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Sample records for electronic catch recordings

  1. Electronic health record and electronic patient record.

    PubMed

    Dimond, Bridgit

    This article considers the government plans for the development of electronic health and patient records as set out in the NHS Plan and the progress and problems which have been encountered in their realization. PMID:16116372

  2. Landsat electron beam recorder

    NASA Astrophysics Data System (ADS)

    Grosso, P. F.; Whitley, J. P.

    A minicomputer-controlled electron beam recorder (EBR) presently in use at the Brazilian Government's Institute De Pesquisas Espaclais (INPE) satellite ground station is described. This 5-in.-film-size EBR is used to record both Landsat and SPOT satellite imagery in South America. A brief electron beam recorder technology review is presented. The EBR is capable of recording both vector and text data from computer-aided design, publishing, and line art systems and raster data from image scanners, raster image processors (RIPS), halftone/screen generators, and remote image sensors. A variety of image formats may be recorded on numerous film sizes (16 mm, 35 mm, 70 mm, 105 mm, 5-in, 5.5-in., and 9.5-in.). These recordings are used directly or optically enlarged depending on the final product.

  3. Catching a Wave in the Internet Surf: Electronic Extemporaneous Speaking.

    ERIC Educational Resources Information Center

    Voth, Ben

    1997-01-01

    Elaborates results of using electronic extemporaneous speaking in debate tournaments. Provides analysis around four points: preparation, event operation, participant reaction, and postevent analysis by forensic staff. (PA)

  4. Electronic Health Records

    MedlinePlus

    ... Does your doc scribble notes onto sheets of paper and then slide them into an ever-expanding ... for errors. Security. There's always the chance that paper records can get lost or misfiled or somehow ...

  5. Problems in the Preservation of Electronic Records.

    ERIC Educational Resources Information Center

    Lin, Lim Siew; Ramaiah, Chennupati K.; Wal, Pitt Kuan

    2003-01-01

    Discusses issues related to the preservation of electronic records. Highlights include differences between physical and electronic records; volume of electronic records; physical media; authenticity; migration of electronic records; metadata; legal issues; improved storage media; and projects for preservation of electronic records. (LRW)

  6. Global estimates of shark catches using trade records from commercial markets.

    PubMed

    Clarke, Shelley C; McAllister, Murdoch K; Milner-Gulland, E J; Kirkwood, G P; Michielsens, Catherine G J; Agnew, David J; Pikitch, Ellen K; Nakano, Hideki; Shivji, Mahmood S

    2006-10-01

    Despite growing concerns about overexploitation of sharks, lack of accurate, species-specific harvest data often hampers quantitative stock assessment. In such cases, trade studies can provide insights into exploitation unavailable from traditional monitoring. We applied Bayesian statistical methods to trade data in combination with genetic identification to estimate by species, the annual number of globally traded shark fins, the most commercially valuable product from a group of species often unrecorded in harvest statistics. Our results provide the first fishery-independent estimate of the scale of shark catches worldwide and indicate that shark biomass in the fin trade is three to four times higher than shark catch figures reported in the only global data base. Comparison of our estimates to approximated stock assessment reference points for one of the most commonly traded species, blue shark, suggests that current trade volumes in numbers of sharks are close to or possibly exceeding the maximum sustainable yield levels.

  7. 5 CFR 850.301 - Electronic records; other acceptable records.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... electronic or digital form by means of image scanning or other forms of electronic or digital conversion. (b) Documents that are not converted to an electronic or digital form will continue to be acceptable records for... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Electronic records; other...

  8. 5 CFR 850.301 - Electronic records; other acceptable records.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... electronic or digital form by means of image scanning or other forms of electronic or digital conversion. (b) Documents that are not converted to an electronic or digital form will continue to be acceptable records for... 5 Administrative Personnel 2 2011-01-01 2011-01-01 false Electronic records; other...

  9. Behavioral health electronic medical record.

    PubMed

    Lawlor, Ted; Barrows, Erik

    2008-03-01

    The electronic medical record (EMR) will be an important part of the future of medical practice. Behavioral health treatment demands certain additions to the capabilities of a standard general medical EMR. The current focus on the quality management and financial aspects of the EMR are only initial examples of what this tool can do. It is important for behavioral health practitioners to understand that they must embrace this innovation and mold it into a product that serves their needs and the needs of their patients. An efficient and effective EMR will greatly assist the overall clinical enterprise in a number of important areas. PMID:18295041

  10. 32 CFR 701.21 - Electronic record.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false Electronic record. 701.21 Section 701.21... THE NAVY DOCUMENTS AFFECTING THE PUBLIC FOIA Definitions and Terms § 701.21 Electronic record. Records (including e-mail) which are created, stored, and retrieved by electronic means....

  11. 32 CFR 701.21 - Electronic record.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... THE NAVY DOCUMENTS AFFECTING THE PUBLIC FOIA Definitions and Terms § 701.21 Electronic record. Records (including e-mail) which are created, stored, and retrieved by electronic means. ... 32 National Defense 5 2010-07-01 2010-07-01 false Electronic record. 701.21 Section...

  12. Electronic Dental Records System Adoption.

    PubMed

    Abramovicz-Finkelsztain, Renata; Barsottini, Claudia G N; Marin, Heimar Fatima

    2015-01-01

    The use of Electronic Dental Records (EDRs) and management software has become more frequent, following the increase in prevelance of new technologies and computers in dental offices. The purpose of this study is to identify and evaluate the use of EDRs by the dental community in the São Paulo city area. A quantitative case study was performed using a survey on the phone. A total of 54 offices were contacted and only one declinedparticipation in this study. Only one office did not have a computer. EDRs were used in 28 offices and only four were paperless. The lack of studies in this area suggests the need for more usability and implementation studies on EDRs so that we can improve EDR adoption by the dental community.

  13. Biometrics for electronic health records.

    PubMed

    Flores Zuniga, Alejandro Enrique; Win, Khin Than; Susilo, Willy

    2010-10-01

    Securing electronic health records, in scenarios in which the provision of care services is share among multiple actors, could become a complex and costly activity. Correct identification of patients and physician, protection of privacy and confidentiality, assignment of access permissions for healthcare providers and resolutions of conflicts rise as main points of concern in the development of interconnected health information networks. Biometric technologies have been proposed as a possible technological solution for these issues due to its ability to provide a mechanism for unique verification of an individual identity. This paper presents an analysis of the benefit as well as disadvantages offered by biometric technology. A comparison between this technology and more traditional identification methods is used to determine the key benefits and flaws of the use biometric in health information systems. The comparison as been made considering the viability of the technologies for medical environments, global security needs, the contemplation of a share care environment and the costs involved in the implementation and maintenance of such technologies. This paper also discusses alternative uses for biometrics technologies in health care environments. The outcome of this analysis lays in the fact that even when biometric technologies offer several advantages over traditional method of identification, they are still in the early stages of providing a suitable solution for a health care environment. PMID:20703610

  14. Biometrics for electronic health records.

    PubMed

    Flores Zuniga, Alejandro Enrique; Win, Khin Than; Susilo, Willy

    2010-10-01

    Securing electronic health records, in scenarios in which the provision of care services is share among multiple actors, could become a complex and costly activity. Correct identification of patients and physician, protection of privacy and confidentiality, assignment of access permissions for healthcare providers and resolutions of conflicts rise as main points of concern in the development of interconnected health information networks. Biometric technologies have been proposed as a possible technological solution for these issues due to its ability to provide a mechanism for unique verification of an individual identity. This paper presents an analysis of the benefit as well as disadvantages offered by biometric technology. A comparison between this technology and more traditional identification methods is used to determine the key benefits and flaws of the use biometric in health information systems. The comparison as been made considering the viability of the technologies for medical environments, global security needs, the contemplation of a share care environment and the costs involved in the implementation and maintenance of such technologies. This paper also discusses alternative uses for biometrics technologies in health care environments. The outcome of this analysis lays in the fact that even when biometric technologies offer several advantages over traditional method of identification, they are still in the early stages of providing a suitable solution for a health care environment.

  15. PACS and electronic health records

    NASA Astrophysics Data System (ADS)

    Cohen, Simona; Gilboa, Flora; Shani, Uri

    2002-05-01

    Electronic Health Record (EHR) is a major component of the health informatics domain. An important part of the EHR is the medical images obtained over a patient's lifetime and stored in diverse PACS. The vision presented in this paper is that future medical information systems will convert data from various medical sources -- including diverse modalities, PACS, HIS, CIS, RIS, and proprietary systems -- to HL7 standard XML documents. Then, the various documents are indexed and compiled to EHRs, upon which complex queries can be posed. We describe the conversion of data retrieved from PACS systems through DICOM to HL7 standard XML documents. This enables the EHR system to answer queries such as 'Get all chest images of patients at the age of 20-30, that have blood type 'A' and are allergic to pine trees', which a single PACS cannot answer. The integration of data from multiple sources makes our approach capable of delivering such answers. It enables the correlation of medical, demographic, clinical, and even genetic information. In addition, by fully indexing all the tagged data in DICOM objects, it becomes possible to offer access to huge amounts of valuable data, which can be better exploited in the specific radiology domain.

  16. Implementation of electronic medical records

    PubMed Central

    Greiver, Michelle; Barnsley, Jan; Glazier, Richard H.; Moineddin, Rahim; Harvey, Bart J.

    2011-01-01

    Abstract Objective To apply the diffusion-of-innovations theory to the examination of factors that are perceived by family physicians as influencing the implementation of electronic medical records (EMRs). Design Qualitative study with 2 focus groups 18 months after EMR implementation; participants also took part in a concurrent quantitative study examining EMR implementation and preventive services. Setting Toronto, Ont. Participants Twelve community-based family physicians. Methods We employed a semistructured interview guide. The interviews were audiotaped and transcribed verbatim; 2 researchers independently categorized and coded the transcripts and then met to compare and contrast their findings, category mapping, and interpretations. Findings were then mapped to an existing theoretical framework. Main findings Multiple barriers to EMR implementation were described. These included lack of relative advantage for many processes, high complexity of the system, low compatibility with physician needs and past experiences, difficulty with adaptation of the EMR to the organization and adaptation of the organization to the EMR, and lack of organizational slack. Positive factors were the presence of a champion and relative advantages for some processes. Conclusion Early EMR implementation experience is consistent with theoretical concepts associated with implementation of innovations. A problematic implementation process helps to explain, at least in part, the lack of improvement in preventive services in our quantitative results. PMID:21998247

  17. The last frontier: catch records of white sharks (Carcharodon carcharias) in the Northwest Pacific Ocean.

    PubMed

    Christiansen, Heather M; Lin, Victor; Tanaka, Sho; Velikanov, Anatoly; Mollet, Henry F; Wintner, Sabine P; Fordham, Sonja V; Fisk, Aaron T; Hussey, Nigel E

    2014-01-01

    White sharks are highly migratory apex predators, globally distributed in temperate, sub-tropical, and tropical waters. Knowledge of white shark biology and ecology has increased recently based on research at known aggregation sites in the Indian, Atlantic, and Northeast Pacific Oceans; however, few data are available for the Northwest Pacific Ocean. This study provides a meta-analysis of 240 observations of white sharks from the Northwest Pacific Ocean between 1951 and 2012. Records comprise reports of bycatch in commercial fisheries, media accounts, personal communications, and documentation of shark-human interactions from Russia (n = 8), Republic of Korea (22), Japan (129), China (32), Taiwan (45), Philippines (1) and Vietnam (3). Observations occurred in all months, excluding October-January in the north (Russia and Republic of Korea) and July-August in the south (China, Taiwan, Philippines, and Vietnam). Population trend analysis indicated that the relative abundance of white sharks in the region has remained relatively stable, but parameterization of a 75% increase in observer effort found evidence of a minor decline since 2002. Reliably measured sharks ranged from 126-602 cm total length (TL) and 16-2530 kg total weight. The largest shark in this study (602 cm TL) represents the largest measured shark on record worldwide. For all countries combined the sex ratio was non-significantly biased towards females (1∶1.1; n = 113). Of 60 females examined, 11 were confirmed pregnant ranging from the beginning stages of pregnancy (egg cases) to near term (140 cm TL embryos). On average, 6.0±2.2 embryos were found per litter (maximum of 10) and gestation period was estimated to be 20 months. These observations confirm that white sharks are present in the Northwest Pacific Ocean year-round. While acknowledging the difficulties of studying little known populations of a naturally low abundance species, these results highlight the need for dedicated research to

  18. The Last Frontier: Catch Records of White Sharks (Carcharodon carcharias) in the Northwest Pacific Ocean

    PubMed Central

    Christiansen, Heather M.; Lin, Victor; Tanaka, Sho; Velikanov, Anatoly; Mollet, Henry F.; Wintner, Sabine P.; Fordham, Sonja V.; Fisk, Aaron T.; Hussey, Nigel E.

    2014-01-01

    White sharks are highly migratory apex predators, globally distributed in temperate, sub-tropical, and tropical waters. Knowledge of white shark biology and ecology has increased recently based on research at known aggregation sites in the Indian, Atlantic, and Northeast Pacific Oceans; however, few data are available for the Northwest Pacific Ocean. This study provides a meta-analysis of 240 observations of white sharks from the Northwest Pacific Ocean between 1951 and 2012. Records comprise reports of bycatch in commercial fisheries, media accounts, personal communications, and documentation of shark-human interactions from Russia (n = 8), Republic of Korea (22), Japan (129), China (32), Taiwan (45), Philippines (1) and Vietnam (3). Observations occurred in all months, excluding October-January in the north (Russia and Republic of Korea) and July-August in the south (China, Taiwan, Philippines, and Vietnam). Population trend analysis indicated that the relative abundance of white sharks in the region has remained relatively stable, but parameterization of a 75% increase in observer effort found evidence of a minor decline since 2002. Reliably measured sharks ranged from 126–602 cm total length (TL) and 16–2530 kg total weight. The largest shark in this study (602 cm TL) represents the largest measured shark on record worldwide. For all countries combined the sex ratio was non-significantly biased towards females (1∶1.1; n = 113). Of 60 females examined, 11 were confirmed pregnant ranging from the beginning stages of pregnancy (egg cases) to near term (140 cm TL embryos). On average, 6.0±2.2 embryos were found per litter (maximum of 10) and gestation period was estimated to be 20 months. These observations confirm that white sharks are present in the Northwest Pacific Ocean year-round. While acknowledging the difficulties of studying little known populations of a naturally low abundance species, these results highlight the need for dedicated

  19. Privacy, confidentiality, and electronic medical records.

    PubMed Central

    Barrows, R C; Clayton, P D

    1996-01-01

    The enhanced availability of health information in an electronic format is strategic for industry-wide efforts to improve the quality and reduce the cost of health care, yet it brings a concomitant concern of greater risk for loss of privacy among health care participants. The authors review the conflicting goals of accessibility and security for electronic medical records and discuss nontechnical and technical aspects that constitute a reasonable security solution. It is argued that with guiding policy and current technology, an electronic medical record may offer better security than a traditional paper record. PMID:8653450

  20. Clean catch urine sample

    MedlinePlus

    Urine culture - clean catch; Urinalysis - clean catch; Clean catch urine specimen; Urine collection - clean catch ... lips" (labia). You may be given a special clean-catch kit that contains sterile wipes. Sit on ...

  1. Electronic medical record: Time to migrate?

    PubMed Central

    Rustagi, Neeti; Singh, Ritesh

    2012-01-01

    Gone are the days when records of patients were kept in paper format. Majority of things going digital, it is inevitable that hospitals will adopt electronic medical record in near future. It is simple, reliable and cost effective in long term. PMID:23293762

  2. Electronic medical record: Time to migrate?

    PubMed

    Rustagi, Neeti; Singh, Ritesh

    2012-10-01

    Gone are the days when records of patients were kept in paper format. Majority of things going digital, it is inevitable that hospitals will adopt electronic medical record in near future. It is simple, reliable and cost effective in long term.

  3. Catching Sunlight

    NASA Astrophysics Data System (ADS)

    Friedman, Alan

    Everyone knows that astronomy is done in the dark. Astronomers are creatures of the night, like vampires, sleeping during the day and working all night long to catch the faint light of their elusive prey.

  4. Electronic health records: current and future use.

    PubMed

    Peters, Steve G; Khan, Munawwar A

    2014-09-01

    This paper provides an overview of the current state of the electronic medical record, including benefits and shortcomings, and presents key factors likely to drive development in the next decade and beyond. The current electronic medical record to a large extent represents a digital version of the traditional paper legal record, owned and maintained by the practitioner. The future electronic health record is expected to be a shared tool, engaging patients in decision making, wellness and disease management and providing data for individual decision support, population management and analytics. Many drivers will determine this path, including payment model reform, proliferation of mobile platforms, telemedicine, genomics and individualized medicine and advances in 'big data' technologies.

