Reviewing the integration of patient data: how systems are evolving in practice to meet patient needs

<p>Abstract</p> <p>Background</p> <p>The integration of Information Systems (IS) is essential to support shared care and to provide consistent care to individuals – patient-centred care. This paper identifies, appraises and summarises studies examining different approaches to integrate patient data from heterogeneous IS.</p> <p>Methods</p> <p>The literature was systematically reviewed between 1995–2005 to identify articles mentioning patient records, computers and data integration or sharing.</p> <p>Results</p> <p>Of 3124 articles, 84 were included describing 56 distinct projects. Most of the projects were on a regional scale. Integration was most commonly accomplished by messaging with pre-defined templates and middleware solutions. HL7 was the most widely used messaging standard. Direct database access and web services were the most common communication methods. The user interface for most systems was a Web browser. Regarding the type of medical data shared, 77% of projects integrated diagnosis and problems, 67% medical images and 65% lab results. More recently significantly more IS are extending to primary care and integrating referral letters.</p> <p>Conclusion</p> <p>It is clear that Information Systems are evolving to meet people's needs by implementing regional networks, allowing patient access and integration of ever more items of patient data. Many distinct technological solutions coexist to integrate patient data, using differing standards and data architectures which may difficult further interoperability.</p

Security Management in Health Care Information Systems- A Literature Review

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Improving network performance in the health care system: a network-based analysis of the Hungarian health care services = A hálózati teljesítmény javítása az egészségügyi rendszerben: a magyar egészségügyi szolgáltatások hálózati megközelítésű elemzése

The dissertation aims to contribute to better understanding of what role networks play in the organisation of health services, and how networks can contribute to better performance in the health care sector. Literature about performance measurement and management of public services as well as network research in public administration and public management was reviewed, and served as a solid theoretical base for the empirical research. Examples from the health care sector were provided throughout the literature review, building on the findings of health care management. The main ambition of the research was to contribute to the refinement of theories and models that describe the performance of public services and service provision networks. Since the research was carried out in the context of the Hungarian health sector, policy implications for the development of the Hungarian health care were also given. Based on the research aim and the current state of art, a mix of descriptive and exploratory approach was used. The dissertation analysed two cases from the Hungarian health sector: the case of regional e-health developments and the formation of general practitioner clusters. (...

A Note on End-User Requirements Elicitation for Electronic Medical Records Implementations

This paper summarises the arguments and counterarguments within the scientific discussion on the issue of the implementation of Electronic Medical Records (EMR). The primary purpose of the research is to present a framework for gathering end-user requirements in EMR system implementation. The cross-geographical literature review demonstrates EMR system implementation to be a complicated task to manage. A systematic review of literature sources and approaches for solving the problem indicates that a lack of end-user participation often results in technology rollbacks. The failures to implement electronic medical records are considered to be the reasons for financial losses, followed by the rearrangements of key personnel. The author of the article investigates the role of the main actors involved in the healthcare process. Consequently, as the market adoption of EMRs grows and its impact as a workflow management tool in care facilities increases, focusing on end-user requirements during the implementation phase becomes essential. Investigation of the topic reveals that the opposing points of view, learning investments, and the embedded nature of older technologies deter users from accepting new technology. Methodological research tools involved studying the workflows in a regular outpatient journey. Taking the case of a standard outpatient facility, the paper attempts to present its results through a framework for requirement gathering in the pre-implementation stages. A plan of action for eliciting end-user requirements for the users in a three-stage framework is being proposed. Considering the diverse number of actors in the standard outpatient journey, the three-stage framework breaks down requirements by roles and educational backgrounds and gathers into 1) antecedent or existing conditions; 2) formal and informal communication channels; 3) user and system-generated requirements. This framework relies on synthesising existing frameworks and arranging them in sequential order for real-world implementations based on existing research papers

Quality framework for semantic interoperability in health informatics: definition and implementation

Aligned with the increased adoption of Electronic Health Record (EHR) systems, it is recognized that semantic interoperability provides benefits for promoting patient safety and continuity of care. This thesis proposes a framework of quality metrics and recommendations for developing semantic interoperability resources specially focused on clinical information models, which are defined as formal specifications of structure and semantics for representing EHR information for a specific domain or use case. This research started with an exploratory stage that performed a systematic literature review with an international survey about the clinical information modelling best practice and barriers. The results obtained were used to define a set of quality models that were validated through Delphi study methodologies and end user survey, and also compared with related quality standards in those areas that standardization bodies had a related work programme. According to the obtained research results, the defined framework is based in the following models: Development process quality model: evaluates the alignment with the best practice in clinical information modelling and defines metrics for evaluating the tools applied as part of this process. Product quality model: evaluates the semantic interoperability capabilities of clinical information models based on the defined meta-data, data elements and terminology bindings. Quality in use model: evaluates the suitability of adopting semantic interoperability resources by end users in their local projects and organisations. Finally, the quality in use model was implemented within the European Interoperability Asset register developed by the EXPAND project with the aim of applying this quality model in a broader scope to contain any relevant material for guiding the definition, development and implementation of interoperable eHealth systems in our continent. Several European projects already expressed interest in using the register, which will now be sustained by the European Institute for Innovation through Health Data

Is South Africa ready for a national Electronic Health Record (EHR)?

Bibliography: leaves 94-100eHealth Strategies in countries have shown a trend that countries are moving to Electronic Health Records(EHR). EHR implementation is expected to produce benefits for patients, professionals, organisations, and the population as a whole. The use of some format of an Electronic Health Record is used by many countries and others are in the implementation or planning phases. South Africa has kicked of the project to implement a national EHR as part of the national eHealth Strategy. This study aims to analyse the key success factors from other EHR implementation projects and evaluate if South Africa is ready to implement an EHR.Graduate School of Business LeadershipMB