Can a healthy youth development clinic serving latino families be youth friendly and family oriented? A mixed-methods evaluation.

BACKGROUND: Parenting adolescents poses challenges that are exacerbated by immigration. Aqui Para Ti [Here for You] (APT) is a clinic-based, healthy youth development program that provides family-centered care for Latino youth and their families who are mostly immigrants from Mexico and Latin America. OBJECTIVES: To present the APT model of care and report the experiences of youth and their parents. SUBJECTS: APT patients between 11 and 24 years (n=30) and parents (n=15). Most youth patients were female, between 11 and 17 years, and from Mexico. Most parents were female, 40 years or younger, and from Mexico. METHODS: Youth participants completed a survey and participated in an individual semi-structured interview, and parent participants attended focus groups. Descriptive statistics summarized survey data. Interviews and focus groups were transcribed and analyzed in Spanish using content analysis by two independent coders. Quantitative and qualitative findings were integrated using side-by-side comparisons. Researchers not involved in the coding process contributed with the interpretation of the findings. RESULTS: Youth and parents were satisfied with the services received at APT. Youth felt listened to by their providers (100%), felt they could trust them (100%) and valued comprehensive care. Eighty-seven percent reported that their experiences at APT were better than at other clinics. Parents valued the family parallel care, confidentiality, family-centeredness, and the cultural inclusivity of the APT services. CONCLUSION: Patients and parents were satisfied with the services offered at APT. Family parallel care could be a positive alternative to deliver confidential and family-centered services to immigrant families.

Towards the Implementation of an openEHR-based Open Source EHR Platform (a vision paper).

Healthcare Information Systems are a big business. Currently there is an explosion of EHR/EMR products available on the market, and the best tools are really expensive. Many developing countries and healthcare providers cannot access such tools, and for those who can, there is not a clear strategy for the evolution, scaling, and cost of these electronic health products. The lack of standard-based implementations conduct to the creation of isolated information silos that cannot be exploited (i.e. shared between providers to promote a holistic view of each patient's medical history). This paper exposes the main elements behind a Standard-based Open Source EHR Platform that is future-proof and allows to evolve and scale with minimal cost. The proposed EHR Architecture is based on openEHR specifications, adding elements emerged from research and development experiences, leading to a design that can be implemented in any modern technology. Different implementations will be interoperable by design. This Platform will leverage contexts of scarce resources, reusing clinical knowledge, a common set of software components and services.

Electronic medical record: a balancing act of patient safety, privacy and health care delivery.

With almost $35 billion appropriated in government incentives and additional funds spent in development by institutions, the concept of an electronic patient record (EPR) within integrated health information technology (HIT) systems has taken the United States by storm. However, the United Kingdom's expensive struggle to implement a seamless EPR highlights the variety of pitfalls and unforeseen complications ranging from recognizing the importance of accurately assessing EPR-related patient risks to understanding the difficulties in the exchange of information across a gradient of distinct interfaces. Furthermore, the tenuous relationship between HIT implementation and patient outcomes in the short-term draws into question the value of EPR construction costs along with the ethical and privacy issues they create. Nonetheless, experts agree that with future software advances and physician familiarization, a robust HIT will be an important asset to patient autonomy, epidemiologic and clinical research, evidence-based error reduction and the potential for cost reduction. This article seeks to review the current status of this initiative and potential pitfalls that remain.

La protección de datos en la práctica privada / Data protection in private practice

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Protecting and using patient information: the role of the Caldicott Guardian.

All patient information is confidential and must be protected and used appropriately by all members of the healthcare team. Caldicott Guardians have a strategic, advisory and facilitative role to ensure that the Caldicott Principles underpin the approach organizations develop to protect and use patient identifiable information. It is essential all staff and students receive appropriate training and are aware that the responsibility for protecting and using patient information lies with the organisation headed by the Chief Executive and with each individual.

Ethical dilemmas in personality assessment courses: using the classroom for in vivo training.

In this article, we argue that the student's first lessons in ethical decision making in personality assessment are in those assessment courses that have a practice component. In these courses, the student has an opportunity to experience in vivo how ethical problems are identified, addressed, and resolved. The faculty member's demonstration of a process wherein the ethical principles activated are highlighted and explored, will enable students to internalize a model for addressing future dilemmas. Four particular ethical situations are considered: (a) the students' procurement of personal experience with personality testing, (b) the identification of assessment participants, (c) the development of informed consent procedures for assessment participants, and (d) classroom presentations. This discussion does not provide concrete solutions to ethical problems but offers a consideration of the relevant ethical principles that any adequate solution must encompass.