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Lin RH, kofi kujabi B. Addressing Challenges in the Development of Health Information Systems in The Gambia. HEALTH POLICY AND TECHNOLOGY 2022. [DOI: 10.1016/j.hlpt.2022.100658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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2
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Park H, Kang SH, Lee YS, Lee IS, Hwangbo Y, Cho K. Global Trends of Regional Health Information Systems and Suggested Strategic Utilization of their Medical Information. Healthc Inform Res 2021; 27:175-181. [PMID: 34384199 PMCID: PMC8369055 DOI: 10.4258/hir.2021.27.3.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 04/10/2021] [Indexed: 11/23/2022] Open
Abstract
Objectives Along with the exponentially-growing data produced and accumulated every day through mobile platforms, social networking services, the Internet, and other media, information is becoming increasingly important as a strategic resource. This report presents specific and clear directions and suggests empirical project plans regarding innovations in regional health information systems to promote the utilization of medical information. Methods We reviewed and examined documents about global trends and examples of regional health information systems. The problems and solutions of health information utilization and regional health information systems in Korea were analyzed. Results This study presented examples of the establishment of health information systems, problems in the use of local healthcare information, and an empirical project for improvement. Conclusions The results of this study imply the need for long-term and systematic approaches for the use of medical information and the establishment of a local healthcare information system, along with implementation plans. As a first step, it is imperative to clarify the goal of building a medical information system, the information that must be provided to build the system, and the data that should be collected to provide such information, while moving away from the mentality of focusing on technology-oriented medical information services. In addition, it is necessary to consider information governance, data-based service development, and the medical innovation framework, which are ways to efficiently manage, utilize, and systemize the data to be collected.
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Affiliation(s)
- Hyejin Park
- Department of International Healthcare Administration, Daegu Catholic University, Gyeongsan, Korea
| | - Sung-Hong Kang
- Department of Health Policy & Management, Inje University, Gimhae, Korea
| | - Young Sung Lee
- Department of Health Informatics and Management, Chungbuk National University College of Medicine, Cheongju, Korea
| | - In-Sik Lee
- Department of Rehabilitation Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Yul Hwangbo
- Healthcare AI Team, National Cancer Center, Goyang, Korea
| | - Kyunghee Cho
- Department of Family Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
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Huang M, Wang J, Nicholas S, Maitland E, Guo Z. Development, Status Quo, and Challenges to China's Health Informatization During COVID-19: Evaluation and Recommendations. J Med Internet Res 2021; 23:e27345. [PMID: 34061761 PMCID: PMC8213061 DOI: 10.2196/27345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 03/17/2021] [Accepted: 05/27/2021] [Indexed: 01/25/2023] Open
Abstract
By applying advanced health information technology to the health care field, health informatization helps optimize health resource allocation, improve health care services, and realize universal health coverage. COVID-19 has tested the status quo of China's health informatization, revealing challenges to the health care system. This viewpoint evaluates the development, status quo, and practice of China's health informatization, especially during COVID-19, and makes recommendations to address the health informatization challenges. We collected, assessed, and evaluated data on the development of China's health informatization from five perspectives-health information infrastructure, information technology (IT) applications, financial and intellectual investment, health resource allocation, and standard system-and discussed the status quo of the internet plus health care service pattern during COVID-19. The main data sources included China's policy documents and national plans on health informatization, commercial and public welfare sources and websites, public reports, institutional reports, and academic papers. In particular, we extracted data from the 2019 National Health Informatization Survey released by the National Health Commission in China. We found that China developed its health information infrastructure and IT applications, made significant financial and intellectual informatization investments, and improved health resource allocations. Tested during COVID-19, China's current health informatization system, especially the internet plus health care system, has played a crucial role in monitoring and controlling the pandemic and allocating medical resources. However, an uneven distribution of health resources and insufficient financial and intellectual investment continue to challenge China's health informatization. China's rapid development of health informatization played a crucial role during COVID-19, providing a reference point for global pandemic prevention and control. To further promote health informatization, China's health informatization needs to strengthen top-level design, increase investment and training, upgrade the health infrastructure and IT applications, and improve internet plus health care services.
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Affiliation(s)
- Mian Huang
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Beijing, China.,Center for Health Economics and Management, School of Economics and Management, Wuhan University, Wuhan, China
| | - Jian Wang
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Beijing, China.,Center for Health Economics and Management, School of Economics and Management, Wuhan University, Wuhan, China
| | - Stephen Nicholas
- Australian National Institute of Management and Commerce, Sydney, Australia.,Newcastle Business School, University of Newcastle, Newcastle, Australia.,Guangdong Institute for International Strategies, Guangdong University of Foreign Studies, Guangzhou, China.,School of Economics, Tianjin Normal University, Tianjin, China.,School of Management, Tianjin Normal University, Tianjin, China
| | - Elizabeth Maitland
- School of Management, University of Liverpool, Liverpool, United Kingdom
| | - Ziyue Guo
- Dong Fureng Institute of Economic and Social Development, Wuhan University, Beijing, China.,Center for Health Economics and Management, School of Economics and Management, Wuhan University, Wuhan, China
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Saigí-Rubió F, Pereyra-Rodríguez JJ, Torrent-Sellens J, Eguia H, Azzopardi-Muscat N, Novillo-Ortiz D. Routine Health Information Systems in the European Context: A Systematic Review of Systematic Reviews. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4622. [PMID: 33925384 PMCID: PMC8123776 DOI: 10.3390/ijerph18094622] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/20/2021] [Accepted: 04/22/2021] [Indexed: 11/20/2022]
Abstract
(1) Background: The aim of this study is to provide a better understanding of the requirements to improve routine health information systems (RHISs) for the management of health systems, including the identification of best practices, opportunities, and challenges in the 53 countries and territories of the WHO European region. (2) Methods: We conducted an overview of systematics reviews and searched the literature in the databases MEDLINE/PubMed, Cochrane, EMBASE, and Web of Science electronic databases. After a meticulous screening, we identified 20 that met the inclusion criteria, and RHIS evaluation results were presented according to the Performance of Routine Information System Management (PRISM) framework. (3) Results: The reviews were published between 2007 and 2020, focusing on the use of different systems or technologies and aimed to analyze interventions on professionals, centers, or patients' outcomes. All reviews examined showed variability in results in accordance with the variability of interventions and target populations. We have found different areas for improvement for RHISs according to the three determinants of the PRISM framework that influence the configuration of RHISs: technical, organizational, or behavioral elements. (4) Conclusions: RHIS interventions in the European region are promising. However, new global and international strategies and the development of tools and mechanisms should be promoted to highly integrate platforms among European countries.
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Affiliation(s)
- Francesc Saigí-Rubió
- Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), 08018 Barcelona, Spain; (F.S.-R.); (H.E.)
- Interdisciplinary Research Group on ICTs, 08035 Barcelona, Spain;
| | | | - Joan Torrent-Sellens
- Interdisciplinary Research Group on ICTs, 08035 Barcelona, Spain;
- Faculty of Economics and Business, Universitat Oberta de Catalunya (UOC), 08035 Barcelona, Spain
| | - Hans Eguia
- Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), 08018 Barcelona, Spain; (F.S.-R.); (H.E.)
- SEMERGEN New Technologies Working Group, 28009 Madrid, Spain
| | - Natasha Azzopardi-Muscat
- Division of Country Health Policies and Systems, Regional Office for Europe, World Health Organization, 2100 Copenhagen, Denmark;
| | - David Novillo-Ortiz
- Division of Country Health Policies and Systems, Regional Office for Europe, World Health Organization, 2100 Copenhagen, Denmark;
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Dong S, Jiang H, Fan M, Li Y, Zhang C, Lin S, Zhu Y, Ta N, Guo J, Wang Z, Zhang L, Wang L. Evaluation of the Integrated Information System for Brucellosis Case Diagnosis and Management - Inner Mongolia Autonomous Region, China, 2019. China CDC Wkly 2021; 3:110-113. [PMID: 34595015 PMCID: PMC8393113 DOI: 10.46234/ccdcw2021.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 01/28/2021] [Indexed: 11/15/2022] Open
Abstract
What is already known about this topic? Wulanchabu City Center for Endemic Disease Prevention and Control had established and used a Brucellosis Integrated Information System (BIIS) since 2013. However, it had not been systematically evaluated and promoted so far. What is added by this report? The BIIS had significantly improved the efficiency of brucellosis reporting and provided convenience for follow-up management of cases, which was valuable for finishing completely routine therapy. However, the stability of the system needs to be improved. What are the implications for public health practice? The results of the BIIS assessment demonstrated its advantages and disadvantages, which could provide some evidence for its implementation in other areas of China.
