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 Chapter 8:  The Internet & Health Information Systems




Information is a valuable commodity and the judicious management of it determines the decision-making process in an information-intensive field such as in the health sciences. More specifically, veterinary medicine as a profession must initiate innovative academic information systems which are wisely conceptualized and structured to improve access and to manage the overload caused by the continuing expansion of knowledge so profound in medical sciences. Incorporating new technology and current information into the curriculum and making it available for biomedical research, health care service and teaching is a costly undertaking, but a necessary one.

Optimal health care delivery is conditioned upon a well designed and managed problem solving-process which consists of: a) problem identification and definition so as to establish the diagnosis of a health problem; followed by, b) delivery of appropriate health care to resolve the health problem.

This is a decision-making process which is governed by the availability of appropriate information at the time needed. It entails: a) data acquisition - the collection, retention, retrieval and processing of a large amount of biomedical information pertaining to a wide variety of animal species, b) acquisition and representation of the corresponding biomedical knowledge in a format that would enable the extraction of the most relevant information needed for diagnosing and managing health problems. Since such a task is complex and dynamic, it is necessary to keep current with new information to be coupled with the more or less established body of preexisting medical knowledge.

The goals of health care delivery could be categorized into three areas, viz. therapeutic, preventive, and health maintenance and promotion. Whatever one does in health care delivery in each of these three areas is a result of a scientific endeavor which must integrate and interrelate the teaching and research activities of the biomedical sciences. More formally:

Service = f (teaching, research).

A brief examination of teaching and research as determinants of appropriate health care delivery is necessary. A major problem in health education is the explosion of knowledge. The generation of new knowledge has continued its unrelenting course, doubling at least every ten years. The world's knowledge base is shifting inexorably from a paper to an electronic base. New ways of synthesizing, compacting and representing knowledge are developing. The challenge, therefore is to apply new technology appropriately so as to make new and better uses of the knowledge base that is available.

But currently, biomedical education relies mainly on human memory-oriented training focused on good performance at selected cross-sections of time such as on national and speciality board examinations. Obviously, the human memory has limits in its capacity to store and recall scientific information.

Clearly then, a revaluation of the memory oriented medical education system is a prerequisite towards appropriate health care delivery. The second determinant, research, which broadly includes all observational experiences, formal and informal, is the source of cumulative medical knowledge. Such preexisting knowledge, generally massive in content, rich in diversity, sometimes plagued by contradictions, should be brought to bear to solve health problems.

The task the health care provider faces then is how to make the best possible decisions to provide optimal health care in the face of constraints which are products of educational system which currently depends mainly on human memory with its inherent limitations; and the need to process and evaluate a massive body of preexisting biomedical knowledge.

As if by fate, the medium which could provide the best solution to such problems is currently available in the form of computer technology. Recognition for use of computers in health care delivery in a carefully planned and judicious manner is certainly a must. This paper is intended to bring out some of the significant considerations for the use of computers in veterinary medicine.

Some Background on Computers

A computer is an electronic machine which has the capability for storage, processing and retrieval of information which could then be used in problem solving and decision making. Basically, the computer is composed of three parts and these determine the way it operates. These are: the hardware, the software, and human-ware. The human component makes the two operational. There are basically two functions that a computer system performs viz: a) manipulation of data for scientific computations and/or, b) manipulation of files for record keeping.

Both of these could actually be classified as information processing- a contemporary phrase with many meanings but one which refers to the storage, processing, analysis and display of information needed by individuals and/or organizations. This basically is the area of data base management systems. Nowadays, computerized data base systems are used by doctors, lawyers, students, consumer and others to enhance their informational needs and requirements.

Great advances have been made in the application of information technology in health care and delivery of health care based on determined work spanning the last two decades. There are many examples on the use of computers in human medicine, but only a few prominent ones will be selected. Today, the conversion from analog to digital information (such as ECG, EEG) could be accomplished essentially in real time although a few years ago such a task was frustrating and time consuming. Using artificial intelligence and other sophisticated programs, diagnostic consultative aids and many other decision - making support systems have been developed.

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