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Neirat D, Batran A, Ayed A. Development of an electronic medical records project for Al-Razi hospital in Palestine. J Public Health Res 2023; 12:22799036231217795. [PMID: 38058992 PMCID: PMC10697050 DOI: 10.1177/22799036231217795] [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: 08/03/2023] [Accepted: 11/14/2023] [Indexed: 12/08/2023] Open
Abstract
Background Electronic medical records (EMR) are considered an important aspect to improve medical services provided to patients. The purpose of this study was to assess the development of an Electronic Medical Records Project for Al-Razi hospital in Palestine. Design and Methods The study was mixed method, qualitative and quantitative. The use of a questionnaire for the staff in the Al-Razi hospital and seven administrators' participants were meat as focus group. Results Approximately 136 participants in the study. The study findings reported that employees perceived the use of EMRs to have several benefits. The most common benefits include promoting patient safety culture and drug error reduction. In addition, the study findings reported that employees perceived the use of EMRs to have several challenges. The most common challenges include lack of knowledge and skill, insufficient time to use EMR, and limited of computers. Conclusions Health informatics brings various benefits to the healthcare system. Some participants believed that the EMR system would improve patient care and it will improve patient satisfaction.
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Affiliation(s)
- Doaa Neirat
- Faculty of Graduate Studies, Arab American University, Palestine
| | - Ahmad Batran
- Faculty of Allied Medical Sciences, Department of Nursing, Palestine Ahliya University, Bethlehem, Palestine
| | - Ahmad Ayed
- Faculty of Nursing, Arab American University, Bethlehem, Palestine
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2
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Ng CT, Tan LL, Sohn IS, Gonzalez Bonilla H, Oka T, Yinchoncharoen T, Chang WT, Chong JH, Cruz Tan MK, Cruz RR, Astuti A, Agarwala V, Chien V, Youn JC, Tong J, Herrmann J. Advancing Cardio-Oncology in Asia. Korean Circ J 2023; 53:69-91. [PMID: 36792558 PMCID: PMC9932224 DOI: 10.4070/kcj.2022.0255] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 10/25/2022] [Indexed: 11/25/2022] Open
Abstract
Cardio-oncology is an emerging multi-disciplinary field, which aims to reduce morbidity and mortality of cancer patients by preventing and managing cancer treatment-related cardiovascular toxicities. With the exponential growth in cancer and cardiovascular diseases in Asia, there is an emerging need for cardio-oncology awareness among physicians and country-specific cardio-oncology initiatives. In this state-of-the-art review, we sought to describe the burden of cancer and cardiovascular disease in Asia, a region with rich cultural and socio-economic diversity. From describing the uniqueness and challenges (such as socio-economic disparity, ethnical and racial diversity, and limited training opportunities) in establishing cardio-oncology in Asia, and outlining ways to overcome any barriers, this article aims to help advance the field of cardio-oncology in Asia.
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Affiliation(s)
- Choon Ta Ng
- Department of Cardiovascular Medicine, Mayo Clinic Rochester, Rochester, MN, USA
- Department of Cardiology, National Heart Centre Singapore, Singapore.
| | - Li Ling Tan
- Department of Cardiology, National University Heart Centre Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Il Suk Sohn
- Department of Cardiology, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | | | - Toru Oka
- Onco-Cardiology Unit, Department of Internal Medicine, Saitama Cancer Center, Saitama, Japan
| | | | - Wei-Ting Chang
- Division of Cardiology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, Taiwan
| | - Jun Hua Chong
- Department of Cardiology, National Heart Centre Singapore, Singapore
| | | | - Rochelle Regina Cruz
- Department of Cardiology, Cardinal Santos Medical Center, Metro Manila, The Philippines
| | - Astri Astuti
- Department of Cardiology and Vascular Medicine, Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Vivek Agarwala
- Department of Medical Oncology and Haemato-Oncology, Narayana Superspeciality Hospital and Cancer Institute, Howrah, India
| | - Van Chien
- Department of Cardiology, National Heart Institute, Hanoi, Vietnam
| | - Jong-Chan Youn
- Seoul St. Mary's Hospital, Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jieli Tong
- Department of Cardiology, Tan Tock Seng Hospital, Singapore
| | - Joerg Herrmann
- Department of Cardiovascular Medicine, Mayo Clinic Rochester, Rochester, MN, USA.
