Health information is central to changes in healthcare: A clinician's view

Changes in healthcare, such as integrated care, the use of big data, electronic health records (EHRs), telemedicine, decision support systems and consumer empowerment, are impacting on the management of health information. Integrated care requires linked data; activity-based funding requires valid coding; EHRs require standards for documentation, retrieval and analysis; and decision support systems require standardised nomenclatures. The ethical oversight of how health-related information is used, as opposed to governance of its content, storage and communication, remains ill-defined. More fundamentally, the conceptual foundations of health information in terms of "diagnostic" constructs are creating limitations: Why should a medical diagnosis be privileged as the key descriptor of care, over disability or other aspects of the human experience? Who gets to say what matters, and how and by whom is that translated into meaningful information? These are important questions on which the health information management profession is well placed to lead. In this changing environment, threats and opportunities for the profession are presented and discussed. Highlighted is the need for leadership from the profession on the ethical use of health information.