  5. Patient information: confidentiality and the electronic record.

    PubMed

    Griffith, Richard

    The rise of the electronic record now allows nurses to access a large archive of patient information that was more difficult to obtain when records consisted of manually held paper files. There have been several instances where curiosity and, occasionally, more malicious motivations have led nurses to access these records and read the notes of a celebrity or a person they know. In this article, Richard Griffith considers whether nurses' accessing and reading of the record of someone who is not in their care is in breach of their duty of confidentiality. PMID:26419719

  6. Principal Challenges Facing Electronic Records Management in Federal Agencies Today.

    ERIC Educational Resources Information Center

    Patterson, Giovanna; Sprehe, J. Timothy

    2002-01-01

    Discusses electronic records management in the federal government. Highlights include managing electronic mail; information technology planning, systems design, and architecture; updating conventional records management; integrating electronic records management with other information technology systems; challenges of end-user training; business…

  7. Syndromic Surveillance Using Ambulatory Electronic Health Records

    PubMed Central

    Hripcsak, George; Soulakis, Nicholas D.; Li, Li; Morrison, Frances P.; Lai, Albert M.; Friedman, Carol; Calman, Neil S.; Mostashari, Farzad

    2009-01-01

    Objective To assess the performance of electronic health record data for syndromic surveillance and to assess the feasibility of broadly distributed surveillance. Design Two systems were developed to identify influenza-like illness and gastrointestinal infectious disease in ambulatory electronic health record data from a network of community health centers. The first system used queries on structured data and was designed for this specific electronic health record. The second used natural language processing of narrative data, but its queries were developed independently from this health record. Both were compared to influenza isolates and to a verified emergency department chief complaint surveillance system. Measurements Lagged cross-correlation and graphs of the three time series. Results For influenza-like illness, both the structured and narrative data correlated well with the influenza isolates and with the emergency department data, achieving cross-correlations of 0.89 (structured) and 0.84 (narrative) for isolates and 0.93 and 0.89 for emergency department data, and having similar peaks during influenza season. For gastrointestinal infectious disease, the structured data correlated fairly well with the emergency department data (0.81) with a similar peak, but the narrative data correlated less well (0.47). Conclusions It is feasible to use electronic health records for syndromic surveillance. The structured data performed best but required knowledge engineering to match the health record data to the queries. The narrative data illustrated the potential performance of a broadly disseminated system and achieved mixed results. PMID:19261941

  8. Preserving electronic records: Not the easiest task

    NASA Technical Reports Server (NTRS)

    Eaton, Fynnette

    1993-01-01

    The National Archives and Records Administration has had a program for accessioning, describing, preserving and providing reference service to the electronic records (machine-readable records) created by Federal agencies for more than twenty years. Although there have been many changes in the name of the office, its basic mission has remained the same: to preserve and make available those records created by Federal agencies that the National Archives has determined to have value beyond the short-term need of the originating agency. A phrase that was once coined for a preservation conference still applies: the National Archives, when it decides to accept the transfer of records into its custody, is committing itself to preserving these records for perpetuity.

  9. Towards a Model Based Electronic Nursing Record

    PubMed Central

    Jansen, Niels; Bekkering, Tino; Ruber, Alexander; Gooskens, Erik; Goossen, William T.F.

    2012-01-01

    The electronic nursing record (ENR) as part of the larger electronic health record has been discussed for years. Its implementation is not that widespread as often considered. E.g. in the Netherlands, a fraction of hospitals uses it. This paper describes a nurse led project in a Dutch hospital where an electronic nursing record system has been defined, based on requirements analysis, standardization through Detail Clinical Models (DCM), and implementation. Standardization of data with DCM is a method and a format to organize clinical knowledge, concepts, and data elements such that managing and exchanging semantics of data is independent from specific technology. 28 DCM are used in the specifications of the ENR. Using the DCM standards approach and the mapping of data elements to professional terminologies enable a vendor to develop what is needed for quality care, rather then sell a fixed set product. PMID:24199083

  10. Electronic medical records in clinical teaching.

    PubMed

    Warboys, Ina; Mok, Wai Yin; Frith, Karen H

    2014-01-01

    The purpose of the project was to provide students with experiences to develop their technology competency and examine student perceptions about an academic electronic medical record (EMR) as a learning tool. Nurse educators need to integrate EMRs into their curricula to give students practice in the use of electronic documentation and retrieval of clinical information. The findings of this study indicated that students' use of EMRs at least 5 times resulted in the development of positive perceptions about their EMR experience. PMID:25073041

  11. Teaching Electronic Health Record Communication Skills.

    PubMed

    Palumbo, Mary Val; Sandoval, Marie; Hart, Vicki; Drill, Clarissa

    2016-06-01

    This pilot study investigated nurse practitioner students' communication skills when utilizing the electronic health record during history taking. The nurse practitioner students (n = 16) were videotaped utilizing the electronic health record while taking health histories with standardized patients. The students were videotaped during two separate sessions during one semester. Two observers recorded the time spent (1) typing and talking, (2) typing only, and (3) looking at the computer without talking. Total history taking time, computer placement, and communication skills were also recorded. During the formative session, mean history taking time was 11.4 minutes, with 3.5 minutes engaged with the computer (30.6% of visit). During the evaluative session, mean history taking time was 12.4 minutes, with 2.95 minutes engaged with the computer (24% of visit). The percentage of time individuals spent changed over the two visits: typing and talking, -3.1% (P = .3); typing only, +12.8% (P = .038); and looking at the computer, -9.6% (P = .039). This study demonstrated that time spent engaged with the computer during a patient encounter does decrease with student practice and education. Therefore, students benefit from instruction on electronic health record-specific communication skills, and use of a simple mnemonic to reinforce this is suggested.

  12. Patient Perceptions of Electronic Health Records

    ERIC Educational Resources Information Center

    Lulejian, Armine

    2011-01-01

    Research objective. Electronic Health Records (EHR) are expected to transform the way medicine is delivered with patients/consumers being the intended beneficiaries. However, little is known regarding patient knowledge and attitudes about EHRs. This study examined patient perceptions about EHR. Study design. Surveys were administered following…

  13. Nurses' Perceptions of the Electronic Health Record

    ERIC Educational Resources Information Center

    Crawley, Rocquel Devonne

    2013-01-01

    The implementation of electronic health records (EHR) by health care organizations has been limited. Despite the broad consensus on the potential benefits of EHRs, health care organizations have been slow to adopt the technology. The purpose of this qualitative phenomenological study was to explore licensed practical and registered nurses'…

  14. Barriers to implement Electronic Health Records (EHRs)

    PubMed Central

    Ajami, Sima; Arab-Chadegani, Razieh

    2013-01-01

    Introduction: During the past 20 years, with huge advances in information technology and particularly in the areas of health, various forms of electronic records have been studied, analyzed, designed or implemented. An Electronic Health Records (EHRs) is defined as digitally stored healthcare information throughout an individual’s lifetime with the purpose of supporting continuity of care, education, and research. The EHRs may include such things as observations, laboratory tests, medical images, treatments, therapies; drugs administered, patient identifying information, legal permissions, and so on. Despite of the potential benefits of electronic health records, implement of this project facing with barriers and restriction ,that the most of these limitations are cost constraints, technical limitations, standardization limits, attitudinal constraints–behavior of individuals and organizational constraints. Aim: The aim of this study was to express the main barriers to implement EHRs. Methods: This study was unsystematic-review study. The literature was searched on main barriers to implement EHRs with the help of library, books, conference proceedings, data bank, and also searches engines available at Google, Google scholar. For our searches, we employed the following keywords and their combinations: Electronic health record, implement, obstacle, and information technology in the searching areas of title, keywords, abstract, and full text. Results and discussion: In this study, more than 43 articles and reports were collected and 32 of them were selected based on their relevancy. Many studies indicate that the most important factor than other limitations to implement the EHR are resistance to change. PMID:24167440

  15. [Nurse's coworking to electronic medical record].

    PubMed

    Maresca, M; Gavaciuto, D; Cappelli, G

    2007-01-01

    Nephrologists need to register and look at a great number of clinical data. The use of electronic medical records may improve efficiency and reduce errors. Aim of our work is to report the experience of Villa Scassi Hospital in Genoa, where a "patient file" has been performed to improve nephrology practice management. The file contains all clinical records, laboratory and radiology data, therapy, dialysis clinics, in addition to reports of out-patients department. This system allowed a better efficiency in diagnosis and treatment of the patient. Moreover experience of nurses in employing electronic medical records is reported. A reduced number of errors was found in therapy administering, because of a only one data source for physicians and nurses. PMID:17922451

  16. Electronic Health Record Meets Digital Library

    PubMed Central

    Humphreys, Betsy L.

    2000-01-01

    Linking the electronic health record to the digital library is a Web-era reformulation of the long-standing informatics goal of seamless integration of automated clinical data and relevant knowledge-based information to support informed decisions. The spread of the Internet, the development of the World Wide Web, and converging format standards for electronic health data and digital publications make effective linking increasingly feasible. Some existing systems link electronic health data and knowledge-based information in limited settings or limited ways. Yet many challenging informatics research problems remain to be solved before flexible and seamless linking becomes a reality and before systems become capable of delivering the specific piece of information needed at the time and place a decision must be made. Connecting the electronic health record to the digital library also requires positive resolution of important policy issues, including health data privacy, government envouragement of high-speed communications, electronic intellectual property rights, and standards for health data and for digital libraries. Both the research problems and the policy issues should be important priorities for the field of medical informatics. PMID:10984463

  17. Legal Considerations for Electronic Health Records.

    PubMed

    Mostofi, Sherry; Hoffman, Andrew L

    2015-05-01

    Electronic health record (EHR) solutions provide many potential benefits for dental practices, whether those programs run internally on a dental practice's computers or are cloud-based solutions. However, these programs also create new risks for a dental practice, which may be mitigated through due diligence and adequate contractual provisions to ensure protection for dentists. This article addresses the legal considerations associated with a dentist entering into a service contract with an EHR vendor.

  18. National electronic health record interoperability chronology.

    PubMed

    Hufnagel, Stephen P

    2009-05-01

    The federal initiative for electronic health record (EHR) interoperability began in 2000 and set the stage for the establishment of the 2004 Executive Order for EHR interoperability by 2014. This article discusses the chronology from the 2001 e-Government Consolidated Health Informatics (CHI) initiative through the current congressional mandates for an aligned, interoperable, and agile DoD AHLTA and VA VistA.

  19. Legal Considerations for Electronic Health Records.

    PubMed

    Mostofi, Sherry; Hoffman, Andrew L

    2015-05-01

    Electronic health record (EHR) solutions provide many potential benefits for dental practices, whether those programs run internally on a dental practice's computers or are cloud-based solutions. However, these programs also create new risks for a dental practice, which may be mitigated through due diligence and adequate contractual provisions to ensure protection for dentists. This article addresses the legal considerations associated with a dentist entering into a service contract with an EHR vendor. PMID:26798899

  20. Confidentiality, electronic health records, and the clinician.

    PubMed

    Graves, Stuart

    2013-01-01

    The advent of electronic health records (EHRs) to improve access and enable research in the everyday clinical world has simultaneously made medical information much more vulnerable to illicit, non-beneficent uses. This wealth of identified, aggregated data has and will attract attacks by domestic governments for surveillance and protection, foreign governments for espionage and sabotage, organized crime for illegal profits, and large corporations for "legal" profits. Against these powers with almost unlimited resources no security scheme is likely to prevail, so the design of such systems should include appropriate security measures. Unlike paper records, where the person maintaining and controlling the existence of the records also controls access to them, these two functions can be separated for EHRs. By giving physical control over access to individual records to their individual owners, the aggregate is dismantled, thereby protecting the nation's identified health information from large-scale data mining or tampering. Control over the existence and integrity of all the records--yet without the ability to examine their contents--would be left with larger institutions. This article discusses the implications of all of the above for the role of the clinician in assuring confidentiality (a cornerstone of clinical practice), for research and everyday practice, and for current security designs.

  1. Security infrastructure services for electronic archives and electronic health records.

    PubMed

    Pharow, Peter; Blobel, Bernd

    2004-01-01

    Communication and co-operation in the domain of healthcare and welfare require a well-defined set of security services based on a Public Key Infrastructure and provided by a Trusted Third Party (TTP). These services describe both status and relation of communicating principals, corresponding keys and attributes, and the access rights to applications and data. Additional services are needed to provide trustworthy information about dynamic issues of communication and co-operation such as time and location of processes, workflow relations, and system behaviour. Legal, social, behavioural and ethical requirements demand securely stored patient information and well-established access tools and tokens. Electronic (and more specifically digital) signatures--as important means for securing the integrity of a message or file--along with certified time stamps or time signatures are especially important for purposes of data storage in electronic archives and electronic health records (EHR). While just mentioning technical storage problems (e.g. lifetime of the storage devices, interoperability of retrieval and presentation software), this paper identifies mechanisms of securing data items, files, messages, sets of archived items or documents, electronic archive structures, and life-long electronic health records. Other workshop contributions will demonstrate related aspects of policies, patient privacy, and privilege management.

  2. Recent perspectives of electronic medical record systems

    PubMed Central

    ZHANG, XIAO-YING; ZHANG, PEIYING

    2016-01-01

    Implementation of electronic medical record (EMR) systems within developing contexts as part of efforts to monitor and facilitate the attainment of health-related aims has been on the increase. However, these efforts have been concentrated on urban hospitals. Recent findings showed that development processes of EMR systems are associated with various discrepancies between protocols and work practices. These discrepancies were mainly caused by factors including high workload, lack of medical resources, misunderstanding of the protocols by health workers, and client/patient practices. The present review focused on the effects of EMRs on patient care work, and on appropriate EMR designs principles and strategies to ameliorate these systems. PMID:27284289

  3. Big data and the electronic health record.

    PubMed

    Peters, Steve G; Buntrock, James D

    2014-01-01

    The electronic medical record has evolved from a digital representation of individual patient results and documents to information of large scale and complexity. Big Data refers to new technologies providing management and processing capabilities, targeting massive and disparate data sets. For an individual patient, techniques such as Natural Language Processing allow the integration and analysis of textual reports with structured results. For groups of patients, Big Data offers the promise of large-scale analysis of outcomes, patterns, temporal trends, and correlations. The evolution of Big Data analytics moves us from description and reporting to forecasting, predictive modeling, and decision optimization.

  4. Architecture for networked electronic patient record systems.

    PubMed

    Takeda, H; Matsumura, Y; Kuwata, S; Nakano, H; Sakamoto, N; Yamamoto, R

    2000-11-01

    There have been two major approaches to the development of networked electronic patient record (EPR) architecture. One uses object-oriented methodologies for constructing the model, which include the GEHR project, Synapses, HL7 RIM and so on. The second approach uses document-oriented methodologies, as applied in examples of HL7 PRA. It is practically beneficial to take the advantages of both approaches and to add solution technologies for network security such as PKI. In recognition of the similarity with electronic commerce, a certificate authority as a trusted third party will be organised for establishing networked EPR system. This paper describes a Japanese functional model that has been developed, and proposes a document-object-oriented architecture, which is-compared with other existing models. PMID:11154967

  5. Electronic Health Record Application Support Service Enablers.

    PubMed

    Neofytou, M S; Neokleous, K; Aristodemou, A; Constantinou, I; Antoniou, Z; Schiza, E C; Pattichis, C S; Schizas, C N

    2015-08-01

    There is a huge need for open source software solutions in the healthcare domain, given the flexibility, interoperability and resource savings characteristics they offer. In this context, this paper presents the development of three open source libraries - Specific Enablers (SEs) for eHealth applications that were developed under the European project titled "Future Internet Social and Technological Alignment Research" (FI-STAR) funded under the "Future Internet Public Private Partnership" (FI-PPP) program. The three SEs developed under the Electronic Health Record Application Support Service Enablers (EHR-EN) correspond to: a) an Electronic Health Record enabler (EHR SE), b) a patient summary enabler based on the EU project "European patient Summary Open Source services" (epSOS SE) supporting patient mobility and the offering of interoperable services, and c) a Picture Archiving and Communications System (PACS) enabler (PACS SE) based on the dcm4che open source system for the support of medical imaging functionality. The EHR SE follows the HL7 Clinical Document Architecture (CDA) V2.0 and supports the Integrating the Healthcare Enterprise (IHE) profiles (recently awarded in Connectathon 2015). These three FI-STAR platform enablers are designed to facilitate the deployment of innovative applications and value added services in the health care sector. They can be downloaded from the FI-STAR cataloque website. Work in progress focuses in the validation and evaluation scenarios for the proving and demonstration of the usability, applicability and adaptability of the proposed enablers. PMID:26736531

  6. Quality and Certification of Electronic Health Records

    PubMed Central

    Hoerbst, A.; Ammenwerth, E.

    2010-01-01

    Background Numerous projects, initiatives, and programs are dedicated to the development of Electronic Health Records (EHR) worldwide. Increasingly more of these plans have recently been brought from a scientific environment to real life applications. In this context, quality is a crucial factor with regard to the acceptance and utility of Electronic Health Records. However, the dissemination of the existing quality approaches is often rather limited. Objectives The present paper aims at the description and comparison of the current major quality certification approaches to EHRs. Methods A literature analysis was carried out in order to identify the relevant publications with regard to EHR quality certification. PubMed, ACM Digital Library, IEEExplore, CiteSeer, and Google (Scholar) were used to collect relevant sources. The documents that were obtained were analyzed using techniques of qualitative content analysis. Results The analysis discusses and compares the quality approaches of CCHIT, EuroRec, IHE, openEHR, and EN13606. These approaches differ with regard to their focus, support of service-oriented EHRs, process of (re-)certification and testing, number of systems certified and tested, supporting organizations, and regional relevance. Discussion The analyzed approaches show differences with regard to their structure and processes. System vendors can exploit these approaches in order to improve and certify their information systems. Health care organizations can use these approaches to support selection processes or to assess the quality of their own information systems. PMID:23616834

  7. Disassociation for electronic health record privacy.

    PubMed

    Loukides, Grigorios; Liagouris, John; Gkoulalas-Divanis, Aris; Terrovitis, Manolis

    2014-08-01

    The dissemination of Electronic Health Record (EHR) data, beyond the originating healthcare institutions, can enable large-scale, low-cost medical studies that have the potential to improve public health. Thus, funding bodies, such as the National Institutes of Health (NIH) in the U.S., encourage or require the dissemination of EHR data, and a growing number of innovative medical investigations are being performed using such data. However, simply disseminating EHR data, after removing identifying information, may risk privacy, as patients can still be linked with their record, based on diagnosis codes. This paper proposes the first approach that prevents this type of data linkage using disassociation, an operation that transforms records by splitting them into carefully selected subsets. Our approach preserves privacy with significantly lower data utility loss than existing methods and does not require data owners to specify diagnosis codes that may lead to identity disclosure, as these methods do. Consequently, it can be employed when data need to be shared broadly and be used in studies, beyond the intended ones. Through extensive experiments using EHR data, we demonstrate that our method can construct data that are highly useful for supporting various types of clinical case count studies and general medical analysis tasks.