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3
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Kotevski DP, Smee RI, Field M, Broadley K, Vajdic CM. The Utility of Oncology Information Systems for Prognostic Modelling in Head and Neck Cancer. J Med Syst 2023; 47:9. [PMID: 36640212 PMCID: PMC9840592 DOI: 10.1007/s10916-023-01907-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 01/03/2023] [Indexed: 01/15/2023]
Abstract
Cancer centres rely on electronic information in oncology information systems (OIS) to guide patient care. We investigated the completeness and accuracy of routinely collected head and neck cancer (HNC) data sourced from an OIS for suitability in prognostic modelling and other research. Three hundred and fifty-three adults diagnosed from 2000 to 2017 with head and neck squamous cell carcinoma, treated with radiotherapy, were eligible. Thirteen clinically relevant variables in HNC prognosis were extracted from a single-centre OIS and compared to that compiled separately in a research dataset. These two datasets were compared for agreement using Cohen's kappa coefficient for categorical variables, and intraclass correlation coefficients for continuous variables. Research data was 96% complete compared to 84% for OIS data. Agreement was perfect for gender (κ = 1.000), high for age (κ = 0.993), site (κ = 0.992), T (κ = 0.851) and N (κ = 0.812) stage, radiotherapy dose (κ = 0.889), fractions (κ = 0.856), and duration (κ = 0.818), and chemotherapy treatment (κ = 0.871), substantial for overall stage (κ = 0.791) and vital status (κ = 0.689), moderate for grade (κ = 0.547), and poor for performance status (κ = 0.110). Thirty-one other variables were poorly captured and could not be statistically compared. Documentation of clinical information within the OIS for HNC patients is routine practice; however, OIS data was less correct and complete than data collected for research purposes. Substandard collection of routine data may hinder advancements in patient care. Improved data entry, integration with clinical activities and workflows, system usability, data dictionaries, and training are necessary for OIS data to generate robust research. Data mining from clinical documents may supplement structured data collection.
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Affiliation(s)
- Damian P Kotevski
- Department of Radiation Oncology, Prince of Wales Hospital, Level 1, Bright Building, Barker St, Randwick, NSW, 2031, Australia.
- Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Kensington, NSW, Australia.
| | - Robert I Smee
- Department of Radiation Oncology, Prince of Wales Hospital, Level 1, Bright Building, Barker St, Randwick, NSW, 2031, Australia
- Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Kensington, NSW, Australia
- Department of Radiation Oncology, Tamworth Base Hospital, Tamworth, NSW, Australia
| | - Matthew Field
- South Western Sydney Clinical School, Faculty of Medicine, University of New South Wales, Kensington, NSW, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Kathryn Broadley
- Cancer and Haematology Services, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Claire M Vajdic
- Centre for Big Data Research in Health, Faculty of Medicine, University of New South Wales, Kensington, NSW, Australia
- Kirby Institute, Faculty of Medicine, University of New South Wales, Kensington, NSW, Australia
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4
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Ngwa W, Addai BW, Adewole I, Ainsworth V, Alaro J, Alatise OI, Ali Z, Anderson BO, Anorlu R, Avery S, Barango P, Bih N, Booth CM, Brawley OW, Dangou JM, Denny L, Dent J, Elmore SNC, Elzawawy A, Gashumba D, Geel J, Graef K, Gupta S, Gueye SM, Hammad N, Hessissen L, Ilbawi AM, Kambugu J, Kozlakidis Z, Manga S, Maree L, Mohammed SI, Msadabwe S, Mutebi M, Nakaganda A, Ndlovu N, Ndoh K, Ndumbalo J, Ngoma M, Ngoma T, Ntizimira C, Rebbeck TR, Renner L, Romanoff A, Rubagumya F, Sayed S, Sud S, Simonds H, Sullivan R, Swanson W, Vanderpuye V, Wiafe B, Kerr D. Cancer in sub-Saharan Africa: a Lancet Oncology Commission. Lancet Oncol 2022; 23:e251-e312. [PMID: 35550267 PMCID: PMC9393090 DOI: 10.1016/s1470-2045(21)00720-8] [Citation(s) in RCA: 102] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/02/2021] [Accepted: 12/06/2021] [Indexed: 01/13/2023]
Abstract
