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1.
Infect Dis Poverty ; 9(1): 93, 2020 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-32660568

RESUMO

BACKGROUND: The Coronavirus Disease 2019 (COVID-19) pandemic has sparked attention in many countries, especially those that have experienced a steep spike in the number of identified cases. The continued spread of the coronavirus suggests that this situation may be here to stay for a while. Contact tracing is a time-consuming and resource-intensive process, which taps on the already lean healthcare resource in certain countries. Furthermore, the massive infodemic on COVID-19 on the Internet has also resulted in widespread circulation of misinformation online. This outbreak has evoked irrational fear and anxiety from the public, which has resulted in destabilizing of societal norms, such as panic buying and hoarding of daily necessities, and can potentially pose serious health risks to the public. The aim of this paper is to present a COVID-19 Symptom Monitoring and Contact Tracking Record (CoV-SCR) web-app as a bottom-up, proactive approach to supplement the current management strategies for COVID-19. MAIN TEXT: The CoV-SCR web-app ( http://bit.ly/covscrapp ) enables individuals to keep a personal record of their close contacts and monitor their symptoms on a daily basis, so that they can provide relevant and accurate details when they see the doctor and during the contact tracing process. Individuals can record their temperature and rate their symptoms on a 5-point severity scale, as well as record details of their travel and contact history for the last 14 days. The recorded information will be sent to their e-mail address for potential symptom monitoring and contact tracing purposes. In addition, this web-app consolidates evidence-based information on the coronavirus from credible sources, such as the World Health Organization, countries' health authorities, and PubMed literature. CONCLUSIONS: A COVID-19 Symptom Monitoring and Contact Tracking web-app has been developed to facilitate contact tracing efforts through public engagement. This app serves an additional purpose of providing information about COVID-19 from reliable resources.


Assuntos
Betacoronavirus/fisiologia , Busca de Comunicante/métodos , Infecções por Coronavirus/diagnóstico , Monitoramento Epidemiológico , Registros de Saúde Pessoal , Aplicativos Móveis , Pneumonia Viral/diagnóstico , Busca de Comunicante/instrumentação , Humanos , Pandemias
2.
Cien Saude Colet ; 25(suppl 1): 2487-2492, 2020 Jun.
Artigo em Português, Inglês | MEDLINE | ID: covidwho-594341

RESUMO

Data has become increasingly important and valuable for both scientists and health authorities searching for answers to the COVID-19 crisis. Due to difficulties in diagnosing this infection in populations around the world, initiatives supported by digital technologies are being developed by governments and private companies to enable the tracking of the public's symptoms, contacts and movements. Considering the current scenario, initiatives designed to support infection surveillance and monitoring are essential and necessary. Nonetheless, ethical, legal and technical questions abound regarding the amount and types of personal data being collected, processed, shared and used in the name of public health, as well as the concomitant or posterior use of this data. These challenges demonstrate the need for new models of responsible and transparent data and technology governance in efforts to control SARS-COV2, as well as in future public health emergencies.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Saúde Global , Registros de Saúde Pessoal , Pandemias , Pneumonia Viral/epidemiologia , Vigilância da População/métodos , Privacidade , Confidencialidade , Busca de Comunicante/métodos , Anonimização de Dados , Humanos , Mídias Sociais
3.
Stud Health Technol Inform ; 270: 931-935, 2020 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-32570518

RESUMO

Personal health records could help patients overcome the anxiety related to gaps on health related information. The objective of this research was to explore what type of information was perceived by patients as useful to receive as a notification on their PHR as a framework for the design of a patient-centered notification system. We applied a qualitative approach followed by usability tests. From interviews to patients, we obtained main categories of notifications to include according to its perceived usefulness while, from iterative usability tests, we obtained a final version of prototypes developed according to patient-interface interaction experiences. This research helped us to understand patients needs and behavior to design an efficient notification system and also represents the first step for the development of clinical decision support systems for patients into the PHR with the potential to improve clinical outcomes and healthcare delivery.


Assuntos
Registros de Saúde Pessoal , Assistência à Saúde
4.
Stud Health Technol Inform ; 270: 1021-1025, 2020 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-32570536

RESUMO

The work environment for nurses is challenging, and even though new technology has major advantages, it has often also caused new stressors and problems for nurses. When Patient Accessible Electronic Health Records (PAEHR) was introduced in Sweden, research showed that nurses were worried about possible negative effects for patients as well as on their work. However, to this date there are very few follow up studies on the more long term effects of PAEHR, despite research pointing to the fact that reactions after long term use might differ from initial experiences. In this paper we present an interview study to fill this research gap. An analysis based on interviews with physicians and nurses in Oncology care reveals three areas where nurses' work is experienced to have been affected: 1) nurses receive more questions from patients after PAEHR has been introduced, 2) nurses have changed their documentation practices and 3) the log list functionality has made nurses feel questioned. Finally, these results are discussed in relation to nurses' work environment from a sociotechnical and gender perspective.


