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1.
Stud Health Technol Inform ; 264: 1036-1040, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438082

RESUMO

Health information exchange (HIE) is implemented in Quebec, Canada to improve the exchange and use of clinical information for decision making in the province's health care system. The objective of this mixed-method approach study was to evaluate the usage, usability, and usefulness of an electronic health record (EHR) to access and import clinical information from a centralized HIE. First, a heuristic analysis was performed of three different commercial EHRs, using end users to analyze the integration feature through think aloud protocols. Second, interviews were conducted with advanced users to describe the usefulness. Third, usage data were analyzed to describe the level of use of each data domain, per EHR and user. The results show that usefulness is high for medication data; leading to greater use of this domain, its relation to integration, and meets the needs of general practitioners. Difficulties in the implementation processes reduced the potential of this system.


Assuntos
Troca de Informação em Saúde , Registros Eletrônicos de Saúde , Quebeque , Interface Usuário-Computador
2.
Stud Health Technol Inform ; 264: 1726-1727, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438313

RESUMO

Recently Health Information Exchange (HIE) is gradually spreading in Japan. But there are few reports about the effect of the hospital management. So we examined the effect for hospital management through the number of the newly admitted patients from 2013 to 2017. In this study both the total number of the admitted patients who was reserved as first visit patients was higher than not reserved and the number of the admitted patients who visited with introduction letters was higher than without introduction letters. (p < 0.01) The total number of the admitted patients who had been registered to the Ajisai-net was 624 (41.2%) for the same 5 years, and was revealed to be significantly higher than the number of the admitted patients who was reserved first visit with introduction letters. (p < 0.01) In conclusion, use of the Japanese type of the HIE has a potential to increase the newly admitted patients finally.


Assuntos
Registros Eletrônicos de Saúde , Troca de Informação em Saúde , Admissão do Paciente , Hospitalização , Humanos , Japão
3.
Can Assoc Radiol J ; 70(3): 212-218, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31376884

RESUMO

PURPOSE: Secondary usage of patient data has recently become of increasing interest for the development and application of computer analytic techniques. Strict oversight of these data is required and the individual patients themselves are integral to providing guidance. We sought to understand patients' attitudes to sharing their imaging data for research purposes. These images could provide a great wealth of information for researchers. METHODS: Patients from the Greater Toronto Area attending Sunnybrook Health Sciences Centre for imaging (magnetic resonance imagining, computed tomography, or ultrasound) examination areas were invited to participate in an electronic survey. RESULTS: Of the 1083 patients who were approached (computed tomography 609, ultrasound 314, and magnetic resonance imaging 160), 798 (74%) agreed to take the survey. Overall median age was 60 (interquartile range = 18, Q1 = 52, Q3 = 70), 52% were women, 42% had a university degree, and 7% had no high school diploma. In terms of willingness to share de-identified medical images for research, 76% were willing (agreed and strongly agreed), while 7% refused. Most participants gave their family physicians (73%) and other physicians (57%) unconditional data access. Participants chose hospitals/research institutions to regulate electronic images databases (70%), 89% wanted safeguards against unauthorized access to their data, and over 70% wanted control over who will be permitted, for how long, and the ability to revoke that permission. CONCLUSIONS: Our study found that people are willing to share their clinically acquired de-identified medical images for research studies provided that they have control over permissions and duration of access.


Assuntos
Confidencialidade/psicologia , Diagnóstico por Imagem/psicologia , Registros Eletrônicos de Saúde/estatística & dados numéricos , Troca de Informação em Saúde/estatística & dados numéricos , Opinião Pública , Sujeitos da Pesquisa/psicologia , Adolescente , Adulto , Fatores Etários , Idoso , Canadá , Segurança Computacional , Bases de Dados Factuais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
4.
Stud Health Technol Inform ; 264: 1373-1377, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438151

RESUMO

This paper presents results concerning the traceability of a secure data collection infrastructure based on the Bloom Filter involving standardized electronic medical record (EMR) storage. The objective of this infrastructure is to facilitate rapid secondary use of exported EMR data in cross-patient or cross-institutional analyses based on the Standardized Structured Medical Information eXchange (SS-MIX), Japan's domestic standard for EMR export. Secondary use of EMR data should be based on the principle of patient consent. Therefore, securing the traceability of patient EMR data is important for achieving reliable data collection systems for secondary use. Blockchain is a strong candidate, and we evaluated its performance using several implementations. As shown by the evaluation, it is difficult to realize the method of recording the query history of secondary use on the blockchain. We thus propose a method for recording index information of distributed log data.


