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Sample on Quality Improvement Model


Medicine is information – intensive practice that requires sufficient, efficient and updated information flow between the practitioners and patients; medical practitioners themselves and the public at large to function. A Physicians job encompasses gathering, recording, reviewing and the management of information. Examples of such include taking customer information, consulting with other physicians, preparing diagnostic procedures, designing patient care strategies, performing research, analyzing test results, carrying out tests a among others.1 Among the several challenges encountered by medicine practitioners, the immensely increasing biomedical information is definitely one of them that should be looked at in order to achieve effective service delivery.2

In order to attain efficient service delivery, there is need for more than general database systems. Epidemiological and clinical research findings should be fully utilized so that the knowledge acquired from these studies can be applied. This underlines the significance of informatics in   future and current medical practice and the approaches. The fundamental bioinformatics approaches and Information systems related to health are essential in enhancing knowledge- driven practice that is based on sufficient research. Such technological advancement like Clinical data repositories, Electronic Health records have since changed the manner in which medicine is practiced.3

The research paper shall look attempt to seek comprehension on various aspects of Bioinformatics and Healthcare. We shall give an outline depicting the manner in which IT Informatics tools and procedures can influence on the enhancement of quality in healthcare. We develop a framework in which all the stakeholders in healthcare effectively utilize bioinformatics to enable the enhancement of healthcare provision.

Literature Review

There have been various researchers who have studied different aspects of clinical informatics more specifically there are several studies on clinical informatics improvement models.4, 5    Outcome research explains the final results of a specific health practice and interventions on particular populations and patients. This evaluates the economics associated with the health results. It usually involves wide range of data gathering and combination techniques. There are two types of information needed to perform an outcomes study namely: these are patient-specific information and information generated in the course of the patients care. The later can be obtained from EHRs or medical literature. Outcome studies are very vital in the development of medicine .It needs dynamic population data-sets and present data sets to assess measures like procedural complications, mortality rates. , hospitalization day among others hence the importance of bioinformatics

The Role of Bioinformatics System in Medicine

Biomedical informatics can be viewed as a major enhancer of outcomes research outcomes sequence. A method of determining the significance of biomedical informatics is the platforms that have been advanced such as the EHR, research specific Information management that have now been made available to patients. There is a model associated with how IT systems can be used in clinical research. There are several researches specific IS (information systems) than enable clinical research. PubMed is an example of literature search tool that is usually used in the development of hypothesis and making preparations for the studies.6 The EHRs is system that is used in the collection of clinical data about research subjects structurally to limit redundancy and ambiguity. There are also used for data mining and identification of specific potential cohort participants and decision support systems.7, 8, 9

There are general and clinical information systems that are focused on research. They include visualization and simulation tools that aid in data analysis; protocol making tools that permit geographical dispersed authors to cooperate on complex research; electronic data capture; research particular websites and decision support systems that give assistance to researcher such as the trial participant’s protocol.7, 8, 9. Several studies and reports have come to the conclusion that these tools could result in raised data and research quality. The informatics platform has revealed been used in multisite researches to enhance efficiency and effectiveness of the studies.9, 11. The capacity of IT to aid clinical trials depends on the ability to gather, store and analyze biomedical data.

There are general and clinical in formation systems that are focused on research. They include visualization and simulation tools that aid in data analysis, protocol making tools that permit geographical dispersed authors to cooperate on complex research, electronic data capture, research particular websites and decision support systems that give assistance to researcher such as the trial participant’s protocol.10, 11, 12

Several studies and reports have come to the conclusion that these tools could result in raised data and research quality. The informatics platform has revealed been used in multisite researches to enhance efficiency and effectiveness of the studies.9, 11. The capacity of IT to aid clinical trials depends on the ability to gather, store and analyze biomedical data.