Assuntos
Registros de Saúde Pessoal , Registros Eletrônicos de Saúde , Humanos , Enfermeiras e Enfermeiros , Médicos , Suécia , Local de Trabalho
5.
Stud Health Technol Inform ; 270: 1056-1060, 2020 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-32570543

RESUMO

During recent years, patient accessible electronic health records (PAEHRs) have been implemented nationally in Sweden, as well as internationally, as a means of supporting patient engagement and shared decision making. Few studies have, however, investigated the long-term effects of PAEHRs on communicaiton with care professionals and involvement in care. The national survey study presented here, answered by 2587 patients in Sweden, focuses on these aspects specifically. The results show that the Swedish PAEHR system Journalen has had a positive impact on communication with care overall (84% agree or strongly agree with that communication with medical staff has improved), but only 31% agree or strongly agree with that the content of the PAEHR is discussed with care professionals. Journalen also seems to have a positive impact on involvement in care, but the results are mixed when it comes to effects on shared decision making.


Assuntos
Registros Eletrônicos de Saúde , Registros de Saúde Pessoal , Comunicação , Humanos , Inquéritos e Questionários , Suécia
6.
Cien Saude Colet ; 25(suppl 1): 2487-2492, 2020 Jun.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32520293

RESUMO

Data has become increasingly important and valuable for both scientists and health authorities searching for answers to the COVID-19 crisis. Due to difficulties in diagnosing this infection in populations around the world, initiatives supported by digital technologies are being developed by governments and private companies to enable the tracking of the public's symptoms, contacts and movements. Considering the current scenario, initiatives designed to support infection surveillance and monitoring are essential and necessary. Nonetheless, ethical, legal and technical questions abound regarding the amount and types of personal data being collected, processed, shared and used in the name of public health, as well as the concomitant or posterior use of this data. These challenges demonstrate the need for new models of responsible and transparent data and technology governance in efforts to control SARS-COV2, as well as in future public health emergencies.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Saúde Global , Registros de Saúde Pessoal , Pandemias , Pneumonia Viral/epidemiologia , Vigilância da População/métodos , Privacidade , Confidencialidade , Busca de Comunicante/métodos , Anonimização de Dados , Humanos , Mídias Sociais
7.
Stud Health Technol Inform ; 270: 1347-1348, 2020 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-32570652

RESUMO

Personal Health Record (PHR) is not just the collection of personal health data but also a personal healthcare and disease management tool for the individual patient as well as a communication tool with the medical staff. Moreover, recently PHR has been considered an indispensable tool for patient engagement in the area of non-communicable diseases (NCDs) and has gained importance. Like many other developing countries, the growth of NCDs is very high in Bangladesh. Portable Health Clinic (PHC) system has been developed there with a focus on NCDs and PHR is there from the beginning. This study for the standardization of PHR system of PHC with the reference of the PHR proposed by Japanese Clinical Societies could be a reference work for the national PHR system development in the country.


Assuntos
Registros de Saúde Pessoal , Instituições de Assistência Ambulatorial , Bangladesh , Comunicação , Registros Eletrônicos de Saúde , Humanos , Participação do Paciente
9.
Stud Health Technol Inform ; 270: 1373-1374, 2020 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-32570665

RESUMO

We developed the service showing patient health record altogether which is managed by each hospital separately and recording the patient health information based on mobile application. We evaluated the effectiveness and satisfaction of the service. This study is aimed to reduce instances where patient's medical records are unknown to the medical staff in emergencies and allow patients to use and utilize their health information.