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Affiliation(s)
- Shuaibing Dong
- Division of Infectious Disease, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.,Beijing Center for Disease Prevention and Control, Beijing Research Center for Preventive Medicine, Beijing, China
| | - Hai Jiang
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mengguang Fan
- Inner Mongolia Autonomous Region Comprehensive Center for Disease Control and Prevention, Hohhot, Inner Mongolia, China
| | - Yuexi Li
- Wulanchabu City Center for Endemic Disease Prevention and Control, Wulanchabu, Inner Mongolia, China
| | - Cuihong Zhang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shenghong Lin
- Division of Infectious Disease, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yuliang Zhu
- Division of Infectious Disease, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Na Ta
- Inner Mongolia Autonomous Region Comprehensive Center for Disease Control and Prevention, Hohhot, Inner Mongolia, China
| | - Jianke Guo
- Wulanchabu City Center for Endemic Disease Prevention and Control, Wulanchabu, Inner Mongolia, China
| | - Zijun Wang
- Office of General Administration, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lijie Zhang
- Department of Field Epidemiology, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Liping Wang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
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Tian CY, Xu RH, Mo PKH, Dong D, Wong ELY. Generic Health Literacy Measurements for Adults: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7768. [PMID: 33114157 PMCID: PMC7660647 DOI: 10.3390/ijerph17217768] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/13/2020] [Accepted: 10/19/2020] [Indexed: 12/02/2022]
Abstract
BACKGROUND Generic health literacy measurement (GHLM) is an important tool to identify individuals with limited health literacy and can assist the design of tailored interventions for improving public health literacy. However, there is no consensus on measuring generic health literacy. The present study aims to review current GHLM used for adults in the literature. METHODS A scoping review was undertaken to map the available measurements designed to assess generic health literacy. RESULTS The review identified 19 GHLM for adults. Most of them applied a multidimensional definition of health literacy with a focus on individuals' abilities to access, appraise, understand, and apply health information and services. Nutbeam's conceptual model and Sørensen's integrated model were widely used among the identified measures as the theoretical foundation. While the social determinants of health (SDH) were acknowledged in the two models, it remains unmentioned in many of the identified measures based on the Nutbeam's model and needs further development in the measure based on the Sørensen's model. A total of 39 different domains were assessed in the 19 measurements: prose was identified in 8 measurements and was the most prominent domain; followed by numeracy (n = 7) and interactive (n = 7). SDH related domains such as social support (n = 3), social capital (n = 1) were seldom included in the identified measurements. CONCLUSIONS Although current GHLM adopted a multidimensional construct, they mainly focused on individuals' abilities and SDH has not been well-developed in the assessment. Further research is required to advance the measuring of the interaction between SDH and health literacy.
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Affiliation(s)
- Cindy Yue Tian
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China; (C.Y.T.); (R.H.X.); (P.K.-H.M.); (D.D.)
| | - Richard Huan Xu
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China; (C.Y.T.); (R.H.X.); (P.K.-H.M.); (D.D.)
- Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Phoenix Kit-Han Mo
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China; (C.Y.T.); (R.H.X.); (P.K.-H.M.); (D.D.)
| | - Dong Dong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China; (C.Y.T.); (R.H.X.); (P.K.-H.M.); (D.D.)
- Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Eliza Lai-Yi Wong
- Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong 999077, China; (C.Y.T.); (R.H.X.); (P.K.-H.M.); (D.D.)
- Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong 999077, China
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JointCalc: A web-based personalised patient decision support tool for joint replacement. Int J Med Inform 2020; 142:104217. [PMID: 32853974 PMCID: PMC7607377 DOI: 10.1016/j.ijmedinf.2020.104217] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 06/02/2020] [Accepted: 06/06/2020] [Indexed: 11/23/2022]
Abstract
JointCalc is the first complete web decision support tool for joint replacement. User-centred design helps avoid common health information system design. Modern software production methods synergise with and enable user-centred design. JointCalc implementation supports claims of high efficiency of eHealth.
Background and purpose Health information systems (HIS) are expected to be effective and efficient in improving healthcare services, but empirical observation of HIS reveals that most perform poorly in terms of these metrics. Theoretical factors of HIS performance are widely studied, and solutions to mitigate poor performance have been proposed. In this paper we implement effective methods to eliminate some common drawbacks of HIS design and demonstrate the synergy between the methods. JointCalc, the first comprehensive patient-facing web-based decision support tool for joint replacement, is used as a case study for this purpose. Methods and results User-centred design and thorough end-user involvement are employed throughout the design and development of JointCalc. This is supported by modern software production paradigms, including continuous integration/continuous development, agile and service-oriented architecture. The adopted methods result in a user-approved application delivered well within the scope of project. Conclusion This work supports the claims of high potential efficiency of HIS. The methods identified are shown to be applicable in the production of an effective HIS whilst aiding development efficiency.
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Afzali M, Etemad K, Kazemi A, Rabiei R. Cerebral palsy information system with an approach to information architecture: a systematic review. BMJ Health Care Inform 2020; 26:bmjhci-2019-100055. [PMID: 31892529 PMCID: PMC7252971 DOI: 10.1136/bmjhci-2019-100055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 11/06/2019] [Accepted: 12/13/2019] [Indexed: 11/13/2022] Open
Abstract
Background Long-term complications and high costs of cerebral palsy (CP) as well as inconsistency in data related to this disease reveal the need for extensive planning to obtain accurate and complete data for the effective management of patients. Objective The present study reviews the information architecture of CP information system. Method The relevant articles published from early 1988 to 31 July 2018 were extracted through searching PubMed, Scopus, Cochran, Web of Science and Embase databases conducted independently by two researchers. Results A total of 39 articles on CP information system were reviewed. Hospitals, rehabilitation centres and outpatient clinics were found to be the main organisations in charge of generating CP data. Each CP database used several data sources, with hospitals serving as the most important sources of information and the main generators of data. The main CP datasets were categorised into four groups of demographic data, diagnosis, motor function and visual impairment. The majority of data standards were related to the use of the International Classification of Functioning, Disability and Health and the Gross Motor Function Classification System. Finally, accuracy, completeness and consistency were the criteria employed in data quality control. Conclusion Developing a robust CP information system requires deploying the principles of information architecture when developing the system, as these can improve data structure and content of CP system, as well as data quality and data sharing.