  8. Mining Electronic Health Records using Linked Data.

    PubMed

    Odgers, David J; Dumontier, Michel

    2015-01-01

    Meaningful Use guidelines have pushed the United States Healthcare System to adopt electronic health record systems (EHRs) at an unprecedented rate. Hospitals and medical centers are providing access to clinical data via clinical data warehouses such as i2b2, or Stanford's STRIDE database. In order to realize the potential of using these data for translational research, clinical data warehouses must be interoperable with standardized health terminologies, biomedical ontologies, and growing networks of Linked Open Data such as Bio2RDF. Applying the principles of Linked Data, we transformed a de-identified version of the STRIDE into a semantic clinical data warehouse containing visits, labs, diagnoses, prescriptions, and annotated clinical notes. We demonstrate the utility of this system though basic cohort selection, phenotypic profiling, and identification of disease genes. This work is significant in that it demonstrates the feasibility of using semantic web technologies to directly exploit existing biomedical ontologies and Linked Open Data.

  9. Electronic health records for cardiovascular medicine.

    PubMed

    Ouhbi, Sofia; Idri, Ali; Fernández-Alemán, Jose Luis; Toval, Ambrosio; Benjelloun, Halima

    2014-01-01

    Nowadays, many cardiology health care centers and hospitals adopt new technologies to improve interaction with their patients. The Electronic Health Records (EHR) offer health care centers and institutions the possibility to improve the management of their patients' health data. Currently, many physicians are using EHRs to improve health care quality and efficiency. A large number of companies have emerged to provide hospitals with the opportunity to adopt EHRs within a health care platform proposing different functionalities and services which achieve certain certification criteria. This paper identifies the current list of certified EHRs for cardiovascular medicine and assesses the specifications of the EHRs selected. The result of this paper may assist EHR seekers for cardiovascular medicine in their tasks. PMID:25570218

  10. Mining Electronic Health Records using Linked Data

    PubMed Central

    Odgers, David J.; Dumontier, Michel

    2015-01-01

    Meaningful Use guidelines have pushed the United States Healthcare System to adopt electronic health record systems (EHRs) at an unprecedented rate. Hospitals and medical centers are providing access to clinical data via clinical data warehouses such as i2b2, or Stanford’s STRIDE database. In order to realize the potential of using these data for translational research, clinical data warehouses must be interoperable with standardized health terminologies, biomedical ontologies, and growing networks of Linked Open Data such as Bio2RDF. Applying the principles of Linked Data, we transformed a de-identified version of the STRIDE into a semantic clinical data warehouse containing visits, labs, diagnoses, prescriptions, and annotated clinical notes. We demonstrate the utility of this system though basic cohort selection, phenotypic profiling, and identification of disease genes. This work is significant in that it demonstrates the feasibility of using semantic web technologies to directly exploit existing biomedical ontologies and Linked Open Data. PMID:26306276

  11. Transforming Education for Electronic Health Record Implementation.

    PubMed

    Nicklaus, Jennifer; Kusser, Janet; Zessin, Julie; Amaya, Michael

    2015-08-01

    Outcomes are an integral part of health care. Over the years, the educational team at the authors' hospital has sought effective, realistic options for electronic health record (EHR) training that ensures standardized documentation of patient data by nursing personnel. Thus, providers will have easily available access and clinicians will experience confidence in the proficiency of their skills to use the EHR. This article describes the transformation from an instructor-led classroom training plan into a focused clinician workflow training pathway using Benner's novice-to-expert model and Lowe's five Key Principles for Successful EHR Training. Multiple teaching strategies have been incorporated into the education plan, including a computer skills assessment test, an EHR proficiency tool, web-based training modules, clinical (or specialty) scenarios, followed by practice in learning laboratories. The educational plan has produced individualized EHR learning, confident nursing performance, and overall unit management satisfaction. PMID:26247658

  12. Mining Electronic Health Records using Linked Data.

    PubMed

    Odgers, David J; Dumontier, Michel

    2015-01-01

    Meaningful Use guidelines have pushed the United States Healthcare System to adopt electronic health record systems (EHRs) at an unprecedented rate. Hospitals and medical centers are providing access to clinical data via clinical data warehouses such as i2b2, or Stanford's STRIDE database. In order to realize the potential of using these data for translational research, clinical data warehouses must be interoperable with standardized health terminologies, biomedical ontologies, and growing networks of Linked Open Data such as Bio2RDF. Applying the principles of Linked Data, we transformed a de-identified version of the STRIDE into a semantic clinical data warehouse containing visits, labs, diagnoses, prescriptions, and annotated clinical notes. We demonstrate the utility of this system though basic cohort selection, phenotypic profiling, and identification of disease genes. This work is significant in that it demonstrates the feasibility of using semantic web technologies to directly exploit existing biomedical ontologies and Linked Open Data. PMID:26306276

  13. Macro influencers of electronic health records adoption.

    PubMed

    Raghavan, Vijay V; Chinta, Ravi; Zhirkin, Nikita

    2015-01-01

    While adoption rates for electronic health records (EHRs) have improved, the reasons for significant geographical differences in EHR adoption within the USA have remained unclear. To understand the reasons for these variations across states, we have compiled from secondary sources a profile of different states within the USA, based on macroeconomic and macro health-environment factors. Regression analyses were performed using these indicator factors on EHR adoption. The results showed that internet usage and literacy are significantly associated with certain measures of EHR adoption. Income level was not significantly associated with EHR adoption. Per capita patient days (a proxy for healthcare need intensity within a state) is negatively correlated with EHR adoption rate. Health insurance coverage is positively correlated with EHR adoption rate. Older physicians (>60 years) tend to adopt EHR systems less than their younger counterparts. These findings have policy implications on formulating regionally focused incentive programs.

  14. Change management with the electronic health record.

    PubMed

    Schmucker, DeeAnn

    2009-01-01

    Many medical organizations have already changed to, are implementing, or are contemplating implementing an electronic health record (EHR) system. As in all change, some people accept the switch from paper to EHRs much easier and with more enthuiasm than others. It is common for organizations to overlook the importance of including change management properties as they create the overall plan for the change from paper to paperless. Often the result of this is anger, frustration, and lack of cooperation or even sabotage from physicians and office staff who are the recipients of the training on the EHR system. This article examines the steps for, opportunities for, and positive results from incorporating change management principles from the very beginning, and the benefits accrued by understanding and utilizing the concepts of good choices, relationships, planning, and feedback.

  15. [Shared electronic health record in Catalonia, Spain].

    PubMed

    Marimon-Suñol, Santiago; Rovira-Barberà, María; Acedo-Anta, Mateo; Nozal-Baldajos, Montserrat A; Guanyabens-Calvet, Joan

    2010-02-01

    Under the law adopted by its Parliament, the Government of Catalonia has developed an electronic medical record system for its National Health System (NHS). The model is governed by the following principles: 1) The citizen as owner of the data: direct access to his data and right to exercise his opposition's privileges; 2) Generate confidence in the system: security and confidentiality strength; 3) Shared model of information management: publishing system and access to organized and structured information, keeping in mind that the NHS of Catalonia is formally an "Integrated system of healthcare public use" (catalan acronym: SISCAT) with a wide variety of legal structures within its healthcare institutions; 4) Use of communication standards and catalogs as a need for technological and functional integration. In summary: single system of medical records shared between different actors, using interoperability tools and whose development is according to the legislation applicable in Catalonia and within its healthcare system. The result has been the establishment of a set of components and relation rules among which we highlight the following: 1) Display of information that collects sociodemographic data of the citizen, documents or reports (radiology, laboratory, therapeutic procedures, hospital release, emergency room), diagnostic health, prescription and immunization plus a summary screen with the most recent and relevant references; 2) Set of tools helping the user and direct messaging between professionals to facilitate their cooperation; 3) Model designed for supranational connections which will allow adding later, with ad hoc rules, clinical data provided by the private health sector or the proper citizen.

  16. Breaches of health information: are electronic records different from paper records?

    PubMed

    Sade, Robert M

    2010-01-01

    Breaches of electronic medical records constitute a type of healthcare error, but should be considered separately from other types of errors because the national focus on the security of electronic data justifies special treatment of medical information breaches. Guidelines for protecting electronic medical records should be applied equally to paper medical records.

  17. 49 CFR 228.205 - Access to electronic records.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... CFR Part 212 must have access to hours of service records created and maintained electronically that... 49 Transportation 4 2011-10-01 2011-10-01 false Access to electronic records. 228.205 Section 228... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION HOURS OF SERVICE OF RAILROAD EMPLOYEES Electronic...

  18. 49 CFR 228.205 - Access to electronic records.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... CFR Part 212 must have access to hours of service records created and maintained electronically that... 49 Transportation 4 2010-10-01 2010-10-01 false Access to electronic records. 228.205 Section 228... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION HOURS OF SERVICE OF RAILROAD EMPLOYEES Electronic...

  19. Predictability Bounds of Electronic Health Records

    PubMed Central

    Dahlem, Dominik; Maniloff, Diego; Ratti, Carlo

    2015-01-01

    The ability to intervene in disease progression given a person’s disease history has the potential to solve one of society’s most pressing issues: advancing health care delivery and reducing its cost. Controlling disease progression is inherently associated with the ability to predict possible future diseases given a patient’s medical history. We invoke an information-theoretic methodology to quantify the level of predictability inherent in disease histories of a large electronic health records dataset with over half a million patients. In our analysis, we progress from zeroth order through temporal informed statistics, both from an individual patient’s standpoint and also considering the collective effects. Our findings confirm our intuition that knowledge of common disease progressions results in higher predictability bounds than treating disease histories independently. We complement this result by showing the point at which the temporal dependence structure vanishes with increasing orders of the time-correlated statistic. Surprisingly, we also show that shuffling individual disease histories only marginally degrades the predictability bounds. This apparent contradiction with respect to the importance of time-ordered information is indicative of the complexities involved in capturing the health-care process and the difficulties associated with utilising this information in universal prediction algorithms. PMID:26148751

  20. Comparing concepts for electronic health record architectures.

    PubMed

    Blobel, Bernd

    2002-01-01

    Keeping all relevant information directly or indirectly related to patient's care, electronic health records (EHR) systems are supposed to be kernel application for any kind of health information systems. For facilitating shared care, managed care, or disease management, such EHR systems have to be scalable, portable, distributed, and interoperable which has to be enabled by a proper architecture supporting informational and functional needs as well. Advanced EHR architectures are based on object-oriented or component-oriented paradigms and use modern tooling to design, specify, implement and maintain EHR solutions. They reflect not only medical information but also underlying concepts and integrate an extended vocabulary. The most advanced EHR architecture approaches CEN ENV 13606, G-CPR, HL7 RIM and derived models, and finally the Australian GEHR project are shortly characterised. For comparing the solutions, the ISO RM - ODP, the Generic Component Model and the CORBA 3 methodology have been used. The HARP methodology for enhancing the current harmonisation of openEHR is shortly discussed.

  1. Electronic Health Records Place 1st at Indy 500

    MedlinePlus

    ... Electronic Health Records were instantly, securely available to medical personnel at the world-famous Indy 500 motor race. ... data-sharing system that allows physicians and emergency medical personnel access to individual patient records. It is made ...

  2. 49 CFR 228.205 - Access to electronic records.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...; SLEEPING QUARTERS Electronic Recordkeeping § 228.205 Access to electronic records. (a) FRA inspectors and State inspectors participating under 49 CFR Part 212 must have access to hours of service...

  3. 49 CFR 228.205 - Access to electronic records.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...; SLEEPING QUARTERS Electronic Recordkeeping § 228.205 Access to electronic records. (a) FRA inspectors and State inspectors participating under 49 CFR Part 212 must have access to hours of service...

  4. 49 CFR 228.205 - Access to electronic records.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...; SLEEPING QUARTERS Electronic Recordkeeping § 228.205 Access to electronic records. (a) FRA inspectors and State inspectors participating under 49 CFR Part 212 must have access to hours of service...

  5. Towards Educational Electronic Health Records (EHRs): A Design Process for Integrating EHRs, Simulation, and Video Tutorials.

    PubMed

    Shachak, Aviv; Elamrousy, Samer; Borycki, Elizabeth M; Domb, Sharon; Kushniruk, Andre W

    2016-01-01

    Electronic health records (EHRs) are becoming ubiquitous in healthcare practice. However, their use in medical education has been slower to catch on and a new category of EHRs is beginning to emerge known as eduEHRs. These systems allow learners to explore and experiment with EHRs in the context of medical education. However, current eduEHRs have limitations, such as a lack of dynamic interaction built-in that would mimic real-world use of these tools. To overcome this, the integration of eduEHRs with software and tools such as video simulations and tutorials has considerable promise. In this paper we describe a new design process for integrating EHRs, simulations, and video tutorials. PMID:27577459

  6. Towards Educational Electronic Health Records (EHRs): A Design Process for Integrating EHRs, Simulation, and Video Tutorials.

    PubMed

    Shachak, Aviv; Elamrousy, Samer; Borycki, Elizabeth M; Domb, Sharon; Kushniruk, Andre W

    2016-01-01

    Electronic health records (EHRs) are becoming ubiquitous in healthcare practice. However, their use in medical education has been slower to catch on and a new category of EHRs is beginning to emerge known as eduEHRs. These systems allow learners to explore and experiment with EHRs in the context of medical education. However, current eduEHRs have limitations, such as a lack of dynamic interaction built-in that would mimic real-world use of these tools. To overcome this, the integration of eduEHRs with software and tools such as video simulations and tutorials has considerable promise. In this paper we describe a new design process for integrating EHRs, simulations, and video tutorials.

  7. Electronic Health Records and Quality of Care

    PubMed Central

    Yanamadala, Swati; Morrison, Doug; Curtin, Catherine; McDonald, Kathryn; Hernandez-Boussard, Tina

    2016-01-01

    Abstract Electronic health records (EHRs) were implemented to improve quality of care and patient outcomes. This study assessed the relationship between EHR-adoption and patient outcomes. We performed an observational study using State Inpatient Databases linked to American Hospital Association survey, 2011. Surgical and medical patients from 6 large, diverse states were included. We performed univariate analyses and developed hierarchical regression models relating level of EHR utilization and mortality, readmission rates, and complications. We evaluated the effect of EHR adoption on outcomes in a difference-in-differences analysis, 2008 to 2011. Medical and surgical patients sought care at hospitals reporting no EHR (3.5%), partial EHR (55.2%), and full EHR systems (41.3%). In univariate analyses, patients at hospitals with full EHR had the lowest rates of inpatient mortality, readmissions, and Patient Safety Indicators followed by patients at hospitals with partial EHR and then patients at hospitals with no EHR (P < 0.05). However, these associations were not robust when accounting for other patient and hospital factors, and adoption of an EHR system was not associated with improved patient outcomes (P > 0.05). These results indicate that patients receiving medical and surgical care at hospitals with no EHR system have similar outcomes compared to patients seeking care at hospitals with a full EHR system, after controlling for important confounders. To date, we have not yet seen the promised benefits of EHR systems on patient outcomes in the inpatient setting. EHRs may play a smaller role than expected in patient outcomes and overall quality of care. PMID:27175631

  8. GSFC specification electronic data processing magnetic recording tape

    NASA Technical Reports Server (NTRS)

    Tinari, D. F.; Perry, J. L.

    1980-01-01

    The design requirements are given for magnetic oxide coated, electronic data processing tape, wound on reels. Magnetic recording tape types covered by this specification are intended for use on digital tape transports using the Non-Return-to-Zero-change-on-ones (NRZI) recording method for recording densities up to and including 800 characters per inch (cpi) and the Phase-Encoding (PE) recording method for a recording density of 1600 cpi.

  9. Permanent record. Electronic records aid in the aftermath of Joplin tornado.

    PubMed

    Russell, Matthew

    2011-09-01

    When a tornado struck St. John's Regional Medical Center in May 2011, its patient records were stored in a newly launched electronic health record system, helping prevent a bad situation from being worse. PMID:21980902

  10. Permanent record. Electronic records aid in the aftermath of Joplin tornado.

    PubMed

    Russell, Matthew

    2011-09-01

    When a tornado struck St. John's Regional Medical Center in May 2011, its patient records were stored in a newly launched electronic health record system, helping prevent a bad situation from being worse.

  11. Recording media on materials with electron capture

    NASA Astrophysics Data System (ADS)

    Petrov, Viacheslav V.; Zimenko, Vladislav I.; Kravets, Vasyliy G.

    1993-12-01

    Theoretic research and experimental investigations are showing the possibility of repeated information recording and read-out on new recording media with optically stimulated luminescence (OSL) effect. OSL concentration and spectral dependencies in Ca(Sr)S:Eu2+(Ce3+)-Sm3+ were determined. OSL in CaS films doped only by Sm3+ ions was detected.

  12. The evolution of the electronic health record.

    PubMed

    Doyle-Lindrud, Susan

    2015-04-01

    Medical record documentation of patient data has evolved during the past several years. Early patient medical records included brief, written case history reports maintained for teaching purposes. One such document obtained is a text from Egypt of 48 case reports that includes injuries, fractures, wounds, dislocations, and tumors that date back to 1600 BC. This document was written on papyrus text and acquired by Edwin Smith, an Egyptologist, in 1862 (Atta, 1999; Gillum, 2013). Case reports served as the patient record for many years, used only intermittently by physicians. By the 1880s, concerns regarding medical records as legal documents for insurance and malpractice cases encouraged administrators of hospitals to supervise record content (Gillum, 2013). By 1898, the patient record came to the bedside, moving from retrospective documentation to cases reported in actual time. Medical records resembled more of the present-day record with family history, patient habits, previous illnesses, present illness, physical examination, admission urine, blood analysis, progress notes, discharge diagnosis, and instructions (Gillum, 2013). 
. PMID:25840379

  13. Teaching Electronic Records Management in the Archival Curriculum

    ERIC Educational Resources Information Center

    Zhang, Jane

    2016-01-01

    Electronic records management has been incorporated into the archival curriculum in North America since the 1990s. This study reported in this paper provides a systematic analysis of the content of electronic records management (ERM) courses currently taught in archival education programs. Through the analysis of course combinations and their…

  14. 42 CFR 425.506 - Electronic health records technology.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Electronic health records technology. 425.506 Section 425.506 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Standards and Reporting § 425.506 Electronic health records technology. (a) ACOs, ACO participants, and...

