Journal:Benefits of information technology in healthcare: Artificial intelligence, internet of things, and personal health records
| Full article title | Benefits of information technology in healthcare: Artificial intelligence, internet of things, and personal health records |
|---|---|
| Journal | Healthcare Informatics Research |
| Author(s) | Chang, Hyejung; Choi, Jae-Young; Shim, Jaesun; Kim, Mihui; Choi, Mona |
| Author affiliation(s) | Kyung Hee University, Hallym University, Seoul Health Foundation, Jeonju University, Yonsei University |
| Primary contact | Email: monachoi at yuhs dot ac |
| Year published | 2023 |
| Volume and issue | 29(4) |
| Page(s) | 323-333 |
| DOI | 10.4258/hir.2023.29.4.323 |
| ISSN | 2093-369X |
| Distribution license | Creative Commons Attribution 4.0 International |
| Website | https://e-hir.org/journal/view.php?doi=10.4258/hir.2023.29.4.323 |
| Download | https://e-hir.org/upload/pdf/hir-2023-29-4-323.pdf (PDF) |
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This article should be considered a work in progress and incomplete. Consider this article incomplete until this notice is removed. |
Abstract
Objectives: Systematic evaluations of the benefits of health information technology (HIT) play an essential role in enhancing healthcare quality by improving outcomes. However, there is limited empirical evidence regarding the benefits of IT adoption in healthcare settings. This study aimed to review the benefits of artificial intelligence (AI), the internet of things (IoT), and personal health records (PHR), based on scientific evidence.
Methods: The literature published in peer-reviewed journals between 2016 and 2022 was searched for systematic reviews and meta-analysis studies using the PubMed, Cochrane, and Embase databases. Manual searches were also performed using the reference lists of systematic reviews and eligible studies from major health informatics journals. The benefits of each HIT were assessed from multiple perspectives across four outcome domains.
Results: Twenty-four systematic review or meta-analysis studies on AI, IoT, and PHR were identified. The benefits of each HIT were assessed and summarized from a multifaceted perspective, focusing on four outcome domains: clinical, psycho-behavioral, managerial, and socioeconomic. The benefits varied depending on the nature of each type of HIT and the diseases to which they were applied.
Conclusions: Overall, our review indicates that AI and PHR can positively impact clinical outcomes, while IoT holds potential for improving managerial efficiency. Despite ongoing research into the benefits of health IT in line with advances in healthcare, the existing evidence is limited in both volume and scope. The findings of our study can help identify areas for further investigation.
Keywords: health informatics, artificial intelligence, internet of things, personal health records, review
Introduction
The healthcare sector is increasingly recognized as an industry well-suited for the future, particularly in the era of hyperconnectivity where cutting-edge information technology (IT) can be applied. However, there is limited empirical evidence regarding the benefits of IT in healthcare settings. Therefore, it is crucial to systematically evaluate the advantages of health information technology (HIT) to ensure that these efforts will help enhance the quality of healthcare by improving outcomes.
The present study aims to summarize several cases where IT has been applied in healthcare and to review the published systematic reviews and meta-analyses on the benefits of HIT. The scope of this review focuses on three types of HIT: artificial intelligence (AI), the internet of things (IoT), and personal health records (PHR). These were identified as priority areas of high significance and immediacy within the realm of technology development in a previous Delphi study. [1]
Areas of focus in this study on HIT
Artificial intelligence
AI is expected not only to contribute to providing personalized healthcare based on patient-centered big data systems, but also to enable the more efficient use of medical resources. With the aging of the global population and the increasing prevalence of chronic diseases, combined with the paradigm shift toward patient-centered care, it is becoming increasingly important to predict diseases based on symptoms and risk factors and effectively manage chronic diseases. In addition, given the shift toward personalized healthcare [2], AI technologies may help predict and prevent diseases using patient-centered big data systems. This would facilitate accurate disease diagnoses and the recommendation of the most effective treatment. [3]
Since AI is capable of automating repetitive, daily medical tasks, it has a high potential for applications in a wide range of healthcare settings, including patient and resource management. As such, this technology will be rapidly adopted in the healthcare sector and play an important role in improving managerial efficiency. [4]
Internet of things
The use of IoT has been widely promoted in various industries, such as home appliances and automobiles. Medical devices, in particular, have been recognized as an area where IoT can be employed particularly effectively and have a greater impact on our daily lives. Its applications in the medical field are as follows [5]:
- Home healthcare: Monitoring using sensors (e.g., detecting falls, seizures, or the risk of pressure ulcers);
- m-Health solutions: Monitoring using various types of sensors linked to smartphones;
- e-Health: Medical services connected to the internet to perform various remote medical services (e.g., remote monitoring, remote consulting, robot-assisted surgery, etc.); and
- Hospital management: Logistics supply chain management, remote patient monitoring, and drug identification monitoring.