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Affiliation(s)
- Mina Afzali
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences School of Paramedical Sciences, Tehran, Iran
| | - Korosh Etemad
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences School of Public Health, Tehran, Iran
| | - Alireza Kazemi
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences School of Paramedical Sciences, Tehran, Iran
| | - Reza Rabiei
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences School of Paramedical Sciences, Tehran, Iran
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Duftschmid G, Rinner C, Sauter SK, Endel G, Klimek P, Mitsch C, Heinzl H. Patient-Sharing Relations in the Treatment of Diabetes and Their Implications for Health Information Exchange: Claims-Based Analysis. JMIR Med Inform 2019; 7:e12172. [PMID: 30977733 PMCID: PMC6484263 DOI: 10.2196/12172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/08/2018] [Accepted: 01/20/2019] [Indexed: 12/04/2022] Open
Abstract
Background Health information exchange (HIE) among care providers who cooperate in the treatment of patients with diabetes mellitus (DM) has been rated as an important aspect of successful care. Patient-sharing relations among care providers permit inferences about corresponding information-sharing relations. Objectives This study aimed to obtain information for an effective HIE platform design to be used in DM care by analyzing patient-sharing relations among various types of care providers (ToCPs), such as hospitals, pharmacies, and different outpatient specialists, within a nationwide claims dataset of Austrian DM patients. We focus on 2 parameters derived from patient-sharing networks: (1) the principal HIE partners of the different ToCPs involved in the treatment of DM and (2) the required participation rate of ToCPs in HIE platforms for the purpose of effective communication. Methods The claims data of 7.9 million Austrian patients from 2006 to 2007 served as our data source. DM patients were identified by their medication. We established metrics for the quantification of our 2 parameters of interest. The principal HIE partners were derived from the portions of a care provider’s patient-sharing relations with different ToCPs. For the required participation rate of ToCPs in an HIE platform, we determine the concentration of patient-sharing relations among ToCPs. Our corresponding metrics are derived in analogy from existing work for the quantification of the continuity of care. Results We identified 324,703 DM patients treated by 12,226 care providers; the latter were members of 16 ToCPs. On the basis of their score for 2 of our parameters, we categorized the ToCPs into low, medium, and high. For the most important HIE partner parameter, pharmacies, general practitioners (GPs), and laboratories were the representatives of the top group, that is, our care providers shared the highest numbers of DM patients with these ToCPs. For the required participation rate of type of care provide (ToCP) in HIE platform parameter, the concentration of DM patient-sharing relations with a ToCP tended to be inversely related to the ToCPs member count. Conclusions We conclude that GPs, pharmacies, and laboratories should be core members of any HIE platform that supports DM care, as they are the most important DM patient-sharing partners. We further conclude that, for implementing HIE with ToCPs who have many members (in Austria, particularly GPs and pharmacies), an HIE solution with high participation rates from these ToCPs (ideally a nationwide HIE platform with obligatory participation of the concerned ToCPs) seems essential. This will raise the probability of HIE being achieved with any care provider of these ToCPs. As chronic diseases are rising because of aging societies, we believe that our quantification of HIE requirements in the treatment of DM can provide valuable insights for many industrial countries.
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Affiliation(s)
- Georg Duftschmid
- Section for Medical Information Management, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Christoph Rinner
- Section for Medical Information Management, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Simone Katja Sauter
- Section for Medical Information Management, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Gottfried Endel
- Main Association of Austrian Social Security Institutions, Vienna, Austria
| | - Peter Klimek
- Section for Science of Complex Systems, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria.,Complexity Science Hub Vienna, Vienna, Austria
| | - Christoph Mitsch
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Harald Heinzl
- Section for Clinical Biometrics, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
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Hogaboam L, Daim T. Technology adoption potential of medical devices: The case of wearable sensor products for pervasive care in neurosurgery and orthopedics. HEALTH POLICY AND TECHNOLOGY 2018. [DOI: 10.1016/j.hlpt.2018.10.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Esmaeilzadeh P. Challenges and Opportunities of Health Information Exchange (HIE) From Health Consumers' Perspective. INTERNATIONAL JOURNAL OF E-HEALTH AND MEDICAL COMMUNICATIONS 2018. [DOI: 10.4018/ijehmc.2018070102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The implementation of HIE depends on a number of entities and one of the key participants is health consumers. All potential gains of HIE cannot be achieved without consumers' favorable beliefs and support. However, little is known about the factors affecting consumers to endorse electronic information exchange between healthcare organizations. The primary objective of this article is to identify how and why patients would support HIE used by healthcare providers. The author has conducted an online questionnaire-based survey in the U.S. This study has shown that perceived value of HIE is significantly related to consumers HIE supportive intention. Moreover, perceived value fully mediates the effects of perceived benefit and cost of HIE implementation on consumer tendency to endorse HIE. The findings also provide evidence to highlight that consumers' attitude toward exchange model moderates the relationship between value perception and intention to support HIE. Relying on the results, this study offers several practical and theoretical contributions.
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Affiliation(s)
- Pouyan Esmaeilzadeh
- Department of Information Systems and Business Analytics, College of Business, Florida International University, Miami, USA
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12
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Bartkiewicz T, Bautsch W, Gerlach A, Goldapp M, Haux R, Heller U, Kierdorf HP, Kleinschmidt T, Ludwig W, Markurth U, Pfingsten-Würzburg S, Plischke M, Reilmann H, Schubert R, Seidel C, Warnke R, Gusew N. A Regional Health Care Network: eHealth.Braunschweig. Methods Inf Med 2018; 51:199-209. [DOI: 10.3414/me11-02-0010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2011] [Accepted: 05/24/2011] [Indexed: 11/09/2022]
Abstract
SummaryBackground: Health care network eHealth.Braunschweig has been started in the South-East region of Lower Saxony in Germany in 2009. It composes major health care players, participants from research institutions and important local industry partners.Objectives: The objective of this paper is firstly to describe the relevant regional characteristics and distinctions of the eHealth.Braunschweig health care network and to inform about the goals and structure of eHealth.Braunschweig; secondly to picture and discuss the main concepts and domain fields which are addressed in the health care network; and finally to discuss the architectural challenges of eHealth.Braunschweig regarding the addressed domain fields and defined requirements.Methods: Based on respective literature and former conducted projects we discuss the project structure and goals of eHealth.Braunschweig, depict major domain fields and requirements gained in workshops with participants and discuss the architectural challenges as well as the architectural approach of eHealth.Braunschweig network.Results: The regional healthcare network eHealth.Braunschweig has been established in April 2009. Since then the network has grown constantly and a sufficient progress in network activities has been achieved. The main domain fields have been specified in different workshops with network participants and an architectural realization approach for the transinstitutional information system architecture in the healthcare network has been developed. However, the effects on quality of information processing and quality of patient care have not been proved yet. Systematic evaluation studies have to be done in future in order to investigate the impact of information and communication technology on the quality of information processing and the quality of patient care.Conclusions: In general, the aspects described in this paper are expected to contribute to a systematic approach for the establishment of regional health care networks with lasting and sustainable effects on patient-centered health care in a regional context.
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Meyerhoefer CD, Sherer SA, Deily ME, Chou SY, Peng L, Hu T, Nihen M, Sheinberg M, Levick D. A mixed methods study of clinical information availability in obstetric triage and prenatal offices. J Am Med Inform Assoc 2018; 24:e87-e94. [PMID: 27539200 DOI: 10.1093/jamia/ocw113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 07/02/2016] [Indexed: 11/14/2022] Open
Abstract
Objective To determine the effect of availability of clinical information from an integrated electronic health record system on pregnancy outcomes at the point of care. Materials and methods We used provider interviews and surveys to evaluate the availability of pregnancy-related clinical information in ambulatory practices and the hospital, and applied multiple regression to determine whether greater clinical information availability is associated with improvements in pregnancy outcomes and changes in care processes. Our regression models are risk adjusted and include physician fixed effects to control for unobservable characteristics of physicians that are constant across patients and time. Results Making nonstress test results, blood pressure data, antenatal problem lists, and tubal sterilization requests from office records available to hospital-based providers is significantly associated with reductions in the likelihood of obstetric trauma and other adverse pregnancy outcomes. Better access to prenatal records also increases the probability of labor induction and decreases the probability of Cesarean section (C-section). Availability of lab test results and new diagnoses generated in the hospital at ambulatory offices is associated with fewer preterm births and low-birth-weight babies. Discussion and conclusions Increased availability of specific clinical information enables providers to deliver better care and improve outcomes, but some types of clinical data are more important than others. More available information does not always result from automated integration of electronic records, but rather from the availability of the source records. Providers depend upon information that they trust to be reliable, complete, consistent, and easily retrievable, even if this requires multiple interfaces.