  15. 42 CFR 425.506 - Electronic health records technology.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Electronic health records technology. 425.506 Section 425.506 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Standards and Reporting § 425.506 Electronic health records technology. (a) ACOs, ACO participants, and...

  16. 42 CFR 425.506 - Electronic health records technology.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Electronic health records technology. 425.506 Section 425.506 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Standards and Reporting § 425.506 Electronic health records technology. (a) ACOs, ACO participants, and...

  17. Technology Acceptance of Electronic Medical Records by Nurses

    ERIC Educational Resources Information Center

    Stocker, Gary

    2010-01-01

    The purpose of this study was to evaluate the Technology Acceptance Model's (TAM) relevance of the intention of nurses to use electronic medical records in acute health care settings. The basic technology acceptance research of Davis (1989) was applied to the specific technology tool of electronic medical records (EMR) in a specific setting…

  18. Mandatory Use of Electronic Health Records: Overcoming Physician Resistance

    ERIC Educational Resources Information Center

    Brown, Viseeta K.

    2012-01-01

    Literature supports the idea that electronic health records hold tremendous value for the healthcare system in that it increases patient safety, improves the quality of care and provides greater efficiency. The move toward mandatory implementation of electronic health records is a growing concern in the United States health care industry. The…

  19. Electronic Imaging in Admissions, Records & Financial Aid Offices.

    ERIC Educational Resources Information Center

    Perkins, Helen L.

    Over the years, efforts have been made to work more efficiently with the ever increasing number of records and paper documents that cross workers' desks. Filing records on optical disk through electronic imaging is an alternative that many feel is the answer to successful document management. The pioneering efforts in electronic imaging in…

  20. Perspectives on electronic medical records adoption: electronic medical records (EMR) in outcomes research.

    PubMed

    Belletti, Dan; Zacker, Christopher; Mullins, C Daniel

    2010-07-01

    Health information technology (HIT) is engineered to promote improved quality and efficiency of care, and reduce medical errors. Healthcare organizations have made significant investments in HIT tools and the electronic medical record (EMR) is a major technological advance. The Department of Veterans Affairs was one of the first large healthcare systems to fully implement EMR. The Veterans Health Information System and Technology Architecture (VistA) began by providing an interface to review and update a patient's medical record with its computerized patient record system. However, since the implementation of the VistA system there has not been an overall substantial adoption of EMR in the ambulatory or inpatient setting. In fact, only 23.9% of physicians were using EMRs in their office-based practices in 2005. A sample from the American Medical Association revealed that EMRs were available in an office setting to 17% of physicians in late 2007 and early 2008. Of these, 17% of physicians with EMR, only 4% were considered to be fully functional EMR systems. With the exception of some large aggregate EMR databases the slow adoption of EMR has limited its use in outcomes research. This paper reviews the literature and presents the current status of and forces influencing the adoption of EMR in the office-based practice, and identifies the benefits, limitations, and overall value of EMR in the conduct of outcomes research in the US.

  1. Operating Room Delays: Meaningful Use in Electronic Health Record.

    PubMed

    Van Winkle, Rachelle A; Champagne, Mary T; Gilman-Mays, Meri; Aucoin, Julia

    2016-06-01

    Perioperative areas are the most costly to operate and account for more than 40% of expenses. The high costs prompted one organization to analyze surgical delays through a retrospective review of their new electronic health record. Electronic health records have made it easier to access and aggregate clinical data; 2123 operating room cases were analyzed. Implementing a new electronic health record system is complex; inaccurate data and poor implementation can introduce new problems. Validating the electronic health record development processes determines the ease of use and the user interface, specifically related to user compliance with the intent of the electronic health record development. The revalidation process after implementation determines if the intent of the design was fulfilled and data can be meaningfully used. In this organization, the data fields completed through automation provided quantifiable, meaningful data. However, data fields completed by staff that required subjective decision making resulted in incomplete data nearly 24% of the time. The ease of use was further complicated by 490 permutations (combinations of delay types and reasons) that were built into the electronic health record. Operating room delay themes emerged notwithstanding the significant complexity of the electronic health record build; however, improved accuracy could improve meaningful data collection and a more accurate root cause analysis of operating room delays. Accurate and meaningful use of data affords a more reliable approach in quality, safety, and cost-effective initiatives. PMID:27046388

  2. 76 FR 52991 - Renewal of Advisory Committee on Electronic Records Archives

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-24

    ... RECORDS ADMINISTRATION Renewal of Advisory Committee on Electronic Records Archives AGENCY: National... Administration's (NARA) Advisory Committee on Electronic Records Archives. In accordance with Office of... Electronic Records Archives in NARA's ceiling of discretionary advisory committees. FOR FURTHER...

  3. 22 CFR 503.9 - Electronic records.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... the Government's use of computers enhances the public's access to Government information. This section... to view such records in hard copy or to access the Internet via the BBG's computer, please contact... with the operations of the agency or the agency's use of its computers, we will consider the effort...

  4. 22 CFR 503.9 - Electronic records.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... the Government's use of computers enhances the public's access to Government information. This section... to view such records in hard copy or to access the Internet via the BBG's computer, please contact... with the operations of the agency or the agency's use of its computers, we will consider the effort...

  5. 22 CFR 503.9 - Electronic records.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... the Government's use of computers enhances the public's access to Government information. This section... to view such records in hard copy or to access the Internet via the BBG's computer, please contact... with the operations of the agency or the agency's use of its computers, we will consider the effort...

  6. 22 CFR 503.9 - Electronic records.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... the Government's use of computers enhances the public's access to Government information. This section... to view such records in hard copy or to access the Internet via the BBG's computer, please contact... with the operations of the agency or the agency's use of its computers, we will consider the effort...

  7. 22 CFR 503.9 - Electronic records.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... the Government's use of computers enhances the public's access to Government information. This section... to view such records in hard copy or to access the Internet via the BBG's computer, please contact... with the operations of the agency or the agency's use of its computers, we will consider the effort...

  8. 36 CFR 1236.6 - What are agency responsibilities for electronic records management?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...-1235 of this subchapter; (b) Integrate records management and preservation considerations into the... responsibilities for electronic records management? 1236.6 Section 1236.6 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT...

  9. Platform links clinical data with electronic health records

    Cancer.gov

    To make data gathered from patients in clinical trials available for use in standard care, NCI has created a new computer tool to support interoperability between clinical research and electronic health record systems. This new software represents an inno

  10. Use of Electronic Health Records in Residential Care Communities

    MedlinePlus

    ... billing purposes, does this facility use electronic health records? This is a computerized version of the resident's health and personal information used in the management of the resident's health care." All providers were ...

  11. Longevity of Electronic/Digital Records: An Annotated Bibliography

    SciTech Connect

    Deken, J

    2004-03-02

    Current resources, publications, web sites and projects on the longevity and preservation of electronic/digital records are provided, along with brief comments about sites and publications of particular relevance and interest.

  12. Recent developments in electronic medical records.

    PubMed

    Worth, E R

    1998-05-01

    Human factors engineering principles will guide the development of future EMR systems. Physicians will use wireless palmtop computers to record patient data so that the computer does not come between the physician and patient in routine encounters. With few exceptions, the pieces for this type of system are available today, but not in one package. I believe EMR developers have recognized the ubiquity and power of the Internet. Because of advances in computers, software, and telecommunications reliability, solutions using thin-client technology will lower the cost of EMRs to physicians. PMID:9604665

  13. Confidentiality of Patron Records in Electronic Library Circulation Systems.

    ERIC Educational Resources Information Center

    Seaman, Scott

    Issues concerning the confidentiality of library-patron records in the age of electronics are explored. Confidentiality of patron records is a relatively new concept for libraries and was first introduced in the 1938 Code of Ethics of the American Library Association (ALA). Librarians have worked on a state-by-state basis to protect library…

  14. Physician Interaction with Electronic Medical Records: A Qualitative Study

    ERIC Educational Resources Information Center

    Noteboom, Cherie Bakker

    2010-01-01

    The integration of EHR (Electronic Health Records) in IT infrastructures supporting organizations enable improved access to and recording of patient data, enhanced ability to make better and more-timely decisions, and improved quality and reduced errors. Despite these benefits, there are mixed results as to the use of EHR. The literature suggests…

  15. Admissibility of Electronically Filed Federal Records as Evidence.

    ERIC Educational Resources Information Center

    Government Information Quarterly, 1992

    1992-01-01

    Presents guidelines prepared by Department of Justice Management Division staff to provide an understanding of the rules of evidence as they apply to electronically filed records and ensure that appropriate agency procedures are instituted in creating and maintaining such records. Hearsay, authentication, and the laying of a proper foundation are…

  16. Next-generation phenotyping of electronic health records

    PubMed Central

    Hripcsak, George; Albers, David J

    2013-01-01

    The national adoption of electronic health records (EHR) promises to make an unprecedented amount of data available for clinical research, but the data are complex, inaccurate, and frequently missing, and the record reflects complex processes aside from the patient's physiological state. We believe that the path forward requires studying the EHR as an object of interest in itself, and that new models, learning from data, and collaboration will lead to efficient use of the valuable information currently locked in health records. PMID:22955496

  17. 78 FR 65884 - 2014 Edition Electronic Health Record Certification Criteria: Revision to the Definition of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-04

    ... electronic health record (EHR) technology testing and certification. DATES: Effective date: This regulation... Computer technology, Electronic health record, Electronic information system, Electronic transactions... HUMAN SERVICES Office of the Secretary 45 CFR Part 170 RIN 0991-AB91 2014 Edition Electronic...

  18. Barriers for Adopting Electronic Health Records (EHRs) by Physicians

    PubMed Central

    Ajami, Sima

    2013-01-01

    CONFLICT OF INTEREST: NONE DECLARED Introduction Electronic Medical Records (EMRs) are computerized medical information systems that collect, store and display patient information. They are means to create legible and organized recordings and to access clinical information about individual patients. Despite of the positive effects of the EMRs usage in medical practices, the adoption rate of such systems is still low and meets resistance from physicians. The EHRs represent an essential tool for improving both in the safety and quality of health care, though physicians must actively use these systems to accrue the benefits. This study was unsystematic-review. Aim The aim of this study was to express barriers perceived y physicians to the adoption of the EHRs. Method of the study This study was non-systematic reviewed which the literature was searched on barriers perceived by physicians to the adoption of Electronic Health Records (EHRs) with the help of library, books, conference proceedings, data bank, and also searches engines available at Google, Google scholar. Discussion For our searches, we employed the following keywords and their combinations: physicians, electronic medical record, electronic health record, barrier, and adoption in the searching areas of title, keywords, abstract, and full text. In this study, more than 100 articles and reports were collected and 27 of them were selected based on their relevancy. Electronic health record use requires the presence of certain user and system attributes, support from others, and numerous organizational and environment facilitators. PMID:24058254

  19. Electronic health record: implementation across the Michigan Academic Consortium.

    PubMed

    Bostrom, Andrea C; Schafer, Patricia; Dontje, Kathy; Pohl, Joanne M; Nagelkerk, Jean; Cavanagh, Stephen J

    2006-01-01

    The Michigan Academic Consortium of academic nurse-managed primary care centers supported member sites to venture into computer-based advances with the potential to improve quality of health services and students' educational experiences. The experiences of this consortium as it incorporated electronic health records in tandem with an electronic patient management system at several of its member sites reveal the benefits and challenges of such an endeavor. The processes of selection, adoption, and implementation of the electronic health record are discussed in this article. Many lessons learned in the process are discussed.

  20. A cloud based architecture to support Electronic Health Record.

    PubMed

    Zangara, Gianluca; Corso, Pietro Paolo; Cangemi, Francesco; Millonzi, Filippo; Collova, Francesco; Scarlatella, Antonio

    2014-01-01

    We introduce a novel framework of electronic healthcare enabled by a Cloud platform able to host both Hospital Information Systems (HIS) and Electronic Medical Record (EMR) systems and implement an innovative model of Electronic Health Record (EHR) that is not only patient-oriented but also supports a better governance of the whole healthcare system. The proposed EHR model adopts the state of the art of the Cloud technologies, being able to join the different clinical data of the patient stored within the HISs and EMRs either placed into a local Data Center or hosted into a Cloud Platform enabling new directions of data analysis. PMID:25488244

  1. Approaches to Recording Drug Allergies in Electronic Health Records: Qualitative Study

    PubMed Central

    Fernando, Bernard; Morrison, Zoe; Kalra, Dipak; Cresswell, Kathrin; Sheikh, Aziz

    2014-01-01

    Background Drug allergy represent an important subset of adverse drug reactions that is worthy of attention because many of these reactions are potentially preventable with use of computerised decision support systems. This is however dependent on the accurate and comprehensive recording of these reactions in the electronic health record. The objectives of this study were to understand approaches to the recording of drug allergies in electronic health record systems. Materials and Methods We undertook a case study comprising of 21 in-depth interviews with a purposefully selected group of primary and secondary care clinicians, academics, and members of the informatics and drug regulatory communities, observations in four General Practices and an expert group discussion with 15 participants from the Allergy and Respiratory Expert Resource Group of the Royal College of General Practitioners. Results There was widespread acceptance among healthcare professionals of the need for accurate recording of drug allergies and adverse drug reactions. Most drug reactions were however likely to go unreported to and/or unrecognised by healthcare professionals and, even when recognised and reported, not all reactions were accurately recorded. The process of recording these reactions was not standardised. Conclusions There is considerable variation in the way drug allergies are recorded in electronic health records. This limits the potential of computerised decision support systems to help alert clinicians to the risk of further reactions. Inaccurate recording of information may in some instances introduce new problems as patients are denied treatments that they are erroneously believed to be allergic to. PMID:24740090

  2. 36 CFR 1236.10 - What records management controls must agencies establish for records in electronic information...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Implementing Electronic Information Systems § 1236.10 What records management controls must agencies establish for records in electronic information systems? The following types of records management controls are... controls must agencies establish for records in electronic information systems? 1236.10 Section...

  3. 36 CFR 1236.10 - What records management controls must agencies establish for records in electronic information...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... controls must agencies establish for records in electronic information systems? 1236.10 Section 1236.10... ELECTRONIC RECORDS MANAGEMENT Records Management and Preservation Considerations for Designing and Implementing Electronic Information Systems § 1236.10 What records management controls must agencies...

  4. Catching Conical Intersections in the Act; Monitoring Transient Electronic Coherences by Attosecond Stimulated X-Ray Raman Signals

    NASA Astrophysics Data System (ADS)

    Bennett, Kochise; Kowalewski, Markus; Dorfman, Konstantin; Mukamel, Shaul

    Conical intersections (CIs) dominate the pathways and outcomes of virtually all photochemical molecular processes. Despite extensive experimental and theoretical effort, CIs have not been directly observed yet and the experimental evidence is inferred from fast reaction rates and vibrational signatures. We show that short X-ray pulses can directly detect the passage through a CI with the adequate temporal and spectral sensitivity. The non-adiabatic coupling that exists in the region of a CI redistributes electronic population but also generates electronic coherence. This coherent oscillation can then be detected via a coherent Raman process that employs a composite femtosecond/attosecond X-ray pulse. This technique, dubbed Transient Redistribution of Ultrafast Electronic Coherences (TRUECARS) is reminiscent of Coherent Anti-Stokes Raman Spectroscopy (CARS) in that a coherent oscillation is set in motion and then monitored, but differs in that the dynamics is electronic (CARS generally observes nuclear dynamics) and the coherence is generated internally by passage through a region of non-adiabatic coupling rather than by an externally applied laser. Support provided by U.S. Department of Energy through Award No. DE-FG02-04ER15571, the National Science Foundation (Grant No CHE-1361516), and the Alexander von Humboldt foundation through the Feodor Lynen program.

  5. Are In-Bed Electronic Weights Recorded in the Medical Record Accurate?

    PubMed

    Gerl, Heather; Miko, Alexandra; Nelson, Mandy; Godaire, Lori

    2016-01-01

    This study found large discrepancies between in-bed weights recorded in the medical record and carefully obtained standing weights with a calibrated, electronic bedside scale. This discrepancy appears to be related to inadequate bed calibration before patient admission and having excessive linen, clothing, and/or equipment on the bed during weighing by caregivers. PMID:27522846

  6. Integrating an Academic Electronic Health Record: Challenges and Success Strategies.

    PubMed

    Herbert, Valerie M; Connors, Helen

    2016-08-01

    Technology is increasing the complexity in the role of today's nurse. Healthcare organizations are integrating more health information technologies and relying on the electronic health record for data collection, communication, and decision making. Nursing faculty need to prepare graduates for this environment and incorporate an academic electronic health record into a nursing curriculum to meet student-program outcomes. Although the need exists for student preparation, some nursing programs are struggling with implementation, whereas others have been successful. To better understand these complexities, this project was intended to identify current challenges and success strategies of effective academic electronic health record integration into nursing curricula. Using Rogers' 1962 Diffusion of Innovation theory as a framework for technology adoption, a descriptive survey design was used to gain insights from deans and program directors of nursing schools involved with the national Health Informatics & Technology Scholars faculty development program or Cerner's Academic Education Solution Consortium, working to integrate an academic electronic health record in their respective nursing schools. The participants' experiences highlighted approaches used by these schools to integrate these technologies. Data from this project provide nursing education with effective strategies and potential challenges that should be addressed for successful academic electronic health record integration.