Assuntos
Registros de Saúde Pessoal , Registros Eletrônicos de Saúde , Emergências , Humanos , Aplicativos Móveis , Satisfação Pessoal
10.
JMIR Mhealth Uhealth ; 8(7): e19902, 2020 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-32568728

RESUMO

BACKGROUND: As a counter-cluster measure to prevent the spread of the infectious novel coronavirus disease (COVID-19), an efficient system for health observation outside the hospital is urgently required. Personal health records (PHRs) are suitable for the daily management of physical conditions. Importantly, there are no major differences between the items collected by daily health observation via PHR and the observation of items related to COVID-19. Until now, observations related to COVID-19 have been performed exclusively based on disease-specific items. Therefore, we hypothesize that PHRs would be suitable as a symptom-tracking tool for COVID-19. To this end, we integrated health observation items specific to COVID-19 with an existing PHR-based app. OBJECTIVE: This study is conducted as a proof-of-concept study in a real-world setting to develop a PHR-based COVID-19 symptom-tracking app and to demonstrate the practical use of health observations for COVID-19 using a smartphone or tablet app integrated with PHRs. METHODS: We applied the PHR-based health observation app within an active epidemiological investigation conducted by Wakayama City Public Health Center. At the public health center, a list is made of individuals who have been in close contact with known infected cases (health observers). Email addresses are used by the app when a health observer sends data to the public health center. Each health observer downloads the app and installs it on their smartphone. Self-observed health data are entered daily into the app. These data are then sent via the app by email at a designated time. Localized epidemiological officers can visualize the collected data using a spreadsheet macro and, thus, monitor the health condition of all health observers. RESULTS: We used the app as part of an active epidemiological investigation executed at a public health center. During the investigation, 72 close contacts were discovered. Among them, 57 had adopted the use of the health observation app. Before the introduction of the app, all health observers would have been interviewed by telephone, a slow process that took four epidemiological officers more than 2 hours. After the introduction of the app, a single epidemiological officer can carry out health observations. The app was distributed for free beginning in early March, and by mid-May, it had been used by more than 20,280 users and 400 facilities and organizations across Japan. Currently, health observation of COVID-19 is socially recognized and has become one of the requirements for resuming social activities. CONCLUSIONS: Health observation by PHRs for the purpose of improving health management can also be effectively applied as a measure against large-scale infectious diseases. Individual habits of improving awareness of personal health and the use of PHRs for daily health management are powerful armaments against the rapid spread of infectious diseases. Ultimately, similar actions may help to prevent the spread of COVID-19.


Assuntos
Busca de Comunicante/métodos , Infecções por Coronavirus/prevenção & controle , Registros de Saúde Pessoal , Aplicativos Móveis , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/epidemiologia , Estudos de Viabilidade , Humanos , Japão/epidemiologia , Pneumonia Viral/epidemiologia
13.
PLoS One ; 15(3): e0230522, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32214333

RESUMO

Chart review is an important tool to identify patient hazards. Most advanced medical students perform poorly during chart review but can learn how to identify patient hazards context-independently. Many hospitals have implemented electronic health records, which enhance patient safety but also pose challenges. We investigated whether electronic charts impair advanced medical students' recognition of patient hazards compared with traditional paper charts. Fifth-year medical students were randomized into two equal groups. Both groups attended a lecture on patient hazards and a training session on handling electronic health records. One group reviewed an electronic chart with 12 standardized patient hazards and then reviewed another case in a paper chart; the other group reviewed the charts in reverse order. The two case scenarios (diabetes and gastrointestinal bleeding) were used as the first and second case equally often. After each case, the students were briefed about the patient safety hazards. In total, 78.5% of the students handed in their notes for evaluation. Two blinded raters independently assessed the number of patient hazards addressed in the students' notes. For the diabetes case, the students identified a median of 4.0 hazards [25%-75% quantiles (Q25-Q75): 2.0-5.5] in the electronic chart and 5.0 hazards (Q25-Q75: 3.0-6.75) in the paper chart (equivalence testing, p = 0.005). For the gastrointestinal bleeding case, the students identified a median of 5.0 hazards (Q25-Q75: 4.0-6.0) in the electronic chart and 5.0 hazards (Q25-Q75: 3.0-6.0) in the paper chart (equivalence testing, p < 0.001). We detected no improvement between the first case [median 5.0 (Q25-Q75: 3.0-6.0)] and second case [median, 5.0 (Q25-Q75: 3.0-6.0); p < 0.001, test for equivalence]. Electronic charts do not seem to facilitate advanced medical students' recognition of patient hazards during chart review and may impair expertise formation.


Assuntos
Registros Eletrônicos de Saúde , Registros de Saúde Pessoal , Segurança do Paciente , Estudantes de Medicina , Adulto , Complicações do Diabetes/complicações , Complicações do Diabetes/diagnóstico , Diabetes Mellitus/diagnóstico , Educação Médica , Feminino , Hemorragia Gastrointestinal/complicações , Hemorragia Gastrointestinal/diagnóstico , Humanos , Masculino , Reconhecimento Psicológico , Adulto Jovem
14.
Am J Nurs ; 120(4): 19-20, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32218037

RESUMO

Partnerships between tech companies and health systems challenge privacy expectations and laws.


