A Review On Electronic Personalized Health Records

In accordance with the current information communication technology growth up in widely used at everywhere. Therefore the implementation in ICT is highly assisted patient on their health.As the current technology can be access at everywhere in anytime,the electronic personalized health records are considered as the best solution for the patient to care and monitor their health.This research paper provides a cross review of relevant literature from the previous study in order to clarify the rationality.Its continue with reviewing, comparing and contrasting the existing studies in order to obtain the factors that influence the adoption of electronic personalized health records.A summary that clarifies the relation each factor has been mentioned serve as the foundation for this empirical analysis.In addition,a logical justification is provided concerning the theory based meta-analysis from other studies

Biomedical informatics and translational medicine

Biomedical informatics involves a core set of methodologies that can provide a foundation for crossing the "translational barriers" associated with translational medicine. To this end, the fundamental aspects of biomedical informatics (e.g., bioinformatics, imaging informatics, clinical informatics, and public health informatics) may be essential in helping improve the ability to bring basic research findings to the bedside, evaluate the efficacy of interventions across communities, and enable the assessment of the eventual impact of translational medicine innovations on health policies. Here, a brief description is provided for a selection of key biomedical informatics topics (Decision Support, Natural Language Processing, Standards, Information Retrieval, and Electronic Health Records) and their relevance to translational medicine. Based on contributions and advancements in each of these topic areas, the article proposes that biomedical informatics practitioners ("biomedical informaticians") can be essential members of translational medicine teams

Design Strategy for Integrated Personal Health Records: Improving the User Experience of Digital Healthcare and Wellbeing

This dissertation addresses the timely problem of designing Integrated Personal Health Records (PHR). The goal is to provide citizens with digital user experiences, sustainable and flexible enough, for gaining control over their personal health information in a seamless way. Most importantly, so that people are able to reflect and act upon their selfknowledge, towards the accomplishment of their good health and wellbeing. Towards this end, the Integrated PHR as an emerging model in the field of Health IT, was the framework that set this research forward on exploring how communication and collaboration between patients and providers can be improved, which naturally impacts the field of HCI. Acknowledging that today patients are the ones who own all that is recorded about their health data, this new model was object of a design strategy that shaped the results presented in this dissertation. These have showed how patients can have more control of their health over time, through a patient-centered, organic system, which has the ability of combining multiple sources of data both from patient and provider side. As this new type of PHR fosters the creation of integrated networks, this milestone was achieved in this research by interacting with cross-channel user experiences that took part of nationwide healthcare ecosystems. The work presented herein, has demonstrated through the analysis and development of two use cases in cooperation with organizations connected to the Portuguese Ministry of Health, how an Integrated PHR can be a powerful personal tool, to be used by the citizen with undeniable value to the demands of an aging society. The use cases structured the thesis into two parts. The first part in collaboration with the Portuguese National Patient Portal, combines an Integrated PHR and incorporates the Portuguese Data Sharing Platform (PDS), which can be used by any Portuguese citizen. This use case study led to a proposal of the portal by also creating a foundational model for designing Integrated PHRs. The second part in collaboration with the Portuguese National Senior Telehealth Program (Saúde 24 Sénior), led to another proposal for an Integrated PHR, applying the outcomes from Part 1 and the requirements that derived from the findings explored in this second use case study. The proposed solution, has the potential to be used by the Portuguese senior community in the scope of home assistive care. Both proposals applied a user experience design methodology and included the development of two prototypes. The engagement of the stakeholders during the two case studies was accomplished with participatory design methods and followed a multidisciplinary approach to create solutions that would meet the human, politics and behavior interdependencies that were inherent to the process of working with large healthcare organizations. The provided contributions from this thesis intent to be part of a transition process that is changing the behavior of the healthcare sector, which is increasingly moving towards the improvement of the patient-provider relationship, patient engagement, collaborative care and positive computing, where digital technologies play a key role