Assessment of Current Bioinformatics Technology

There is also data ware houses that are used as databases specifically designed to have particular features that aid it in performing tasks. The purposes such characteristics are enable definitional factors such as subject orientation, time variation, and integration. There are several contexts in which data warehouses can be used according to different authors. They nay be used to retrieve cohorts, for statistical analysis to determine or test hypothesis, indicate phenomena like infections, and implementation of complex regulatory reasons.13, 14 The data warehouses have several benefits but there are shortcomings linked to them. These include surpassing data privacy and concerns pertaining to confidentiality, maintaining quality of data going to the warehouse, and issues of confidentiality, executing and backing adequately and efficiently interface between warehouses and production system, availing timely datasets for reflective studies.15 Bioinformatics has lead to several models for making clinical decision over the years. There are several examples like Arden syntax, which is employed in logic modules.15

The internet has in recent years altered the manner in which medicine is done. About 137 million U.S citizens and 68% of adult population use the Net.16 Approximately 95 million adults have browsed the net for information on medicine. The harmony of protocols has made it possible for information sharing. EMRs have lead to harmony in patient care. The numerous data repositories and the internet have seen new trends in contemporary medicine. The is referred to as evidence based medicine that conglomerates immense medical information for effective medical practice. Sackett describes evident based medicine as the judicious, conscientious and explicit employment of recent evidence in decision making concerning the individual care of a health patient. This has altered the manner in which physicians are thinking today. Currently a physician is required to have a grasp of evidence based medicine which requires one to be knowledgeable in search functionality and medical information. According to Cochrane, (2007), their website give evidence founded reviews that are updated searches. Their database has been mainstreamed into main research. There system permits easy access to information that consists of most advanced levels of evidence obtained in literature and reviews17, 18.

Dynamed is an online resource that contains evidence based information. It has some of the most efficiency features that enable it transfer knowledge in a user-friendly manner. Alper, white &Ge, state that it provides contemporary family physicians via the following characteristics: relevance, convenience, Validity, comprehensiveness and Timelessness. Evidence based medicine is leading by finest practice solutions and making sure that provides healthcare have access to such solutions.19

There has been advancement growth in the use of telemedicine and can be implemented via different media. These include the use of electronic media to transfer information between individuals, Electronic media includes: audio exchange, video conference and electronic exchange like the electronic medical records. Currently there has been a rise in the use of this form of medicine. There are various techniques that are used in telemedicine conferences. The convectional teleconference is that between physician and patient. There has been a new model proposed that would enable practitioner to practitioner interaction. Hu and Chauargue that although there are developments in technology based telemedicine are attractive; physician’s embracement of the method is still the major stumbling block.20

There are various tools that used by the physician in clinical informatics.  The biomedical informatics field is wide; however clinical informatics is centered on patient’s direct involvement with health information Technology. This is usually meant to add value to health care given to the patient. There are several website that provide a range of services that may supplement the physician’s knowledge hence enhancing patient education and health care. Search engines that provide medical literature are very important to the practice. There are various examples aforementioned include Pubmed and Medline. There are also other commercial websites that provide health information, professional societies and educational resources.


Quality Improvement Model

Medical Informatics is a field that came to existence from use of Information technology through adding value to medical practice.  We have seen various websites and online tools that assist practitioners to gain more knowledge and have access to information improving health care. This basically presents a move from the situation of a physician with all knowledge to an evolved practice where there is continuous learning and knowledge flow. This implies that they don’t have all knowledge but can access the latest and complete knowledge through clinical informatics. Online resources, telemedicine and evidence founded medicine have enabled practitioners to make best decisions regarding patient care using best practice guidelines. Patients are now able to access medical literature and information on disease treatment and diagnosis due to the rise in technology21. As was the norm medicine has employed the model physician to patient while the physicians used technology to add value to the association of patient to physician. This can be illustrated in the diagram below

Patient                       Practitioner                       Information Technology

This is the current model in which the patient and physician relationship is added to value by information technology. The physician and the patient are vital for the relationship model. When we switch the position of the physician and the patient, this will prove to add more value to the model. This implies that information technology play the main role. The patient therefore uses information technology thereby inputting more information about themselves and their families. There should be a new website that is dedicated to patient health information records. The patient has control over their own health information record and share with the health providers. The patients are permitted to access care from multiple sites but get all their information from a single site. In proposed model shown below the patient has access to different medical search engines, websites, and evidence based literature that they use to educate themselves. The patients make use of information technology to look after their own health and consult provider on implementing treatment decisions diagnosis21. The proposed model which puts the physician as a value added alternative would theoretically lead to better educated patients allowing advancement in their health. This may ease the burden on healthcare community aiding in the efficient utilization of healthcare resources and allowing practitioners to focus on patients in need of sustained care.