Assuntos
Confidencialidade/normas , Registros de Saúde Pessoal/ética , Privacidade/legislação & jurisprudência , Confidencialidade/legislação & jurisprudência , Humanos , Governo Estadual
15.
J Med Syst ; 44(2): 53, 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31925566

RESUMO

The focus on personal data has merited the EU concerns and attention, resulting in the legislative change regarding privacy and the protection of personal data. The General Data Protection Regulation (GDPR) aims to reform existing measures on the protection of personal data of European Union citizens, with a strong impact on the rights and freedoms of individuals in establishing rules for the processing of personal data. The GDPR considers a special category of personal data, the health data, being these considered as sensitive data and subject to special conditions regarding treatment and access by third parties. This work presents the evolution of the applicability of the Regulation (EU) 2016/679 six months after its application in Portuguese health clinics. The results of the present study are discussed in the light of future literature and work are identified.


Assuntos
Acesso à Informação/legislação & jurisprudência , Segurança Computacional/legislação & jurisprudência , Registros Eletrônicos de Saúde/legislação & jurisprudência , Sistemas de Informação Hospitalar/legislação & jurisprudência , Segurança Computacional/normas , Registros Eletrônicos de Saúde/normas , União Europeia , Troca de Informação em Saúde/legislação & jurisprudência , Registros de Saúde Pessoal , Sistemas de Informação Hospitalar/normas , Humanos
16.
J Med Internet Res ; 22(1): e15585, 2020 01 08.
Artigo em Inglês | MEDLINE | ID: mdl-31913129

RESUMO

BACKGROUND: As the US health care system is embracing data-driven care, personal health information (PHI) has become a valuable resource for various health care stakeholders. In particularly, health consumers are expected to autonomously manage and share PHI with their health care partners. To date, there have been mixed views on the factors influencing individuals' health data-sharing behaviors. OBJECTIVE: This study aimed to identify a key factor to better understand health information sharing behavior from a health consumer's perspective. We focused on daily settings, wherein health data-sharing behavior becomes a part of individuals' daily information management activities. Considering the similarity between health and finance information management, we explicitly examined whether health consumers' daily habit of similar data sharing from the financial domain affects their PHI-sharing behaviors in various scenarios. METHODS: A Web-based survey was administered to US health consumers who have access to and experience in using the internet. We collected individual health consumers' intention to share PHI under varying contexts, habit of financial information management (operationalized as internet banking [IB] use in this paper), and the demographic information from the cross-sectional Web-based survey. To isolate the effect of daily IB on PHI-sharing behaviors in everyday contexts, propensity score matching was used to estimate the average treatment effect (ATE) and average treatment effect on the treated (ATET) regarding IB use. We balanced the treatment and control groups using caliper matching based on the observed confounding variables (ie, gender, income, health status, and access to primary care provider), all of which resulted in a minimal level of bias between unmatched and matched samples (bias <5%). RESULTS: A total of 339 responses were obtained from a cross-sectional Web-based survey. The ATET results showed that in terms of sharing contents, those who used IB daily were more likely to share general information (P=.01), current information (P=.003), and entire data (P=.04). Regarding occasions for sharing occasions, IB users were prone to share their information in all cases (P=.02). With regard to sharing recipients, daily IB users were more willing to share their personal health data with stakeholders who were not directly involved in their care, such as health administrators (P=.05). These results were qualitatively similar to the ATE results. CONCLUSIONS: This study examined whether daily management of similar information (ie, personal financial information) changes health consumers' PHI-sharing behavior under varying sharing conditions. We demonstrated that daily financial information management can encourage health information sharing to a much broader extent, in several instances, and with many stakeholders. We call for more attention to this unobserved daily habit driven by the use of various nonhealth technologies, all of which can implicitly affect patterns and the extent of individuals' PHI-sharing behaviors.


