Integrated, reliable and cloud-based personal health record: a scoping review.

Personal Health Records (PHR) emerge as an alternative to integrate patient’s health information to give a global view of patients' status. However, integration is not a trivial feature when dealing with a variety electronic health systems from healthcare centers. Access to PHR sensitive information must comply with privacy policies defined by the patient. Architecture PHR design should be in accordance to these, and take advantage of nowadays technology. Cloud computing is a current technology that provides scalability, ubiquity, and elasticity features. This paper presents a scoping review related to PHR systems that achieve three characteristics: integrated, reliable and cloud-based. We found 101 articles that addressed thosecharacteristics. We identified four main research topics: proposal/developed systems, PHR recommendations for development, system integration and standards, and security and privacy. Integration is tackled with HL7 CDA standard. Information reliability is based in ABE security-privacy mechanism. Cloud-based technology access is achieved via SOA.CONACYT - Consejo Nacional de Ciencia y TecnologíaPROCIENCI

Innovative technology and change management: E-health applications in Canada.

Background Focusing on the Canadian healthcare system, this study explores factors influencing the adoption of recent specialized technology in e-health applications due to concerns about the allocation of economic resources and governmental policy formulation. This study focuses on the specific technologies of the Electronic Medical Record (EMR)-based-Personal Health Record (PHR) and their use by physicians and residents of Northern Ontario. Objectives The primary objective of this study is to understand the interdisciplinary factors that predict Northern residents’ attitude toward EMR-based-PHR innovative technology. Conducting this study also serves to increase awareness of patient-driven e-health in Northern Ontario and provides decision makers with useful quantitative data and strategies to support future initiatives. Methods/Materials Using customized data obtained from the National Physician Survey (NPS) in Canada and primary data collected through an adaptation of this survey, a comparative analysis was conducted to understand the electronic patient-physician relationship and explore interdisciplinary factors regarding perception and use of EMR-based-PHR. The data was analyzed using Descriptive Statistics, Z Test for two Population Proportions, ANOVA and Regression Analysis. Results The results indicate significant differences between Northern physicians and patients in usage and preference regarding several technological applications. More Northern patients use websites, social media and mobile applications than Northern physicians. In capturing health information, fewer physicians exclusively prefer to use electronic records than use a combination of paper charts and electronic records, and most Northern patients prefer either a combination of both methods or exclusively paper charts in their healthcare. Interdisciplinary factors related to EMR-based-PHR were significant predictors and explained 69.6% of the variance in the behavioral attitude and 74.5% of the variance in the behavioral intention to adopt this innovative technology. Conclusions. Establishing an electronic patient-physician relationship in the Canadian healthcare system requires coordinated and concerted efforts from all stakeholders involved in this process. Significant cost without benefits is evidence of a misallocation of Canadian resources and requires increased attention. New strategies must address current gaps in educational, technical, managerial, and financial supports. Physician support, however, is ultimately the key to increasing the adoption rate of EMR and fostering positive attitudes toward PHR among the Canadian people.Doctor of Philosophy (PhD) in Human Studie