Patient                       Information Technology                         Practitioner


Developments in medicine together with emerging new technologies have allowed biomedical informatics to prosper. Practitioners get patient information, evidence founded medicine has resulted to more informed and well planned physician s to tackle the challenges of contemporary medicine. Patients have the choice of using online information sources on medicine to have a better comprehension of various disease processes and diagnosis. When the patients are educated, they may employ they knowledge to asses the potential state of relevant disease and the different treatments available. This implies that providers can concentrate more productively. These resources lead to a stronger relationship between the patient and the provider. The online technologies allow both the patient and the healthcare provider to have access most recent, updated evidence founded information hence the progress in medical practice.


1. An, Ji-Young; Hayman, Laura L.; Panniers, Teresa; & Carty, Barbara, (2007). Theory Development in Nursing and Healthcare Informatics: A Model Explaining and Predicting Information and Communication Technology Acceptance by Healthcare Consumers. Advances in Nursing Science. Volume 30(3),July/September2007, p E37–E49

2. Hersh WR. Medical informatics: improving health care through information. JAMA. 2002; 288: 1955–1958.

6.National Information Center on Health Services Research and Health Care Technology (NICHSR) glossary. Available at: http://www.nlm.nih.gov/nichsr/hta101/ta101014.html. Accessed Nov , 2012

7.Briggs B. Clinical trials getting a hand. Health Data Manag. 2002; 10: 56–60, 62.

8. Marks RG, Conlon M, Ruberg SJ. Paradigm shifts in clinical trials enabled by information technology. Stat Med. 2001; 20: 2683–2696.

9. Marks RG, Conlon M, Ruberg SJ. Paradigm shifts in clinical trials enabled by information technology. Stat Med. 2001; 20: 2683–2696.

10.Teich JM, Merchia PR, Schmiz JL, Kuperman GJ, Spurr CD, Bates DW. Effects of computerized physician order entry on prescribing practices. Arch Intern Med. 2000; 160: 2741–2747.

11. Shapiro JS. Evaluating public health uses of health information exchange. J Biomed Inform. 2007; 40: S46–S49.

12. Kim JH, Kohane IS, Ohno-Machado L. Visualization and evaluation of clusters for exploratory analysis of gene expression data. J Biomed Inform. 2002; 35: 25–36.

13. Rubin DL, Gennari J, Musen MA. Knowledge representation and tool support for critiquing clinical trial protocols. Proc AMIA Symp. 2000: 724–728.

14. Blobel BG, Engel K, Pharow P. Semantic interoperability: HL7 Version 3 compared to advanced architecture standards. Methods Inf Med. 2006; 45: 343–353.

15. Dewitt JG, Hampton PM. Development of a data warehouse at an academic health system: knowing a place for the first time. Acad Med. 2005; 80: 1019–1025.

16.Fox, S., (2005). Digital divisions.

http://www.pewinternet.org/pdfs/PIP_Digital_Divisions_Oct_5_2005/ Accessed Nov 20, 2012..Sackett, DL; Rosenberg, W. M. C.; Gray, J.A.M.; Haynes, R.B.; & Richardson, W.S. (1996).

Evidence base medicine: what it is and what it isn’t. BMJ, 312: 71-2

18.Cochrane 2007. cochrane.org, July 20, 2007

19. Alper, Brian; White, David S. & Ge, Bin, (2005). Physicians Answer More Clinical

Questions and Change Clinical Decisions More Often With Synthesized Evidence: A Randomized Trial in Primary Care. Annals of Family Medicine 3:507-513, 2005.

20. HU. Hu, Paul Jen-Hwa PhD; Chau, Patrick Yam-Keung PhD. Physician Acceptance of

Telemedicine Technology: An Empirical Investigation. Topics in Health Information Management. Volume 19(4), May 1999, pp 20-

21. Rohm, B.W. Trevor and Rohm C.E. Tapie Jr. (2002). A Vision of the E-Healthcare Era.

International Journal of Healthcare Technology and Management, Vol. 4, No. 1/2.

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