Literacia em saúde: da gestão da informação à decisão inteligente

RESUMO - Introdução: A noção de um sistema de saúde centrado no cidadão e o papel que este pode assumir no controlo e gestão da sua própria saúde têm estado presentes na teoria e prática da saúde pública ao longo dos últimos anos. A centralidade no cidadão é especialmente notória quando acompanhamos a evolução de dois dos pilares da Saúde Pública, a promoção de Literacia em Saúde, enquadrada nos modelos teóricos da educação para a saúde, e a Gestão de Informação de Saúde, apoiada fortemente na evolução dos Sistemas de Informação em Saúde. Objetivos: Analisou-se o momento em que a evolução dos dois pilares convergem, permitindo que estas novas ferramentas de gestão da informação e comunicação se constituíssem instrumentos de promoção da literacia em saúde do cidadão. Assim pretendeu-se (i) traduzir, adaptar culturalmente e validar o European Health Literacy Survey (HLS-EU) para o contexto português (HLS-EU-PT), por forma a poder (ii) avaliar o nível de literacia em saúde da população portuguesa, e subsequentemente comparar com a população europeia (iii) descrever e analisar a decisão partilhada e os sistemas de informação de saúde centrados no cidadão como mediadores de promoção de literacia em saúde, (iv) identificar quais as principais barreiras e fatores facilitadores para a utilização destes mediadores; e (v) descrever e validar uma proposta de Estratégia Nacional de Literacia em Saúde. Métodos: Para a concretização dos objetivos foi seguido um modelo misto com recurso a metodologias quantitativas e qualitativas de recolha e análise de informação. Para tal, foi recolhida informação através de questionário, revisão da literatura, entrevistas, observação participante, análise documental, grupo focal e técnica de grupo nominal. Resultados: O HLS-EU-PT evidencia propriedades psicométricas comparáveis às versões utilizadas nos outros países. Em Portugal, 61,4% da população inquirida apresenta um nível de literacia em saúde problemático ou inadequado. No subíndice Cuidados de Saúde a percentagem é de 55,1%; no Prevenção da Doença 55,1% e no Promoção de Saúde a percentagem sobe para 60,2%. Os sistemas de informação de saúde centrados no cidadão têm evoluído de repositórios estáticos de informação de saúde para instrumentos de apoio ao conhecimento, à literacia em saúde e à negociação de objetivos. A baixa literacia em saúde do cidadão e a falta de consciência da sua utilidade são apontadas como as principais barreiras à utilização de PHIS no contexto de saúde português. Do ponto de vista tecnológico, a falta de acesso ou de suporte tecnológico e a baixa literacia digital são as principais iv barreiras à sua utilização. Do ponto de vista da relação e de sistema acrescem as atitudes negativas do médico e o pouco tempo disponível na consulta. A formação e acompanhamento do cidadão no que diz respeito à sua utilização, a perceção dos benefícios e o envolvimento e apoio do médico no processo são os principais fatores que podem facilitar a sua implementação e utilização em Portugal. Analisando a participação do cidadão nas decisões sobre a sua própria saúde, continua a existir uma tendência para a adoção de um modelo paternalista, no qual o médico se substitui ao cidadão na decisão. O nível de literacia em saúde do cidadão surge como o aspeto que mais dificulta a adoção do modelo de decisão partilhada. Identificam-se também como barreiras o facto de o doente não querer participar, precisar de ser guiado, o seu estado emocional, a doença não permitir, a sua capacidade para comunicar não possibilitar e o não querer assumir responsabilidade. Relacionados com o médico, a suas competências comunicacionais são apontadas como o fator que mais influencia a adoção do modelo partilhado, e com o contexto o pouco tempo disponível para cada consulta. Conclusões: Tendo em conta que os cuidados de saúde centrados no cidadão devem contemplar a promoção da literacia em saúde, da facilitação do acesso e gestão informação de saúde pelo cidadão e da decisão partilhada, conclui-se que, apesar de existirem várias iniciativas a decorrer neste sentido, há ainda um longo caminho a percorrer. A análise dos resultados do HLS-EU-PT revelam níveis de literacia em saúde baixos e particularmente preocupantes nas populações tidas como vulneráveis. Os dois mediadores analisados podem ter um papel fundamental na promoção de literacia em saúde. Mas se por um lado a promovem, por outro a sua utilização é fortemente influenciada por esta, pelo que é fundamental quebrar este circulo. O envolvimento efetivo dos médicos, a formação e acompanhamento do cidadão e a formação dos médicos no que diz respeito às suas competências relacionais e comunicacionais podem ser o caminho para o fazer. A problemática da literacia em saúde não é um problema individual, é sistémica e carece de uma abordagem holística, pelo que a concretização de uma Estratégia Nacional de Literacia em Saúde, deve ser feita em cinco eixos estratégicos: incluir a literacia em saúde no próprio sistema; assegurar o acesso e gestão da informação; assegurar uma