A socio-technical analytical framework on the EHR-organizational innovation interplay: Insights from a public hospital in Greece

The healthcare sector globally is confronted with increasing internal and external pressures that urge for a radical reform of health systems' status quo. The role of technological innovations such as Electronic Health Records (EHR) is recognized as instrumental in this transition process as it is expected to accelerate organizational innovations. This is why the widespread uptake of EHR systems is a top priority in the global healthcare agenda. The successful co-deployment though of EHR systems and organizational innovations within the context of secondary healthcare institutions is a complex and multifaceted issue. Existing research in the field has made little progress thus emphasizing the need for further research contribution that will incorporate a holistic perspective. This paper presents insights about the EHR-organizational innovation interplay from a public hospital in Greece into a socio-technical analytical framework providing a multilevel set of action points for the eHealth roadmap with worldwide relevance

PENGKAJIAN KEPERAWATAN KOMUNITAS BERBASIS SISTEM ELEKTRONIK DENGAN IDENTIFIKASI PERILAKU DAN SOSIAL BUDAYA: STUDI LITERATUR

Pendahuluan: Pengkajian keperawatan di tatanan komunitas yang terpadu dengan sistem informasi manajemen belum banyak terlihat di Indonesia. Terdapat satu program pengkajian yang sudah terintegrasi sistem, seperti aplikasi keluarga sehat dari Kemenkes RI. Namun, aplikasi tersebut masih ada keterbatasan, yakni belum secara khususnya mengkaji keunikan perilaku dan determinan sosial budaya masyarakat. Padahal masyarakat merupakan makhluk yang holistik. Tujuan: Memberikan gambaran dari studi sebelumnya tentang kebermanfaatan aplikasi elektronik guna mengidentifikasi perilaku dan determinan sosial budaya di tatanan komunitas. Metode: Studi ini merupakan studi literatur non sistematik yang menggunakan 10 jurnal internasional publikasi tahun 2015-2019. Hasil: Berdasarkan hasil analisis pada 10 jurnal pilihan, didapatkan suatu kesimpulan bahwa dengan menggunakan sistem elektronik (electronic health records) untuk mengkaji keragaman perilaku dan sosial budaya masyarakat ada beberapa manfaat, yaitu keefektifan kinerja, hasil pengkajian yang lebih cepat teridentifikasi, luaran kesehatan yang lebih optimal bagi komunitas, serta lebih tepatnya penemuan sasaran dari adanya indikasi masalah kesehatan

Research Brief: Technology and Health Education: An Exploratory Study of Older Chinese Immigrants

Technology advances, especially in the Internet, provide new tools to deliver health education to limited English proficient immigrants. This paper presents the findings of a qualitative descriptive study of older limited English proficient Chinese immigrants’ perspectives regarding computer-based health education. The sample consisted of 33 foreign-born Chinese recruited in Seattle, Washington. Data were generated through six focus groups and an 18-item demographic questionnaire. The analyses revealed that the majority was not skillful in computer use and Internet browsing, and the Internet was not a common health information source. Nevertheless, participants were supportive of having computer-based health information designed for Chinese immigrants. Interface designs, interface features, and content for the computer-based health education were discussed. The results support developing more computer-based programs requiring minimal computer, English language, and health literacy for immigrants, as well as investigations of cultural influence on the suitability and cost-effectiveness of computer-based health education for Chinese immigrants

Complex temporal topic evolution modelling using the Kullback-Leibler divergence and the Bhattacharyya distance

The rapidly expanding corpus of medical research literature presents major challenges in the understanding of previous work, the extraction of maximum information from collected data, and the identification of promising research directions. We present a case for the use of advanced machine learning techniques as an aide in this task and introduce a novel methodology that is shown to be capable of extracting meaningful information from large longitudinal corpora and of tracking complex temporal changes within it. Our framework is based on (i) the discretization of time into epochs, (ii) epoch-wise topic discovery using a hierarchical Dirichlet process-based model, and (iii) a temporal similarity graph which allows for the modelling of complex topic changes. More specifically, this is the first work that discusses and distinguishes between two groups of particularly challenging topic evolution phenomena: topic splitting and speciation and topic convergence and merging, in addition to the more widely recognized emergence and disappearance and gradual evolution. The proposed framework is evaluated on a public medical literature corpus.Publisher PDFPeer reviewe

Application of Lifetime Electronic Health Records: Are we ready yet?