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Affiliation(s)
| | | | - Mary E Deily
- Department of Economics, Lehigh University, Bethlehem, Pennsylvania
| | - Shin-Yi Chou
- Department of Economics, Lehigh University, Bethlehem, Pennsylvania
| | - Lizhong Peng
- Research and Evaluation Group, American Institutes for Research, Washington, D.C
| | - Tianyan Hu
- Department of Health Policy and Management, Florida International University, Miami
| | - Marion Nihen
- Department of Obstetrics and Gynecology, Lehigh Valley Health Network, Allentown, Pennsylvania
| | - Michael Sheinberg
- Department of Obstetrics and Gynecology, Lehigh Valley Health Network, Allentown, Pennsylvania
| | - Donald Levick
- Department of Pediatrics, Lehigh Valley Health Network
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Rouleau G, Gagnon MP, Côté J, Payne-Gagnon J, Hudson E, Dubois CA. Impact of Information and Communication Technologies on Nursing Care: Results of an Overview of Systematic Reviews. J Med Internet Res 2017; 19:e122. [PMID: 28442454 PMCID: PMC5424122 DOI: 10.2196/jmir.6686] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 01/27/2017] [Accepted: 03/05/2017] [Indexed: 12/17/2022] Open
Abstract
Background Information and communication technologies (ICTs) are becoming an impetus for quality health care delivery by nurses. The use of ICTs by nurses can impact their practice, modifying the ways in which they plan, provide, document, and review clinical care. Objective An overview of systematic reviews was conducted to develop a broad picture of the dimensions and indicators of nursing care that have the potential to be influenced by the use of ICTs. Methods Quantitative, mixed-method, and qualitative reviews that aimed to evaluate the influence of four eHealth domains (eg, management, computerized decision support systems [CDSSs], communication, and information systems) on nursing care were included. We used the nursing care performance framework (NCPF) as an extraction grid and analytical tool. This model illustrates how the interplay between nursing resources and the nursing services can produce changes in patient conditions. The primary outcomes included nurses’ practice environment, nursing processes, professional satisfaction, and nursing-sensitive outcomes. The secondary outcomes included satisfaction or dissatisfaction with ICTs according to nurses’ and patients’ perspectives. Reviews published in English, French, or Spanish from January 1, 1995 to January 15, 2015, were considered. Results A total of 5515 titles or abstracts were assessed for eligibility and full-text papers of 72 articles were retrieved for detailed evaluation. It was found that 22 reviews published between 2002 and 2015 met the eligibility criteria. Many nursing care themes (ie, indicators) were influenced by the use of ICTs, including time management; time spent on patient care; documentation time; information quality and access; quality of documentation; knowledge updating and utilization; nurse autonomy; intra and interprofessional collaboration; nurses’ competencies and skills; nurse-patient relationship; assessment, care planning, and evaluation; teaching of patients and families; communication and care coordination; perspectives of the quality of care provided; nurses and patients satisfaction or dissatisfaction with ICTs; patient comfort and quality of life related to care; empowerment; and functional status. Conclusions The findings led to the identification of 19 indicators related to nursing care that are impacted by the use of ICTs. To the best of our knowledge, this was the first attempt to apply NCPF in the ICTs’ context. This broad representation could be kept in mind when it will be the time to plan and to implement emerging ICTs in health care settings. Trial Registration PROSPERO International Prospective Register of Systematic Reviews: CRD42014014762; http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42014014762 (Archived by WebCite at http://www.webcitation.org/6pIhMLBZh)
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Affiliation(s)
- Geneviève Rouleau
- Faculty of Nursing Sciences, Université Laval, Quebec, QC, Canada.,Research Center of the Centre Hospitalier de l'Université de Montréal, Research Chair in Innovative Nursing Practices, Montreal, QC, Canada
| | - Marie-Pierre Gagnon
- Faculty of Nursing Sciences, Université Laval, Quebec, QC, Canada.,Research Centre of the Centre Hospitalier Universitaire de Québec-Université Laval, Quebec, QC, Canada
| | - José Côté
- Research Center of the Centre Hospitalier de l'Université de Montréal, Research Chair in Innovative Nursing Practices, Montreal, QC, Canada.,Faculty of Nursing Sciences, Université de Montréal, Montreal, QC, Canada
| | - Julie Payne-Gagnon
- Research Centre of the Centre Hospitalier Universitaire de Québec-Université Laval, Quebec, QC, Canada
| | - Emilie Hudson
- School of Nursing, McGill University, Montreal, QC, Canada
| | - Carl-Ardy Dubois
- Faculty of Nursing Sciences, Université de Montréal, Montreal, QC, Canada
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15
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Mäenpää T, Asikainen P, Suominen T. Views of patient, healthcare professionals and administrative staff on flow of information and collaboration in a regional health information exchange: a qualitative study. Scand J Caring Sci 2017; 31:939-947. [PMID: 28144972 DOI: 10.1111/scs.12417] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 11/22/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Nowadays, patients can be more involved in developing healthcare services with their healthcare professionals. Patient-centred information is a key part of improving regional health information exchange (HIE), giving patients an active role in care management. AIM The aim was to get a deeper understanding of the flow of information and collaboration in one hospital district area from the viewpoint of patients, healthcare professionals and administrative staff. METHODS The data were collected by themed interviews and analysed using both deductive and inductive content analyses. The interview themes were the flow of information and collaboration after 5 years of HIE usage in one hospital district area in Finland. FINDINGS Health information exchange usage had changed the regional flow of information after the 5-year period. The patients were satisfied that their primary care physician was able to access their special care information. The experiences of healthcare professionals and administrative staff also showed that information availability and information exchange had improved regionally. HIE usage was also found to have improved regional collaboration between different organisations in patient health care. CONCLUSIONS It was recognised that patients had taken on more responsibility for transferring their follow-up treatment information. Healthcare information exchange between professionals not only improves patient care or patient involvement in their own care, but it also requires that patient self-care or self-care management is integrated into HIE systems to share information not only among professionals, but also between patients and professionals. This information will be used in the development of healthcare systems to meet more the developing of the continuity of care the patient's point of view.
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Affiliation(s)
| | - Paula Asikainen
- Satakunta Hospital District, Pori, Finland.,University of Tampere, Tampere, Finland
| | - Tarja Suominen
- School of Health Sciences, Nursing Science, University of Tampere, Tampere, Finland
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16
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Ferrão JC, Oliveira MD, Janela F, Martins HMG. Preprocessing structured clinical data for predictive modeling and decision support. A roadmap to tackle the challenges. Appl Clin Inform 2016; 7:1135-1153. [PMID: 27924347 PMCID: PMC5228148 DOI: 10.4338/aci-2016-03-soa-0035] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 10/01/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND EHR systems have high potential to improve healthcare delivery and management. Although structured EHR data generates information in machine-readable formats, their use for decision support still poses technical challenges for researchers due to the need to preprocess and convert data into a matrix format. During our research, we observed that clinical informatics literature does not provide guidance for researchers on how to build this matrix while avoiding potential pitfalls. OBJECTIVES This article aims to provide researchers a roadmap of the main technical challenges of preprocessing structured EHR data and possible strategies to overcome them. METHODS Along standard data processing stages - extracting database entries, defining features, processing data, assessing feature values and integrating data elements, within an EDPAI framework -, we identified the main challenges faced by researchers and reflect on how to address those challenges based on lessons learned from our research experience and on best practices from related literature. We highlight the main potential sources of error, present strategies to approach those challenges and discuss implications of these strategies. RESULTS Following the EDPAI framework, researchers face five key challenges: (1) gathering and integrating data, (2) identifying and handling different feature types, (3) combining features to handle redundancy and granularity, (4) addressing data missingness, and (5) handling multiple feature values. Strategies to address these challenges include: cross-checking identifiers for robust data retrieval and integration; applying clinical knowledge in identifying feature types, in addressing redundancy and granularity, and in accommodating multiple feature values; and investigating missing patterns adequately. CONCLUSIONS This article contributes to literature by providing a roadmap to inform structured EHR data preprocessing. It may advise researchers on potential pitfalls and implications of methodological decisions in handling structured data, so as to avoid biases and help realize the benefits of the secondary use of EHR data.