comunicação efetiva; integrar a literacia em saúde na educação; e garantir a sustentabilidade das iniciativas.ABSTRACT - Introduction: The conception of a citizen-centred health system and the role that citizens can play in controlling and managing their own health have been present in public health theory and practice over the past few years. The centrality of the citizen is especially evident when we follow the evolution of two pillars of Public Health, (i) the promotion of Health Literacy, framed in the theoretical models of health education, and (ii) Health Information Management, strongly supported in the evolution of citizen-centred health information systems. Aims: This thesis aims to analyse the moment where these two pillars converge, allowing new tools of information and communication management to be powerful instruments in the promotion of citizens' health literacy. The specific aims were (i) to translate, culturally adapt and validate the European Health Literacy Survey (HLS-EU) into the Portuguese context (HLS-EU-PT), in order to be able (ii) to evaluate the level of health literacy of the Portuguese population, and subsequently to compare it with the European population, (iii) to identify, describe and analyse shared decision and personaliwed health information systems as mediators of health literacy promotion, and (iv) to describe and validate a National Health Literacy Strategy proposal. Methods: A mixed model was followed, using quantitative and qualitative approaches to collect and analyse information. The information was collected through questionnaires, literature review, interviews, participant observation, documental analyses, focus groups and nominal group techniques. Results: The HLS-EU-PT shows psychometric properties comparable to the versions used in the other countries. In Portugal, 61.4% of the surveyed population presents a problematic or inadequate level of general health literacy. In the sub-index Health Care the percentage is 55.1%; in Disease Prevention 55.1% and in Health Promotion the percentage rises to 60.2%. Citizen-centered health information systems have evolved from static repositories of personal health information to tools that support knowledge, health literacy, and health goals negotiation. Citizens’ low health literacy and lack of awareness of its usefulness are pointed out as the main barriers to the use of PHIS in the Portuguese health context. From a technological point of view, lack of access or technological support and low digital literacy are the main barriers to its use. From the point of view of the relationship and the system, it adds to the negative attitudes of the doctor and the short time available in the consultation. Citizens’ training and support, as well as their perception of the benefits of vi use that and the doctors’ involvement in the process are the main factors that could enable its implementation and use in Portugal. When analysing the participation of citizens in health decisions, there continues to be a tendency towards the adoption of a paternalistic model, in which the physician substitutes the citizen in the decision. The level of citizenship health literacy appears as the aspect that makes it more difficult to adopt a shared decision model. Also identified as a barrier is the fact that the patient does not want to participate, or needs to be guided, their emotional state, their disease or ability to communicate do not enable to participate and they do not want to take responsibility. As for physicians, their communicational skills are singled out as the factor that most influences the adoption of a shared decision model. Added to these factors is the limited time available in each consultation. Conclusions: Taking into account that citizen-centred health care should include health literacy promotion, citizens’ access and management to their own health information and shared decision, it is concluded that, although there are several initiatives to be taken in this direction, there is still a long way to go. The analysis of HLS-EU-PT results reveals that Portuguese health literacy levels are low and are especially worrying in the populations considered as vulnerable. The two mediators analysed can play a key role in promoting health literacy. However, on the one hand they promote it, on the other hand its adoption and use are strongly influenced by health literacy, so it is fundamental to break this circle. The effective involvement of physicians, the training and support of the citizen and the training of physicians regarding their relational and communicational skills may be the way forward. Taking into account that health literacy is not an individual problem but rather a systemic one, hence needinga holistic approach the implementation of a National Strategy for Health Literacy is suggested, focusing on five strategic axes: include health literacy in the system itself; ensure access to, and management of health information; ensure effective communication; integrate health literacy into education; and ensure the sustainability of initiatives to promote health literacy