A need for information professionals / by Denis Protti

A need for information professionals by Denis Protti A health information professional must understand why information is important before using a computer to process it and communication technology to transmit it. B A health care system is a complex network of integrated, though largely autonomous, public and private sector components. These include indi- viduals, institutions such as hospitals, community health agencies, occupa- tional health departments, public health departments, clinics and doctors' offices, laboratories, medical, nursing and other health professional schools, accrediting and licensing bodies, local and central government bodies and vendors of goods and services. All of these organizations use in- formation to support decisions about health promotion, disease prevention, prov1s10n of care, monitoring, evaluat- ing and controlling health care re- sources, planning and formulating policy, and advancing knowledge through education and research. Information systems and the applica- tion of information technology are an extension of the study of organizations, organizational functions, and manage- ment. The most outstanding features of any information system are its emphasis upon the flow of information and the impact it has on the people who use it. Health Information Science, as a field of study, is particularly concerned with the effectiveness of these information flows within health care organization. So what is the role of a Health Information Professional, and how does he or she become an integrated member of the health care team? Such a profes- sional is concerned with the nature of information and information processes in a health care setting; the organization of information and its effect on the performance of health care delivery; the communication of information between individuals, health care providers, administrators, evaluators, planners and legislators; and the behaviour of these participants with respect to the generation and use of information. Not once has a computer been mentioned - nor should it have been! To be effective, physicians must under- stand why a stethoscope is important before they can use it as a diagnostic tool. Engineers must understand why a steel beam of a certain type can only withstand certain stress or certain con- ditions, before they can build a bridge. In a similar fashion a health information professional must understand why information is important to someone before starting to use a computer to process it, and communication tech- nology to receive or transmit it. One cannot over-stress the importance of understanding one's environment; understanding the people involved, their roles, their background, their values; understanding the organization, its structure, its history, even its politics! Health care is acknowledged by almost everyone who has worked in the field as the most complex system in society. After all, how many industries deal with life and death? How many industries deal with a product that cannot be defined? Or operate in an environment that has, for the past 40 The proceedings of this meeting during this year's World Health Assembly in Geneva were put straight into the word-processor by a skilled secretary. years, virtually ignored costs, an industry which virtually has not had a bottom line? How many industries deal with the unique situation that the individuals responsible for the majority of the costs do not even work for the company? How many industries have regular customers who do not pay for the products they receive? Until one has been taught or has spent a number of years working in the system it is difficult to understand why sound management principles which have been proven in the private sector and other public sector agencies simply do not work in health care. Only recently have health care organizations begun to view informa- tion as a corporate resource. Only recently have hospitals begun to realise that 40 to 50 per cent of their operating budgets are for the processing of data. Only recently have provincial ministries of health begun to realise that they are spending billions of dollars moving data around in the health care system. And only recently has health care begun to accept the notion that information is indeed a valuable resource which, like other resources, must be planned, managed, conserved, recycled and © protected. ~ Health care systems are gradually ~ recognising that they are indeed in the information business; that information is an essential commodity; and that in- formation is a key ingredient to being successful. Health care is gradually recognising that it needs someone to establish and implement a long range information systems plan which is consistent with the organization's objectives and direct- ion. That person has to determine the investment to be made in information technology and provide a rigorous and disciplined framework for evaluating information benefits versus information costs; anticipate and understand the consequences of new information tech- nology; and plan and coordinate all information resources within the organ- ization - not just computers. Even more important, such a person must explain the impact of information technology to staff at all levels of the organization. A multitude of forces - for instance, an aging population which is living longer, and a doubling of medical knowledge every five years thus forcing health care disciplines into more and more specialisation which fractionalises care and complicates communications - are generating increasing demands for more reliable and timely information, WORLD HEALTH, August/September 1989 and more effective systems to collect, process and distribute data. Health care services need information systems which enhance the operating efficiencies of their organizations and help to determine the efficacy of their pro- cedures. In turn this calls for individuals who truly understand the information needs of the many people dedicated to the delivery of care, the promotion of health, the prevention of disease and the postponement of disability. • Schoolchildren in many countries are already learning computer skills as part of the regular curriculum. 27