  7. Integrating an Academic Electronic Health Record: Challenges and Success Strategies.

    PubMed

    Herbert, Valerie M; Connors, Helen

    2016-08-01

    Technology is increasing the complexity in the role of today's nurse. Healthcare organizations are integrating more health information technologies and relying on the electronic health record for data collection, communication, and decision making. Nursing faculty need to prepare graduates for this environment and incorporate an academic electronic health record into a nursing curriculum to meet student-program outcomes. Although the need exists for student preparation, some nursing programs are struggling with implementation, whereas others have been successful. To better understand these complexities, this project was intended to identify current challenges and success strategies of effective academic electronic health record integration into nursing curricula. Using Rogers' 1962 Diffusion of Innovation theory as a framework for technology adoption, a descriptive survey design was used to gain insights from deans and program directors of nursing schools involved with the national Health Informatics & Technology Scholars faculty development program or Cerner's Academic Education Solution Consortium, working to integrate an academic electronic health record in their respective nursing schools. The participants' experiences highlighted approaches used by these schools to integrate these technologies. Data from this project provide nursing education with effective strategies and potential challenges that should be addressed for successful academic electronic health record integration. PMID:27326804

  8. The use of electronic health records in Spanish hospitals.

    PubMed

    Marca, Guillem; Perez, Angel; Blanco-Garcia, Martin German; Miravalles, Elena; Soley, Pere; Ortiga, Berta

    2014-01-01

    The aims of this study were to describe the level of adoption of electronic health records in Spanish hospitals and to identify potential barriers and facilitators to this process. We used an observational cross-sectional design. The survey was conducted between September and December 2011, using an electronic questionnaire distributed through email. We obtained a 30% response rate from the 214 hospitals contacted, all belonging to the Spanish National Health Service. The level of adoption of electronic health records in Spanish hospitals was found to be high: 39.1% of hospitals surveyed had a comprehensive EHR system while a basic system was functioning in 32.8% of the cases. However, in 2011 one third of the hospitals did not have a basic electronic health record system, although some have since implemented electronic functionalities, particularly those related to clinical documentation and patient administration. Respondents cited the acquisition and implementation costs as the main barriers to implementation. Facilitators for EHR implementation were: the possibility to hire technical support, both during and post implementation; security certification warranty; and objective third-party evaluations of EHR products. In conclusion, the number of hospitals that have electronic health records is in general high, being relatively higher in medium-sized hospitals.

  9. 36 CFR 1235.44 - What general transfer requirements apply to electronic records?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... requirements apply to electronic records? 1235.44 Section 1235.44 Parks, Forests, and Public Property NATIONAL... electronic records? (a) Each agency must retain a copy of permanent electronic records that it transfers to... preservation of the records. (b) For guidance related to the transfer of electronic records other than...

  10. 36 CFR 1236.20 - What are appropriate recordkeeping systems for electronic records?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... recordkeeping systems for electronic records? 1236.20 Section 1236.20 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Additional Requirements for Electronic Records § 1236.20 What are appropriate recordkeeping systems for electronic...

  11. 36 CFR 1236.22 - What are the additional requirements for managing electronic mail records?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... requirements for managing electronic mail records? 1236.22 Section 1236.22 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Additional Requirements for Electronic Records § 1236.22 What are the additional requirements for managing electronic...

  12. 36 CFR 1236.22 - What are the additional requirements for managing electronic mail records?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... requirements for managing electronic mail records? 1236.22 Section 1236.22 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Additional Requirements for Electronic Records § 1236.22 What are the additional requirements for managing electronic...

  13. 36 CFR 1236.22 - What are the additional requirements for managing electronic mail records?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... requirements for managing electronic mail records? 1236.22 Section 1236.22 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Additional Requirements for Electronic Records § 1236.22 What are the additional requirements for managing electronic...

  14. 36 CFR 1235.44 - What general transfer requirements apply to electronic records?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... preservation of the records. (b) For guidance related to the transfer of electronic records other than those... requirements apply to electronic records? 1235.44 Section 1235.44 Parks, Forests, and Public Property NATIONAL... electronic records? (a) Each agency must retain a copy of permanent electronic records that it transfers...

  15. 36 CFR 1235.44 - What general transfer requirements apply to electronic records?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... continuing preservation of the records. (b) For guidance related to the transfer of electronic records other... requirements apply to electronic records? 1235.44 Section 1235.44 Parks, Forests, and Public Property NATIONAL... apply to electronic records? (a) Each agency must retain a copy of permanent electronic records that...

  16. 36 CFR 1235.44 - What general transfer requirements apply to electronic records?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... preservation of the records. (b) For guidance related to the transfer of electronic records other than those... requirements apply to electronic records? 1235.44 Section 1235.44 Parks, Forests, and Public Property NATIONAL... electronic records? (a) Each agency must retain a copy of permanent electronic records that it transfers...

  17. 36 CFR 1236.22 - What are the additional requirements for managing electronic mail records?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... requirements for managing electronic mail records? 1236.22 Section 1236.22 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Additional Requirements for Electronic Records § 1236.22 What are the additional requirements for managing electronic...

  18. 36 CFR 1235.44 - What general transfer requirements apply to electronic records?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... preservation of the records. (b) For guidance related to the transfer of electronic records other than those... requirements apply to electronic records? 1235.44 Section 1235.44 Parks, Forests, and Public Property NATIONAL... electronic records? (a) Each agency must retain a copy of permanent electronic records that it transfers...

  19. Perfusion Electronic Record Documentation Using Epic Systems Software.

    PubMed

    Steffens, Thomas G; Gunser, John M; Saviello, George M

    2015-12-01

    This paper describes the design and use of Epic Systems software for documentation of perfusion activities as part of the patient electronic medical record. The University of Wisconsin Hospital and Clinics adapted the Anesthesia software module and developed an integrated perfusion/anesthesia record for the documentation of cardiac and non-cardiac surgical procedures. This project involved multiple committees, approvals, and training to successfully implement. This article will describe our documentation options, concepts, design, challenges, training, and implementation during our initial experience.

  20. National electronic medical records integration on cloud computing system.

    PubMed

    Mirza, Hebah; El-Masri, Samir

    2013-01-01

    Few Healthcare providers have an advanced level of Electronic Medical Record (EMR) adoption. Others have a low level and most have no EMR at all. Cloud computing technology is a new emerging technology that has been used in other industry and showed a great success. Despite the great features of Cloud computing, they haven't been utilized fairly yet in healthcare industry. This study presents an innovative Healthcare Cloud Computing system for Integrating Electronic Health Record (EHR). The proposed Cloud system applies the Cloud Computing technology on EHR system, to present a comprehensive EHR integrated environment.

  1. National electronic medical records integration on cloud computing system.

    PubMed

    Mirza, Hebah; El-Masri, Samir

    2013-01-01

    Few Healthcare providers have an advanced level of Electronic Medical Record (EMR) adoption. Others have a low level and most have no EMR at all. Cloud computing technology is a new emerging technology that has been used in other industry and showed a great success. Despite the great features of Cloud computing, they haven't been utilized fairly yet in healthcare industry. This study presents an innovative Healthcare Cloud Computing system for Integrating Electronic Health Record (EHR). The proposed Cloud system applies the Cloud Computing technology on EHR system, to present a comprehensive EHR integrated environment. PMID:23920993

  2. Template and Model Driven Development of Standardized Electronic Health Records.

    PubMed

    Kropf, Stefan; Chalopin, Claire; Denecke, Kerstin

    2015-01-01

    Digital patient modeling targets the integration of distributed patient data into one overarching model. For this integration process, both a theoretical standard-based model and information structures combined with concrete instructions in form of a lightweight development process of single standardized Electronic Health Records (EHRs) are needed. In this paper, we introduce such a process along side a standard-based architecture. It allows the modeling and implementation of EHRs in a lightweight Electronic Health Record System (EHRS) core. The approach is demonstrated and tested by a prototype implementation. The results show that the suggested approach is useful and facilitates the development of standardized EHRSs. PMID:26262004

  3. Dynamic optometer. [for electronic recording of human lens anterior surface

    NASA Technical Reports Server (NTRS)

    Wilson, D. C.

    1974-01-01

    A dynamic optometer that electronically records the position of the anterior surface of the human lens is described. The geometrical optics of the eye and optometer, and the scattering of light from the lens, are closely examined to determine the optimum conditions for adjustment of the instrument. The light detector and associated electronics are also considered, and the operating conditions for obtaining the best signal-to-noise ratio are determined.

  4. Catching the role of anisotropic electronic distribution and charge transfer in halogen bonded complexes of noble gases

    SciTech Connect

    Bartocci, Alessio; Cappelletti, David; Pirani, Fernando; Belpassi, Leonardo; Falcinelli, Stefano; Grandinetti, Felice; Tarantelli, Francesco

    2015-05-14

    The systems studied in this work are gas-phase weakly bound adducts of the noble-gas (Ng) atoms with CCl{sub 4} and CF{sub 4}. Their investigation was motivated by the widespread current interest for the intermolecular halogen bonding (XB), a structural motif recognized to play a role in fields ranging from elementary processes to biochemistry. The simulation of the static and dynamic behaviors of complex systems featuring XB requires the formulation of reliable and accurate model potentials, whose development relies on the detailed characterization of strength and nature of the interactions occurring in simple exemplary halogenated systems. We thus selected the prototypical Ng-CCl{sub 4} and Ng-CF{sub 4} and performed high-resolution molecular beam scattering experiments to measure the absolute scale of their intermolecular potentials, with high sensitivity. In general, we expected to probe typical van der Waals interactions, consisting of a combination of size (exchange) repulsion with dispersion/induction attraction. For the He/Ne-CF{sub 4}, the analysis of the glory quantum interference pattern, observable in the velocity dependence of the integral cross section, confirmed indeed this expectation. On the other hand, for the He/Ne/Ar-CCl{sub 4}, the scattering data unravelled much deeper potential wells, particularly for certain configurations of the interacting partners. The experimental data can be properly reproduced only including a shifting of the repulsive wall at shorter distances, accompanied by an increased role of the dispersion attraction, and an additional short-range stabilization component. To put these findings on a firmer ground, we performed, for selected geometries of the interacting complexes, accurate theoretical calculations aimed to evaluate the intermolecular interaction and the effects of the complex formation on the electron charge density of the constituting moieties. It was thus ascertained that the adjustments of the potential

  5. Catching the role of anisotropic electronic distribution and charge transfer in halogen bonded complexes of noble gases

    NASA Astrophysics Data System (ADS)

    Bartocci, Alessio; Belpassi, Leonardo; Cappelletti, David; Falcinelli, Stefano; Grandinetti, Felice; Tarantelli, Francesco; Pirani, Fernando

    2015-05-01

    The systems studied in this work are gas-phase weakly bound adducts of the noble-gas (Ng) atoms with CCl4 and CF4. Their investigation was motivated by the widespread current interest for the intermolecular halogen bonding (XB), a structural motif recognized to play a role in fields ranging from elementary processes to biochemistry. The simulation of the static and dynamic behaviors of complex systems featuring XB requires the formulation of reliable and accurate model potentials, whose development relies on the detailed characterization of strength and nature of the interactions occurring in simple exemplary halogenated systems. We thus selected the prototypical Ng-CCl4 and Ng-CF4 and performed high-resolution molecular beam scattering experiments to measure the absolute scale of their intermolecular potentials, with high sensitivity. In general, we expected to probe typical van der Waals interactions, consisting of a combination of size (exchange) repulsion with dispersion/induction attraction. For the He/Ne-CF4, the analysis of the glory quantum interference pattern, observable in the velocity dependence of the integral cross section, confirmed indeed this expectation. On the other hand, for the He/Ne/Ar-CCl4, the scattering data unravelled much deeper potential wells, particularly for certain configurations of the interacting partners. The experimental data can be properly reproduced only including a shifting of the repulsive wall at shorter distances, accompanied by an increased role of the dispersion attraction, and an additional short-range stabilization component. To put these findings on a firmer ground, we performed, for selected geometries of the interacting complexes, accurate theoretical calculations aimed to evaluate the intermolecular interaction and the effects of the complex formation on the electron charge density of the constituting moieties. It was thus ascertained that the adjustments of the potential suggested by the analysis of the

  6. Catch a Star!

    NASA Astrophysics Data System (ADS)

    2006-11-01

    ESO and the European Association for Astronomy Education are launching today the 2007 edition of 'Catch a Star!', their international astronomy competition for school students. Now in its fifth year, the competition offers students the chance to win a once-in-a-lifetime trip to ESO's flagship observatory in Chile, as well as many other prizes. Students are invited to 'become astronomers' and embark on a journey to explore the Universe. ESO PR Photo 42/06 The competition includes separate categories - 'Catch a Star Researchers' and 'Catch a Star Adventurers' - to ensure that every student, whatever their level, has the chance to enter and win exciting prizes. For the artistically minded, 'Catch a Star!' also includes an artwork competition, 'Catch a Star Artists'. "'Catch a Star!' offers a unique opportunity for students to learn more about astronomy and about the methods scientists use to discover new things about the Universe", said Douglas Pierce-Price, Education Officer at ESO. In teams, students choose an astronomical topic to study and produce an in-depth report. An important part of the project for 'Catch a Star Researchers' is to think about how ESO's telescopes or a telescope of the future can contribute to their investigations of the subject. As well as the top prize - a trip to one of ESO's observatory sites in Chile - visits to observatories in Germany, Austria and Spain, and many other prizes are also available to be won. 'Catch a Star Researchers' winners will be chosen by an international jury, and 'Catch a Star Adventurers' will be awarded further prizes by lottery. Entries for 'Catch a Star Artists' will be displayed on the web and winners chosen with the help of a public online vote. The first editions of 'Catch a Star!' have attracted several hundred entries from more than 25 countries worldwide. Previous winning entries have included "Star clusters and the structure of the Milky Way" (Budapest, Hungary), "Vega" (Acqui Terme, Italy) and "Venus

  7. Electronic Health Records and Community Health Surveillance of Childhood Obesity

    PubMed Central

    Flood, Tracy L.; Zhao, Ying-Qi; Tomayko, Emily J.; Tandias, Aman; Carrel, Aaron L.; Hanrahan, Lawrence P.

    2015-01-01

    Background Childhood obesity remains a public health concern, and tracking local progress may require local surveillance systems. Electronic health record data may provide a cost-effective solution. Purpose To demonstrate the feasibility of estimating childhood obesity rates using de-identified electronic health records for the purpose of public health surveillance and health promotion. Methods Data were extracted from the Public Health Information Exchange (PHINEX) database. PHINEX contains de-identified electronic health records from patients primarily in south central Wisconsin. Data on children and adolescents (aged 2–19 years, 2011–2012, n=93,130) were transformed in a two-step procedure that adjusted for missing data and weighted for a national population distribution. Weighted and adjusted obesity rates were compared to the 2011–2012 National Health and Nutrition Examination Survey (NHANES). Data were analyzed in 2014. Results The weighted and adjusted obesity rate was 16.1% (95% CI=15.8, 16.4). Non-Hispanic white children and adolescents (11.8%, 95% CI=11.5, 12.1) had lower obesity rates compared to non-Hispanic black (22.0%, 95% CI=20.7, 23.2) and Hispanic (23.8%, 95% CI=22.4, 25.1) patients. Overall, electronic health record–derived point estimates were comparable to NHANES, revealing disparities from preschool onward. Conclusions Electronic health records that are weighted and adjusted to account for intrinsic bias may create an opportunity for comparing regional disparities with precision. In PHINEX patients, childhood obesity disparities were measurable from a young age, highlighting the need for early intervention for at-risk children. The electronic health record is a cost-effective, promising tool for local obesity prevention efforts. PMID:25599907

  8. 36 CFR 1236.10 - What records management controls must agencies establish for records in electronic information...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Implementing Electronic Information Systems § 1236.10 What records management controls must agencies establish for records in electronic information systems? The following types of records management controls are... 36 Parks, Forests, and Public Property 3 2013-07-01 2012-07-01 true What records...

  9. Electronic health records: what does your signature signify?

    PubMed

    Victoroff Md, Michael S

    2012-01-01

    Electronic health records serve multiple purposes, including clinical communication, legal documentation, financial transaction capture, research and analytics. Electronic signatures attached to entries in EHRs have different logical and legal meanings for different users. Some of these are vestiges from historic paper formats that require reconsideration. Traditionally accepted functions of signatures, such as identity verification, attestation, consent, authorization and non-repudiation can become ambiguous in the context of computer-assisted workflow processes that incorporate functions like logins, auto-fill and audit trails. This article exposes the incompatibility of expectations among typical users of electronically signed information. PMID:22888846

  10. Quality and Electronic Health Records in Community Health Centers

    ERIC Educational Resources Information Center

    Lesh, Kathryn A.

    2014-01-01

    Adoption and use of health information technology, the electronic health record (EHR) in particular, has the potential to help improve the quality of care, increase patient safety, and reduce health care costs. Unfortunately, adoption and use of health information technology has been slow, especially when compared to the adoption and use of…

  11. School Nurse Role in Electronic School Health Records. Position Statement

    ERIC Educational Resources Information Center

    Hiltz, Cynthia; Johnson, Katie; Lechtenberg, Julia Rae; Maughan, Erin; Trefry, Sharonlee

    2014-01-01

    It is the position of the National Association of School Nurses (NASN) that Electronic Health Records (EHRs) are essential for the registered professional school nurse (hereinafter referred to as school nurse) to provide efficient and effective care in the school and monitor the health of the entire student population. It is also the position of…

  12. Biobanks and Electronic Medical Records: Enabling Cost-Effective Research

    PubMed Central

    Bowton, Erica; Field, Julie R.; Wang, Sunny; Schildcrout, Jonathan S.; Van Driest, Sara L.; Delaney, Jessica T.; Cowan, James; Weeke, Peter; Mosley, Jonathan D.; Wells, Quinn S.; Karnes, Jason H.; Shaffer, Christian; Peterson, Josh F.; Denny, Joshua C.; Roden, Dan M.; Pulley, Jill M.

