Abstract
The authors review telemedicine and e-health from an organizational perspective. To evaluate their effectiveness, they review organizational and system theory along with field and laboratory results. Theory of the conservation of information (COI) provides the means to study tradeoffs across space and over time as telemedicine and e-health management make operational decisions for virtual communities users. With the authors’ three case studies, they evaluate COI for telemedicine and e-health networks operating in the state of Georgia. After analyzing the case studies with COI, the authors close with a review of future trends that includes an interaction rate equation, an agent-based model (ABM) using natural selection (machine learning), and a Monte Carlo simulation of return on investments (ROI).
TopBackground
Digital technologies are transforming many areas of human endeavor from commerce and entertainment to government and communications (Miller & West, 2006). Policymakers are emphasizing Information Technology (IT) for healthcare to improve service delivery, promote efficiency, educate consumers, and increase satisfaction. But other than gathering information from websites, few people are using IT to communicate online with health care personnel or to purchase medical services. This digital divide has impeded e-health’s acceptance. Less well educated, lower income individuals in rural areas use the web less often for health care than better educated, higher income urbanites. To gain the benefits of IT for healthcare, it needs to become more widespread and its benefits more evident to consumers of all types across the country.
Medical care depends on physicians to collect and process patient information (White, 2008). But increasing knowledge requirements for patients and doctors, the need to evaluate populations of patients whether treated or not, unmet healthcare expectations, the costliness of fragmented care, and the rising demand for chronic disease care challenge traditional healthcare models that refinements alone may not solve. Healthcare IT is the best option for future medical progress. According to Lucas (2008), IT includes computer-aided diagnosis and treatment monitoring; telemedicine; and IT to inform the public and physicians on health and healthcare. But incorrect beliefs about IT pose a deterrent to telemedicine. England and Stewart (2007) warn that even senior healthcare executives hold beliefs inimical to the increased adoption of IT in healthcare.
Key Terms in this Chapter
Virtual Healthcare Teams: Virtual healthcare teams are professionals who collaborate and share information on patients with digital equipment.
E-Health: E-health is at the intersection of medical informatics, public health and business, health services and information delivered over the web. It characterizes technology, a way of thinking, and a commitment for global healthcare action. eHealth conveys the promises and excitement of bringing e-commerce to health care.
Web Medicine: The future Semantic Web includes a Health Care and Life Sciences Interest Group to establish interoperable data standards for “connected knowledge” to collaborate across health care and life sciences. The goal for HCLSIG is to reduce medical errors, increase physician efficiency and advance patient care and satisfaction. It includes document annotation and rule processing.
Conservation of Information (COI): The conservation of information (COI) concept is derived from signal detection theory (SDT) based on duration-bandwidth tradeoffs: The shorter the duration of a signal, the wider becomes its bandwidth and vice versa. To extend COI to organizational performance and to mergers and acquisitions (M&A), an organization can focus its attention (e.g., situational awareness) on a narrow business model to increase its rate of plan execution or the inverse.
Conservation of Information for Organizations: A worldview reduces multiple interpretations into a single, stable perspective of reality. However, COI acts as a tradeoff in attention directed at reducing uncertainty in one of two interdependent factors, such as a worldview or business model or military plan of action, increasing uncertainty in its interdependent factor, such as opposing worldviews or an action taken in agreement with a worldview or the execution of a business model or the locations of a military plan’s chain of sequential or interdependent events. COI indicates that the more focused is a collective on acting out a series of steps, the less attention it has available to be observant of all of its actions. Applied to organizations, COI forms a causal path for different cultures based on multiple interpretations of the same worldview or business model or military plan of action. Four interdependent factors exist. COI links organizational uncertainty between planning and execution as well as between resource availability and the duration of a plan’s execution.
Telemedicine: Telemedicine is the use of telecommunication channels to provide medical information and services. The simplest form of Telemedicine is used daily by most health professionals as they discuss a case over the telephone. More sophisticated Telemedicine applications used by the military and some large medical centers include: using satellite technology to broadcast a consultation between providers at facilities in two countries; videoconferencing equipment; and distance-robotic technology. Bandwidth in the telemedicine system determines its constraints. More bandwidth generates higher costs but more capacity for real-time images, video, and higher quality resolution. The qualities of transmission issues of importance to medicine are sound fidelity, image resolution (spatial or contract), range of motion displayed, and transmission speed. The future semantic web could be telemedicine’s answer to the need for high-speed transmission of high quality video.
Organizations: Multi-tasking for individuals produces poor results. However, organizations are designed to multi-task. Organizations perform a function which cannot be done by an individual alone by assigning interdependent roles to a set of independent individuals, but making them interdependent requires information coordination, channeling and blocking to form its members into a multi-tasking collective that amplifies the capabilities of a single individual. An organization is functional when its operational costs are less than the benefits it accrues and provides to its members. It is likely constructed around a geospatial centroid about which its business attributes are centered, planned, modeled, and executed.