ABSTRACT
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 662
Characteristics of the Healthcare Industry . . . . . . . . 662
The Healthcare Industry . . . . . . . . . . . . . . . . . . . . . . . . 662
Complexity of Science and Technology . . . . . . . . . . 662
Chronic Conditions . . . . . . . . . . . . . . . . . . . . . . . . . . 663
Organization of the Delivery System . . . . . . . . . . . . . 663
Information Technology . . . . . . . . . . . . . . . . . . . . . . 663
Consumerism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 663
The Healthcare Regulatory Environment . . . . . . . . . . . 664
Transaction Standards and Coding Sets . . . . . . . . . . 664
Privacy and Security . . . . . . . . . . . . . . . . . . . . . . . . . . 664
Healthcare Informatics . . . . . . . . . . . . . . . . . . . . . . . . 665
Consumer Health Information . . . . . . . . . . . . . . . . . . . 665
Interactive Health Communication . . . . . . . . . . . . . . . 665
Consumer/Patient Web-Based
Applications and e-Health . . . . . . . . . . . . . . . . . . . . . . 666
Provider Healthcare Informatics . . . . . . . . . . . . . . . . . . 666
Electronic Medical Records EMRs . . . . . . . . . . . . . . . 666
Computerized Physician Order Entry
Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 667
Patient Monitoring Systems . . . . . . . . . . . . . . . . . . . . 667
Imaging Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . 667
Information-Retrieval Systems . . . . . . . . . . . . . . . . . 668
Decision-Support Systems . . . . . . . . . . . . . . . . . . . . . . 668
Clinical-Decision-Support Systems . . . . . . . . . . . . . 668
Patient Decision-Support Systems . . . . . . . . . . . . . . 668
Patient Preferences . . . . . . . . . . . . . . . . . . . . . . . . . . 669
HCI Challenges in Patient DSS . . . . . . . . . . . . . . . . . 669
Evaluating Computerized Healthcare
Applications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 669
Future Opportunities and Challenges . . . . . . . . . . . . 674
Supporting/Enhancing the Patient-Provider
Interaction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 674
Supporting/Enhancing Collaborative
Work Among Providers . . . . . . . . . . . . . . . . . . . . . . . . . 675
Developing and Utilizing New Information
and Communication Technologies . . . . . . . . . . . . . . . 675
Designing and Utilizing Adaptive HCIs . . . . . . . . . . . . 675
Moving to e-Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . 675
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 676
U.S. healthcare expenditures were nearly $1.7 trillion in 2003 and were expected to grow to $2 trillion by 2005 (BlueCross BlueShield Association). Despite such large spending, many Americans remain uninsured and do not have access to healthcare services. Furthermore, while our country has the most formidable medical workforce in the world and develops and uses the most modern medical technologies, the World Health Organization (2000) recently rated the quality and performance of the U.S. healthcare systems as being worse than most of its counterparts in the western world. Chassin, Galvin, and the National Roundtable on Health Care Quality (1998) documented three types of quality problems: (a) overuse, (b) underuse, and (c) misuse. The results of an extensive review of over 70 publications covering years 1993 through 2000 provide “abundant evidence that serious and extensive quality problems exist throughout American medicine resulting in harm to many Americans” (Institute of Medicine, 2001, p. 24). In its first report, To Err is Human, the Institute of Medicine (2000) reported serious and widespread errors in healthcare delivery that resulted in frequent avoidable injuries to patients. The Institute of Medicine (2001) suggested four key underlying reasons for inadequate quality of care in the U.S. healthcare system: (a) the growing complexity of science and technology, (b) the increase in chronic conditions, (c) a poorly organized delivery system, and (d) constraints on exploiting the revolution in information technology.