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Affiliation(s)
- José Carlos Ferrão
- José Carlos Ferrão, Rua Irmãos Siemens 1, Ed. 3 Piso 3, 2720-093 Amadora, Portugal, Email address: , Telephone: (+351) 214 178 668, Fax: (+351) 214 178 030
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17
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Rehman SU, Chaudhry AS. Health Knowledge Workers: Strategies for Literacy Development. JOURNAL OF INFORMATION & KNOWLEDGE MANAGEMENT 2016. [DOI: 10.1142/s0219649216500210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Health information systems (HISs) provide automated solutions for the clinical, informational, and managerial life of a hospital. These systems are optimally used when the knowledge workers are adequately equipped with the needed competencies. Three Kuwaiti hospitals have been engaged in adopting and using the same HIS. Jahra Public Hospital, one of the three, has been making progress in the use of HIS. It was hypothesised that capabilities and preparedness of knowledge workers are correlated with their extent of use of the HIS. Data were gathered from 124 healthcare knowledge workers using stratified random sampling. It was found that skills and abilities of these knowledge professionals are strongly correlated with their use of information and communication technologies (ICT) and HIS. Almost all the professionals used HIS, yet there was a wide variation in the use of HIS modules and applications. We also examined whether personal attributes of knowledge workers made any difference in their ICT and HIS skills and use. Results however revealed no such association. These professionals attached a great deal of importance with formal training, but urged that these knowledge workers had enhanced and involved role.
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Affiliation(s)
- Sajjad ur Rehman
- Department of Library and Information Science, College of Social Sciences, Kuwait University, P. O. Box 68168, Kaifan 71962, Kuwait
| | - Abdus Sattar Chaudhry
- Department of Library and Information Science, College of Social Sciences, Kuwait University, P. O. Box 68168, Kaifan 71962, Kuwait
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18
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Rinner C, Sauter SK, Endel G, Heinze G, Thurner S, Klimek P, Duftschmid G. Improving the informational continuity of care in diabetes mellitus treatment with a nationwide Shared EHR system: Estimates from Austrian claims data. Int J Med Inform 2016; 92:44-53. [PMID: 27318070 DOI: 10.1016/j.ijmedinf.2016.05.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 05/04/2016] [Accepted: 05/06/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE Shared Electronic Health Record (EHR) systems, which provide a health information exchange (HIE) within a community of care, were found to be a key enabler of informational continuity of diabetes mellitus (DM) care. Quantitative analyses of the actual contribution of Shared EHR systems to informational continuity of care are rare. The goal of this study was to quantitatively analyze (i) the degree of fragmentation of DM care in Austria as an indicator for the need for HIE, and (ii) the quantity of information (i.e. number of documents) from Austrian DM patients that would be made available by a nationwide Shared EHR system for HIE. METHODS Our analyses are based on social security claims data of 7.9 million Austrians from 2006 and 2007. DM patients were identified through medication data and inpatient diagnoses. The degree of fragmentation was determined by the number of different healthcare providers per patient. The amount of information that would be made available by a nationwide Shared EHR system was estimated by the number of documents that would have been available to a healthcare provider if he had access to information on the patient's visits to any of the other healthcare providers. As a reference value we determined the number of locally available documents that would have originated from the patient's visits to the healthcare provider himself. We performed our analysis for two types of systems: (i) a "comprehensive" Shared EHR system (SEHRS), where each visit of a patient results in a single document (progress note), and (ii) the Austrian ELGA system, which allows four specific document types to be shared. RESULTS 391,630 DM patients were identified, corresponding to 4.7% of the Austrian population. More than 90% of the patients received health services from more than one healthcare provider in one year. Both, the SEHRS as well as ELGA would have multiplied the available information during a patient visit in comparison to an isolated local EHR system; the median ratio of external to local medical documents was between 1:1 for a typical visit at a primary care provider (SEHRS as well as ELGA) and 39:1 (SEHRS) respectively 28:1 (ELGA) for a typical visit at a hospital. CONCLUSIONS Due to the high degree of care fragmentation, there is an obvious need for HIE for Austrian DM patients. Both, the SEHRS as well as ELGA could provide a substantial contribution to informational continuity of care in Austrian DM treatment. Hospitals and specialists would have gained the most amount of external information, primary care providers and pharmacies would have at least doubled their available information. Despite being the most important potential feeders of a national Shared EHR system according to our analysis, primary care providers will not tap their full corresponding potential under the current implementation scenario of ELGA.
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Affiliation(s)
- Christoph Rinner
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, A-1090 Vienna, Austria
| | - Simone Katja Sauter
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, A-1090 Vienna, Austria
| | - Gottfried Endel
- Main Association of Austrian Social Security Institutions, Kundmanngasse 21, A-1031 Vienna, Austria
| | - Georg Heinze
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, A-1090 Vienna, Austria
| | - Stefan Thurner
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, A-1090 Vienna, Austria; Santa Fe Institute, Santa Fe, NM 87501, USA; International Institute for Applied Systems Analysis, A-2361 Laxenburg, Austria
| | - Peter Klimek
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, A-1090 Vienna, Austria
| | - Georg Duftschmid
- Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, A-1090 Vienna, Austria.
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Abstract
Documentation in the patient record must be systematic and rigorous. However, each health care profession documents parts of the electronic health record (EHR) separately. This system can lead to double documentation. The aim of the study was to describe the amount of double documentation in health records for in-patients. A retrospective descriptive review of 30 records for in-patients diagnosed with hip fracture was conducted. Double documentation occurred on all records reviewed during the stay in hospital and in or between all professions reviewed. In total, 822 instances of double documentation were found. The EHRs available today are not designed to monitor processes. Instead, they follow each health profession, which can lead to double documentation. It would be desirable to develop an EHR from a process perspective and not a record per profession.
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Affiliation(s)
| | - Eva Törnvall
- Research and Development Unit, Local Health Care, County of Östergötland, Linköping, Sweden
- Linköping University, Sweden
| | - Inger Jansson
- Institute of Health and Care Sciences, University of Gothenburg, Sweden
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20
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Shah MH, Peikari HR. Electronic Prescribing Usability: Reduction of Mental Workload and Prescribing Errors Among Community Physicians. Telemed J E Health 2016; 22:36-44. [DOI: 10.1089/tmj.2014.0246] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mahmood Hussain Shah
- Lancashire Business School, University of Central Lancashire, Preston, United Kingdom
| | - Hamid Reza Peikari
- Department of Management, Ragheb Isfahani Higher Education Institute, Esfahan, Iran
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21
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World Workshop on Oral Medicine VI: Utilization of Oral Medicine-specific software for support of clinical care, research, and education: current status and strategy for broader implementation. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:172-84. [PMID: 25843941 DOI: 10.1016/j.oooo.2015.02.484] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Revised: 01/28/2015] [Accepted: 02/11/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To assess the current scope and status of Oral Medicine-specific software (OMSS) utilized to support clinical care, research, and education in Oral Medicine and to propose a strategy for broader implementation of OMSS within the global Oral Medicine community. STUDY DESIGN An invitation letter explaining the objectives was sent to the global Oral Medicine community. Respondents were interviewed to obtain information about different aspects of OMSS functionality. RESULTS Ten OMSS tools were identified. Four were being used for clinical care, one was being used for research, two were being used for education, and three were multipurpose. Clinical software was being utilized as databases developed to integrate of different type of clinical information. Research software was designed to facilitate multicenter research. Educational software represented interactive, case-orientated technology designed for clinical training in Oral Medicine. Easy access to patient data was the most commonly reported advantage. Difficulty of use and poor integration with other software was the most commonly reported disadvantage. CONCLUSIONS The OMSS presented in this paper demonstrate how information technology (IT) can have an impact on the quality of patient care, research, and education in the field of Oral Medicine. A strategy for broader implementation of OMSS is proposed.