In sub-Saharan Africa (SSA), urgent action is needed to curb a growing crisis in cancer incidence and mortality. Without rapid interventions, data estimates show a major increase in cancer mortality from 520 348 in 2020 to about 1 million deaths per year by 2030. Here, we detail the state of cancer in SSA, recommend key actions on the basis of analysis, and highlight case studies and successful models that can be emulated, adapted, or improved across the region to reduce the growing cancer crises. Recommended actions begin with the need to develop or update national cancer control plans in each country. Plans must include childhood cancer plans, managing comorbidities such as HIV and malnutrition, a reliable and predictable supply of medication, and the provision of psychosocial, supportive, and palliative care. Plans should also engage traditional, complementary, and alternative medical practices employed by more than 80% of SSA populations and pathways to reduce missed diagnoses and late referrals. More substantial investment is needed in developing cancer registries and cancer diagnostics for core cancer tests. We show that investments in, and increased adoption of, some approaches used during the COVID-19 pandemic, such as hypofractionated radiotherapy and telehealth, can substantially increase access to cancer care in Africa, accelerate cancer prevention and control efforts, increase survival, and save billions of US dollars over the next decade. The involvement of African First Ladies in cancer prevention efforts represents one practical approach that should be amplified across SSA. Moreover, investments in workforce training are crucial to prevent millions of avoidable deaths by 2030. We present a framework that can be used to strategically plan cancer research enhancement in SSA, with investments in research that can produce a return on investment and help drive policy and effective collaborations. Expansion of universal health coverage to incorporate cancer into essential benefits packages is also vital. Implementation of the recommended actions in this Commission will be crucial for reducing the growing cancer crises in SSA and achieving political commitments to the UN Sustainable Development Goals to reduce premature mortality from non-communicable diseases by a third by 2030.
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Affiliation(s)
- Wilfred Ngwa
- Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA; Sidney Kimmel Comprehensive Cancer Center, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Information and Sciences, ICT University, Yaoundé, Cameroon.
| | - Beatrice W Addai
- Breast Care International, Peace and Love Hospital, Kumasi, Ghana
| | - Isaac Adewole
- College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Victoria Ainsworth
- Department of Physics and Applied Physics, University of Massachusetts Lowell, Lowell, MA, USA
| | - James Alaro
- National Cancer Institute, National Institute of Health, Bethesda, MD, USA
| | | | - Zipporah Ali
- Kenya Hospices and Palliative Care Association, Nairobi, Kenya
| | - Benjamin O Anderson
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Non-communicable Diseases, WHO, Geneva, Switzerland
| | - Rose Anorlu
- Department of Obstetrics and Gynaecology, College of Medicine, University of Lagos, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Stephen Avery
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Prebo Barango
- WHO, Regional Office for Africa, Brazzaville, Republic of the Congo
| | - Noella Bih
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Christopher M Booth
- Division of Cancer Care and Epidemiology, Cancer Research Institute, Queen's University, Kingston, ON, Canada
| | - Otis W Brawley
- Sidney Kimmel Comprehensive Cancer Center, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | | | - Lynette Denny
- Department of Obstetrics and Gynaecology, University of Cape Town, Cape Town, South Africa; South African Medical Research Council, Gynaecological Cancer Research Centre, Tygerberg, South Africa
| | | | - Shekinah N C Elmore
- Department of Radiation Oncology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Ahmed Elzawawy
- Department of Clinical Oncology, Suez Canal University, Ismailia, Egypt
| | | | - Jennifer Geel
- Division of Paediatric Haematology and Oncology, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Katy Graef
- BIO Ventures for Global Health, Seattle, WA, USA
| | - Sumit Gupta
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | | | - Nazik Hammad
- Department of Oncology, Queen's University, Kingston, ON, Canada
| | - Laila Hessissen
