How may ICT be used for development in the field of Medicine?

Introduction

Information and communication technologies (ICT) has transformed the ways modern healthcare systems acquire, store, access and communicate medical information. These developments offer significant benefits to patients and healthcare providers, but they give rise to ethical and legal challenges in the protection of patient privacy and confidentiality. One effective approach to continue the use of ICT in medicine while minimizing its potential hazards is through legal reforms and setting public standards for accessibility and expression of patient autonomy.
ICT has, in the last few decades, become so well assimilated into healthcare delivery systems that few doctors can imagine a day without using the computer or the network Two areas of medical practice have been particularly revolutionized by computer technology: the acquisition and storage of electronic medical records, and the accessibility and rapid transmission of healthcare information over the internet.ICT has also helped in enhancement of healthcare administration and management through medical information systems, establishment of information “health profiles” and decision-support systems on regional, national, rural, and district levels, linking health centers, delivery services and medical transport to patients, improving access to skilled diagnosis through tele-medicine and also improving distribution and reducing costs of medical supplies.
ICT revolution and medical technology have transformed health systems worldwide technological developments- wireless and satellite systems, broadband communications, better access to services and increasing digital processing power and storage capacity. Health is an information-intensive sector and ICT has transformed health information systems to knowledge-based systems according to world health organization (WHO) 40% of health is exchanging information.
ICT has had a huge impact on health sector some of them are as follows:

  • Health profiles
  • Access to diagnosis
  • Effective medical planning
  • Health education and training
  • Drug supply and inventory tracking
  • Treatment procedures and protocols
  • Health care resource tracking and support in remote areas

ICT has helped in development in the field of medicine in developing nations particularly African nations like Ethiopia, Ghana, Sudan ,Kenya etc and the process is ongoing and many more initiatives have been undertaken to improve health facilities particularly in the third world developing nations.
For example in Africa doctors have started to use handheld computers for the purpose of:

  • Diagnosis
  • Medical reference
  • Billing
  • Patient management
  • Drug dosage calculations
  • Disease surveys

But there is another aspect of using ICT in medicine i.e. critics have raised ethical issues one major ethical conundrum in using ICT in medicine is inevitable increase in the vulnerability of patients’ privacy and confidentiality. As the healthcare industry becomes increasingly driven by fiscal considerations we will see an increase in the utilization of ICT to acquire, store and disseminate healthcare information in cost effective manner. There are concerns at unprotected accessibility and potential abuse of confidential medical information although confidentiality issues have long existed before the arrival of the computer and internet, the use of IT that is capable of transmitting large amounts of data in very short time intervals, and of bypassing the conventional physical barriers and safeguards, certainly heightens public anxiety. But as the benefits of ICT in medicine are deemed too good to forego, then one effective approach as suggested by some experts would be to manage the utilization of ICT in medicine through the use of legislative and regulatory measures they suggest looking into legal reforms to enhance the privacy of health information, for example, empowering patients with rights to consent to disclosure, laws to limit disclosure when consent is absent, incorporating industry-wide security protections and establishing a national data protection authority in addition minimal privacy standards that protect individual autonomy yet take into account public health concerns should be established to guide the electronic collection and accessibility of personal healthcare information.
Another problematic area is in the communication between physician and patients via emails. This form of clinical interaction is asynchronous, lacks human touch, legally ambiguous, but equally costly in terms of time and resources, and is fragile in terms of privacy and confidentiality. Even systems with audio-visual and real time capabilities such as teleconferencing also precludes sensory modalities such as smell and touch which can be vital in the assessment of patients. Most importantly, it erodes the humanistic nature of doctor-patient interaction and deprives patients of physician’s healing touch, which can only be delivered through a person-to-person encounter. Electronic communication should therefore be used judiciously and cautiously as an adjunct to clinical management.