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Juhr M, Haux R, Suzuki T, Takabayashi K. Overview of recent trans-institutional health network projects in Japan and Germany. J Med Syst 2015; 39:50. [PMID: 25732082 DOI: 10.1007/s10916-015-0234-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 02/11/2015] [Indexed: 11/28/2022]
Abstract
Worldwide populations are aging and countries have to prepare for the effects of demographic change in health care. Health information exchange (HIE), which is the process of moving patient information across health care providers electronically, can help overcome health data fragmentation and open opportunities to improve patient care in terms of quality, economy and efficiency. Since Japan and Germany are among the first countries strongly impacted by demographic changes of aging populations, we report on current developments about health information systems carrying out HIE based on case studies in both countries. Four projects that address the improvement of HIE within a defined region have been selected and investigated: the German project of the Lower Saxony Bank of Health and the Japanese projects Chiba ITnet, Nagasaki AjisaiNet and the National Disaster and Backup System of Japan. The project descriptions are based on relevant English publications, on-site visits and interviews with developers and users. The projects are introduced in terms of their basic architecture and implementation, their present status and future objectives. The projects' developments are still in progress and all have to cope with significant challenges before they will be able to provide a fully working trans-institutional health network solution.
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Affiliation(s)
- Maren Juhr
- Peter L. Reichertz Institute for Medical Informatics, University of Braunschweig and Hannover Medical School, Muehlenpfordtstr. 23, 38106, Braunschweig, Germany,
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23
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Byrne CM, Mercincavage LM, Bouhaddou O, Bennett JR, Pan EC, Botts NE, Olinger LM, Hunolt E, Banty KH, Cromwell T. The Department of Veterans Affairs' (VA) implementation of the Virtual Lifetime Electronic Record (VLER): findings and lessons learned from Health Information Exchange at 12 sites. Int J Med Inform 2014; 83:537-47. [PMID: 24845146 DOI: 10.1016/j.ijmedinf.2014.04.005] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 03/06/2014] [Accepted: 04/15/2014] [Indexed: 11/18/2022]
Abstract
PURPOSE We describe the Department of Veterans Affairs' (VA) Virtual Lifetime Health Electronic Record (VLER) pilot phase in 12 communities to exchange health information with private sector health care organizations and the Department of Defense (DoD), key findings, lessons, and implications for advancing Health Information Exchanges (HIE), nationally. METHODS A mixed methods approach was used to monitor and evaluate the status of VLER Health Exchange pilot phase implementation from December 2009 through October 2012. Selected accomplishments, contributions, challenges, and early lessons that are relevant to the growth of nationwide HIE are discussed. RESULTS Veteran patient and provider acceptance, trust, and perceived value of VLER Health Exchange are found to be high, and usage by providers is steadily growing. Challenges and opportunities to improve provider use are identified, such as better data quality and integration with workflow. Key findings and lessons for advancing HIE are identified. CONCLUSIONS VLER Health Exchange has made great strides in advancing HIE nationally by addressing important technical and policy issues that have impeded scalability, and by increasing trust and confidence in the value and accuracy of HIE among users. VLER Health Exchange has advanced HIE interoperability standards and patient consent policies nationally. Policy, programmatic, technology, and health Information Technology (IT) standards implications to advance HIE for improved delivery and coordination of health care are discussed. The pilot phase success led to VA-wide deployment of this data sharing capability in 2013.
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Affiliation(s)
| | | | | | - Jamie R Bennett
- Department of Veterans Affairs (VA), VLER Health Program, Washington, DC, USA
| | - Eric C Pan
- Westat, Center for Health IT, Rockville, MD, USA.
| | | | | | - Elaine Hunolt
- Department of Veterans Affairs (VA), VLER Health Program, Washington, DC, USA
| | - Karl H Banty
- Westat, Center for Health IT, Cambridge, MA, USA
| | - Tim Cromwell
- Department of Veterans Affairs (VA), VLER Health Program, Washington, DC, USA
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Ryu S, Park M, Lee J, Kim SS, Han BS, Mo KC, Lee HS. Web-based integrated public healthcare information system of Korea: development and performance. Healthc Inform Res 2013; 19:314-23. [PMID: 24523997 PMCID: PMC3920045 DOI: 10.4258/hir.2013.19.4.314] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2013] [Revised: 12/26/2013] [Accepted: 12/26/2013] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVES The Web-based integrated public healthcare information system (PHIS) of Korea was planned and developed from 2005 to 2010, and it is being used in 3,501 regional health organizations. This paper introduces and discusses development and performance of the system. METHODS We reviewed and examined documents about the development process and performance of the newly integrated PHIS. The resources we analyzed the national plan for public healthcare, information strategy for PHIS, usage and performance reports of the system. RESULTS The integrated PHIS included 19 functional business areas, 47 detailed health programs, and 48 inter-organizational tasks. The new PHIS improved the efficiency and effectiveness of the business process and inter-organizational business, and enhanced user satisfaction. Economic benefits were obtained from five categories: labor, health education and monitoring, clinical information management, administration and civil service, and system maintenance. The system was certified by a patent from the Korean Intellectual Property Office and accredited as an ISO 9001. It was also reviewed and received preliminary comments about its originality, advancement, and business applicability from the Patent Cooperation Treaty. It has been found to enhance the quality of policy decision-making about regional healthcare at the self-governing local government level. CONCLUSIONS PHIS, a Web-based integrated system, has contributed to the improvement of regional healthcare services of Korea. However, when it comes to an appropriate evolution, the needs and changing environments of community-level healthcare service and IT infrastructure should be analyzed properly in advance.
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Affiliation(s)
- Seewon Ryu
- Department of Health Policy and Healthcare Management, Inje Institute of Advanced Studies, Seoul, Korea
| | - Minsu Park
- Department of Health Policy and Healthcare Management, Inje Institute of Advanced Studies, Seoul, Korea
| | - Jaegook Lee
- Department of Emergency and Medical Services, Sunmoon University, Asan, Korea
| | - Sung-Soo Kim
- Department of Healthcare Management, Cheongju University, Cheongju, Korea
| | - Bum Soo Han
- Korea Health and Welfare Information Service, Seoul, Korea
| | - Kyoung Chun Mo
- Korea Health and Welfare Information Service, Seoul, Korea
| | - Hyung Seok Lee
- Korea Health and Welfare Information Service, Seoul, Korea
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Tully MP, Kettis Å, Höglund AT, Mörlin C, Schwan Å, Ljungberg C. Transfer of data or re-creation of knowledge – Experiences of a shared electronic patient medical records system. Res Social Adm Pharm 2013; 9:965-74. [DOI: 10.1016/j.sapharm.2013.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Revised: 02/15/2013] [Accepted: 02/16/2013] [Indexed: 10/27/2022]
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Hyppönen H, Reponen J, Lääveri T, Kaipio J. User experiences with different regional health information exchange systems in Finland. Int J Med Inform 2013; 83:1-18. [PMID: 24200753 DOI: 10.1016/j.ijmedinf.2013.10.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 10/09/2013] [Accepted: 10/09/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE The interest in cross-organizational Health Information Exchange (HIE) is increasing at regional, national and cross-European levels. The purpose of our study was to compare user experiences (usability) of different regional health information exchange system (RHIE) types as well as the factors related to the experienced level of success of different RHIE system types. METHODS A web-based questionnaire was sent to 95% of Finnish physicians aged between 25 and 65 years of age. RHIE systems were mainly available in the public sector and only in certain regions. Those 1693 physicians were selected from the 3929 respondents of the original study, who met these criteria. The preferred means (paper/fax vs. electronic) of cross-organizational HIE, and replies to the 11 questions measuring RHIE success were used as the main dependent variables. RESULTS Two thirds (73%) of the primary care physicians and one third (33%) of the specialized care physicians replied using an electronic RHIE system rather than paper or fax as a primary means of cross-organizational HIE. Respondents from regions where a regional virtual EHR (type 3) RHIE system was employed had used electronic means rather than paper HIE to a larger extend compared to their colleagues in regions where a master patient index-type (type 1) or web distribution model (type 2) RHIE system was used. Users of three local EHR systems preferred electronic HIE to paper to a larger extend than users of other EHR systems. Experiences with an integrated RHIE system (type 3) were more positive than those with other types or RHIE systems. CONCLUSIONS The study revealed User preferences for the integrated virtual RHIE-system (type 3) over the master index model (type 1) or web distribution model (type 2). Success of individual HIE tasks of writing, sending and reading were impacted by the way these functionalities were realized in the EHR systems. To meet the expectations of increased efficiency, continuity, safety and quality of care, designers of HIE systems also need to take into account the different HIE needs of primary care clinicians and their secondary care colleagues in hospitals. Both national legislation and local interpretations of data protection possibly hinder the full use of any RHIE systems. These findings should be taken into account when designing usable HIE systems. More qualitative research is needed on specific features of those local systems that are associated with positive or negative user experience.
