6,101 research outputs found
The Electronic Health Record Scorecard: A Measure of Utilization and Communication Skills
As the adoption rate of electronic health records (EHRs) in the United States continues to grow, both providers and patients will need to adapt to the reality of a third actor being present during the visit encounter. The purpose of this project is to provide insight on “best” practice patterns for effective communication and efficient use of the EHR in the clinical practice setting. Through the development of a comprehensive scorecard, this project assessed current status of EHR use and communication skills among health care providers in various clinical practice settings. Anticipated benefits of this project are increased comfortability in interfacing with the EHR and increased satisfaction on the part of the provider as well as the patient. Serving as a benchmark, this assessment has the potential to help guide future health information technology development, training, and education for both students and health care providers
Impact of a brief faculty training to improve patient-centered communication while using electronic health records
Objective
Despite rapid EHR adoption, few faculty receive training in how to implement patient-centered communication skills while using computers in exam rooms. We piloted a patient-centered EHR use training to address this issue.
Methods
Faculty received four hours of training at Cleveland Clinic and a condensed 90-minute version at the University of Chicago. Both included a lecture and a Group-Objective Structured Clinical Exam (GOSCE) experience. Direct observations of 10 faculty in their clinical practices were performed pre- and post-workshop.
Results
Thirty participants (94%) completed a post-workshop evaluation assessing knowledge, attitude, and skills. Faculty reported that training was important, relevant, and should be required for all providers; no differences were found between longer versus shorter training. Participants in the longer training reported higher GOSCE efficacy, however shorter workshop participants agreed more with the statement that they had gained new knowledge. Faculty improved their patient-centered EHR use skills in clinical practice on post- versus pre-workshop ratings using a validated direct-observation rating tool.
Conclusion
A brief lecture and GOSCE can be effective in training busy faculty on patient-centered EHR use skills.
Practice Implications
Faculty training on patient-centered EHR skills can enhance patient-doctor communication and promotes positive role modeling of these skills to learners
Reporting an Experience on Design and Implementation of e-Health Systems on Azure Cloud
Electronic Health (e-Health) technology has brought the world with
significant transformation from traditional paper-based medical practice to
Information and Communication Technologies (ICT)-based systems for automatic
management (storage, processing, and archiving) of information. Traditionally
e-Health systems have been designed to operate within stovepipes on dedicated
networks, physical computers, and locally managed software platforms that make
it susceptible to many serious limitations including: 1) lack of on-demand
scalability during critical situations; 2) high administrative overheads and
costs; and 3) in-efficient resource utilization and energy consumption due to
lack of automation. In this paper, we present an approach to migrate the ICT
systems in the e-Health sector from traditional in-house Client/Server (C/S)
architecture to the virtualised cloud computing environment. To this end, we
developed two cloud-based e-Health applications (Medical Practice Management
System and Telemedicine Practice System) for demonstrating how cloud services
can be leveraged for developing and deploying such applications. The Windows
Azure cloud computing platform is selected as an example public cloud platform
for our study. We conducted several performance evaluation experiments to
understand the Quality Service (QoS) tradeoffs of our applications under
variable workload on Azure.Comment: Submitted to third IEEE International Conference on Cloud and Green
Computing (CGC 2013
Electronic Health Records: An International Perspective on "Meaningful Use"
Examines the extent of meaningful use of electronic health records in Denmark, New Zealand, and Sweden, including sharing information with organizations, health authorities, and patients. Outlines challenges of and insights into encouraging U.S. adoption
Alcuni abstract di articoli che trattano argomenti relativi all'eHealth
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Barriers to the adoption of health information technology
Information Technology (IT) is successfully applied in a diverse range of fields. Though, the field of Medical Informatics is more than three decades old, it shows a very slow progress compared to many other fields in which the application of IT is growing rapidly. The spending on IT in health care is shooting up but the road to successful use of IT in health care has not been easy. This paper discusses about the barriers to the successful adoption of information technology in clinical environments and outlines the different approaches used by various countries and organisations to tackle the issues successfully. Investing financial and other resources to overcome the barriers for successful adoption of HIT is highly important to realise the dream of a future healthcare system with each customer having secure, private Electronic Health Record (EHR) that is available whenever and wherever needed, enabling the highest degree of coordinated medical care based on the latest medical knowledge and evidence. Arguably, the paper reviews barriers to HIT from organisations’ alignment in respect to the leadership; with their stated values when accepting or willingness to consider the HIT as a determinant factor on their decision-making processes. However, the review concludes that there are many aspects of the organisational accountability and readiness to agree to the technology implementation
Utilizing RxNorm to Support Practical Computing Applications: Capturing Medication History in Live Electronic Health Records
RxNorm was utilized as the basis for direct-capture of medication history
data in a live EHR system deployed in a large, multi-state outpatient
behavioral healthcare provider in the United States serving over 75,000
distinct patients each year across 130 clinical locations. This tool
incorporated auto-complete search functionality for medications and proper
dosage identification assistance. The overarching goal was to understand if and
how standardized terminologies like RxNorm can be used to support practical
computing applications in live EHR systems. We describe the stages of
implementation, approaches used to adapt RxNorm's data structure for the
intended EHR application, and the challenges faced. We evaluate the
implementation using a four-factor framework addressing flexibility, speed,
data integrity, and medication coverage. RxNorm proved to be functional for the
intended application, given appropriate adaptations to address high-speed
input/output (I/O) requirements of a live EHR and the flexibility required for
data entry in multiple potential clinical scenarios. Future research around
search optimization for medication entry, user profiling, and linking RxNorm to
drug classification schemes holds great potential for improving the user
experience and utility of medication data in EHRs.Comment: Appendix (including SQL/DDL Code) available by author request.
Keywords: RxNorm; Electronic Health Record; Medication History;
Interoperability; Unified Medical Language System; Search Optimizatio
Towards A Well-Secured Electronic Health Record in the Health Cloud
The major concerns for most cloud implementers particularly in the health care industry have remained data security
and privacy. A prominent and major threat that constitutes a hurdle for practitioners within the health industry from exploiting and
benefiting from the gains of cloud computing is the fear of theft of patients health data in the cloud. Investigations and surveys
have revealed that most practitioners in the health care industry are concerned about the risk of health data mix-up amongst the
various cloud providers, hacking to comprise the cloud platform and theft of vital patients’ health data.An overview of the
diverse issues relating to health data privacy and overall security in the cloud are presented in this technical report. Based on
identifed secure access requirements, an encryption-based eHR security model for securing and enforcing authorised access to
electronic health data (records), eHR is also presented. It highlights three core functionalities for managing issues relating to
health data privacy and security of eHR in health care cloud
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