Objectives

Some of the important objectives of this project are as follows:

  • The primary objective is to explore that how information and communication technologies are helping in advancement and development in the field of medicine.
  • Study and explain various important applications of ICT in the field of medicine for example the most important one are telemedicine which helps in facilitating the distribution of human resources and professional competencies and also patient records, equipment, research, web-based diagnosis etc.
  • Fast and easy access to updated and latest information regarding information and communication technologies in medicine.
  • To explain some advanced applications of ICT like “Remote medicine” and telemedicine in areas of disaster.
  • Another important objective of this project is to study the effect of ICT on health facilities in developing countries particularly the African countries such as Ethiopia, Uganda, Tanzania, and Kenya etc.
  • To study and explain different other projects on ICT in medicine like the “Health ware project” in Europe and also the XHOME project to explore ICT health and living in Netherlands.
  • And last but not the least to study different problems faced by health sector in Pakistan and how ICT can help in improving health facilities in Pakistan particularly in the rural areas.

Project Details:

Some of the important project details are as follows;
ICT is helping greatly in the field of medicine and helping improve health care delivery facilities worldwide particularly in developing nations as the main challenges of developing nations are epidemics, spread of infectious diseases, Aids highest infant and maternal mortality rate lowest level of life expectancy in the world and lowest world ratio of doctors per capita.
Now ICT can help solve these problems through enhancement of health administration and management through medical information systems by improving distribution and reducing costs of medical supplies. The beneficiaries are definitely the society and health care providers as they can establish and maintain databases on public and private medical centers. Provide on-line access to national and international medical databases and expertise. Health care providers can link health care systems with centers for disease control and for early warnings of plagues and infectious diseases and also link health care systems with insurance companies, medical practitioners, and the public. ICT can help reduce child mortality, improve maternal health and combat HIV/AIDS, malaria and other diseases.

ICT in Health Education:

Information and communication technologies are also helping greatly in health education they have become a basic tool in development of education and access to information. ICT can advance development of HIV/AIDS related education by providing a platform and tools for access to information and resources. ICT can help create everyday knowledge about disease, its cause, symptoms, consequences and management. ICT can also help create training programs on prevention, care, support and treatment on HIV/AIDS for front-line health workers. A comprehensive approach in access to prevention services and culturally sensitive interventions is paramount to fighting the disease ICT can help broaden this approach Access to information is only the beginning of a good HIV/AIDS prevention movement it is well accepted that active engagement and interaction with issues, and not mere absorption facts, allows for personal meaning and deeper learning of information. Creating an interactive approach through web-based content, email, chat services and conferencing in issues surrounding AIDS helps in advancement of knowledge and skills. From a health communication perspective, “e-health” applications- interactive websites providing tailored health information and other services to users can be effective in helping people manage diseases, access health services, and obtain social support or provide assistance in changing behavior.
ICT based programs also provide the option of remote, distant delivery of health care services, despite physical barriers and time zones offering a cost effective way to build knowledge and skills. However, it is important the approach to prevention services using ICT is culturally significant. HIV/AIDS educational campaigns which take a “one-size-fits-all” approach do not work. Attitudes and methods used for one community will not necessarily work for another. ICT-related programs derived from cultural-specific worldview and practices will be more readily accepted by a community.

Impact of ICT on Health in developing nations:

ICT has helped improve medical and health care facilities in developing countries for example in Kenya telemedicine has been used effectively in following ways;

  • Transmission of medical data and images
  • Tele-expertise and tele consultation
  • Video conferencing and online medical consultancy
  • Medical distant learning accessing lectures online and conducting live online lectures
  • Training of health workers by effectively using ICT

Health workers can effectively use ICT in following different ways:

  • Access to medical databases
  • Sharing valuable information with other health workers
  • Discussion groups
  • Online publishing

General public can also have following benefits by using ICT some of them are:

  • Directory of health centers and pharmacies
  • Health education
  • Health alerts on different deadly diseases, epidemics and ways and means for heir prevention and cure
  • Weekly report on disease control with a special list

In Uganda personal data assistants (PDAs) also known as a palmtop computer many of them employ touch screen an important use of PDAs is synchronizing data with a PC. Its advantage is that it prevents loss of information they can collect data quickly they are effectively used in Uganda in following ways:

  • Conduct an epidemiological survey on malaria
  • Use medical reference tools and texts in their daily medical practice
  • Collect field survey information

Personal data assistants proved to be viable and useful in following ways:

  • Effective tool for collection of health data and information dissemination.
  • Medical reference materials available on PDA can help improve the provision of health care.
  • Appropriate technology for use in African context
  • Inexpensive alternative to PCs in terms of computer power per dollar
  • Simple to use, easily integrated into the daily routines of healthcare professionall

Synchronizing onto a central data system is simple and convenient

  • It is quite easy to use by users and project managers.