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Affiliation(s)
- Hannele Hyppönen
- National Institute for Health and Welfare (THL), Information Department, P.O. Box 30, FI-00271 Helsinki, Finland.
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Campion TR, Edwards AM, Johnson SB, Kaushal R. Health information exchange system usage patterns in three communities: Practice sites, users, patients, and data. Int J Med Inform 2013; 82:810-20. [DOI: 10.1016/j.ijmedinf.2013.05.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 04/30/2013] [Accepted: 05/02/2013] [Indexed: 11/25/2022]
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Tamblyn R, Poissant L, Huang A, Winslade N, Rochefort CM, Moraga T, Doran P. Estimating the information gap between emergency department records of community medication compared to on-line access to the community-based pharmacy records. J Am Med Inform Assoc 2013; 21:391-8. [PMID: 23956015 PMCID: PMC3994851 DOI: 10.1136/amiajnl-2013-001704] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective Errors in community medication histories increase the risk of adverse events. The objectives of this study were to estimate the extent to which access to community-based pharmacy records provided more information about prescription drug use than conventional medication histories. Materials and methods A prospective cohort of patients with public drug insurance who visited the emergency departments (ED) in two teaching hospitals in Montreal, Quebec was recruited. Drug lists recorded in the patients’ ED charts were compared with pharmacy records of dispensed medications retrieved from the public drug insurer. Patient and drug-related predictors of discrepancies were estimated using general estimating equation multivariate logistic regression. Results 613 patients participated in the study (mean age 63.1 years, 59.2% women). Pharmacy records identified 41.5% more prescribed medications than were noted in the ED chart. Concordance was highest for anticoagulants, cardiovascular drugs and diuretics. Omissions in the ED chart were more common for drugs that may be taken episodically. Patients with more than 12 medications (OR 2.92, 95% CI 1.71 to 4.97) and more than one pharmacy (OR 3.85, 95% CI 1.80 to 6.59) were more likely to have omissions in the ED chart. Discussion The development of health information exchanges could improve the efficiency and accuracy of information about community medication histories if they enable automated access to dispensed medication records from community pharmacies, particularly for the most vulnerable populations with multiple morbidities. Conclusions Pharmacy records identified a substantial number of medications that were not in the ED chart. There is potential for greater safety and efficiency with automated access to pharmacy records.
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Affiliation(s)
- Robyn Tamblyn
- Department of Epidemiology and Biostatistics, McGill University, Montreal, Canada
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Peikari HR, Zakaria MS, Yasin NM, Shah MH, Elhissi A. Role of computerized physician order entry usability in the reduction of prescribing errors. Healthc Inform Res 2013; 19:93-101. [PMID: 23882414 PMCID: PMC3717443 DOI: 10.4258/hir.2013.19.2.93] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 06/01/2013] [Accepted: 06/05/2013] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Some hospitals have implemented computerized physician order entry (CPOE) systems to reduce the medical error rates. However, research in this area has been very limited, especially regarding the impact of CPOE use on the reduction of prescribing errors. Moreover, the past studies have dealt with the overall impact of CPOE on the reduction of broadly termed "medical errors", and they have not specified which medical errors have been reduced by CPOE. Furthermore, the majority of the past research in this field has been either qualitative or has not used robust empirical techniques. This research examined the impacts of usability of CPOE systems on the reduction of doctors' prescribing errors. METHODS One hundred and sixty-six questionnaires were used for quantitative data analyses. Since the data was not normally distributed, partial least square path modelling-as the second generation of multivariate data analyses-was applied to analyze data. RESULTS It was found that the ease of use of the system and information quality can significantly reduce prescribing errors. Moreover, the user interface consistency and system error prevention have a significant positive impact on the perceived ease of use. More than 50% of the respondents believed that CPOE reduces the likelihood of drug allergy, drug interaction, and drug dosing errors thus improving patient safety. CONCLUSIONS Prescribing errors in terms of drug allergy, drug interaction, and drug dosing errors are reduced if the CPOE is not error-prone and easy to use, if the user interface is consistent, and if it provides quality information to doctors.
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Affiliation(s)
- Hamid Reza Peikari
- Graduate School of Business, Universiti Kebangsaan Malaysia, Bangi, Malaysia
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Jensen TB. Design principles for achieving integrated healthcare information systems. Health Informatics J 2013; 19:29-45. [PMID: 23486824 DOI: 10.1177/1460458212448890] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Achieving integrated healthcare information systems has become a common goal for many countries in their pursuit of obtaining coordinated and comprehensive healthcare services. This article focuses on how a small local project termed 'Standardized pull of patient data' expanded and is now used on a large scale providing a majority of hospitals, general practitioners and citizens across Denmark with the possibility of accessing healthcare data from different electronic patient record systems and other systems. I build on design theory for information infrastructures, as presented by Hanseth and Lyytinen, to examine the design principles that facilitated this smallscale project to expand and become widespread. As a result of my findings, I outline three lessons learned that emphasize: (i) principles of flexibility, (ii) expansion from the installed base through modular strategies and (iii) identification of key healthcare actors to provide them with immediate benefits.
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Rodrigo ESS, Wimalaratne SRU, Marasinghe RB, Edirippulige S. A pilot health information management system for public health midwives serving in a remote area of Sri Lanka. J Telemed Telecare 2012; 18:159-63. [PMID: 22362835 DOI: 10.1258/jtt.2012.sft109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We developed an electronic Health Information Management System (HIMS) for Public Health Midwives (PHMs) in Sri Lanka. We conducted a needs analysis amongst 16 PHMs, which found that they spent most of their time managing health records. The HIMS was designed so that it could accept data from the PHMs, and generate reports which could be used by the PHMs themselves as well as by their supervisors. The HIMS was trialled by a group of 16 PHMs in a remote area of the Ratnapura district of Sri Lanka. Mini-laptops with the software were distributed to the PHMs and they were given the necessary training. They started entering historical data from the registers into the system by themselves. Nearly 10,000 public health records were generated in the first three months. In a subsequent survey, the PHMs all gave positive answers indicating that they were happy with the pilot system, they would like to continue using it to enhance their service and they wanted to see it expanded across the whole of Ratnapura district. The system seems to be a practical solution for the field activities of PHMs in Sri Lanka.
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Affiliation(s)
- E Shan S Rodrigo
- Post Graduate Institute of Medicine, University of Colombo, Sri Lanka
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Wu IL, Kuo YZ. A Balanced Scorecard Approach in Assessing IT Value in Healthcare Sector: An Empirical Examination. J Med Syst 2012; 36:3583-96. [DOI: 10.1007/s10916-012-9834-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Accepted: 02/09/2012] [Indexed: 10/28/2022]
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Johnson KB, Unertl KM, Chen Q, Lorenzi NM, Nian H, Bailey J, Frisse M. Health information exchange usage in emergency departments and clinics: the who, what, and why. J Am Med Inform Assoc 2012; 18:690-7. [PMID: 21846788 DOI: 10.1136/amiajnl-2011-000308] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Health information exchange (HIE) systems are being developed across the nation. Understanding approaches taken by existing successful exchanges can help new exchange efforts determine goals and plan implementations. The goal of this study was to explore characteristics of use and users of a successful regional HIE. DESIGN We used a mixed-method analysis, consisting of cross-sectional audit log data, semi-structured interviews, and direct observation in a sample of emergency departments and ambulatory safety net clinics actively using HIE. For each site, we measured overall usage trends, user logon statistics, and data types accessed by users. We also assessed reasons for use and outcomes of use. RESULTS Overall, users accessed HIE for 6.8% of all encounters, with higher rates of access for repeat visits, for patients with comorbidities, for patients known to have data in the exchange, and at sites providing HIE access to both nurses and physicians. Discharge summaries and test reports were the most frequently accessed data in the exchange. Providers consistently noted retrieving additional history, preventing repeat tests, comparing new results to retrieved results, and avoiding hospitalizations as a consequence of HIE access. CONCLUSION HIE use in emergency departments and ambulatory clinics was focused on patients where missing information was believed to be present in the exchange and was related to factors including the roles of people with access, the setting, and other site-specific issues that impacted the overall breadth of routine system use. These data should form an important foundation as other sites embark upon HIE implementation.
