This goal of this chapter is to introduce digital strategies for healthcare. The chapter begins with an analysis of key indicators of public health and the healthcare sector. Next, the chapter presents key principles for healthcare, focusing on the constitution of the national health system. A case study focusing on Poland is then presented. After this, the chapter puts forth a digital strategy for the national health system. This is followed by an analysis of several health systems: the patient information system, the clinic information system, the pharmacy information, and the hospital information system. Next, the use of big data for healthcare is considered. The chapter concludes by putting forth a model for the national health information system and by discussing important trends in the development of digital health.
TopIntroduction
At one time, 1000 years ago, human life expectancy was a surprisingly short 24 years. At the threshold of the Industrial Revolution in 1820, it rose to 36 years; it then reached 66 years after World War II and rose to 78 years for developed countries in 1999. This incredible extension of life expectancy—a more than three-fold increase—has been achieved thanks to the development of an economy that can develop medicine. Knowledge, including medical knowledge, has proved to be a great driver behind the development of civilization. It is worth noting that the developmental gap between the world’s leader, the United States, and Africa is now as much as 20 to 1. What is more, in 1000 CE, the currently developed states (belonging to Western civilization) were more impoverished than those in Asia and Africa (Maddison, 2003).
Nowadays, citizens not only dream but demand healthcare services that effectively take care of them so that they can achieve their ambitious goal of increasing their lifespan. The foremost precondition for long life is, of course, good health, without which other dreams are hard to realize. 2350 years ago, Aristotle claimed that people are stupid because they do not know the purpose of their lives; thus, they cannot make wise decisions in everyday life. Well, at that time, the average human lived less than 24 years, and their goals were to survive until tomorrow, not be killed, not die of hunger, and not fall into captivity. Now many people live up to 100 years, but they are “worried” about what to do with such a long life.
The computerization of health care may help humans realize their dreams of longevity; however, before such a strategy is developed, it is necessary to consider what it should be so as to assure the strategy makes sense and that the expenditures incurred have positive results. Therefore, in this chapter, we will first reflect on the idea of what health services are worth computerizing. Then, we will deal with strategic solutions for its computerization.
A model of the goals of human life (MGL) is presented in Figure 1.
Figure 1. A model of goals of life in the 21st century (The Targowski Model) (Targowski, 2013, p. 56)
As the hierarchy of goals in the MGL model shows, living a healthy life, after securing peace, is the basis for achieving several advanced goals in life; however, one must be wise to accomplish these goals, and there are questions surrounding our conventional wisdom of life:
Patient health and prevention should be at the top of every list for the state and society.
TopIndicators Of Health For The Public
Economic indicators such as GDP, the Consumer Confidence Index, and more than a dozen others dominate the assessment of the quality of life. These indicators are calculated and published daily, weekly, monthly, quarterly, or yearly. There are also several health indicators, which are updated and posted in cycles every a couple of months (e.g., child abuse), annually (e.g., life expectancy), or even every 2-3 years (e.g., infant mortality and number of youth suicides). Only some countries calculate and publish health assessments for their societies. Without this type of comprehensive public health assessment, the evaluations of the state of the economy are misleading. Today, unfortunately, there are countries where the economy is growing steadily, but where society is collapsing. Can politicians be proud of their policies in such a situation?
In the United States, one health index is the Index of Social Health1, published by the Institute for Innovation in Social Policy (formerly the Fordham Institute for Innovation of Social Policy). The index is based on 16 factors:
- 1.
Infant mortality
- 2.
Child abuse
- 3.
Child poverty
- 4.
Teen suicide
- 5.
Drug abuse
- 6.
School dropouts
- 7.
Average weekly earnings
- 8.
Unemployment
- 9.
Coverage of health insurance
- 10.
The poverty of the elderly
- 11.
Health insurance for the elderly
- 12.
Traffic deaths due to alcohol
- 13.
Homicides
- 14.
Distribution of food stamps
- 15.
Affordable housing
- 16.
Income inequality