Assuntos
Registros Eletrônicos de Saúde , Troca de Informação em Saúde , Instalações de Saúde , Humanos , Japão
5.
Stud Health Technol Inform ; 264: 709-713, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438016

RESUMO

Health information exchange (HIE) is seen as an essential technology for improving health care quality and efficiency by allowing exchange of patient-centered data over time and across organizations. The objective of this study was to evaluate the usage and the perceived usefulness of a nationwide HIE in a centralized model that was implemented in 2013 in the province of Quebec, Canada. A mixed-method study was conducted with a longitudinal descriptive analysis of usage data combined with in-depth comparative case study in four selected primary care organizations and two emergency departments. Perceived benefits were reported by users across all dimensions of care performance, including accessibility, efficiency, quality and safety, and patient experience; however, the experience of users was very heterogeneous and strongly associated with the commercial electronic record system available in their work place and the implementation strategy.


Assuntos
Troca de Informação em Saúde , Canadá , Registros Eletrônicos de Saúde , Humanos , Atenção Primária à Saúde , Quebeque
6.
Stud Health Technol Inform ; 264: 1560-1561, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438231

RESUMO

Constructing multi-site specialty registries typically proves time-consuming. Electronic health record (EHR) data collected during clinical care affords a pragmatic approach to accelerating registry implementation. Heart failure with preserved ejection fraction (HFpEF) is an increasingly common and morbid condition. Building a multi-site registry for HFpEF proved feasible using EHR data coded in standard terminologies (SNOMED CT, LOINC) and shared via Health Information Exchanges.


Assuntos
Troca de Informação em Saúde , Insuficiência Cardíaca , Humanos , Sistema de Registros , Volume Sistólico
7.
Rev. pesqui. cuid. fundam. (Online) ; 11(4): 862-867, jul.-set. 2019. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1005593

RESUMO

Objetivo: Avaliar a influência das ações de alimentação dos Sistemas de Informação utilizados na Atenção Primária a Saúde (APS) sobre os cuidados de enfermagem ao indivíduo ou comunidade. Método: Pesquisa quantitativa, com enfermeiros da Atenção Primária. Utilizaram-se os testes ANOVA one-way, Kruskal-Wallis e correlação de Spearman com significância de 5% e confiança de 95%. Resultados: A maioria dos enfermeiros era mulher (94,5%), 34,4 anos de idade, 8,8 anos de formação, sendo 7,6 anos atuando na atenção primária, especialista e concursada. Observou-se associação negativa (p-valor = 0,008) entre tempo destinado às atividades de alimentação dos sistemas e o tempo de atenção aos pacientes. Conclusão: O estudo aponta a influência das ações gerenciais voltadas aos sistemas de informação sobre a atenção prestada aos indivíduos/comunidade


Objective: To evaluate the influence of the feeding actions of the Information Systems used in Primary Health Care (PHC) on nursing care to the individual or community. Methods: Quantitative research with primary care nurses. One-way ANOVA, Kruskal-Wallis and Spearman correlation with significance of 5% and 95% confidence were used. Results: The majority of the nurses were women (94.5%), 34.4 years old, 8.8 years of training, and 7.6 years working in primary care, specialist and bankrupt. A negative association (p-value = 0.008) was observed between time spent feeding the systems and patient care time. Conclusion: The study points out the influence of the managerial actions directed to the information systems on the attention given to the individuals / community