    2014-01-01

    The use of electronic medical record data linked to biological specimens in health care settings is expected to enable cost-effective and rapid genomic analyses. Here, we present a model that highlights potential advantages for genomic discovery and describe the operational infrastructure that facilitated multiple simultaneous discovery efforts. PMID:24786321

  13. Real and imagined barriers to an electronic medical record.

    PubMed

    Rind, D M; Safran, C

    1993-01-01

    We developed an electronic medical record for ambulatory patients as part of the integrated clinical information system at Beth Israel Hospital. During the four years since it was installed, clinicians have entered 76,060 patient problems, 137,713 medications, and 33,938 notes. Residents, who had to type notes in themselves, entered 49.5% of their notes into OMR. Several factors that we had predicted would be barriers to an electronic medical record, such as clinician reluctance to type or perform data entry, have not proved to be significant problems. Other anticipated barriers, such as difficulties with dual charting on paper during transition to an electronic medical record, have been realized. The major unexpected barrier that has been encountered is increased clinician concern about the privacy and security of full text notes relative to other data elements in the clinical information system. We have attempted to modify the electronic medical record so as to overcome some of these barriers. PMID:8130574

  14. Physician Sensemaking and Readiness for Electronic Medical Records

    ERIC Educational Resources Information Center

    Riesenmy, Kelly Rouse

    2010-01-01

    Purpose: The purpose of this paper is to explore physician sensemaking and readiness to implement electronic medical records (EMR) as a first step to finding strategies that enhance EMR adoption behaviors. Design/methodology/approach: The case study approach provides a detailed analysis of individuals within an organizational unit. Using a…

  15. The electronic patient record: a strategic planning framework.

    PubMed

    Gordon, D B; Marafioti, S; Carter, M; Kunov, H; Dolan, A

    1995-01-01

    Sunnybrook Health Science Center (Sunnybrook) is a multifacility academic teaching center. In May 1994, Sunnybrook struck an electronic patient record taskforce to develop a strategic plan for the implementation of a comprehensive, facility wide electronic patient record (EPR). The taskforce sought to create a conceptual framework which provides context and integrates decision-making related to the comprehensive electronic patient record. The EPR is very much broader in scope than the traditional paper-based record. It is not restricted to simply reporting individual patient data. By the Institute of Medicine's definition, the electronic patient record resides in a system specifically designed to support users through availability of complete and accurate data, practitioner reminders and alerts, clinical decision support systems, links to bodies of medical knowledge, and other aids [1]. It is a comprehensive resource for patient care. The taskforce proposed a three domain model for determining how the EPR affects Sunnybrook. The EPR enables Sunnybrook to have a high performance team structure (domain 1), to function as an integrated organization (domain 2), and to reach out and develop new relationships with external organizations to become an extended enterprise (domain 3) [2]. Domain 1: Sunnybrook's high performance teams or patient service units' (PSUs) are decentralized, autonomous operating units that provide care to patients grouped by 'like' diagnosis and resource needs. The EPR must provide functions and applications which promote patient focused care, such as cross functional charting and care maps, group scheduling, clinical email, and a range of enabling technologies for multiskilled workers. Domain 2: In the integrated organization domain, the EPR should facilitate closer linkages between the arrangement of PSUs into clinical teams and with other facilities within the center in order to provide a longitudinal record that covers a continuum of care

  16. The electronic patient record: a strategic planning framework.

    PubMed

    Gordon, D B; Marafioti, S; Carter, M; Kunov, H; Dolan, A

    1995-01-01

    Sunnybrook Health Science Center (Sunnybrook) is a multifacility academic teaching center. In May 1994, Sunnybrook struck an electronic patient record taskforce to develop a strategic plan for the implementation of a comprehensive, facility wide electronic patient record (EPR). The taskforce sought to create a conceptual framework which provides context and integrates decision-making related to the comprehensive electronic patient record. The EPR is very much broader in scope than the traditional paper-based record. It is not restricted to simply reporting individual patient data. By the Institute of Medicine's definition, the electronic patient record resides in a system specifically designed to support users through availability of complete and accurate data, practitioner reminders and alerts, clinical decision support systems, links to bodies of medical knowledge, and other aids [1]. It is a comprehensive resource for patient care. The taskforce proposed a three domain model for determining how the EPR affects Sunnybrook. The EPR enables Sunnybrook to have a high performance team structure (domain 1), to function as an integrated organization (domain 2), and to reach out and develop new relationships with external organizations to become an extended enterprise (domain 3) [2]. Domain 1: Sunnybrook's high performance teams or patient service units' (PSUs) are decentralized, autonomous operating units that provide care to patients grouped by 'like' diagnosis and resource needs. The EPR must provide functions and applications which promote patient focused care, such as cross functional charting and care maps, group scheduling, clinical email, and a range of enabling technologies for multiskilled workers. Domain 2: In the integrated organization domain, the EPR should facilitate closer linkages between the arrangement of PSUs into clinical teams and with other facilities within the center in order to provide a longitudinal record that covers a continuum of care

  17. Access Control Model for Sharing Composite Electronic Health Records

    NASA Astrophysics Data System (ADS)

    Jin, Jing; Ahn, Gail-Joon; Covington, Michael J.; Zhang, Xinwen

    The adoption of electronically formatted medical records, so called Electronic Health Records (EHRs), has become extremely important in healthcare systems to enable the exchange of medical information among stakeholders. An EHR generally consists of data with different types and sensitivity degrees which must be selectively shared based on the need-to-know principle. Security mechanisms are required to guarantee that only authorized users have access to specific portions of such critical record for legitimate purposes. In this paper, we propose a novel approach for modelling access control scheme for composite EHRs. Our model formulates the semantics and structural composition of an EHR document, from which we introduce a notion of authorized zones of the composite EHR at different granularity levels, taking into consideration of several important criteria such as data types, intended purposes and information sensitivities.

  18. Future of electronic health records: implications for decision support.

    PubMed

    Rothman, Brian; Leonard, Joan C; Vigoda, Michael M

    2012-01-01

    The potential benefits of the electronic health record over traditional paper are many, including cost containment, reductions in errors, and improved compliance by utilizing real-time data. The highest functional level of the electronic health record (EHR) is clinical decision support (CDS) and process automation, which are expected to enhance patient health and healthcare. The authors provide an overview of the progress in using patient data more efficiently and effectively through clinical decision support to improve health care delivery, how decision support impacts anesthesia practice, and how some are leading the way using these systems to solve need-specific issues. Clinical decision support uses passive or active decision support to modify clinician behavior through recommendations of specific actions. Recommendations may reduce medication errors, which would result in considerable savings by avoiding adverse drug events. In selected studies, clinical decision support has been shown to decrease the time to follow-up actions, and prediction has proved useful in forecasting patient outcomes, avoiding costs, and correctly prompting treatment plan modifications by clinicians before engaging in decision-making. Clinical documentation accuracy and completeness is improved by an electronic health record and greater relevance of care data is delivered. Clinical decision support may increase clinician adherence to clinical guidelines, but educational workshops may be equally effective. Unintentional consequences of clinical decision support, such as alert desensitization, can decrease the effectiveness of a system. Current anesthesia clinical decision support use includes antibiotic administration timing, improved documentation, more timely billing, and postoperative nausea and vomiting prophylaxis. Electronic health record implementation offers data-mining opportunities to improve operational, financial, and clinical processes. Using electronic health record data

  19. Designing an Electronic Personal Health Record for Professional Iranian Athletes

    PubMed Central

    Abdolkhani, Robab; Halabchi, Farzin; Safdari, Reza; Dargahi, Hossein; Shadanfar, Kamran

    2014-01-01

    Background: By providing sports organizations with electronic records and instruments that can be accessed at any time or place, specialized care can be offered to athletes regardless of injury location, and this makes the follow-up from first aid through to full recovery more efficient. Objectives: The aim of this study was to develop an electronic personal health record for professional Iranian athletes. Patients and Methods: First, a comparative study was carried out on the types of professional athletes’existing handheld and electronic health information management systems currently being used in Iran and leading countries in the field of sports medicine including; Australia, Canada and the United States. Then a checklist was developed containing a minimum dataset of professional athletes’ personal health records and distributed to the people involved, who consisted of 50 specialists in sports medicine and health information management, using the Delphi method. Through the use of data obtained from this survey, a basic paper model of professional athletes' personal health record was constructed and then an electronic model was created accordingly. Results: Access to information in the electronic record was through a web-based, portal system. The capabilities of this system included: access to information at any time and location, increased interaction between the medical team, comprehensive reporting and effective management of injuries, flexibility and interaction with financial, radiology and laboratory information systems. Conclusions: It is suggested that a framework should be created to promote athletes’ medical knowledge and provide the education necessary to manage their information. This would lead to improved data quality and ultimately promote the health of community athletes. PMID:25741410

  20. Catch a Star 2008!

    NASA Astrophysics Data System (ADS)

    2007-10-01

    ESO and the European Association for Astronomy Education have just launched the 2008 edition of 'Catch a Star', their international astronomy competition for school students. Now in its sixth year, the competition offers students the chance to win a once-in-a-lifetime trip to ESO's flagship observatory in Chile, as well as many other prizes. CAS logo The competition includes separate categories - 'Catch a Star Researchers' and 'Catch a Star Adventurers' - to ensure that every student, whatever their level, has the chance to enter and win exciting prizes. In teams, students investigate an astronomical topic of their choice and write a report about it. An important part of the project for 'Catch a Star Researchers' is to think about how ESO's telescopes such as the Very Large Telescope (VLT) or future telescopes such as the Atacama Large Millimeter/submillimeter Array (ALMA) and the European Extremely Large Telescope (E-ELT) could contribute to investigations of the topic. Students may also include practical activities such as observations or experiments. For the artistically minded, 'Catch a Star' also offers an artwork competition, 'Catch a Star Artists'. Last year, hundreds of students from across Europe and beyond took part in 'Catch a Star', submitting astronomical projects and artwork. "'Catch a Star' gets students thinking about the wonders of the Universe and the science of astronomy, with a chance of winning great prizes. It's easy to take part, whether by writing about astronomy or creating astronomically inspired artwork," said Douglas Pierce-Price, Education Officer at ESO. As well as the top prize - a trip to ESO's Very Large Telescope in Chile - visits to observatories in Austria and Spain, and many other prizes, can also be won. 'Catch a Star Researchers' winners will be chosen by an international jury, and 'Catch a Star Adventurers' will be awarded further prizes by lottery. Entries for 'Catch a Star Artists' will be displayed on the web and winners

  1. Privacy preserving index for encrypted electronic medical records.

    PubMed

    Chen, Yu-Chi; Horng, Gwoboa; Lin, Yi-Jheng; Chen, Kuo-Chang

    2013-12-01

    With the development of electronic systems, privacy has become an important security issue in real-life. In medical systems, privacy of patients' electronic medical records (EMRs) must be fully protected. However, to combine the efficiency and privacy, privacy preserving index is introduced to preserve the privacy, where the EMR can be efficiently accessed by this patient or specific doctor. In the literature, Goh first proposed a secure index scheme with keyword search over encrypted data based on a well-known primitive, Bloom filter. In this paper, we propose a new privacy preserving index scheme, called position index (P-index), with keyword search over the encrypted data. The proposed index scheme is semantically secure against the adaptive chosen keyword attack, and it also provides flexible space, lower false positive rate, and search privacy. Moreover, it does not rely on pairing, a complicate computation, and thus can search over encrypted electronic medical records from the cloud server efficiently.

  2. 36 CFR 1236.24 - What are the additional requirements for managing unstructured electronic records?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... requirements for managing unstructured electronic records? 1236.24 Section 1236.24 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Additional Requirements for Electronic Records § 1236.24 What are the additional requirements for...

  3. 36 CFR 1236.6 - What are agency responsibilities for electronic records management?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... responsibilities for electronic records management? 1236.6 Section 1236.6 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT General § 1236.6 What are agency responsibilities for electronic records management? Agencies must:...

  4. 36 CFR 1236.6 - What are agency responsibilities for electronic records management?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... responsibilities for electronic records management? 1236.6 Section 1236.6 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT General § 1236.6 What are agency responsibilities for electronic records management? Agencies must:...

  5. 36 CFR 1236.6 - What are agency responsibilities for electronic records management?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... responsibilities for electronic records management? 1236.6 Section 1236.6 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT General § 1236.6 What are agency responsibilities for electronic records management? Agencies must:...

  6. 36 CFR 1236.6 - What are agency responsibilities for electronic records management?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... responsibilities for electronic records management? 1236.6 Section 1236.6 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT General § 1236.6 What are agency responsibilities for electronic records management? Agencies must:...

  7. 29 CFR 4000.53 - May I use electronic media to satisfy PBGC's record retention requirements?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false May I use electronic media to satisfy PBGC's record... Electronic Means of Record Retention § 4000.53 May I use electronic media to satisfy PBGC's record retention requirements? General requirements. You may use electronic media to satisfy the record maintenance...

  8. 29 CFR 4000.53 - May I use electronic media to satisfy PBGC's record retention requirements?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false May I use electronic media to satisfy PBGC's record... Electronic Means of Record Retention § 4000.53 May I use electronic media to satisfy PBGC's record retention requirements? General requirements. You may use electronic media to satisfy the record maintenance...

  9. 29 CFR 4000.53 - May I use electronic media to satisfy PBGC's record retention requirements?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false May I use electronic media to satisfy PBGC's record... Electronic Means of Record Retention § 4000.53 May I use electronic media to satisfy PBGC's record retention requirements? General requirements. You may use electronic media to satisfy the record maintenance...

  10. 29 CFR 4000.53 - May I use electronic media to satisfy PBGC's record retention requirements?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false May I use electronic media to satisfy PBGC's record... Electronic Means of Record Retention § 4000.53 May I use electronic media to satisfy PBGC's record retention requirements? General requirements. You may use electronic media to satisfy the record maintenance...

  11. Electron-beam recording of patterns in chalcogenide films

    NASA Astrophysics Data System (ADS)

    Sergeev, S. A.; Iovu, M. S.; Iaseniuc, O. V.

    2015-02-01

    Thin films of chalcogenide glasses (ChG) of different composition have been used for e-beam recording of diffraction grating structures. The dependencies of diffraction efficiency of gratings on radiation dose were studied. The influence of ChG film composition on diffraction properties of gratings was shown. It was established that the refractive index gratings formed in As2S3 films exhibit high stability during their dark storage. The diffraction efficiency enhancement caused by uniform light irradiation was observed for gratings recorded in As4S3Se3 thin films, doped with Sn. With use of computer-controlled positioning of electron beam both the raster scan and vector patterns were recorded in As2S3 films. In the former case the images from BMP-files were patterned. In the latter case the mosaic of diffraction gratings, producing the multi-beam light diffraction was recorded.

  12. 36 CFR 1236.10 - What records management controls must agencies establish for records in electronic information...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false What records management... Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Records Management and Preservation Considerations for Designing...

  13. 36 CFR 1236.10 - What records management controls must agencies establish for records in electronic information...

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false What records management... Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT ELECTRONIC RECORDS MANAGEMENT Records Management and Preservation Considerations for Designing...

  14. Ethical questions must be considered for electronic health records.

    PubMed

    Spriggs, Merle; Arnold, Michael V; Pearce, Christopher M; Fry, Craig

    2012-09-01

    National electronic health record initiatives are in progress in many countries around the world but the debate about the ethical issues and how they are to be addressed remains overshadowed by other issues. The discourse to which all others are answerable is a technical discourse, even where matters of privacy and consent are concerned. Yet a focus on technical issues and a failure to think about ethics are cited as factors in the failure of the UK health record system. In this paper, while the prime concern is the Australian Personally Controlled Electronic Health Record (PCEHR), the discussion is relevant to and informed by the international context. The authors draw attention to ethical and conceptual issues that have implications for the success or failure of electronic health records systems. Important ethical issues to consider as Australia moves towards a PCEHR system include: issues of equity that arise in the context of personal control, who benefits and who should pay, what are the legitimate uses of PCEHRs, and how we should implement privacy. The authors identify specific questions that need addressing.

  15. [Electronic patient record as the tool for better patient safety].

    PubMed

    Schneider, Henning

    2015-01-01

    Recent studies indicate again that there is a deficit in the use of electronic health records (EHR) in German hospitals. Despite good arguments in favour of their use, such as the rapid availability of data, German hospitals shy away from a wider implementation. The reason is the high cost of installing and maintaining the EHRs, for the benefit is difficult to evaluate in monetary terms for the hospital. Even if a benefit can be shown it is not necessarily evident within the hospital, but manifests itself only in the health system outside. Many hospitals only manage to partly implement EHR resulting in increased documentation requirements which reverse their positive effect.In the United States, electronic medical records are also viewed in light of their positive impact on patient safety. In particular, electronic medication systems prove the benefits they can provide in the context of patient safety. As a result, financing systems have been created to promote the digitalisation of hospitals in the United States. This has led to a large increase in the use of IT systems in the United States in recent years. The Universitätsklinikum Eppendorf (UKE) introduced electronic patient records in 2009. The benefits, in particular as regards patient safety, are numerous and there are many examples to illustrate this position. These positive results are intended to demonstrate the important role EHR play in hospitals. A financing system of the ailing IT landscape based on the American model is urgently needed to benefit-especially in terms of patient safety-from electronic medical records in the hospital. PMID:25475524

  16. Lessons premier hospitals learned about implementing electronic health records.

    PubMed

    DeVore, Susan D; Figlioli, Keith

    2010-04-01

    Implementing health information technology (IT) is a major strategic objective for providers. To pinpoint considerations that tie to success, the Premier health care alliance surveyed hospitals to develop an electronic health record best-practices library. Compiled from diverse health care organizations, the library outlines considerations to support "meaningful use" in the areas of computerized physician order entry, medication management, clinical documentation, reporting of measures, privacy, information exchange, management of populations' health, and personal health records. Best practices also uncovered strategies for securing executive leadership, culture change, communication, and support for clinicians. This paper summarizes lessons from the library, providing recommendations to speed up health IT implementation. PMID:20368596

  17. Perfusion Electronic Record Documentation Using Epic Systems Software

    PubMed Central

    Steffens, Thomas G.; Gunser, John M.; Saviello, George M.