- Pediatric Oncology Department, Pediatric Teaching Hospital, Rabat, Morocco
| | - Andre M Ilbawi
- Department of Non-communicable Diseases, WHO, Geneva, Switzerland
| | - Joyce Kambugu
- Department of Pediatrics, Uganda Cancer Institute, Kampala, Uganda
| | - Zisis Kozlakidis
- Laboratory Services and Biobank Group, International Agency for Research on Cancer, WHO, Lyon, France
| | - Simon Manga
- Cameroon Baptist Convention Health Services, Bamenda, Cameroon
| | - Lize Maree
- Department of Nursing Education, University of the Witwatersrand, Johannesburg, South Africa
| | - Sulma I Mohammed
- Department of Comparative Pathobiology, Center for Cancer Research, Purdue University, West Lafayette, IN, USA
| | - Susan Msadabwe
- Department of Radiation Therapy, Cancer Diseases Hospital, Lusaka, Zambia
| | - Miriam Mutebi
- Department of Surgery, Aga Khan University Hospital, Nairobi, Kenya
| | | | - Ntokozo Ndlovu
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Kingsley Ndoh
- Department of Global Health, University of Washington, Seattle, WA, USA
| | | | - Mamsau Ngoma
- Ocean Road Cancer Institute, Dar es Salaam, Tanzania
| | - Twalib Ngoma
- Department of Clinical Oncology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Timothy R Rebbeck
- Dana-Farber Cancer Institute, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Lorna Renner
- Department of Paediatrics, University of Ghana School of Medicine and Dentistry, Accra, Ghana
| | - Anya Romanoff
- Department of Health System Design and Global Health, Icahn School of Medicine, The Mount Sinai Hospital, New York, NY, USA
| | - Fidel Rubagumya
- Department of Oncology, Rwanda Military Hospital, Kigali, Rwanda; University of Global Health Equity, Kigali, Rwanda
| | - Shahin Sayed
- Department of Pathology, Aga Khan University Hospital, Nairobi, Kenya
| | - Shivani Sud
- Department of Radiation Oncology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Hannah Simonds
- Division of Radiation Oncology, Tygerberg Hospital and University of Stellenbosch, Stellenbosch, South Africa
| | | | - William Swanson
- Department of Physics and Applied Physics, Dana-Farber Cancer Institute, University of Massachusetts Lowell, Lowell, MA, USA
| | - Verna Vanderpuye
- National Centre for Radiotherapy, Oncology, and Nuclear Medicine, Korle Bu Teaching Hospital, Accra, Ghana
| | | | - David Kerr
- Radcliffe Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, UK
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5
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Yazdanian A. Oncology Information System: A Qualitative Study to Identify Cancer Patient Care Workflows. J Med Life 2021; 13:469-474. [PMID: 33456594 PMCID: PMC7803303 DOI: 10.25122/jml-2019-0169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Oncology information systems provide solutions for managing the information of cancer patients and enable monitoring of different aspects of cancer patient care. Since the use of oncology information systems enhances the quality of care, improves documentation, optimizes resource allocation, and increases the cost-effectiveness of care services, attention to these systems' performance and their adaptation to workflows seems necessary. The purpose of this study was to identify cancer patient care workflows to design an oncology information system for Iran. This study employed a qualitative design and was conducted in 2019. Semi-structured interviews were conducted with 25 experts to determine their views on identifying workflows for cancer patients' care. The participants were clinical and non-clinical staff at six university hospitals equipped with oncology wards. The method of data analysis was framework analysis. The cancer patient care workflows consisted of two categories, including cancer diagnosis workflows and cancer treatment workflows. Cancer diagnosis workflows fall into three subcategories, i.e., the patient's referral to the clinic, an examination of the patient's condition, and pathology workflows. On the other hand, cancer treatment workflows are divided into various treatments offered to cancer patients and workflows in the chemotherapy and radiotherapy wards. Given the variety of services and the complexity of caring for cancer patients as well as the involvement of various specialists in the process of care, identifying and optimizing workflows in the oncology information system reduces errors, enhances data accuracy, eliminates unnecessary steps, and ultimately improve the service delivery to cancer patients.