Objetivo: Evaluar la influencia de las acciones de alimentación de los Sistemas de Información utilizados en la Atención Primaria a la Salud (APS) sobre los cuidados de enfermería al individuo o comunidad. Método: Investigación cuantitativa, con enfermeros de la Atención Primaria. Se utilizaron las pruebas ANOVA de una forma, Kruskal-Wallis y correlación de Spearman con significancia del 5% y confianza del 95%. Los resultados: La mayoría de los enfermeros eran mujeres (94,5%), 34,4 años de edad, 8,8 años de formación, siendo 7,6 años actuando en la atención primaria, especialista y concursada. Se observó asociación negativa (p-valor = 0,008) entre tiempo destinado a las actividades de alimentación de los sistemas y el tiempo de atención a los pacientes. Conclusión: El estudio apunta la influencia de las acciones gerenciales dirigidas a los sistemas de información sobre la atención prestada a los individuos / comunidad


Assuntos
Humanos , Masculino , Feminino , Atenção Primária à Saúde , Sistemas de Informação/organização & administração , Troca de Informação em Saúde , Cuidados de Enfermagem , Sistema Único de Saúde
8.
RECIIS (Online) ; 13(2): 340-350, abr.-jun. 2019.
Artigo em Português | LILACS | ID: biblio-1005610

RESUMO

Este ensaio apresenta a relação entre as divulgações científicas e as jornalísticas sobre saúde digital, utilizando como base metodológica a midiatização e as textualidades midiáticas. Foi possível demonstrar a similaridade entre os produtos e serviços estudados/divulgados. Os temas em voga foram Internet das coisas, aplicativos, dispositivos vestíveis, Inteligência Artificial, Big Data e robótica. Enquanto nos artigos científicos são apontadas vantagens e desvantagens das aplicações tecnológicas, sendo mais críticos, na mídia especializada valorizam-se as vantagens.


This essay presents the relationship between the scientific and the journalistic articles about digital health, using as a methodological basis the mediatization and the mediatic textuality. It was possible to demonstrate the similarity between the products and services studied/disclosed. The hot topics were Internet of Things, apps, wearable devices, Artificial Intelligence, Big Data and robotics. While in the scientific articles are pointed out advantages and disadvantages of technological applications, being more critical, in the specialized media the advantages are more valued.


Este ensayo presenta la relación entre las divulgaciones científicas y las periodísticas sobre salud digital, utilizando como base metodológica la mediatización y la textualidad mediática. Se pudo demostrar la similitud entre los productos y servicios estudiados/divulgados. Los temas en boga fueron Internet de las cosas, aplicaciones, dispositivos usables, Inteligencia Artificial, Big Data y robótica. Mientras que en los artículos científicos se apuntan ventajas y desventajas de las aplicaciones tecnológicas, siendo estas más críticas, en los medios especializados se valoran mucho más las ventajas.


Assuntos
Humanos , Tecnologia , Telemedicina , Pesquisa Científica e Desenvolvimento Tecnológico , Registros Eletrônicos de Saúde , Mídias Sociais , Inteligência Artificial , Sistemas Computadorizados de Registros Médicos , Ensaios , Jornalismo , Troca de Informação em Saúde
9.
Stud Health Technol Inform ; 262: 380-383, 2019 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-31349247

RESUMO

For ensuring the quality of data and facilitating data exchange between healthcare providers and professional organizations, it is necessary to define a standard data set. The main aim of this study was to define a national minimum data set for colorectal cancer in Iran. To develop this data set, a combination of literature review and two rounds of a modified Delphi technique were used. An initial checklist was proposed based on a literature review and comparative studies. Based on the literature review, main categories, including: demographic information, diagnostic information, treatment information, clinical status assessment information, and clinical trial information were proposed. In this study, the national minimum data set of colorectal cancer was collected. Developing this data set through standard contents can improve effective health information exchange for both healthcare providers and health information systems.