The healthcare sector has been progressively incorporating IoT technology. This technology aids patients in managing their health more effectively, enables providers to improve service quality, decreases costs, and boosts the efficiency of hospital resource management. For patients, the implementation of IoT solutions can increase satisfaction and promote adherence to self-care principles, which are intended to facilitate improved self-management. For service providers, systems based on IoT technology can allow the monitoring of patients who require constant care and attention, thereby increasing the overall standard of healthcare. [6,7] Furthermore, this technology can introduce novel strategies for resource management in healthcare organizations, leading to cost reductions. [8]
Personal health records
The Markle Foundation’s Connecting for Health [9] defines a PHR as an electronic application through which individuals can access, manage, and share their health information, and that of others for whom they are authorized, in a private, secure, and confidential environment. With the healthcare paradigm shift from diagnosis and treatment to prevention and management, the role of PHR is expected to expand to personalized health maintenance services and chronic disease management. Three general types of PHR exist: standalone PHR, electronic medical record (EMR)-tethered PHR, and interconnected PHR. OF these, the EMR-tethered PHR, which is connected with a hospital’s EMR, is most widely used.
For this study, we first summarized HIT use, which is expected to create greater synergy with regard to prediction, diagnosis, health maintenance, and organizational management. We reviewed the benefits reported in previous studies from diverse perspectives across four outcome domains: clinical, psycho-behavioral, managerial, and socioeconomic. For the clinical domain, specific evaluation tools included patient outcomes such as detection of drug-adverse effects, mortality, length of hospital stay, readmission rates, and safety. In the psycho-behavioral domain, user acceptance and satisfaction were used as evaluation tools. The managerial domain was assessed through managerial efficiency, while the socioeconomic domain was evaluated based on cost reduction.
Methods
Search strategy
We searched the PubMed, Cochrane, and Embase databases for systematic review and meta-analysis studies published in peer-reviewed journals between 2016 and 2022. The combination keywords used in searching the databases were as follows: artificial intelligence, Internet of Things, personal health records, patient portals, personal health, and hospitals. Fifty publications in the AI, 10 in the IoT, and 39 in the PHR were initially identified as potentially eligible studies for full-text screening. In addition, we manually searched reference lists from systematic reviews, eligible studies, and publications from major journals. The benefits of each HIT were then assessed, and the results were summarized.
Study selection
Our search found 18 meta-analysis studies on AI, all of which discussed the clinical effectiveness of technologies in the realm of disease prediction and diagnosis. Seven of these studies [10–15] focused on tumor diagnosis, specifically of the stomach, intestine, thyroid, brain, lung, and ovary. Two studies [16,17] were centered on the diagnosis of eye diseases, namely diabetic retinopathy and retinal vascular disease. Another two studies focused on the diagnosis and prognosis of kidney disease [18,19], while one study examined the diagnosis of coronary artery disease. [20] The remaining six studies investigated heart failure [21], sepsis [22], pneumonia [23], intrapartum fetal heart rate [24], trauma [25], and mood disorders. [26] In addition to these, we found two systematic reviews that analyzed the utility of IoT. One paper explored the application of IoT solutions for health management [27], while the other assessed how IoT has enhanced the quality of services. [28] These studies evaluated the effectiveness of IoT from clinical, managerial, and socioeconomic viewpoints. We identified four systematic reviews on PHR. [29–32] The specific conditions examined in these studies included diabetes mellitus, various chronic diseases, and vaccination. Each of the four papers investigated both clinical and psycho-behavioral effectiveness.
Results
In this section, we present findings on the benefits of AI, IoT, and PHR from clinical, psycho-behavioral, managerial, and socioeconomic perspectives. We also summarize the key findings in Table 1.
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References
Notes
This presentation is faithful to the original, with only a few minor changes to presentation. In some cases important information was missing from the references, and that information was added.
