Addressing Semantic Interoperability, Privacy and Security Concerns in Electronic Health Records

The use of Electronic Health Records (EHR) in healthcare has the potential of reducing medical errors, minimizing healthcare cost and significantly improving the healthcare service quality. However, there is a barrier in healthcare data and information exchange between various healthcare systems due to the lack of interoperability. Also, with the implementation of EHR system, there are security and privacy concerns in the storage and transferring data entities.  The healthcare interoperability problem remains an issue of further research and this paper proposes a semantic interoperability framework for solving  this problem by allowing healthcare stakeholders and organizations (doctors, clinics, hospitals)using various healthcare standards to exchange data and its semantics, which can be understood by both machines and humans. Moreover, the proposed framework takes into consideration the security aspects in the semantic interoperability framework by utilizing data encryption and other technologies to secure the communication for the EHR information while ensuring real time data availability.                                                                                                  Keywords:. Semantic interoperability; Interoperability standards; Electronic Health records(EHR); Artifical Intelligence Techniques. Natural Language Processing (NLP), Word2Vec, skip gram, CBO

An Access Control Model to Facilitate Healthcare Information Access in Context of Team Collaboration

The delivery of healthcare relies on the sharing of patients information among a group of healthcare professionals (so-called multidisciplinary teams (MDTs)). At present, electronic health records (EHRs) are widely utilized system to create, manage and share patient healthcare information among MDTs. While it is necessary to provide healthcare professionals with privileges to access patient health information, providing too many privileges may backfire when healthcare professionals accidentally or intentionally abuse their privileges. Hence, finding a middle ground, where the necessary privileges are provided and malicious usage are avoided, is necessary. This thesis highlights the access control matters in collaborative healthcare domain. Focus is mainly on the collaborative activities that are best accomplished by organized MDTs within or among healthcare organizations with an objective of accomplishing a specific task (patient treatment). Initially, we investigate the importance and challenges of effective MDTs treatment, the sharing of patient healthcare records in healthcare delivery, patient data confidentiality and the need for flexible access of the MDTs corresponding to the requirements to fulfill their duties. Also, we discuss access control requirements in the collaborative environment with respect to EHRs and usage scenario of MDTs collaboration. Additionally, we provide summary of existing access control models along with their pros and cons pertaining to collaborative health systems. Second, we present a detailed description of the proposed access control model. In this model, the MDTs is classified based on Belbin’s team role theory to ensure that privileges are provided to the actual needs of healthcare professionals and to guarantee confidentiality as well as protect the privacy of sensitive patient information. Finally, evaluation indicates that our access control model has a number of advantages including flexibility in terms of permission management, since roles and team roles can be updated without updating privilege for every user. Moreover, the level of fine-grained control of access to patient EHRs that can be authorized to healthcare providers is managed and controlled based on the job required to meet the minimum necessary standard and need-to-know principle. Additionally, the model does not add significant administrative and performance overhead.publishedVersio

Conceptions of effective information use and learning in a tele-health organization: a phenomenographic study of information literacy and knowledge management at work.

This research study investigates the concept of workplace information literacy (IL) theoretically and empirically, focusing on the connections between information literacy and knowledge management (KM). This dissertation examines the relevance and applicability of current IL frameworks in a workplace environment by means of a review of the literature, a review of NHS Scotland documentation on its KM initiatives, and a phenomenographic study undertaken with frontline staff at NHS24, a nurse-led, 24/7 service of NHS Scotland that provides over-the-phone consultation and health information. For that study, a working definition of IL as effective information use was employed. The concept of information literacy has been developed mainly within librarianship, researched mainly within educational contexts and focused on individual competence in information use. While its application to workplace environments has been assumed, comparatively little research has been done into workplace situations. On the other hand, the concept of knowledge management is directed at a wider organizational level. However, while there is a clear focus in the KM literature on the value of information and its importance for organizations, little attention has been paid to the theoretical and empirical developments of Library and Information Science (LIS) relative to information behaviour and effective information use. The findings of this research identified limitations in the current IL frameworks, notably the lack of consideration for peoples exchanges of knowledge and information and of the social sense making that influences information interpretation and application. The findings endorse views of learning and information use grounded in socio-constructive perspectives and a consideration of context as situated practice. The conclusions suggest the need for more collaboration between studies of IL and information behaviour, and for LIS research to focus more on workplace studies and knowledge management