Assuntos
Neoplasias Colorretais , Confiabilidade dos Dados , Troca de Informação em Saúde , Sistemas de Informação em Saúde , Lista de Checagem , Técnica Delfos , Humanos , Irã (Geográfico)
10.
N C Med J ; 80(4): 229-233, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31278185

RESUMO

A statewide health information exchange (HIE) can be a vital technology tool and play a pivotal role in driving health care innovation and better health outcomes, especially for providers participating in value-based care models. NC HealthConnex is the state-designated HIE network that gives participating providers secure and timely access to important patient data from more than 4,700 health care facilities spanning geographic locations and care settings.


Assuntos
Troca de Informação em Saúde , Registros Eletrônicos de Saúde , Humanos
11.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46625

RESUMO

Demonstrando a atuação governamental no âmbito do SUS, a Sage possibilita projeções e inferências setoriais, além de contribuir para a transparência das ações desenvolvidas na área da saúde.


Assuntos
Sistema Único de Saúde , Indicadores Básicos de Saúde , Troca de Informação em Saúde
13.
Stud Health Technol Inform ; 260: 33-40, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31118316

RESUMO

The introduction of national electronic patient records such as the electronic patient dossier EPD in Switzerland provides a new basis for digitizing healthcare processes at a national level. One process however, that is currently neglected within the Swiss EPD, is the scheduling process in healthcare. The objective of this work is to analyze the appointment scheduling process and the involved IT systems in order to develop an appointment data structure and a concept for cross-institutional exchange of appointment data. The analysis showed that various outpatient and inpatient information systems support appointment booking through proprietary solutions. A true standard for appointment data exchange is missing. We suggest an appointment data structure and a corresponding data exchange process based on the FHIR standard. In its current implementation, the Swiss EPD does not support this proposed appointment scheduling process. We discuss how potential additions such as the IHE Care Services Discovery (CSD) profile can provide better compatibility.


Assuntos
Agendamento de Consultas , Registros Eletrônicos de Saúde , Troca de Informação em Saúde , Assistência à Saúde , Humanos , Sistemas de Informação , Suíça
15.
J Med Syst ; 43(5): 133, 2019 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-30945011

RESUMO

Now-a-days, the society is witnessing a keen urge to enhance the quality of healthcare services with the intervention of technology in the health sector. The main focus in transforming traditional healthcare to smart healthcare is on facilitating the patients as well as medical professionals. However, this changover is not easy due to various issues of security and integrity associated with it. Security of patients's personal health record and privacy can be handled well by permitting only authorized access to the confidential health-data via suitably designed authentication scheme. In pursuit to contribute in this direction, we came across the role of Universal Serial Bus (USB), the most widely accepted interface, in enabling communication between peripheral devices and a host controller like laptop, personal computer, smart phone, tablet etc. In the process, we analysed a recently proposed a three-factor authentication scheme for consumer USB Mass Storage Devices (MSD) by He et al. In this paper, we demonstrate that He et al.'s scheme is vulnerable to leakage of temporary but session specific information attacks, late detection of message replay, forward secrecy attacks, and backward secrecy attacks. Then motivated with the benefits of USB, we propose a secure three-factor authentication scheme for smart healthcare.


Assuntos
Segurança Computacional/normas , Sistemas de Computação/normas , Troca de Informação em Saúde/normas , Comunicação , Confidencialidade , Registros Eletrônicos de Saúde/normas , Humanos
16.
Int J Med Inform ; 125: 1-12, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30914173

