Health care in the information society. A prognosis for the year 2013

Our society is increasingly influenced by modern information and communication technology (ICT). Health care has profited greatly by this development. How could health care provision look in the near future, in 10 years, or more precisely, in the year 2013? What measures must be undertaken by political and self-governing health institutions, and by medical informatics research, to ensure an efficient, medically advanced and yet affordable future health care system? Three factors will greatly influence the further development of information processing in health care within the near future: the development of the population, medical advances, and advances in informatics. These factors have motivated us to set up 30 theses for health care provision in the year 2013. The theses cover areas of health care, such as its people, its information systems, and its ICT tools. Three major goals requiring achievement have been identified: patient-centered recording and use of medical data for cooperative care, process-integrated decision support through current medical knowledge, comprehensive use of patient data for research and health care reporting. In consequence, political institutions should provide a framework for networked, patient-centered health care. They are called on to regulate the storage and exchange of health care data and of appropriate information system architectures. Finally, the health care institutions themselves must emphasize professional information management more strongly. Relevant research topics in medical informatics are: comprehensive electronic patient records, modern health information system architectures, architectures for medical knowledge centers, specific data processing methods ('medical data mining'), and multi-functional, mobile ICT tools.     

Commentary on 'health care in the information society. A prognosis for the year 2013'

The paper, entitled 'Health care in the information society-a prognosis for the year 2013' is in this commentary compared with previous relevant documents. In the paper quantitative prognoses are presented for each of 30 theses. Some developments such as the influence of genomic medicine on health care were not covered by the theses. ICT measures as suggested in the paper are quite acceptable but the paper does not mention side effects of ICT on health care and is therefore a bit unbalanced. As a reference, the Japanese grand design for information-oriented health care is also introduced.     

Knowledge management prerequisites for building an information society in healthcare

The European Research Area requires either technological development or information literacy of health professionals. This information literacy shall be understood much deeper and broader than a basic preparation to use ICT tools in everyday life only. The author's first aim is to present the literature review and analysis of different definition of the "information" concept in Polish and foreign sources for health sciences, to emphasize a problem fundamental for an information society development, i.e. lack of adequate "information" understanding. Health professionals' information literacy shall also build an awareness of conceptual differences among numerous classifications, thesauruses, and information-retrieval languages, which result in different information received in a retrieval process. This problem can be of crucial effect for either health research or practice. Understanding the problem shall mobilize the researchers, classifiers, and indexers to co-ordinate efforts aimed in organizing "a translator" covering the most popular classifications' and thesauruses' concepts, to make an international research co-operation easier, relevant, and safe for the patients.     

Prognosis for year 2013

New knowledge from biotechnology and new capabilities provided by the evolving global information infrastructure are already transforming health care. Three clusters of technologies hold particular promise: grid computing, intimate computing, and micro laboratory computing. The confluence of these technologies will change clinical laboratory equipment into portable devices, easing the administrative details involved in delivering care and ushering in a new age of monitoring clinical states. Two vignettes, an office visit and a clinical trial, are offered as prognosis for clinical care in 2013. New capabilities hold the power to transform health care, making it truly patient centered as the Institute of Medicine (IOM) has urged.     

The role of methodologies to improve efficiency and effectiveness of care delivery processes for the year 2013

This paper aims at further expanding the vision of future health care delivery systems presented by Haux et al. (2002). Starting from the observation that information and communication technology (ICT) is deeply transforming the shape of organizations as expected, we argue that the coordination of work activities is a fundamental need for any organization. This is even more important for health care organizations since there is an increasing pressure to increase quality of care they deliver without further increasing its costs. However ICT by itself will not cause the desired changes without rethining the way of managing best practice biomedical knowledge and care delivery processes. Thus the paper focuses on the need of developing intense research efforts in the fields of knowledge management and workflow modelling, which have been identified as fundamental to provide suitable solutions to the problems of designing and building innovative health care information systems. Moreover, the paper discusses the role of mobile communication systems. Moreover, the paper discusses the role of mobile communication and speech understanding technologies to support a satisfactory user-system interaction in daily work.     

Allergy to ortho-phthalaldehyde in the healthcare setting: advice for clinicians

This study summarizes and reviews the available health information on ortho-phthalaldehyde (OPA), a recently introduced and widespread disinfectant for heat-sensitive medical equipment, particularly focusing on its possible immunological effects in the healthcare setting. OPA properties derived from laboratory and clinical studies, and in vivo and in vitro tests for the diagnosis of OPA allergy are described. The available evidence suggests the spreading of OPA as disinfectant in endoscopy units despite the little available scientific evidence on its safety. Indeed, some papers reported on serious adverse reactions to OPA in patients and, to a lesser extent, in exposed workers, and in vivo studies suggested that OPA is a dermal and respiratory sensitizer. Finally, until more definite safety data become available only suggestions on possible preventive measures can be provided.     

Body parameters of Czech breastfed children compared to the Czech references and WHO growth standards

Background: The study concerns the comparison of percentile curves of Czech breastfed children with Czech national references from 1991 and 2001 and WHO growth standards. Growth charts of breastfed children demonstrate different curve shapes, especially in the first months of life. Incorrect interpretation of the growth curve could lead to premature introduction of complementary foods or infant formula.

Aim: The comparison of four body parameters of Czech breastfed children with currently used Czech national references and WHO standards in order to recommend that Czech paediatricians use either Czech references or WHO standards in their practice.

Subjects and methods: Nine hundred and sixty breastfed children were included in the study of length-for-age, head circumference-for-age, weight-for-age and weight-for-length parameters. All percentile curves were compared. Values of the 50th percentile expressed in z-scores based on both Czech references and WHO standards were tested.

Results: The study confirmed results of previous surveys documenting that growth of breastfed children is specific. Nevertheless, percentile curves of growth parameters of Czech breastfed children are closer to Czech references than WHO standards.

Conclusions: The Czech national references fulfil the needs of Czech paediatricians (with pointing to specifics of breastfed child growth) and WHO standards are suitable, especially for international comparison.