on healthcare devices, ICT application and storage and retrieval of healthcare data for hospital usage. Technologies such as cloud, remote monitoring, standardization of healthcare data and decision system are currently progressing and there are quite a few good solutions already available. In future, usages of robotics to simulate and perform surgery, more intelligent system to enrich doctors and clinicians to take decisions and common wearable devices will help the diagnostics and treatment in healthcare. We can also think about the futuristic medical IT system model which may be realized in coming 20 years. Where the advance areas of medical system like robotics, genomic IT, predictive health system, wearable systems and current medical developed and upcoming solutions such as home health, patient IT solutions will become part of global health information exchange. Cross industry integration will help to enrich the interoperability of healthcare system for user and service providers.