Quality Requirements for Electronic Health Record Systems*. A Japanese-German Information Management Perspective.

BACKGROUND: For more than 30 years, there has been close cooperation between Japanese and German scientists with regard to information systems in health care. Collaboration has been formalized by an agreement between the respective scientific associations. Following this agreement, two joint workshops took place to explore the similarities and differences of electronic health record systems (EHRS) against the background of the two national healthcare systems that share many commonalities. OBJECTIVES: To establish a framework and requirements for the quality of EHRS that may also serve as a basis for comparing different EHRS. METHODS: Donabedian's three dimensions of quality of medical care were adapted to the outcome, process, and structural quality of EHRS and their management. These quality dimensions were proposed before the first workshop of EHRS experts and enriched during the discussions. RESULTS: The Quality Requirements Framework of EHRS (QRF-EHRS) was defined and complemented by requirements for high quality EHRS. The framework integrates three quality dimensions (outcome, process, and structural quality), three layers of information systems (processes and data, applications, and physical tools) and three dimensions of information management (strategic, tactical, and operational information management). CONCLUSIONS: Describing and comparing the quality of EHRS is in fact a multidimensional problem as given by the QRF-EHRS framework. This framework will be utilized to compare Japanese and German EHRS, notably those that were presented at the second workshop.

GramHealth: a bottom-up approach to provide preventive healthcare services for unreached community.

Insufficient healthcare facilities and unavailability of medical experts in rural areas are the two major reasons that kept the people unreached to healthcare services. Recent penetration of mobile phone and the demand to basic healthcare services, remote health consultancy over mobile phone became popular in developing countries. In this paper, we introduce two such representative initiatives from Bangladesh and discuss the technical challenges they face to serve a remote patient. To solve these issues, we have prototyped a box with necessary diagnostic tools, we call it a "portable clinic" and a software tool, "GramHealth" for managing the patient information. We carried out experiments in three villages in Bangladesh to observe the usability of the portable clinic and verify the functionality of "GramHealth". We display the qualitative analysis of the results obtained from the experiment. GramHealth DB has a unique combination of structured, semi-structured and un-structured data. We are currently looking at these data to see whether these can be treated as BigData and if yes, how to analyze the data and what to expect from these data to make a better clinical decision support.