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Affiliation(s)
- Kevin B Johnson
- Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, Tennessee 37232, USA.
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Abstract
PURPOSE Health information exchange (HIE), the process of electronically moving patient-level information between different organizations, is viewed as a solution to the fragmentation of data in health care. This review provides a description of the current state of HIE in seven nations, as well was three international HIE efforts, with a particular focus on the relation of exchange efforts to national health care systems, common challenges, and the implications of cross-border information sharing. DESIGN/METHODOLOGY/APPROACH National and international efforts highlighted in English language informatics journals, professional associations, and government reports are described. FINDINGS Fully functioning HIE is not yet a common phenomenon worldwide. However, multiple nations see the potential benefits of HIE and that has led to national and international efforts of varying scope, scale, and purview. National efforts continue to work to overcome the challenges of interoperability, record linking, insufficient infrastructures, governance, and interorganizational relationships, but have created architectural strategies, oversight agencies, and incentives to foster exchange. The three international HIE efforts reviewed represent very different approaches to the same problem of ensuring the availability of health information across borders. ORIGINALITY/VALUE The potential of HIE to address many cost and quality issues will ensure HIE remains on many national agendas. In many instances, health care executives and leaders have opportunities to work within national programs to help shape local exchange governance and decide technology partners. Furthermore, HIE raises policy questions concerning the role of centralized planning, national identifiers, standards, and types of information exchanged, each of which are vital issues to individual health organizations and worthy of their attention.
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Affiliation(s)
- Joshua R Vest
- Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
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Remen VM, Grimsmo A. Closing information gaps with shared electronic patient summaries: how much will it matter? Int J Med Inform 2011; 80:775-81. [PMID: 21956001 DOI: 10.1016/j.ijmedinf.2011.08.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Revised: 08/23/2011] [Accepted: 08/24/2011] [Indexed: 11/18/2022]
Abstract
BACKGROUND Information deficits contribute to medical errors. Hence several efforts to develop electronic communication systems to facilitate a flow of information between health care providers have been attempted, including initiatives to develop regional or national electronic patient summaries. OBJECTIVES To study information access and information needs in inpatient emergency departments, and how clinicians in these departments handle deficits in available information. METHODS We conducted an observational study of consecutive unplanned inpatient admissions using a structured form to register a set of predefined parameters and free-text notes, including a post-examination interview with the examining emergency department doctors and nurses. RESULTS We observed 177 patient admissions, excluding any patients under 18 years of age and planned admissions. One in four patients arrived without any referral. Nearly all referrals described the presenting complaint with a tentative diagnosis. One third of the referrals lacked medication record and medical history. Only one in ten referrals contained information about contraindications. If the patient had previously been admitted to the hospital, the emergency department doctors used the existing electronic patient record and seemed to favor previous discharge letters as an information source. Information on current medications was often copied from earlier admissions. In half of the cases the patients also provided supplementary information in other ways not available, though one in five patients was not in a cognitive state to be properly interviewed. The examining doctors reported a lack of crucial information in 10% of the observed referrals. CONCLUSION Overall, information about medications and previous history was described in most referrals, but was still the information most frequently inquired or searched for. Qualitative assessments revealed that insufficient information put a significant stress on both patients and staff, and in turn caused additional workload and risky work-arounds. In our assessment, these information deficits could be effectively mitigated by an up to date easy-access patient summary.
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Affiliation(s)
- Vebjørn Mack Remen
- The Norwegian Electronic Patient Record Research Center, Norwegian University of Technology and Science, Trondheim, Norway.
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Katehakis D, Halkiotis S, Kouroubali A. Materialization of Regional Health Information Networks in Greece: Electronic Health Record Barriers & Enablers. JOURNAL OF HEALTHCARE ENGINEERING 2011. [DOI: 10.1260/2040-2295.2.3.389] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Li JS, Zhou TS, Chu J, Araki K, Yoshihara H. Design and development of an international clinical data exchange system: the international layer function of the Dolphin Project. J Am Med Inform Assoc 2011; 18:683-9. [PMID: 21571747 DOI: 10.1136/amiajnl-2011-000111] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE At present, most clinical data are exchanged between organizations within a regional system. However, people traveling abroad may need to visit a hospital, which would make international exchange of clinical data very useful. BACKGROUND Since 2007, a collaborative effort to achieve clinical data sharing has been carried out at Zhejiang University in China and Kyoto University and Miyazaki University in Japan; each is running a regional clinical information center. Methods An international layer system named Global Dolphin was constructed with several key services, sharing patients' health information between countries using a medical markup language (MML). The system was piloted with 39 test patients. RESULTS The three regions above have records for 966,000 unique patients, which are available through Global Dolphin. Data exchanged successfully from Japan to China for the 39 study patients include 1001 MML files and 152 images. The MML files contained 197 free text-type paragraphs that needed human translation. Discussion The pilot test in Global Dolphin demonstrates that patient information can be shared across countries through international health data exchange. To achieve cross-border sharing of clinical data, some key issues had to be addressed: establishment of a super directory service across countries; data transformation; and unique one-language translation. Privacy protection was also taken into account. The system is now ready for live use. CONCLUSION The project demonstrates a means of achieving worldwide accessibility of medical data, by which the integrity and continuity of patients' health information can be maintained.
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Affiliation(s)
- Jing-song Li
- Healthcare Informatics Engineering Research Center, Zhejiang University, Hangzhou, China.
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Mäenpää T, Asikainen P, Gissler M, Siponen K, Maass M, Saranto K, Suominen T. Outcomes assessment of the regional health information exchange: a five-year follow-up study. Methods Inf Med 2011; 50:308-18. [PMID: 21336419 DOI: 10.3414/me10-01-0048] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2010] [Accepted: 12/21/2010] [Indexed: 11/09/2022]
Abstract
BACKGROUND The implementation of a technology such as health information exchange (HIE) through a Regional Health Information System (RHIS) may improve the mobilization of health care information electronically across organizations. There is a need to coordinate care and bring together regional and local stakeholders. OBJECTIVES To describe how HIE had influenced health care delivery in one hospital district area in Finland. METHOD Trend analysis was used to evaluate the influence of a regional HIE. We conducted a retrospective, longitudinal study for the period 2004-2008 for the eleven federations of municipalities in the study area. We reviewed statistical health data from the time of implementation of an RHIS. The t-test was used to determine statistical significance. The selected outcomes were the data obtained from the regional database on total appointments, emergency department visits, laboratory tests and radiology examinations, and selected laboratory tests and radiology examinations carried out in both primary care and special health care. RESULTS Access to HIE may have influenced health care delivery in the study area. There are indications that there is a connection between access to regional HIE and the number of laboratory tests and radiology examinations performed in both primary care and specialized health care, as observed in the decreased frequency in outcomes such as radiology examinations, number of appointments, and emergency department visits in the study environment. The decreased frequencies of the latter suggest an increased efficiency of outpatient care, but we were not able to estimate to what extent the readily available comprehensive clinical information contributed to these trends. CONCLUSION Outcome assessment of HIE through an RHIS is essential for the success of health information technology (HIT) and as evidence to use in the decision-making process. As health care information becomes more digital, it increases the potential for a strong HIE effect on health care delivery.
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Affiliation(s)
- T Mäenpää
- University of Tampere, School of Health Sciences, Nursing Science, Lääkärikatu 1, 33014 Tampere, Finland.
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