233 research outputs found

    Transforming Patient Check-in/Registration with a Fast Healthcare Interoperability Resources (FHIR) Integrated QR Code System and Mobile App

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    The aim of the project is to examine the implementation of universal quick response (QR) codes issued by health insurance providers for patient identification within electronic health records (EHR). The integration of QR codes into EHR using Fast Healthcare Interoperability Resources Application Programming Interface (FHIR API) can help standardize the identification process, making it more efficient and reducing medical errors. These improvements can lead to a reduction in waiting time, improved patient satisfaction and coordination of care. The paper will provide insights on the possibility for widespread adoption of QR codes for patient identification in healthcare and its impact on the overall quality of patient care. The paper will compare current methods of patient identification with the new approach of using universal QR codes, outline the objectives, project timeline, and deliverables. The findings of this project will be important not only for patients but for healthcare providers, health insurance providers, and policymakers

    Doctor of Philosophy

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    dissertationInadequate care coordination has been identified as a significant problem in patient care, resulting in diminished satisfaction, increased cost, and reduced quality of care. Comprising an estimated 15.6% (approximately 11 million) of the pediatric population, children and youth with special health care needs (CYSHCN) are "those who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally". Caring for CYSHCN is often highly complex, time-, effort-, and resource-intensive, due to complex healthcare conditions, comorbidities, and age of patients. Current electronic health record (EHR) and personal health record (PHR) systems do not adequately support the needs of care coordination. The reasons for this include lack of appropriate tools to support complex care coordination tasks, poor usability, and gaps in information essential for providing team-based patient care. The issues are further amplified while coordinating care for CYSHCN because their health records tend to be voluminous, involve a large care team, and are distributed over multiple systems typically with little to no interoperability. To develop tools that promote effective and efficient care coordination, designers must first understand what information is needed, who needs it, when they need it, and how it can be made available. Our first study focused on identifying and describing information needs and associated goals related to coordinating care for CYSHCN. We found that a critical information goal for care coordination is care networking, which includes building a patient's care team; knowing team member identities, roles, and contact information; and sharing pertinent information with the team to coordinate care. In our second study, we designed and developed two versions of a patient-, family-, and clinician-facing tool to support care networking. We then conducted a formative evaluation and compared the usability, usefulness, and efficiency of the two versions. To enable such tools to help with management of information critical to care coordination, information for care networking needs to be obtained from all information sources involved in the patient's care. In our third study, we identified and assessed prevalent and emerging national data standards to support electronic exchange and extraction of patient care team related data. The findings and innovations from this research are envisioned to help guide the design and development of next generation clinician- and patient-/family-facing applications to support care coordination of complex pediatric patients

    Proposal for an eHealth Based Ecosystem Serving National Healthcare

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    The European Union (EU)'s keen concern about citizens' health and well-being advancement has been expressed at all levels. It has been understood that at present, these can only be achieved through coordinated actions at the individual member states' level based on EU directives, as well as through promoting and funding R&D and expanding the use of eHealth technologies. Despite the diversities and particularities among member states, common values such as universal access to good quality healthcare, equity, and solidarity have been widely accepted across EU. That demanded the adoption of policies and follow directives, which streamlined actions to bridge healthcare gaps, and facilitate cross-border healthcare. This paper articulates a framework for deriving a national healthcare system, based on interoperable Electronic Health Record (EHR) with safeguarding healthcare quality, enabling quadruple helix (Public, Academia, Industry, NGOs) driven R&D and guided by a patient-centered approach. A methodology to develop an integrated EHR at National level is proposed as a prerequisite for eHealth and put into perspective. Recommendations are given for the steps needed, from the managerial, legal, technical, and financial concerns in developing an open access, patient-centered national healthcare system based on the context and constraints of a country. The example of a small country to apply the proposed methodology is demonstrated. Stakeholders, including citizens, healthcare professionals, academia, and the industry are mobilized, enabled, and incentivized for implementing the methodology. Experiences are aspired to be offered as lessons learned for other countries to adapt on their environment

    A Unified Health Information System Framework for Connecting Data, People, Devices, and Systems

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    The COVID-19 pandemic has heightened the necessity for pervasive data and system interoperability to manage healthcare information and knowledge. There is an urgent need to better understand the role of interoperability in improving the societal responses to the pandemic. This paper explores data and system interoperability, a very specific area that could contribute to fighting COVID-19. Specifically, the authors propose a unified health information system framework to connect data, systems, and devices to increase interoperability and manage healthcare information and knowledge. A blockchain-based solution is also provided as a recommendation for improving the data and system interoperability in healthcare