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Affiliation(s)
- Azadeh Yazdanian
- Department of Medical Record and Health Information Technology, School of Allied Medical Sciences,Mazandaran University of Medical Sciences, Sari, Iran
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6
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Organic generation of real-world real-time data for clinical evidence in radiation oncology. Int J Med Inform 2020; 144:104301. [DOI: 10.1016/j.ijmedinf.2020.104301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 10/09/2020] [Indexed: 11/21/2022]
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7
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Yazdanian A, Ayatollahi H, Nahvijou A. A Conceptual Model of an Oncology Information System. Cancer Manag Res 2020; 12:6341-6352. [PMID: 32821154 PMCID: PMC7419618 DOI: 10.2147/cmar.s259013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 07/10/2020] [Indexed: 12/24/2022] Open
Abstract
Introduction Oncologists are usually faced with a huge amount of diagnostic and therapeutic data in the process of cancer care. However, they do not have access to the integrated data. This research aimed to present a conceptual model of an oncology information system based on the users' requirements. Methods This study was conducted in 2019 and composed of two phases. Initially, a questionnaire was designed, and clinical experts (n=34) were asked to identify the most important data elements and functional requirements in an oncology information system. In the second phase, conceptual, structural and behavioral diagrams of the system were drawn based on the results of the first phase. These diagrams were also reviewed and validated by five experts. Results Most of the data elements and all functional requirements were found important by the experts. The data elements were related to different phases of cancer care including screening, prevention, diagnosis, treatment, mental care and pain relief, and end-of-life care. Then, conceptual, structural and behavioral diagrams of the system were designed and approved by the experts or revised based on their comments. Conclusion The conceptual model and the diagrams presented in the current study can be used for developing an oncology information system. This system will be able to manage patients' cancer data from screening to the end-of-life care. However, the system needs to be designed and implemented in a real healthcare setting to see how it can meet users' requirements.
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Affiliation(s)
- Azadeh Yazdanian
- Department of Medical Records and Health Information Technology, School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
| | - Haleh Ayatollahi
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.,Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Azin Nahvijou
- Cancer Research Center of Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
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Zhang B, Chen S, D'Souza WD, Yi B. A systematic quality assurance framework for the upgrade of radiation oncology information systems. Phys Med 2020; 69:28-35. [DOI: 10.1016/j.ejmp.2019.11.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 11/08/2019] [Accepted: 11/26/2019] [Indexed: 11/24/2022] Open
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Yazdanian A, Ayatollahi H, Nahvijou A. Oncology Information System: A Qualitative Study of Users' Requirements. Asian Pac J Cancer Prev 2019; 20:3085-3091. [PMID: 31653158 PMCID: PMC6982650 DOI: 10.31557/apjcp.2019.20.10.3085] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Indexed: 11/25/2022] Open
Abstract
Background: Cancer care is a complex care process and is associated with generating a variety of data during the care process. Therefore, it seems that designing and using information systems is necessary to enhance the accessibility, organization and management of cancer-related data. The aim of this study was to identify users’ requirements of an oncology information system (OIS). Methods: This was a qualitative study conducted in 2018. In depth semi-structured interviews were performed with clinicians and non-clinicians in five teaching hospitals to identify users’ requirements. Data were analyzed by using framework analysis. Results: The four themes emerged from data analysis included: a) methods of recording cancer data in the hospitals, b) required cancer data in different departments, c) comprehensive cancer care documentation, and d) required functions of an oncology information system. Conclusion: According to the results, currently, electronic documentation is less frequently used for cancer patients. Therefore, an extensive effort is needed to identify users’ requirements before designing and implementing an oncology information system. As multidisciplinary teams are involved in cancer care, all potential users and their requirements should be taken into account. Such a system can help to collect and use cancer data effectively.
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Affiliation(s)
- Azaeh Yazdanian
- School of Allied Medical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
| | - Haleh Ayatollahi
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.,Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Azin Nahvijou
- Cancer Research Center of Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
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Dornan L, Pinyopornpanish K, Jiraporncharoen W, Hashmi A, Dejkriengkraikul N, Angkurawaranon C. Utilisation of Electronic Health Records for Public Health in Asia: A Review of Success Factors and Potential Challenges. BIOMED RESEARCH INTERNATIONAL 2019; 2019:7341841. [PMID: 31360723 PMCID: PMC6644215 DOI: 10.1155/2019/7341841] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 06/10/2019] [Accepted: 06/27/2019] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Electronic health records offer a valuable resource to improve health surveillance and evaluation as well as informing clinical decision making. They have been introduced in many different settings, including low- and middle-income countries, yet little is known of the progress and effectiveness of similar information systems within Asia. This study examines the implementation of EHR systems for use at a population health level in Asia and to identify their current role within public health, key success factors, and potential barriers in implementation. MATERIAL AND METHODS A systematic search process was implemented. Five databases were searched with MeSH key terms and Boolean phrases. Articles selected for this review were based on hospital provider electronic records with a component of implementation, utilisation, or evaluation for health systems or at least beyond direct patient care. A proposed analytic framework considered three interactive components: the content, the process, and the context. RESULTS Thirty-two articles were included in the review. Evidence suggests that benefits are significant but identifying and addressing potential challenges are critical for success. A comprehensive preparation process is necessary to implement an effective and flexible system. DISCUSSION Electronic health records implemented for public health can allow the identification of disease patterns, seasonality, and global trends as well as risks to vulnerable populations. Addressing implementation challenges will facilitate the development and efficacy of public health initiatives in Asia to identify current health needs and mitigate future risks.