    2015-01-01

    Abstract: This paper describes the design and use of Epic Systems software for documentation of perfusion activities as part of the patient electronic medical record. The University of Wisconsin Hospital and Clinics adapted the Anesthesia software module and developed an integrated perfusion/anesthesia record for the documentation of cardiac and non-cardiac surgical procedures. This project involved multiple committees, approvals, and training to successfully implement. This article will describe our documentation options, concepts, design, challenges, training, and implementation during our initial experience. PMID:26834288

  18. Lessons premier hospitals learned about implementing electronic health records.

    PubMed

    DeVore, Susan D; Figlioli, Keith

    2010-04-01

    Implementing health information technology (IT) is a major strategic objective for providers. To pinpoint considerations that tie to success, the Premier health care alliance surveyed hospitals to develop an electronic health record best-practices library. Compiled from diverse health care organizations, the library outlines considerations to support "meaningful use" in the areas of computerized physician order entry, medication management, clinical documentation, reporting of measures, privacy, information exchange, management of populations' health, and personal health records. Best practices also uncovered strategies for securing executive leadership, culture change, communication, and support for clinicians. This paper summarizes lessons from the library, providing recommendations to speed up health IT implementation.

  19. Interfacing with the brain using organic electronics (Presentation Recording)

    NASA Astrophysics Data System (ADS)

    Malliaras, George G.

    2015-10-01

    Implantable electrodes are being used for diagnostic purposes, for brain-machine interfaces, and for delivering electrical stimulation to alleviate the symptoms of diseases such as Parkinson's. The field of organic electronics made available devices with a unique combination of attractive properties, including mixed ionic/electronic conduction, mechanical flexibility, enhanced biocompatibility, and capability for drug delivery. I will present examples of organic electrodes, transistors and other devices for recording and stimulation of brain activity and discuss how they can improve our understanding of brain physiology and pathology, and how they can be used to deliver new therapies.

  20. The challenges in making electronic health records accessible to patients.

    PubMed

    Beard, Leslie; Schein, Rebecca; Morra, Dante; Wilson, Kumanan; Keelan, Jennifer

    2012-01-01

    It is becoming increasingly apparent that there is a tension between growing consumer demands for access to information and a healthcare system that may not be prepared to meet these demands. Designing an effective solution for this problem will require a thorough understanding of the barriers that now stand in the way of giving patients electronic access to their health data. This paper reviews the following challenges related to the sharing of electronic health records: cost and security concerns, problems in assigning responsibilities and rights among the various players, liability issues and tensions between flexible access to data and flexible access to physicians.

  1. The challenges in making electronic health records accessible to patients

    PubMed Central

    Beard, Leslie; Schein, Rebecca; Morra, Dante; Wilson, Kumanan

    2011-01-01

    It is becoming increasingly apparent that there is a tension between growing consumer demands for access to information and a healthcare system that may not be prepared to meet these demands. Designing an effective solution for this problem will require a thorough understanding of the barriers that now stand in the way of giving patients electronic access to their health data. This paper reviews the following challenges related to the sharing of electronic health records: cost and security concerns, problems in assigning responsibilities and rights among the various players, liability issues and tensions between flexible access to data and flexible access to physicians. PMID:22120207

  2. Organ Procurement Organizations and the Electronic Health Record.

    PubMed

    Howard, R J; Cochran, L D; Cornell, D L

    2015-10-01

    The adoption of electronic health records (EHRs) has adversely affected the ability of organ procurement organizations (OPOs) to perform their federally mandated function of honoring the donation decisions of families and donors who have signed the registry. The difficulties gaining access to potential donor medical record has meant that assessment, evaluation, and management of brain dead organ donors has become much more difficult. Delays can occur that can lead to potential recipients not receiving life-saving organs. For over 40 years, OPO personnel have had ready access to paper medical records. But the widespread adoption of EHRs has greatly limited the ability of OPO coordinators to readily gain access to patient medical records and to manage brain dead donors. Proposed solutions include the following: (1) hospitals could provide limited access to OPO personnel so that they could see only the potential donor's medical record; (2) OPOs could join with other transplant organizations to inform regulators of the problem; and (3) hospital organizations could be approached to work with Center for Medicare and Medicaid Services (CMS) to revise the Hospital Conditions of Participation to require OPOs be given access to donor medical records.

  3. Patient clustering with uncoded text in electronic medical records.

    PubMed

    Henao, Ricardo; Murray, Jared; Ginsburg, Geoffrey; Carin, Lawrence; Lucas, Joseph E

    2013-01-01

    We propose a mixture model for text data designed to capture underlying structure in the history of present illness section of electronic medical records data. Additionally, we propose a method to induce bias that leads to more homogeneous sets of diagnoses for patients in each cluster. We apply our model to a collection of electronic records from an emergency department and compare our results to three other relevant models in order to assess performance. Results using standard metrics demonstrate that patient clusters from our model are more homogeneous when compared to others, and qualitative analyses suggest that our approach leads to interpretable patient sub-populations when applied to real data. Finally, we demonstrate an example of our patient clustering model to identify adverse drug events.

  4. Surgeons' perspective of a newly initiated electronic medical record.

    PubMed

    Frazee, Richard; Harmon, Laura; Papaconstantinou, Harry T

    2016-01-01

    The American Recovery and Reinvestment Act mandates "meaningful use" of an electronic health record (EHR) to receive current financial incentives and to avoid future financial penalties. Surgeons' ongoing adoption of an EHR nationally will be influenced by the early experiences of institutions that have made the transition from paper to electronic records. We conducted a survey to query surgeons at our institution regarding their perception of the EHR 3 months after institutional implementation. A total of 59 surveys were obtained from 24 senior staff and 35 residents. Results showed that surgeons believed the EHR was more effective as a billing tool than as a form of clinical documentation and believed the billing was more complete and accurate with the EHR. Surgeons also expressed concern that the EHR would negatively impact patient satisfaction, but in spite of this, they indicated that their personal quality of life was not negatively impacted.

  5. Efficient medical information retrieval in encrypted Electronic Health Records.

    PubMed

    Pruski, Cédric; Wisniewski, François

    2012-01-01

    The recent development of eHealth platforms across the world, whose main objective is to centralize patient's healthcare information to ensure the best continuity of care, requires the development of advanced tools and techniques for supporting health professionals in retrieving relevant information in this vast quantity of data. However, for preserving patient's privacy, some countries decided to de-identify and encrypt data contained in the shared Electronic Health Records, which reinforces the complexity of proposing efficient medical information retrieval approach. In this paper, we describe an original approach exploiting standards metadata as well as knowledge organizing systems to overcome the barriers of data encryption for improving the results of medical information retrieval in centralized and encrypted Electronic Health Records. This is done through the exploitation of semantic properties provided by knowledge organizing systems, which enable query expansion. Furthermore, we provide an overview of the approach together with illustrating examples and a discussion on the advantages and limitations of the provided framework.

  6. Patient Clustering with Uncoded Text in Electronic Medical Records

    PubMed Central

    Henao, Ricardo; Murray, Jared; Ginsburg, Geoffrey; Carin, Lawrence; Lucas, Joseph E.

    2013-01-01

    We propose a mixture model for text data designed to capture underlying structure in the history of present illness section of electronic medical records data. Additionally, we propose a method to induce bias that leads to more homogeneous sets of diagnoses for patients in each cluster. We apply our model to a collection of electronic records from an emergency department and compare our results to three other relevant models in order to assess performance. Results using standard metrics demonstrate that patient clusters from our model are more homogeneous when compared to others, and qualitative analyses suggest that our approach leads to interpretable patient sub-populations when applied to real data. Finally, we demonstrate an example of our patient clustering model to identify adverse drug events. PMID:24551361

  7. Training providers: beyond the basics of electronic health records

    PubMed Central

    2013-01-01

    Background Training is a critical part of health information technology implementations, but little emphasis is placed on post-implementation training to support day-to-day activities. The goal of this study was to evaluate the impact of post-implementation training on key electronic health record activities. Methods Based on feedback from providers and requests for technical support, we developed two classes designed to improve providers’ effectiveness with the electronic health record. Training took place at Kaiser Permanente, Mid-Atlantic States. The classes focused on managing patient-level information using problem lists and medication lists, as well as efficient documentation and chart review. Both classes used the blended learning method, integrating concrete scenarios, hands-on exercises and take-home materials to reinforce class concepts. To evaluate training effectiveness, we used a case–control study with a 1:4 match on pre-training performance. We measured the usage rate of two key electronic health record functions (problem list and medication list management) for six months before and after training. Change scores were compared using the Wilcoxon sign rank test. Results 36 participants and 144 non-participants were included in the training evaluation. Training participants were more likely to manage both medication lists and problem lists after training. Class material is now being incorporated into an enterprise-wide multi-modal training program available to all providers at Kaiser Permanente in the Mid-Atlantic States. Conclusions Ongoing information technology training is well-received by healthcare providers, who expressed a clear preference for additional training. Training improved use of two important electronic health record features that are included as part of the Meaningful Use criteria. PMID:24295150

  8. Report Central: quality reporting tool in an electronic health record.

    PubMed

    Jung, Eunice; Li, Qi; Mangalampalli, Anil; Greim, Julie; Eskin, Michael S; Housman, Dan; Isikoff, Jeremy; Abend, Aaron H; Middleton, Blackford; Einbinder, Jonathan S

    2006-01-01

    Quality reporting tools, integrated with ambulatory electronic health records, can help clinicians and administrators understand performance, manage populations, and improve quality. Report Central is a secure web report delivery tool built on Crystal Reports XItrade mark and ASP.NET technologies. Pilot evaluation of Report Central indicates that clinicians prefer a quality reporting tool that is integrated with our home-grown EHR to support clinical workflow.

  9. Task centered visualization of Electronic Medical Record flow sheet.

    PubMed

    Xie, Zhong; Gregg, Peggy; Zhang, Jiajie

    2003-01-01

    Usability problem of Electronic Medical Record (EMR) systems is a major hurdle for their acceptance. In this study we used the methodology of Human-Centered Distributed Information Design (HCDID) to compare and evaluate Flow Sheet module of two commercial EMR systems. After which we tried to develop usable interface of a flow sheet using visualization, focusing on task-representation mapping during design and development.

  10. Psychiatry and the meaningful use of electronic health records.

    PubMed

    Triplett, Patrick

    2013-01-01

    Use of electronic health records (EHRs) for psychiatric care is on the rise, although the software and the workflow patterns on which the software has been built are often based on non-psychiatric practices. For providers, the transition from paper psychiatric records to electronic ones requires the development of a new set of skills that includes accommodating the physical presence of the computer and performing various forms of data entry, while still managing to carry out the tasks required for psychiatric practice. These changes alter the dynamic of communication, including elements of assessment and treatment that occur between the psychiatrist and patient. EHRs also raise issues of security of records and greater access by patients to providers and their records. Although EHRs promise an abundance of useful data for research and potentially helpful innovations, they also impose a practice pattern on psychiatry that is made to work largely through the efforts of the physician. EHRs do not enhance interactions in the psychiatric examination room, but instead alter the traditional pattern on which the doctor-patient relationship is founded in psychiatry and through which care is delivered.

  11. 77 FR 65416 - Advisory Committee on the Electronic Records Archives (ACERA)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-26

    ... RECORDS ADMINISTRATION Advisory Committee on the Electronic Records Archives (ACERA) AGENCY: National... (NARA) announces a meeting of the Advisory Committee on the Electronic Records Archives (ACERA). The..., and service issues related to the Electronic Records Archives (ERA). This includes, but is not...

  12. 75 FR 63208 - Advisory Committee on the Electronic Records Archives (ACERA)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-14

    ... RECORDS ADMINISTRATION Advisory Committee on the Electronic Records Archives (ACERA) AGENCY: National... (NARA) announces a meeting of the Advisory Committee on the Electronic Records Archives (ACERA). The..., and service issues related to the Electronic Records Archives (ERA). This includes, but is not...

  13. 76 FR 19147 - Advisory Committee on the Electronic Records Archives (ACERA)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-06

    ... RECORDS ADMINISTRATION Advisory Committee on the Electronic Records Archives (ACERA) AGENCY: National... Administration (NARA) announces an agenda change for the Advisory Committee on the Electronic Records Archives... to attend must be submitted to the Electronic Records Archives Program at era.program@nara.gov ....

  14. 76 FR 15349 - Advisory Committee on the Electronic Records Archives (ACERA); Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-21

    ... RECORDS ADMINISTRATION Advisory Committee on the Electronic Records Archives (ACERA); Meeting AGENCY... Administration (NARA) announces a meeting of the Advisory Committee on the Electronic Records Archives (ACERA..., mission, and service related to the Electronic Records Archives (ERA). This includes, but is not...

  15. 76 FR 65218 - Advisory Committee on the Electronic Records Archives (ACERA)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-20

    ... RECORDS ADMINISTRATION Advisory Committee on the Electronic Records Archives (ACERA) AGENCY: National... (NARA) announces a meeting of the Advisory Committee on the Electronic Records Archives (ACERA). The..., and service issues related to the Electronic Records Archives (ERA). This includes, but is not...

  16. 36 CFR 1225.24 - When can an agency apply previously approved schedules to electronic records?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... records when the electronic records system replaces a single series of hard copy permanent records or the electronic records consist of information drawn from multiple previously scheduled permanent series. Agencies... Adelphi Road, College Park, MD 20740-6001, phone number 301-837-1738, in writing of series of records...

  17. 36 CFR 1225.24 - When can an agency apply previously approved schedules to electronic records?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... records when the electronic records system replaces a single series of hard copy permanent records or the electronic records consist of information drawn from multiple previously scheduled permanent series. Agencies... Adelphi Road, College Park, MD 20740-6001, phone number 301-837-1738, in writing of series of records...

  18. 36 CFR 1236.22 - What are the additional requirements for managing electronic mail records?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... requirements for managing electronic mail records? 1236.22 Section 1236.22 Parks, Forests, and Public Property... Requirements for Electronic Records § 1236.22 What are the additional requirements for managing electronic mail... requirements for electronic mail records: (1) The names of sender and all addressee(s) and date the message...

  19. Code Status and Resuscitation Options in the Electronic Health Record

    PubMed Central

    Bhatia, Haresh L.; Patel, Neal R.; Choma, Neesha N.; Grande, Jonathan; Giuse, Dario A.; Lehmann, Christoph U.

    2014-01-01

    Aim The advance discussion and documentation of code-status is important in preventing undesired cardiopulmonary resuscitation and related End of Life interventions. Code-status documentation remains infrequent and paper-based, which limits its usefulness. This study evaluates a tool to document code-status in the electronic health records at a large teaching hospital, and analyzes the corresponding data. Methods Encounter data for patients admitted to the Medical Center were collected over a period of 12 months (01-APR-2012 – 31-MAR-2013) and the code-status attribute was tracked for individual patients. The code-status data were analyzed separately for adult and pediatric patient populations. We considered 131,399 encounters for 83,248 adult patients and 80,778 encounters for 55,656 pediatric patients in this study. Results 71% of the adult patients and 30% of the pediatric patients studied had a documented code-status. Age and severity of illness influenced the decision to document code-status. Demographics such as gender, race, ethnicity, and proximity of primary residence were also associated with the documentation of code-status. Conclusion Absence of a recorded code-status may result in unnecessary interventions. Code-status in paper charts may be difficult to access in cardiopulmonary arrest situations and may result in unnecessary and unwanted interventions and procedures. Documentation of Code-status in electronic records creates a readily available reference for care providers. PMID:25447035

  20. Nitrogen catch crops

    Technology Transfer Automated Retrieval System (TEKTRAN)

    High costs of nitrogen (N) fertilizer and the potential for N losses to ground and surface water have resulted in increased interest in using catch crops to recover this N. Research on potatoes has shown that the amount of N lost to leaching can be as much as the amount of N removed from the field ...

  1. Detecting Inappropriate Access to Electronic Health Records Using Collaborative Filtering

    PubMed Central

    Menon, Aditya Krishna; Jiang, Xiaoqian; Kim, Jihoon; Vaidya, Jaideep; Ohno-Machado, Lucila

    2013-01-01

    Many healthcare facilities enforce security on their electronic health records (EHRs) through a corrective mechanism: some staff nominally have almost unrestricted access to the records, but there is a strict ex post facto audit process for inappropriate accesses, i.e., accesses that violate the facility’s security and privacy policies. This process is inefficient, as each suspicious access has to be reviewed by a security expert, and is purely retrospective, as it occurs after damage may have been incurred. This motivates automated approaches based on machine learning using historical data. Previous attempts at such a system have successfully applied supervised learning models to this end, such as SVMs and logistic regression. While providing benefits over manual auditing, these approaches ignore the identity of the users and patients involved in a record access. Therefore, they cannot exploit the fact that a patient whose record was previously involved in a violation has an increased risk of being involved in a future violation. Motivated by this, in this paper, we propose a collaborative filtering inspired approach to predicting inappropriate accesses. Our solution integrates both explicit and latent features for staff and patients, the latter acting as a personalized “finger-print” based on historical access patterns. The proposed method, when applied to real EHR access data from two tertiary hospitals and a file-access dataset from Amazon, shows not only significantly improved performance compared to existing methods, but also provides insights as to what indicates an inappropriate access. PMID:24683293

  2. Integrated electronics for peripheral nerve recording and signal processing.

    PubMed

    Limnuson, Kanokwan; Tyler, Dustin J; Mohseni, Pedram

    2009-01-01

    This paper describes the integrated circuit implementation of an electronic system for peripheral nerve recording and signal processing. Specifically, the system aims to record and condition neural activity from the phrenic nerve as a good indicator for breathing, and generate a stimulus trigger signal for a laryngeal pacemaker device to reanimate a paralyzed muscle with electrical stimulation paced with respiration. The 2.2 x 2.2-mm(2) integrated circuit is fabricated using the AMI 1.5 microm 2P/2M n-well CMOS process, and consumes 1 mW from +/-1.5 V. System architecture, circuit design, simulation results, and measurement data in benchtop experiments are presented.