The effect of computerisation on the quality of care in Australian general practice

This thesis describes a study of the utilisation of computers by individual general practitioners (GPs) in Australia, and compares the practice behaviour of GPs who use a computer as a clinical tool, either by prescribing, ordering tests, or storing patient data in an electronic medical record format, with those who do not use a computer for these functions. A survey of individual GP’s use of computers was conducted among 1,336 GPs who participated in the Bettering the Evaluation and Care of Health (BEACH) program between October 2003 and March 2005. The GPs were then assigned to groups according to their clinical use (or not) of a computer, and were compared on a range of variables including the characteristics of the GPs themselves, their practices, their patients, the morbidity they managed for their patients, and the managements they provided. Their behaviour was also compared, using a set of quality indicators designed for use with the BEACH data, and applicable in a primary care setting, to determine whether the clinical use of a computer has an affect on the quality of care GPs provide to their patients. Finally, GPs who use clinical software with embedded pharmaceutical advertising were compared with GPs not exposed to advertisements via this media, to determine whether such advertising influences the prescribing behaviour of GPs to favour advertised brands. From 44 quality indicators examined, clinical computer users performed ‘better’ on four and ‘worse’ on four. For the remaining 36 they exhibited no difference. Exposure to pharmaceutical advertising embedded in clinical software did not influence the prescribing behaviour of the GPs so exposed. Despite the belief espoused in the literature that computer use will improve the quality of patient care, I have found no evidence to demonstrate that the use of a computer for clinical activity has (as yet) affected, either positively or negatively, the quality of care GPs provide to their patients. The current push to computerise general practice will mean that this method of assessment will be difficult to replicate in the future, given the absence of control groups. Other research methods will need to be developed

Restorative virtual environments for rehabilitation: interactive technologies for enhanced recovery following critical illness and injury

The expectation for patients surviving admission to the Intensive Care Unit (ICU) is that they make the best possible functional recovery. Rehabilitation from the point of physiological stability is directed at reducing the impact of the consequences of critical illness. It was proposed that interactive technologies (iTech) could be used by patients on the ICU to enhance their trajectory and experience of recovery. The aim of this research was to develop and evaluate methodologies to investigate the feasibility of introducing novel iTech-based systems to the ICU. Four novel Virtual Natural Environments were combined with commercial-off-the-shelf technologies to produce interventions to improve pain management and sleep and enhance deep breathing and cycling exercises. Cohort and intervention choice were informed by the development of programme theories describing how the interventions might work. These were further developed and used to investigate mediators and modifiers of response to the interventions. Human Centred Design and Usability Engineering techniques were combined with methods to evaluate complex interventions in clinical settings. The four feasibility studies developed and refined methodologies to evaluate their usefulness and effectiveness. This research concludes with lessons learned and a guide to inform future development and implementation

Textbook of Patient Safety and Clinical Risk Management

Implementing safety practices in healthcare saves lives and improves the quality of care: it is therefore vital to apply good clinical practices, such as the WHO surgical checklist, to adopt the most appropriate measures for the prevention of assistance-related risks, and to identify the potential ones using tools such as reporting & learning systems. The culture of safety in the care environment and of human factors influencing it should be developed from the beginning of medical studies and in the first years of professional practice, in order to have the maximum impact on clinicians' and nurses' behavior. Medical errors tend to vary with the level of proficiency and experience, and this must be taken into account in adverse events prevention. Human factors assume a decisive importance in resilient organizations, and an understanding of risk control and containment is fundamental for all medical and surgical specialties. This open access book offers recommendations and examples of how to improve patient safety by changing practices, introducing organizational and technological innovations, and creating effective, patient-centered, timely, efficient, and equitable care systems, in order to spread the quality and patient safety culture among the new generation of healthcare professionals, and is intended for residents and young professionals in different clinical specialties

KEER2022

Avanttítol: KEER2022. DiversitiesDescripció del recurs: 25 juliol 202