Important applications of ICT In medicine:

There are many useful and innovative applications of ICT s some of them are:

  • Tele medicine
  • Medical equipment
  • Web-based diagnosis and support
  • Patient medical records
  • Communication
  • Research

Computers are being increasingly used in medicine. They assist in many different aspects of medical world. From things like operation equipment to filling systems with the help of computers machines may help to determine the diagnosis and treatment of patients, but they have defects and can break down. Some medical equipment reply on computers because they change the data into format we can read. Some examples of these are CAT and MRI scanners and imaging devices. ICT also help in operations computer guided lasers have been used in operation theatre, and they are used for removal of brain tumors as well. Support devices are controlled by microprocessors. Pacemakers are an example of this; they are used to maintain a patient’s heartbeat with the use of computer.

Web-Based diagnosis:

Web-Based diagnosis and support is also an application of ICT in medicine which includes access to medical journals/research. Symptom diagnosis of patients can be done y patients themselves by identifying their problem with web-based support without having to go to a doctor. Details and information about any treatments or alternative therapies are readily available on the internet diagnosis is aided by expert system information about possible side effects are also available on the internet, Although there are a lot of advantages of using web-based diagnosis and support, not all of them are reliable and trustworthy. This can lead to false information about diagnosis and treatment which could cause anxiety but overall it is immensely useful and productive

Electronic Medical records

One very productive and time savingapplication of ICT in medicine is patient medical records as over a period all patient medical records are gradually being stored in digital format this is helpful because data will be stored in better way and it will take up much less storage space it will be quicker to access required files and data medical conditions can be determined by the examination and analysis of any relevant data. With the help of ICT transfer rate of any and all records between hospitals is quicker and help in saving precious time

Telemedicine:

Communication is also helpful in medicine with the help of teleconferencing, surgeons, for example in one country can be helped by other surgeons in another country. Teleconferencing is a good and reliable way to share expertise. Hospitals can keep in touch with wireless transmission. This helps the medical personnel and the transport workers, and helps them all to stay in touch with the hospital as well. This is also known as field care an example of this is that injured patient has a PIC around his neck which monitors the patient and medical personnel have hand-held PDAs with which they enter information about the patient and conditions of different other patients this helps to get an accurate record of patient’s symptoms and condition.
Conditions such as skin cancer can be seen remotely on a consultant’s screen, while data from heart monitors and x-ray images can be assessed thousands of miles away from patient one very positive and promising use of telecare is that it allows the elderly and more vulnerable people to be treated and cured without having to go into a residential home, and they get to stay within their own home. ICT is helping people take control of their own health advances in telecommunications are revolutionizing the health sector remote diagnosis can be used to diagnose and treat patients remotely patients can self monitor themselves at home wireless transmission provides a vital link between paramedics and hospitals.

Research:

ICT has also revolutionized the way research is carried out in medicine the method of trial and error is how most drugs are developed, but now drugs can be designed to do a specific job. This involves analyzing the atomic structure of the target, and developing the drugs to attack a specific compound structure. This is possible by the use of advanced computer technology.

Remote Medicine:

An advanced application of ICT in medicine is in “remote medicine” an American robotics company has recently designed a 5-ft tall remote controlled “robo-doctor” which is able to move around the hospital wards from bed to bed, soothing patients and listening to their symptoms. It is done with the help of webcams, micro-phones and speakers in the robot which are linked to a real doctor who is located in any office somewhere in the hospital while the robot faces the patient, the face of doctor is displayed on a video screen so that the patient can see it and be able to talk directly to the doctor ‘remotely’. After a consultation has taken place, the doctor can guide the robot with a joystick and move it on next patient in a nearby bed. So the advantage is that no nurse is needed and no requirement for a personal visit by the doctor at this early stage. There are a lot of advantages associated with such an idea some of them are:

  • It may be seen as a possible solution to the growing shortage in the number of doctors in hospitals.
  • Such robots could be used to monitor patients who are bed-ridden or disabled and who are resident in long-term health facilities.
  • Clearly, such a system saves medical travel time whilst maintaining personal contact between a doctor and a patient.