RESUMO

BACKGROUND: Health information exchange (HIE), the ability for health information technology (HIT) to share patient data, can improve the efficiency and effectiveness of healthcare; however, this ability may cause patient concern about their ability to control who can access their health records (i.e., privacy). These concerns may affect a patient's candor in their therapeutic patient-provider relationships, thereby undermining their care. While patient privacy concerns are often cited as a barrier to HIT implementation, the patient privacy perspective is not well understood. The purpose of this systematic review is to provide an in-depth exploration of the patient privacy perspective toward HIE, its antecedents, and its outcomes. MATERIALS AND METHODS: A systematic review was conducted on seven health sciences and interdisciplinary databases. Empirical studies that assessed the patient perception of privacy in context of interoperable HIT were included. All included articles were independently screened, extracted, and analyzed by two reviewers. The results were extracted and categorized based on the dimensions outlined in the Antecedent Privacy Concern Outcomes macro-model (APCO). RESULTS: Of the 1713 unique citations, 59 articles met the inclusion criteria which consisted of 39 (66.1%) quantitative studies, 15 (25.4%) qualitative studies, and 5 (8.5%) mixed methods studies. Fourteen articles (23.7%) were specifically focused on understanding privacy. The patient privacy perspective was operationalized in different ways, with privacy concern being the most common measure (25.4%). The percentage of participants expressing privacy concern ranged from 15% to 74%, depending on the study. Perceived quality of care was associated with lower privacy concerns. Privacy concerns were associated with privacy protective behaviours; however, the perceived benefit of HIE may mitigate the effects of privacy concern. CONCLUSION: Using the APCO as a guide, this review found that the patient privacy perspective is dynamic, complex, and still not well understood. There may be an oversimplification of the patient privacy perspective and its impact given the paucity of privacy-focused research. The evidence suggests patient perceptions of healthcare and the value of HIE are important factors in mitigating privacy concerns and its effects. More in-depth privacy studies are required to further illuminate the nuances of the patient perspective and provide policy-makers with greater insights on the privacy barrier.


Assuntos
Troca de Informação em Saúde , Pacientes/psicologia , Percepção , Privacidade , Humanos , Masculino
17.
J Med Syst ; 43(5): 123, 2019 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-30915578

RESUMO

The boom of Internet of Things devices promotes huge volumes of eHealthcare data will be collected and aggregated at eHealthcare provider. With the help of these health data, eHealthcare provider can offer reliable data service (e.g., k-NN query) to doctors for better diagnosis. However, the IT facility in the eHealthcare provider is incompetent with the huge volumes of eHealthcare data, so one popular solution is to deploy a powerful cloud and appoint the cloud to execute the k-NN query service. In this case, since the eHealthcare data are very sensitive yet cloud servers are not fully trusted, directly executing the k-NN query service in the cloud inevitably incurs privacy challenges. Apart from the privacy issues, efficiency issues also need to be taken into consideration because achieving privacy requirement will incur additional computational cost. However, existing focuses on k-NN query do not (fully) consider the data privacy or are inefficient. For instance, the best computational complexity of k-NN query over encrypted eHealthcare data in the cloud is as large as [Formula: see text], where N is the total number of data. In this paper, aiming at addressing the privacy and efficiency challenges, we design an efficient and privacy-preserving k-NN query scheme for encrypted outsourced eHealthcare data. Our proposed scheme is characterized by integrating the k d-tree with the homomorphic encryption technique for efficient storing encrypted data in the cloud and processing privacy-preserving k-NN query over encrypted data. Compared with existing works, our proposed scheme is more efficient in terms of privacy-preserving k-NN query. Specifically, our proposed scheme can achieve k-NN computation over encrypted data with [Formula: see text] computational complexity, where l and N respectively denote the data dimension and the total number of data. In addition, detailed security analysis shows that our proposed scheme is really privacy-preserving under our security model and performance evaluation also indicates that our proposed scheme is indeed efficient in terms of computational cost.


Assuntos
Segurança Computacional/normas , Confidencialidade/normas , Troca de Informação em Saúde/normas , Internet , Computação em Nuvem/normas , Humanos
18.
J Med Syst ; 43(5): 105, 2019 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-30879188