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Affiliation(s)
- Lesley Dornan
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Muang, Chiang Mai, 50200, Thailand
| | - Kanokporn Pinyopornpanish
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Muang, Chiang Mai, 50200, Thailand
| | - Wichuda Jiraporncharoen
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Muang, Chiang Mai, 50200, Thailand
| | - Ahmar Hashmi
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Muang, Chiang Mai, 50200, Thailand
| | - Nisachol Dejkriengkraikul
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Muang, Chiang Mai, 50200, Thailand
| | - Chaisiri Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Muang, Chiang Mai, 50200, Thailand
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11
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Islam MM, Poly TN, Li YCJ. Recent Advancement of Clinical Information Systems: Opportunities and Challenges. Yearb Med Inform 2018; 27:83-90. [PMID: 30157510 PMCID: PMC6115226 DOI: 10.1055/s-0038-1667075] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objectives:
Clinical information systems (CISs) have generated opportunities for meaningful improvements both in patient care and workflow but there is still a long way to perfection. Healthcare providers are still facing challenges of data exchange, management, and integration due to lack of functionality among these systems. Our objective here is to systematically review, synthesize, and summarize the literature that describes the current stage of clinical information systems, so as to assess the current state of knowledge, and identify benefits and challenges.
Methods:
PubMed, EMBASE, and the bibliographies of articles were searched for studies published until September 1, 2017, which reported on significant advancement of clinical information systems, as well as problems and opportunities in this field. Studies providing the most detailed information were included and the others were kept only as references.
Results:
We selected 23 papers out of 1,026 unique abstracts for full-text review using our selection criteria, and 20 out of these 23 studies met all of our inclusion criteria. We focused on three major areas: 1) Ambulatory and inpatients clinical information systems; 2) Specialty information systems; and 3) Ancillary information systems. As CIS can support evidence-based practices that, in turn, improve patient's safety, quality and efficacy of care, advancement, acceptability, and adaptability of CIS have increased worldwide. Although, the demand for CIS functionality is rising fast, current CISs still have data integration challenges and lack of functionality to exchange patient information from all or some parts of the healthcare system. These limitations can be attributed to technical, human, and organizational factors
Conclusion:
Clinical information systems provide tremendous opportunities to reduce clinical errors such as medication errors and diagnostic errors and to support healthcare professionals by offering up-to-date patient information. They promise to improve workflow and efficiency of care, thus boosting the overall quality of healthcare.
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Affiliation(s)
- Md Mohaimenul Islam
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,International Center for Health Information Technology, Taipei Medical University, Taipei, Taiwan
| | - Tahmina Nasrin Poly
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,International Center for Health Information Technology, Taipei Medical University, Taipei, Taiwan
| | - Yu-Chuan Jack Li
- Graduate Institute of Biomedical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan.,International Center for Health Information Technology, Taipei Medical University, Taipei, Taiwan.,TMU Research Center of Cancer Translational Medicine, Taipei, Taiwan
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Janssen A, Brunner M, Keep M, Hines M, Nagarajan SV, Kielly-Carroll C, Dennis S, McKeough Z, Shaw T. Interdisciplinary eHealth Practice in Cancer Care: A Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111289. [PMID: 29068377 PMCID: PMC5707928 DOI: 10.3390/ijerph14111289] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 10/18/2017] [Accepted: 10/19/2017] [Indexed: 01/25/2023]
Abstract
This review aimed to identify research that described how eHealth facilitates interdisciplinary cancer care and to understand the ways in which eHealth innovations are being used in this setting. An integrative review of eHealth interventions used for interdisciplinary care for people with cancer was conducted by systematically searching research databases in March 2015, and repeated in September 2016. Searches resulted in 8531 citations, of which 140 were retrieved and scanned in full, with twenty-six studies included in the review. Analysis of data extracted from the included articles revealed five broad themes: (i) data collection and accessibility; (ii) virtual multidisciplinary teams; (iii) communication between individuals involved in the delivery of health services; (iv) communication pathways between patients and cancer care teams; and (v) health professional-led change. Use of eHealth interventions in cancer care was widespread, particularly to support interdisciplinary care. However, research has focused on development and implementation of interventions, rather than on long-term impact. Further research is warranted to explore design, evaluation, and long-term sustainability of eHealth systems and interventions in interdisciplinary cancer care. Technology evolves quickly and researchers need to provide health professionals with timely guidance on how best to respond to new technologies in the health sector.
