Current Technology Is Inadequate For Bioterrorism Response
A study of health care technology released this summer concludes that while information technology could help clinicians respond to bioterrorism events, current IT systems are inadequate to meet those challenges.
The report, “Bioterrorism Preparedness and Response: Use of Information Technologies and Decision Support Systems,” was released in August by the Agency for Healthcare Research and Quality (AHRQ), part of the Department of Health and Human Services.
According to the report, information technology and decision support systems (software that analyzes data and attempts to predict the impact of an operations decisions) have potential to help clinicians and public health officials respond to a bioterrorism event. It adds, however, that most of these systems were not designed to deal with bioterrorism, and they have not been adequately described or “evaluated rigorously.”
Part of the problem, according to Eduardo Ortiz, a physician who is a senior service fellow with AHRQ, is that “health care in general lags way behind other [industries] in the use of information technology.” The other part is that until recently, the United States had not experienced a significant bioterrorism threat, he says.
“That didnt surface until the anthrax scare,” Ortiz says. “Then people said, Oh my God, were really not prepared to respond to this kind of thing.”
Ortiz also points out that communication between disparate computer systems “is a big issue in public health.” Most public health agencies, he notes, “dont have sophisticated IT systems running. Even when places do have IT systems, most tend to be stand-alone systems that just work in the county or state; they dont cross state lines.”
The bottom line, he adds, is that “the majority of health care systems are not up to speed. They speak different languages.”
In an effort to remedy that situation, AHRQ is working with other health care organizations to get common standards for electronic communication, says Ortiz. The need for standards, he notes, “is one of the key things that everyone is finally recognizing. When I call something anthrax, any system has to recognize it as anthrax.”
He adds that privacy safeguards, in compliance with the Health Insurance Portability and Accountability Act, also need to be part of the standards equation.
In terms of decision support systems (DSS) for use in bioterrorism events, Ortiz says this is something his agency has been working on. “Theres so much information out there all the time; it really overwhelms the capacity of the human mind,” he explains. “Smart systems help you make decisions and they recognize things that you might miss. They can detect patterns that a human may not [normally] detect. Such a system could also prompt me and let me know that [a situation] could be bioterrorism-related.”
Decision support systems, according to Ortiz, “harness the power of computers, which dont forget. Weve seen that they help physicians make better decisions.”
The AHRQ study noted that three of the general diagnostic DSSs it evaluated “typically performed better than physicians in training, but not as well as experienced clinicians.”