RESUMO

Many hospitals are in the process of replacing their legacy anesthesia information management system (AIMS) with an Electronic Health Record (EHR) system, within which the AIMS is integrated. Using the legacy AIMS security access log table, we studied the extent to which anesthesia providers were accessing historical anesthesia records (January 2006 - March 2017) following implementation of an EHR (April 2017). Statistical analysis was by segmented regression. At the time of implementation of the EHR, in 44.8% (SE = 0.3%) of cases, there was a prior anesthetic record for the patient that had been documented in the legacy AIMS. Following EHR implementation, the mean number of preoperative clinical views of all prior anesthetic records divided by the total number of cases performed decreased to 2.3% (0.3%) from the baseline of 25.1% (0.8%). The estimated ratio of the 2 means was 0.18 (95% CI 0.11 to 0.31, P < 0.00001). For views of unique records, the decrease was to 2.2% (0.3%) from the baseline of 18.3% (0.5%). The estimated ratio was 0.23 (95% CI 0.15 to 0.35, P < 0.00001). These results show that, following conversion to an integrated EHR, providing access to historical anesthesia records by maintaining the legacy AIMS is not an effective strategy to promote review of such records as part of the preoperative evaluation process. Because such records provide important information for many patients, providing linked access to such records within the EHR as part of the patient encounter may be a more effective approach.


Assuntos
Anestesia/estatística & dados numéricos , Registros Eletrônicos de Saúde/estatística & dados numéricos , Troca de Informação em Saúde/estatística & dados numéricos , Registros Eletrônicos de Saúde/organização & administração , Humanos , Assistência Perioperatória
19.
Perspect Health Inf Manag ; 16(Winter): 1d, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30766455

RESUMO

The future of clinical documentation improvement (CDI) will require expanding the reach of CDI programs into new areas of expertise because the traditional realms of CDI work are increasingly becoming automated. CDI-based research and analytics can serve as a means for demonstrating continued value to an institution. We present four studies as examples of these efforts. We explored the use of claims data to determine whether a clinical condition meets the criteria for a secondary diagnosis and to evaluate whether a clinical problem should be elevated to the status of a comorbid or complicating condition. We demonstrated a way in which CDI professionals can evaluate the impacts of changes in clinical definitions, and we explored how CDI can work with other institutional programs to decrease length of stay. We believe that these models may serve as a springboard within institutions and among the larger CDI community to make research and analytics a foundation of future CDI activities.


Assuntos
Documentação/métodos , Registros Eletrônicos de Saúde/organização & administração , Gestão da Informação em Saúde/organização & administração , Melhoria de Qualidade/organização & administração , Pesquisa/organização & administração , Confiabilidade dos Dados , Documentação/normas , Registros Eletrônicos de Saúde/normas , Troca de Informação em Saúde/normas , Gestão da Informação em Saúde/normas , Humanos , Revisão da Utilização de Seguros/estatística & dados numéricos , Tempo de Internação/economia , Tempo de Internação/estatística & dados numéricos , Obesidade Mórbida/diagnóstico , Obesidade Mórbida/terapia , Melhoria de Qualidade/normas , Pesquisa/normas
20.
J Med Syst ; 43(3): 64, 2019 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-30729329

RESUMO

The blockchain technology has reached a great boom in the health sector, due to its importance to overcome interoperability and security challenges of the EHR and EMR systems in eHealth. The main objective of this work is to show a review of the existing research works in the literature, referring to the new blockchain technology applied in ehealth and exposing the possible research lines and trends in which this technology can be focused. The search for blockchain studies in eHealth field was carried out in the following databases: IEEE Xplore, Google Scholar, Science Direct, PubMed, Web of Science and ResearchGate from 2010 to the present. Different search criteria were established such as: "Blockchain" AND ("eHealth" OR "EHR" OR "electronic health records" OR "medicine") selecting the papers considered of most interest. A total of 84 publications on blockchain in eHealth were found, of which 18 have been identified as relevant works, 5.56% correspond to the year 2016, 22.22% to 2017 and 72.22% to 2018. Many of the publications found show how this technology is being developed and applied in the health sector and the benefits it provides. The new blockchain technology applied in eHealth identifies new ways to share the distributed view of health data and promotes the advancement of precision medicine, improving health and preventing diseases.


Assuntos
Troca de Informação em Saúde/normas , Telemedicina , Segurança Computacional , Registros Eletrônicos de Saúde/organização & administração , Melhoria de Qualidade
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