Integrated care concepts can help to diminish demographic challenges. Therefore, the use of eHealth solutions is recognised as an efficient approach. Lifetime electronic health records (LEHRs) are expected to increase continuity, effectiveness, efficiency and thus quality of the care process. With respect to these benefits, an overarching implementation of LEHRs is desirable but non-existent. Hence, the aim of the article is to analyse the current LEHR implementation readiness of EU member states to derive implications for further LEHR research and development. Therefore, a case study on Denmark, Germany and Italy was conducted. The analysis shows that all countries fulfil the technical requirements but Denmark has great experiences and willingness to implement advanced eHealth measures like LEHRs. First Italian pilot projects are quite promising as well. The article paves the way for LEHR implementation and there with for integrated care

The Standardization of Electronic Health Record System in Used in Cross-Organizational Platform

Perkembangan Teknologi Informasi saat ini memiliki pengaruh yang signifikan terhadap pertumbuhan e-Health. e-Health merubah model pelayanan kesehatan dan penyampaian informasi kepada masyarakat melalui penggunaan Internet. e-Health diperkenalkan sebagai solusi yang menjanjikan efektivitas biaya dan kualitas pelayanan kesehatan. Dengan menggunakan e-Health, pasien dapat dengan mudah berkonsultasi dengan profesional kesehatan, mendapatkan informasi yang berkaitan dengan penyakit tertentu, dan mengakses catatan medis. Penulisan ini akan membahas tentang salah satu masalah yang terdapat pada e-Health terkait dengan catatan medis pasien yang dikenal sebagai Electronic Health Record (EHR). EHR digunakan untuk mendokumentasikan informasi kesehatan pasien dalam format digital. Kualitas informasi yang terdapat pada EHR sangat penting bagi tenaga kesehatan untuk mengambil keputusan dalam perawatan pasien. Masalah yang muncul dan menjadi kontemporer adalah terdapat pada standarisasi sistem EHR. Pembahasan dalam penulisan ini akan fokus pada standarisasi sistem EHR terkait dengan penggunaan data di lintas organisasi termasuk data sharing, keamanan data dan data preservation

REKAM MEDIS ELEKTRONIK TIDAK MENJAMIN KELENGKAPAN DOKUMENTASI KESEHATAN PASIEN

Latar belakang: Rekam medis elektronik menjadi komponen integral daripelayanan kesehatan dan sesegera mungkin akan menggantikan rekam medisberbasis kertas.Rekam medik elektronik(RME) memiliki fungsikuatmenyediakan informasi klinis pasien.Metode : Penelitian ini dilakukan dengan mengolah rekam medis elektronik (RME) dari20 puskesmas mulai bulan Juli 2011 sampai dengan Agustus 2012 yang telah tersimpandalam server Dinas Kesehatan Kabupaten Nganjuk. Database RME dengan MicrosoftAcces 2003 dilaporkan puskesmas setiap bulan ke Dinas Kesehatan.Hasil: Rekam medis elektronik merupakan sistem yang dapat memfasilitasiworkflow klinisi dan meningkatkan kualitas pelayanan dan keselamatan pasien.Namun dari database 20 puskesmas mulai bulan Juli s/d November 2011memperlihatkan bahwa ada ketidaklengkapan data rekam medis elektronik (RME)sebesar 50,12%.Dengan rincian kondisi umum tidak diisi = 15,55%,pemeriksaan fisik tidak diisi = 36,92%, diagnosis tidak diisi = 3,10%, dan28,12% resep tidak didokumentasi dalam RME serta hasil laborat tidak diisi =61,99%.Simpulan: Penggunaan rekam medis elektronik belum mampu menjaminkelengkapan data kesehatan pasien

Data mining approach to estimate the duration of drug therapy from longitudinal electronic medical records

Background: Electronic Medical Records (EMRs) from primary/ ambulatory care systems present a new and promising source of information for conducting clinical and translational research. Objectives: To address the methodological and computational challenges in order to extract reliable medication information from raw data which is often complex, incomplete and erroneous. To assess whether the use of specific chaining fields of medication information may additionally improve the data quality. Methods: Guided by a range of challenges associated with missing and internally inconsistent data, we introduce two methods for the robust extraction of patient-level medication data. First method relies on chaining fields to estimate duration of treatment (“chaining”), while second disregards chaining fields and relies on the chronology of records (“continuous”). Centricity EMR database was used to estimate treatment duration with both methods for two widely prescribed drugs among type 2 diabetes patients: insulin and glucagon-like peptide-1 receptor agonists. Results: At individual patient level the “chaining” approach could identify the treatment alterations longitudinally and produced more robust estimates of treatment duration for individual drugs, while the “continuous” method was unable to capture that dynamics. At population level, both methods produced similar estimates of average treatment duration, however, notable differences were observed at individual-patient level. Conclusion: The proposed algorithms explicitly identify and handle longitudinal erroneous or missing entries and estimate treatment duration with specific drug(s) of interest, which makes them a valuable tool for future EMR based clinical and pharmaco-epidemiological studies. To improve accuracy of real-world based studies, implementing chaining fields of medication information is recommended.Publisher PDFPeer reviewe