The first prototypes of these robots have appeared in American hospitals where, much to the amusement of all, they have been rolling down corridors, visiting patient’s rooms the robot is powered by rechargeable batteries and moves smoothly in any direction on three computer-controlled rollers. It is weighted at the bottom, making it hard to knock over if crashed into by porters wheeling a trolley or the like. Doctors also insist the robots are proving useful as they don’t have time to run up to the patients every time someone has a problem but they are not likely to be cheap.

Telemedicine in disaster areas:

Telemedicine in disaster areas is also an advanced application of ICT in medicine. Rural and isolated areas ships navigating in wide areas are common examples of possible emergency and disaster sites. In emergency or disaster sites where medical treatment is the issue studies show that early and specialized pre-hospital patient management contributes to patient’s survival. Mobile telemedicine package has been developed to collect and transmit real-time, far-forward medical data and to assess how this improved capability enhances medical management in disaster areas. Telemedicine projects targeting disasters have been started and during the most recent tragic disaster in Asia telemedicine have been put to action to help victims along the coastal areas ravaged by tsunami with the mobile teams of rescue workers connected with the hospital via satellite greatly helped in medical care.

ICT in medicine Projects:

Healthware Project:

ICT has been used very effectively in medicine by another project in Europe known as the “Health ware project”. It addresses the development of end to end satellite telecommunication systems for telemedicine applications. The project is built on four steps approach:

  • Analysis of users and services requirements
  • System specification and architecture design
  • Industrial test bed integration and validation
  • Pilot deployment, usage/validation and evaluation

It focuses on development of end to end telemedicine solutions/services over satellite technology this project has following information and communication technologies focus:

  • Design a modular, standard based and interoperable platform.
  • To achieve large scale pilot deployment and validation over networks managed by medical users.
  • To identify options that will allow turning the healthware solutions/services into sustainable ones.

The healthware project uses DVB-RCS technology it is a mature and fully operational technology it offers powerful solutions for access and transmission over satellite from anywhere. It also supports interactive multimedia applications and high quality video based applications. This technology is ground network independent.
This project has following medical focus on three conditions:

  • Chronic respiratory diseases
  • Heart problems
  • Oncology (it is a branch of medicine that studies tumors )

The healthcare program in Europe has four preferred applications:

  • Monitoring and remote assistance to patient located in isolated areas and areas with poor telecom infrastructure.
  • Medical knowledge dissemination towards medical staff, nurses, auxiliary nursing staff.
  • Interactive video-communication between specialists and document sharing.

XHOME Project:

The second project which will be discussed regarding ICT in medicine Is XHome project carried out in Netherlands. The XHome project has the details of an analysis of trends, players and in the health care sector with respect to information and communication technology (ICT). It addresses the usefulness of broadband services in health care fields deemed immediately relevant to the patient at home. Some of the findings of this project are as follows:
Computerization of health care involves technology; ICT in particular ICT is used in health care sector in following ways:

  • ICT supports management processes and supply chain management to meet patient demand for flexibility, accessibility and continuity.
  • ICT has helped in decision-making and knowledge transfer to deliver transparent, effective, reliable and transparent care.
  • ICT supports the integration of medical equipment to deliver care outside of the hospital environment.
  • In addition to ICT ‘assistive technology’, robotics offer possible opportunities to enhance self-sufficiency and the ability to care for oneself at home.
  • Another aspect includes health care at a distance. This offers opportunities for sensor technology, image and speech connections, both broadband and mobile for long term home care and post-operative support.
  • Precision medicine is also an aspect which entails reducing patient hospitalizations as much as possible.