Assuntos
Registros de Saúde Pessoal , Disseminação de Informação/métodos , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
17.
Artigo em Japonês | MEDLINE | ID: mdl-31956179
18.
Support Care Cancer ; 28(8): 3905-3914, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31853699

RESUMO

PURPOSE: The objective of this article is to demonstrate how user-centered design theory and methods can be employed to develop and iteratively improve technologies to support survivors of childhood cancer. METHODS: Focus groups and structured interviews with young adult survivors of pediatric cancer (N = 3), parents (N = 11), and healthcare providers (N = 14) were conducted to understand their needs as potential users and the contexts in which they would use an electronic personal health record (PHR) for survivors, Cancer SurvivorLinkTM (https://cancersurvivorlink.org/). Usability evaluations were conducted to assess the functionality of the PHR using think aloud protocol with survivors/parents (N = 4) and focus groups with providers (N = 12). RESULTS: Major themes identified through the needs assessment guided design of the PHR, including (1) education about the lifelong healthcare needs of pediatric cancer survivors ("Learn"), (2) secure electronic storage for healthcare documents to direct long-term follow-up care ("Store"), and (3) communication functionality to allow sharing of health documents with healthcare providers ("Share"). Usability evaluations identified challenges with the PHR design, which informed site enhancements to improve PHR usefulness and ease of use including a registration wizard and healthcare provider directory. CONCLUSIONS: User-centered design methods informed iterative enhancements to an untethered, patient-controlled PHR to address usability barriers and meet the self-identified needs of survivors of childhood cancer and their providers.


Assuntos
Sobreviventes de Câncer , Registros Eletrônicos de Saúde , Registros de Saúde Pessoal , Criança , Grupos Focais , Pessoal de Saúde , Humanos , Disseminação de Informação , Internet , Determinação de Necessidades de Cuidados de Saúde , Neoplasias , Assistência Centrada no Paciente , Design de Software , Interface Usuário-Computador , Adulto Jovem
19.
Int J Med Inform ; 134: 104040, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31865055

RESUMO

BACKGROUND: Blockchain can be described as an immutable ledger, logging data entries in a decentralized manner. This new technology has been suggested to disrupt a wide range of data-driven domains, including the health domain. OBJECTIVE: The purpose of this study was to systematically review, assess and synthesize peer-reviewed publications utilizing/proposing to utilize blockchain to improve processes and services in healthcare, health sciences and health education. METHOD: A structured literature search on the topic was conducted in October 2018 relevant bibliographic databases. RESULT: 39 publications fulfilled the inclusion criteria. The result indicates that Electronic Health Records and Personal Health Records are the most targeted areas using blockchain technology. Access control, interoperability, provenance and data integrity are all issues that are meant to be improved by blockchain technology in this field. Ethereum and Hyperledger fabric seem to be the most used platforms/frameworks in this domain. CONCLUSION: This study shows that the endeavors of using blockchain technology in the health domain are increasing exponentially. There are areas within the health domain that potentially could be highly impacted by blockchain technology.


Assuntos
Blockchain/normas , Assistência à Saúde/normas , Registros Eletrônicos de Saúde/normas , Troca de Informação em Saúde/normas , Registros de Saúde Pessoal , Melhoria de Qualidade , Humanos
20.
PLoS One ; 14(12): e0226765, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31881042

RESUMO

Among women, breast cancer is a leading cause of death. Breast cancer risk predictions can inform screening and preventative actions. Previous works found that adding inputs to the widely-used Gail model improved its ability to predict breast cancer risk. However, these models used simple statistical architectures and the additional inputs were derived from costly and / or invasive procedures. By contrast, we developed machine learning models that used highly accessible personal health data to predict five-year breast cancer risk. We created machine learning models using only the Gail model inputs and models using both Gail model inputs and additional personal health data relevant to breast cancer risk. For both sets of inputs, six machine learning models were trained and evaluated on the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial data set. The area under the receiver operating characteristic curve metric quantified each model's performance. Since this data set has a small percentage of positive breast cancer cases, we also reported sensitivity, specificity, and precision. We used Delong tests (p < 0.05) to compare the testing data set performance of each machine learning model to that of the Breast Cancer Risk Prediction Tool (BCRAT), an implementation of the Gail model. None of the machine learning models with only BCRAT inputs were significantly stronger than the BCRAT. However, the logistic regression, linear discriminant analysis, and neural network models with the broader set of inputs were all significantly stronger than the BCRAT. These results suggest that relative to the BCRAT, additional easy-to-obtain personal health inputs can improve five-year breast cancer risk prediction. Our models could be used as non-invasive and cost-effective risk stratification tools to increase early breast cancer detection and prevention, motivating both immediate actions like screening and long-term preventative measures such as hormone replacement therapy and chemoprevention.


Assuntos
Neoplasias da Mama/epidemiologia , Aprendizado de Máquina , Idoso , Neoplasias da Mama/diagnóstico , Feminino , Registros de Saúde Pessoal , Humanos , Pessoa de Meia-Idade , Curva ROC , Medição de Risco
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