    Access control for social care platforms using fast healthcare interoperability resources

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    The definition of authorization policies is essential to prevent information misuse and to guarantee that only authorized personnel can access specific information. Since not everyone is familiar with special purpose languages, an interpretation tool can allow the management of policies and rules using natural languages. This paper focuses on a parser developed as a component of a platform to support the care of community-dwelling older adults, the SOCIAL platform, allowing to create, read, update and delete authorization policies and rules, using natural languages.publishe

    KETOS: Clinical decision support and machine learning as a service – A training and deployment platform based on Docker, OMOP-CDM, and FHIR Web Services

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    Background and objective To take full advantage of decision support, machine learning, and patient-level prediction models, it is important that models are not only created, but also deployed in a clinical setting. The KETOS platform demonstrated in this work implements a tool for researchers allowing them to perform statistical analyses and deploy resulting models in a secure environment. Methods The proposed system uses Docker virtualization to provide researchers with reproducible data analysis and development environments, accessible via Jupyter Notebook, to perform statistical analysis and develop, train and deploy models based on standardized input data. The platform is built in a modular fashion and interfaces with web services using the Health Level 7 (HL7) Fast Healthcare Interoperability Resources (FHIR) standard to access patient data. In our prototypical implementation we use an OMOP common data model (OMOP-CDM) database. The architecture supports the entire research lifecycle from creating a data analysis environment, retrieving data, and training to final deployment in a hospital setting. Results We evaluated the platform by establishing and deploying an analysis and end user application for hemoglobin reference intervals within the University Hospital Erlangen. To demonstrate the potential of the system to deploy arbitrary models, we loaded a colorectal cancer dataset into an OMOP database and built machine learning models to predict patient outcomes and made them available via a web service. We demonstrated both the integration with FHIR as well as an example end user application. Finally, we integrated the platform with the open source DataSHIELD architecture to allow for distributed privacy preserving data analysis and training across networks of hospitals. Conclusion The KETOS platform takes a novel approach to data analysis, training and deploying decision support models in a hospital or healthcare setting. It does so in a secure and privacy-preserving manner, combining the flexibility of Docker virtualization with the advantages of standardized vocabularies, a widely applied database schema (OMOP-CDM), and a standardized way to exchange medical data (FHIR)

    Antibiotic resistance information exchanges : interim guidance

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    Antibiotic resistance (AR) is a major clinical and public health threat with potential to unravel more than half a century of human health advances offered by modern medical care. Unfortunately, modern healthcare delivery is notably contributory to the spread of antibiotic-resistant organisms, as patients who have become colonized with resistant organisms often receive care across multiple healthcare settings (e.g., ambulatory care, acute care hospitals (ACHs), and various long-term care (LTC) settings, including long-term acute care hospitals (LTACHs) and skilled nursing facilities (SNFs)).Although the threat of antibiotic-resistant organism transmission from a colonized patient to physically proximate patients remains for the duration of colonization, the lack of information sharing between healthcare facilities often results in the colonized status of a patient being unknown to a receiving or admitting facility. When this occurs, the appropriate infection control precautions are less likely to be used from the start of patient care, which increases the likelihood that resistant organisms will spread to other patients.The need for improved AR situational awareness is a major challenge to the U.S. Centers for Disease Control and Prevention\u2019s (CDC\u2019s) strategy to contain the most threatening forms of resistance and the genes responsible for such phenotypes. To fulfill their central role in implementing the CDC\u2019s containment strategy, some state health departments have developed systems (Multidrug-Resistant Organism (MDRO) Registries or MDRO Alert Systems, referred to herein as AR Information Exchanges (ARIEs)) that track patients previously colonized or infected with specific MDROs and then alert healthcare providers when these patients are admitted to a facility. The term AR Information Exchange emphasizes the importance of multidirectional information flow amongst healthcare facilities and public health authorities, as opposed to unidirectional data collection and storage.This interim guidance is intended for operational use by individuals and organizations responsible for developing or enhancing an ARIE; however, it does not constitute legal advice. Public health agencies should follow applicable laws, statues, and/or regulations when developing ARIEs with questions about directed to the entity\u2019s legal counsel.CS 324851-AARIE-Interim-Guidance-508.pdf20211158
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