Some of the key findings of this project regarding ICT in medicine with respect to Netherlands are that ICT in health has two applications namely ‘primary care’ and ‘secondary care’. Primary care involves direct patient care, communication with patients and about patients between specialists. Secondary care involves the organization of health services, administration, logistics, finance and patient information, as well as co-operation between health professionals. A major problem with secondary care is the incompatibility of different systems (hardware and software) .Heath care professionals using different systems is unable to exchange information. This incompatibility is not a technical problem as such, but rather an organizational one. An effective system of secondary care should increase the transparency and effectiveness of health care system and ICT can help immensely in improving secondary care and thus improving health facilities in Netherlands.

Impact of ICT on Medicine in Pakistan:

Pakistan is a developing country with more than 60% of its population residing in rural areas with insufficient health care facilities. The recent advancements in telemedicine provide a significant opportunity to the developing countries to develop a health infrastructure that addresses the needs of the rural population.
In the developing countries the importance of network-based medical system is manifolds because they could act as a catalyst for providing basic health services to the patients who live in underprivileged/underserved rural areas, where health care facilities are either non-existent or of extremely poor quality. The patients in these areas have to travel great distances over a highly inefficient transportation system to reach the nearest health care center. Consequently, a large number of patients die mostly in emergency scenarios. This phenomenon is particularly evident by a very high Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR) in Pakistan. The current medical statistics clearly indicate that the situation is catastrophic. The gravity of the problem is further aggravated due to the scarcity of skilled health care staff.
The prevailing situation clearly indicates the failure of the current health infrastructure of Pakistan. There is a dire need of revamping this infrastructure by utilizing ICT as an enabler. In Pakistan the field of telemedicine is relatively new. Elixir Technologies introduced the concept of Telemedicine first time in Pakistan in 1998. Telemedicine provides the inexpensive way of delivering specialist healthcare facilities to the large population residing in rural areas. However, the people still need to travel to nearest health centers where the facility of video conferencing was made available. Consequently, women population mainly did not use this facility due to the prevailing culture and the socio-economic factors related to taking a day off from their routine job.
Information and Communication Technology (ICT) can help develop a monitoring system that could enhance the quality of health care provided by the lady health workers (LHWs). This would help in saving lives of mother and child; reduction of MMR and IMR. This can be done by creating an automated patient monitoring system for antenatal care of pregnant women in remote areas.

Conclusion:

Some of the important conclusions drawn from the study are;
The development of mobile communications, teleconferencing facilities, multi-media capabilities of telecommunications and the internet, has been of immense benefit in healthcare delivery. By this revolution, special differences between medical specialists and patients have been eliminated. ICT permits valuable professional expertise to be made available to remote areas so as far as medicine is concerned ICT can play a vital role in improving health care facilities specially in developing countries and help decrease the maternal mortality rate (MMR) and infant mortality rate (IMR) and besides ICT can be helpful for lady health workers to effectively use personal data assistants to increase their efficiency and help improve health facilities in developing countries.
As first aid can be vital for the survival of patient a doctor can move freely with his mobile and can easily be reached in case of emergency, to give initial instructions on how to manage while he is on the way to hospital.
ICT is immensely helpful to setup patient monitoring system which enables the doctor to monitor patient at a remote location. It can also be advantageous for exchange of information between health professionals for development in medicine with the help of. With broadband facility and video conferencing, doctors in one part of the world can consult with each other on medical issues.
ICTs also offer a useful and powerful capability for simulation and modeling in medicine. Surgery can be made easy and more effective by giving surgeons to visualize the area of the body that will be subjected to the operation.
Hence, ICT by using ICTs the health situation primarily in developing countries can be improved immensely by using different applications of ICTs like telemedicine, web-based diagnosis, advanced research, electronic patient records which can save a lot of precious time and ICTs can also be useful regarding medicine in conflict zones and in areas of disaster.
So ICTs can help immensely for development in field of medicine but ICTs should be used intelligently and one shouldn’t be over dependent on ICTs in medicine the human interaction between doctor and patient should also be important as it gives the patient more comfort and healing touch and in diagnosis process physical contact between patient and doctor is also important for proper diagnosis and over dependence on email communication between patient and doctor can be a hurdle in proper communication and diagnosis and also electronic records of patients can also be a security risk i.e an anonymous person can view medical records of any patient without any trouble so measures should be taken to avoid this and legal amendments should be made to give the patient legal protection. But overall ICTs are very helpful for development in medicine if they are used intelligently.

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