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Affiliation(s)
- Anna Janssen
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW 2141, Australia.
| | - Melissa Brunner
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW 2141, Australia.
- Faculty of Education and Arts, The University of Newcastle, Newcastle, NSW 2308, Australia.
| | - Melanie Keep
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW 2141, Australia.
| | - Monique Hines
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW 2141, Australia.
| | | | | | - Sarah Dennis
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW 2141, Australia.
- Ingham Institute of Applied Medical Research, Liverpool, NSW 2170, Australia.
| | - Zoe McKeough
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW 2141, Australia.
| | - Tim Shaw
- Faculty of Health Sciences, The University of Sydney, Sydney, NSW 2141, Australia.
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Sicotte C, Lapointe J, Clavel S, Fortin MA. Benefits of improving processes in cancer care with a care pathway-based electronic medical record. Pract Radiat Oncol 2016; 6:26-33. [DOI: 10.1016/j.prro.2015.08.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 08/25/2015] [Accepted: 08/29/2015] [Indexed: 11/28/2022]
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Mayer DK, Shapiro CL, Jacobson P, McCabe MS. Assuring Quality Cancer Survivorship Care: We've Only Just Begun. Am Soc Clin Oncol Educ Book 2015:e583-e591. [PMID: 25993226 DOI: 10.14694/edbook_am.2015.35.e583] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Clinical practice guidelines, quality metrics, and performance improvement projects are the key tools of the national movement to improve and assure quality cancer care. Each of these evaluation instruments is intended to assess quality from a unique perspective, including that of the individual provider, the practice/hospital, and the health care system. A number of organizations have developed or endorsed quality measures specific to cancer, however, these have not formally included survivorship measures. Fortunately, the American Society of Clinical Oncology (ASCO), the National Comprehensive Cancer Network, the American Cancer Society, and the American College of Surgeons (ACoS) have taken a leadership role in developing survivorship guidelines and quality metrics. Both ASCO and ACoS have focused their efforts on the treatment summary and care plan, a document that was proposed in the 2006 Institute of Medicine report on cancer survivorship. ASCO has proposed a care plan template for implementation and incorporation into the electronic health records (EHR), which will lend itself to structure, process, and outcome measurement. ACoS, conversely, has included the care plan in its cancer program standards with annual evaluation metrics. In addition, ASCO has developed a number of key survivorship-relevant metrics as part of its Quality Oncology Practice Initiative (QOPI), a tool developed to measure quality cancer care and assess adherence to guidelines across academic and community practices. Together, these efforts will direct us to more effective ways to disseminate guideline recommendations and to better methods of assessing quality survivorship care nationally.
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Affiliation(s)
- Deborah K Mayer
- From the School of Nursing, UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Dubin Breast Center, Translational Breast Cancer Research, Tisch Cancer Institute, Mount Sinai Medical Center, Division of Hematology/Medical Oncology, Tisch Cancer Institute, New York, NY; Clinical Programs, Survivorship Center, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Charles L Shapiro
- From the School of Nursing, UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Dubin Breast Center, Translational Breast Cancer Research, Tisch Cancer Institute, Mount Sinai Medical Center, Division of Hematology/Medical Oncology, Tisch Cancer Institute, New York, NY; Clinical Programs, Survivorship Center, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Paul Jacobson
- From the School of Nursing, UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Dubin Breast Center, Translational Breast Cancer Research, Tisch Cancer Institute, Mount Sinai Medical Center, Division of Hematology/Medical Oncology, Tisch Cancer Institute, New York, NY; Clinical Programs, Survivorship Center, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Mary S McCabe
- From the School of Nursing, UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Dubin Breast Center, Translational Breast Cancer Research, Tisch Cancer Institute, Mount Sinai Medical Center, Division of Hematology/Medical Oncology, Tisch Cancer Institute, New York, NY; Clinical Programs, Survivorship Center, Memorial Sloan Kettering Cancer Center, New York, NY
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