Hybrid electronic health records

The research related with digital health records has been a hot topic since the last two decades, producing diverse results, particularly in two main types – Electronic Health Records and Personal Health Records. With the current wider citizen mobility, the liberalization of health care providing, as well as alternative medicine, elderly care and remote patient monitoring, new challenges had emerged. These brought more actors to the scene that can belong to different healthcare networks, private or public sector even from different countries. For creating a true patient-centric electronic health record, those actors need to collaborate in the creation and maintenance of the record. In this work, the Hybrid Electronic Health Record (HEHR) is presented, describing how information can be created and used, as well as focusing on how the patient defines the access control. Some new services are also discussed

Privacy-aware relationship semantics–based XACML access control model for electronic health records in hybrid cloud

State-of-the-art progress in cloud computing encouraged the healthcare organizations to outsource the management of electronic health records to cloud service providers using hybrid cloud. A hybrid cloud is an infrastructure consisting of a private cloud (managed by the organization) and a public cloud (managed by the cloud service provider). The use of hybrid cloud enables electronic health records to be exchanged between medical institutions and supports multipurpose usage of electronic health records. Along with the benefits, cloud-based electronic health records also raise the problems of security and privacy specifically in terms of electronic health records access. A comprehensive and exploratory analysis of privacy-preserving solutions revealed that most current systems do not support fine-grained access control or consider additional factors such as privacy preservation and relationship semantics. In this article, we investigated the need of a privacy-aware fine-grained access control model for the hybrid cloud. We propose a privacy-aware relationship semantics–based XACML access control model that performs hybrid relationship and attribute-based access control using extensible access control markup language. The proposed approach supports fine-grained relation-based access control with state-of-the-art privacy mechanism named Anatomy for enhanced multipurpose electronic health records usage. The proposed (privacy-aware relationship semantics–based XACML access control model) model provides and maintains an efficient privacy versus utility trade-off. We formally verify the proposed model (privacy-aware relationship semantics–based XACML access control model) and implemented to check its effectiveness in terms of privacy-aware electronic health records access and multipurpose utilization. Experimental results show that in the proposed (privacy-aware relationship semantics–based XACML access control model) model, access policies based on relationships and electronic health records anonymization can perform well in terms of access policy response time and space storage

Acceptance of Interoperable Electronic Health Record (EHRs) Systems: A Tanzanian e-Health Perspective

The study assessed factors that influence the acceptance of interoperable electronic Health Records (EHRs) Systems in Tanzania Public Hospitals. The study applied a hybrid model that combined the Technology Acceptance Model (TAM) and Technology-Organization-Environment (TOE). Snowball sampling technique was applied and a total of 340 questionnaires were distributed to selected clinics, polyclinics and hospitals, of which 261 (77%) received questionnaires were considered to be valid and reliable for subsequent data analysis. IBM SPSS software version 27.0 was employed for data analysis. Findings indicated that relative advantage, compatibility, management support, organizational competency, training and education, perceived ease of use, perceived usefulness, privacy and security concerns, competitive pressure and regulatory framework have positive and significant effects on acceptance of interoperable EHRs. However, complexity and trading & vendor support were found to have non-significant effects on acceptance of interoperable electronic health records. The study has further provided implications that may assist scholars and policy makers in the implementation of interoperable electronic health systems in the health sector

A hybrid Neural Network Model for Joint Prediction of Presence and Period Assertions of Medical Events in Clinical Notes

In this paper, we propose a novel neural network architecture for clinical text mining. We formulate this hybrid neural network model (HNN), composed of recurrent neural network and deep residual network, to jointly predict the presence and period assertion values associated with medical events in clinical texts. We evaluate the effectiveness of our model on a corpus of expert-annotated longitudinal Electronic Health Records (EHR) notes from Cancer patients. Our experiments show that HNN improves the joint assertion classification accuracy as compared to conventional baselines

A systematic literature review of cloud computing in eHealth

Cloud computing in eHealth is an emerging area for only few years. There needs to identify the state of the art and pinpoint challenges and possible directions for researchers and applications developers. Based on this need, we have conducted a systematic review of cloud computing in eHealth. We searched ACM Digital Library, IEEE Xplore, Inspec, ISI Web of Science and Springer as well as relevant open-access journals for relevant articles. A total of 237 studies were first searched, of which 44 papers met the Include Criteria. The studies identified three types of studied areas about cloud computing in eHealth, namely (1) cloud-based eHealth framework design (n=13); (2) applications of cloud computing (n=17); and (3) security or privacy control mechanisms of healthcare data in the cloud (n=14). Most of the studies in the review were about designs and concept-proof. Only very few studies have evaluated their research in the real world, which may indicate that the application of cloud computing in eHealth is still very immature. However, our presented review could pinpoint that a hybrid cloud platform with mixed access control and security protection mechanisms will be a main research area for developing citizen centred home-based healthcare applications

A hybrid reduced approach to handle missing values in type 2 diabetes prediction

Diabetes gains more attention among medical institutions and health care organizations as the increasing trend of diabetes around the world. In the United States, 29.1 million people or 9.3% of U.S. population are diagnosed with diabetes. About 86 million people are categorized as pre-diabetes and 15-30% of them will develop diabetes within 5 years. To tackle this challenge, National Diabetes Prevention Program (DPP) was introduced in 2002 and it reduces risk of diabetes by 58% through lifestyle change program. In order to help select a better group of prediabetes for intervention and maximize the cost-effectiveness of the program, we propose a Hybrid Reduced approach to handle missing values when predicting type 2 diabetes. This approach deals with 4 challenges in electronic medical records: missing values, missing not at random, class imbalance and predicting at a longer window (2-year). We select three ensemble predictive models: AdaBoost.M1, Gradient Boosting and Extremely Randomized Trees and apply this approach across 7 years to assess its robustness. The Hybrid Reduced approach includes two sub-approaches: Hybrid Reduced Organic and Hybrid Reduced Imputed. Throughout the experiments, Hybrid Reduced Imputed is the best performer and achieves a 5-7% improvement in precision. By simply using this approach, we could save $278 million for healthcare and improve people’s health conditionStatistic