  3. Integration of electronic patient record context with message context.

    PubMed

    De Clercq, Etienne; Bangels, Marc; France, Francis Roger

    2004-01-01

    A methodology to construct specific messages with clear objectives inside clinical processes, while simultaneously including contextual information, remains a problem today. This paper addresses the issue of combining specific message context (process driven) with the context of a patient record (patient centered). In Belgium, simplified conceptual models for Electronic Patient Record (EPR) architecture and for message architecture, based on previous comprehensive and international work, have been produced, validated and mapped into an integrated message format. The resulting model described in this paper highlights the main conceptual links between both basic models: at the action level and at the Transaction level. Using XML, some parts of the model have already been implemented in various national projects. Key lessons learned may be imported at the international level. PMID:15360968

  4. Query log analysis of an electronic health record search engine.

    PubMed

    Yang, Lei; Mei, Qiaozhu; Zheng, Kai; Hanauer, David A

    2011-01-01

    We analyzed a longitudinal collection of query logs of a full-text search engine designed to facilitate information retrieval in electronic health records (EHR). The collection, 202,905 queries and 35,928 user sessions recorded over a course of 4 years, represents the information-seeking behavior of 533 medical professionals, including frontline practitioners, coding personnel, patient safety officers, and biomedical researchers for patient data stored in EHR systems. In this paper, we present descriptive statistics of the queries, a categorization of information needs manifested through the queries, as well as temporal patterns of the users' information-seeking behavior. The results suggest that information needs in medical domain are substantially more sophisticated than those that general-purpose web search engines need to accommodate. Therefore, we envision there exists a significant challenge, along with significant opportunities, to provide intelligent query recommendations to facilitate information retrieval in EHR.

  5. Developmental Surveillance and Screening in the Electronic Health Record.

    PubMed

    Smith, Timothy Ryan

    2016-10-01

    Effective well-child care includes developmental surveillance and screening to identify developmental delays and subsequent interventions. Electronic health records (EHRs) have been widely adopted to improve efficiency and appropriate clinical practice. Developmental surveillance tools have been introduced. This article summarizes a conceptual framework for application and highlights the principles and tools of EHRs applied to developmental assessment, including interoperability, health information exchange, clinical decision support systems, consumer health informatics, dashboards, and patient portals. Further investigation and dedicated resources will be required for successful application to developmental surveillance and screening.

  6. Electronic Health Record in Italy and Personal Data Protection.

    PubMed

    Bologna, Silvio; Bellavista, Alessandro; Corso, Pietro Paolo; Zangara, Gianluca

    2016-06-01

    The present article deals with the Italian Electronic Health Record (hereinafter EHR), recently introduced by Act 221/2012, with a specific focus on personal data protection. Privacy issues--e.g., informed consent, data processing, patients' rights and minors' will--are discussed within the framework of recent e-Health legislation, national Data Protection Code, the related Data Protection Authority pronouncements and EU law. The paper is aimed at discussing the problems arising from a complex, fragmentary and sometimes uncertain legal framework on e-Health.

  7. Electronic recording of holograms with applications to holographic displays

    NASA Technical Reports Server (NTRS)

    Claspy, P. C.; Merat, F. L.

    1979-01-01

    The paper describes an electronic heterodyne recording which uses electrooptic modulation to introduce a sinusoidal phase shift between the object and reference wave. The resulting temporally modulated holographic interference pattern is scanned by a commercial image dissector camera, and the rejection of the self-interference terms is accomplished by heterodyne detection at the camera output. The electrical signal representing this processed hologram can then be used to modify the properties of a liquid crystal light valve or a similar device. Such display devices transform the displayed interference pattern into a phase modulated wave front rendering a three-dimensional image.

  8. Electronic Health Record in Italy and Personal Data Protection.

    PubMed

    Bologna, Silvio; Bellavista, Alessandro; Corso, Pietro Paolo; Zangara, Gianluca

    2016-06-01

    The present article deals with the Italian Electronic Health Record (hereinafter EHR), recently introduced by Act 221/2012, with a specific focus on personal data protection. Privacy issues--e.g., informed consent, data processing, patients' rights and minors' will--are discussed within the framework of recent e-Health legislation, national Data Protection Code, the related Data Protection Authority pronouncements and EU law. The paper is aimed at discussing the problems arising from a complex, fragmentary and sometimes uncertain legal framework on e-Health. PMID:27491249

  9. Securing electronic health records with broadcast encryption schemes.

    PubMed

    Susilo, Willy; Win, Khin Than

    2006-01-01

    Information security is a concern in integrated electronic health record systems (EHRs). This paper discusses the development of a mathematical model to secure the access of EHRs. In this paper, we incorporate the notion of a broadcast encryption scheme for securing EHRs. We present a novel solution to allow a secure access to the EHRs whilst minimising the number of the encrypted ciphertexts. In a nutshell, our proposed solution enjoys shorter ciphertexts compared to having multiple ciphertexts encrypted for several different participants. Our proposed solution is applicable in practice to solve an existing open problem in the effort of securing EHRs.

  10. Application of an Electronic Medical Record in Space Medicine

    NASA Technical Reports Server (NTRS)

    McGinnis, Patrick J.

    2000-01-01

    Electronic Medical Records (EMR) have been emerging over the past decade. Today, they are replacing the paper chart in clinics throughout the nation. Approximately three years ago, the NASA-JSC Flight Medicine Clinic initiated an assessment of the EMRs available on the market. This assessment included comparing these products with the particular scope of practice at JSC. In 1998, the Logician EMR from Medicalogic was selected for the JSC Flight Medicine Clinic. This presentation reviews the process of selection and implementation of the EMR into the unique practice of aerospace medicine at JSC.

  11. Integrating Electronic Health Record Competencies into Undergraduate Health Informatics Education.

    PubMed

    Borycki, Elizabeth M; Griffith, Janessa; Kushniruk, Andre W

    2016-01-01

    In this paper we report on our findings arising from a qualitative, interview study of students' experiences in an undergraduate health informatics program. Our findings suggest that electronic health record competencies need to be integrated into an undergraduate curriculum. Participants suggested that there is a need to educate students about the use of the EHR, followed by best practices around interface design, workflow, and implementation with this work culminating in students spearheading the design of the technology as part of their educational program of study. PMID:27577461

  12. Developmental Surveillance and Screening in the Electronic Health Record.

    PubMed

    Smith, Timothy Ryan

    2016-10-01

    Effective well-child care includes developmental surveillance and screening to identify developmental delays and subsequent interventions. Electronic health records (EHRs) have been widely adopted to improve efficiency and appropriate clinical practice. Developmental surveillance tools have been introduced. This article summarizes a conceptual framework for application and highlights the principles and tools of EHRs applied to developmental assessment, including interoperability, health information exchange, clinical decision support systems, consumer health informatics, dashboards, and patient portals. Further investigation and dedicated resources will be required for successful application to developmental surveillance and screening. PMID:27565369

  13. Ethics and the electronic health record in dental school clinics.

    PubMed

    Cederberg, Robert A; Valenza, John A

    2012-05-01

    Electronic health records (EHRs) are a major development in the practice of dentistry, and dental schools and dental curricula have benefitted from this technology. Patient data entry, storage, retrieval, transmission, and archiving have been streamlined, and the potential for teledentistry and improvement in epidemiological research is beginning to be realized. However, maintaining patient health information in an electronic form has also changed the environment in dental education, setting up potential ethical dilemmas for students and faculty members. The purpose of this article is to explore some of the ethical issues related to EHRs, the advantages and concerns related to the use of computers in the dental operatory, the impact of the EHR on the doctor-patient relationship, the introduction of web-based EHRs, the link between technology and ethics, and potential solutions for the management of ethical concerns related to EHRs in dental schools.

  14. Application of routine electronic health record databases for pharmacogenetic research.

    PubMed

    Yasmina, A; Deneer, V H M; Maitland-van der Zee, A H; van Staa, T P; de Boer, A; Klungel, O H

    2014-06-01

    Inter-individual variability in drug responses is a common problem in pharmacotherapy. Several factors (non-genetic and genetic) influence drug responses in patients. When aiming to obtain an optimal benefit-risk ratio of medicines and with the emergence of genotyping technology, pharmacogenetic studies are important for providing recommendations on drug treatments. Advances in electronic healthcare information systems can contribute to increasing the quality and efficiency of such studies. This review describes the definition of pharmacogenetics, gene selection and study design for pharmacogenetic research. It also summarizes the potential of linking pharmacoepidemiology and pharmacogenetics (along with its strengths and limitations) and provides examples of pharmacogenetic studies utilizing electronic health record databases. PMID:24581153

  15. 65 FR 8669 - Technical Implementation of Electronic Records and Electronic Signatures; Public Meeting and...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2000-02-22

    ... Records and Electronic Signatures; Public Meeting and Request for Presentation Abstracts AGENCY: Food and... a presentation at this meeting, send a brief abstract (no longer than one page), along with the... abstracts and speaker information materials, and presentation handouts upon completion of the meeting....

  16. Relevance of the electronic computer to hospital medical records.

    PubMed

    Mitchell, J H

    1969-10-18

    During the past 30 years an "information explosion" has completely changed patterns of illness. Unit files of individual patients have become so large that they are increasingly difficult both to store physically and to assimilate mentally. We have reached a communications barriers which poses a major threat to the efficient practice of clinical medicine.At the same time a new kind of machine, the electronic digital computer, which was invented only 26 years ago, has already come to dominate large areas of military, scientific, commercial, and industrial activity. Its supremacy rests on its ability to perform any data procedure automatically and incredibly quickly.Computers are being employed in clinical medicine in hospitals for various purposes. They can act as arithmetic calculators, they can process and analyse output from recording devices, and they can make possible the automation of various machine systems.However, in the field of case records their role is much less well defined, for here the organization of data as a preliminary to computer input is the real stumbling-block. Data banks of retrospective selected clinical information have been in operation in some centres for a number of years. Attempts are now being made to design computerized "total information systems" to replace conventional paper records, and the possibility of automated diagnosis is being seriously discussed.In my view, however, the medical profession is in danger of being dazzled by optimistic claims about the usefulness of computers in case record processing. The solution to the present problems of record storage and handling is very simple, and does not involve computerization.

  17. Influence of electron dose rate on electron counting images recorded with the K2 camera.

    PubMed

    Li, Xueming; Zheng, Shawn Q; Egami, Kiyoshi; Agard, David A; Cheng, Yifan

    2013-11-01

    A recent technological breakthrough in electron cryomicroscopy (cryoEM) is the development of direct electron detection cameras for data acquisition. By bypassing the traditional phosphor scintillator and fiber optic coupling, these cameras have greatly enhanced sensitivity and detective quantum efficiency (DQE). Of the three currently available commercial cameras, the Gatan K2 Summit was designed specifically for counting individual electron events. Counting further enhances the DQE, allows for practical doubling of detector resolution and eliminates noise arising from the variable deposition of energy by each primary electron. While counting has many advantages, undercounting of electrons happens when more than one electron strikes the same area of the detector within the analog readout period (coincidence loss), which influences image quality. In this work, we characterized the K2 Summit in electron counting mode, and studied the relationship of dose rate and coincidence loss and its influence on the quality of counted images. We found that coincidence loss reduces low frequency amplitudes but has no significant influence on the signal-to-noise ratio of the recorded image. It also has little influence on high frequency signals. Images of frozen hydrated archaeal 20S proteasome (~700 kDa, D7 symmetry) recorded at the optimal dose rate retained both high-resolution signal and low-resolution contrast and enabled calculating a 3.6 Å three-dimensional reconstruction from only 10,000 particles.

  18. Influence of electron dose rate on electron counting images recorded with the K2 camera.

    PubMed

    Li, Xueming; Zheng, Shawn Q; Egami, Kiyoshi; Agard, David A; Cheng, Yifan

    2013-11-01

    A recent technological breakthrough in electron cryomicroscopy (cryoEM) is the development of direct electron detection cameras for data acquisition. By bypassing the traditional phosphor scintillator and fiber optic coupling, these cameras have greatly enhanced sensitivity and detective quantum efficiency (DQE). Of the three currently available commercial cameras, the Gatan K2 Summit was designed specifically for counting individual electron events. Counting further enhances the DQE, allows for practical doubling of detector resolution and eliminates noise arising from the variable deposition of energy by each primary electron. While counting has many advantages, undercounting of electrons happens when more than one electron strikes the same area of the detector within the analog readout period (coincidence loss), which influences image quality. In this work, we characterized the K2 Summit in electron counting mode, and studied the relationship of dose rate and coincidence loss and its influence on the quality of counted images. We found that coincidence loss reduces low frequency amplitudes but has no significant influence on the signal-to-noise ratio of the recorded image. It also has little influence on high frequency signals. Images of frozen hydrated archaeal 20S proteasome (~700 kDa, D7 symmetry) recorded at the optimal dose rate retained both high-resolution signal and low-resolution contrast and enabled calculating a 3.6 Å three-dimensional reconstruction from only 10,000 particles. PMID:23968652

  19. 78 FR 22345 - Advisory Committee on the Electronic Records Archives (ACERA)

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-15

    ... contact Kimberly Scates, Information Services, National Archives and Records Administration, by April 26... Scates, Information Services, National Archives and Records Administration, 8601 Adelphi Road, College..., and service issues related to the Electronic Records Archives (ERA). This includes, but is not...

  20. 36 CFR 1235.50 - What specifications and standards for transfer apply to electronic records?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... electronic records in a format that is independent of specific hardware or software. Except as specified in... indicators for variable length records, or marks delimiting a data element, field, record, or file....

  1. 36 CFR 1235.50 - What specifications and standards for transfer apply to electronic records?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... electronic records in a format that is independent of specific hardware or software. Except as specified in... indicators for variable length records, or marks delimiting a data element, field, record, or file....

  2. 36 CFR 1235.50 - What specifications and standards for transfer apply to electronic records?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... electronic records in a format that is independent of specific hardware or software. Except as specified in... indicators for variable length records, or marks delimiting a data element, field, record, or file....

  3. Using ISO 25040 standard for evaluating electronic health record systems.

    PubMed

    Oliveira, Marília; Novaes, Magdala; Vasconcelos, Alexandre

    2013-01-01

    Quality of electronic health record systems (EHR-S) is one of the key points in the discussion about the safe use of this kind of system. It stimulates creation of technical standards and certifications in order to establish the minimum requirements expected for these systems. [1] In other side, EHR-S suppliers need to invest in evaluation of their products to provide systems according to these requirements. This work presents a proposal of use ISO 25040 standard, which focuses on the evaluation of software products, for define a model of evaluation of EHR-S in relation to Brazilian Certification for Electronic Health Record Systems - SBIS-CFM Certification. Proposal instantiates the process described in ISO 25040 standard using the set of requirements that is scope of the Brazilian certification. As first results, this research has produced an evaluation model and a scale for classify an EHR-S about its compliance level in relation to certification. This work in progress is part for the acquisition of the degree of master in Computer Science at the Federal University of Pernambuco.

  4. Ethical governance in biobanks linked to electronic health records.

    PubMed

    Caenazzo, L; Tozzo, P; Borovecki, A

    2015-11-01

    In the last years an alternative to traditional research projects conducted with patients has emerged: it is represented by the pairing of different type of disease biobanks specimens with Electronic Health Records (EHRs). Even if informed consent remains one of the most contested issues of biobank policy, other ethical challenges still require careful attention, given that additional issues are related to the use of EHRs. In this new way of doing research harmonization of governance is essential in practice, with the aim to make the most use of resources at our disposal, and sharing of samples and data among researchers under common policies regulating the distribution and the use. A biobank-specific Ethics Committee could be seen as a new and type of Ethics Committee, that we suggest to be applied to each biobank, with possible different functions. In particular, considering the possible use of electronic health record data linked to biological specimens in biobanking research, this specific Ethics Committee could draft best practice and ethical guidelines for the utilisation of the EHRs as a tool for genetic research, addressing concerns on accessibility, return of results and privacy and help to educate patients and healthcare providers. PMID:26592845

  5. Standards for the Content of the Electronic Health Record

    PubMed Central

    Watzlaf, Valerie J.M; Zeng, Xiaoming; Jarymowycz, Christine; Firouzan, Patti Anania

    2004-01-01

    A descriptive, cross-sectional study was performed to measure the awareness, use, and validity of the minimum content recommended in the American Society for Testing and Materials (ASTM) standards for content and structure of electronic health records. A Web-based survey was developed and used as the primary tool to collect this data. Data was collected from a random sample of healthcare facilities from across the country, vendors, and volunteers. Thirteen percent of respondents had an electronic health record (EHR) system fully in place while 10 percent did not have or did not plan to have an EHR system. The majority of respondents (62 percent) used a vendor system for EHR development. The majority of respondents were not aware or slightly aware of the ASTM E1384 standards. Respondents believed that the minimum data elements outlined in the ASTM standards should be included in all EHR systems. Data items such as educational level, patient instructions related to disposition, problem numbers, treatment plan ID, provider agency ID code, and medication date of last refill should not always be included in EHR systems. PMID:18066381

  6. Ethical governance in biobanks linked to electronic health records.

    PubMed

    Caenazzo, L; Tozzo, P; Borovecki, A

    2015-11-01

    In the last years an alternative to traditional research projects conducted with patients has emerged: it is represented by the pairing of different type of disease biobanks specimens with Electronic Health Records (EHRs). Even if informed consent remains one of the most contested issues of biobank policy, other ethical challenges still require careful attention, given that additional issues are related to the use of EHRs. In this new way of doing research harmonization of governance is essential in practice, with the aim to make the most use of resources at our disposal, and sharing of samples and data among researchers under common policies regulating the distribution and the use. A biobank-specific Ethics Committee could be seen as a new and type of Ethics Committee, that we suggest to be applied to each biobank, with possible different functions. In particular, considering the possible use of electronic health record data linked to biological specimens in biobanking research, this specific Ethics Committee could draft best practice and ethical guidelines for the utilisation of the EHRs as a tool for genetic research, addressing concerns on accessibility, return of results and privacy and help to educate patients and healthcare providers.

  7. Electronic Health Record-Driven Workflow for Diagnostic Radiologists.

    PubMed

    Geeslin, Matthew G; Gaskin, Cree M

    2016-01-01

    In most settings, radiologists maintain a high-throughput practice in which efficiency is crucial. The conversion from film-based to digital study interpretation and data storage launched the era of PACS-driven workflow, leading to significant gains in speed. The advent of electronic health records improved radiologists' access to patient data; however, many still find this aspect of workflow to be relatively cumbersome. Nevertheless, the ability to guide a diagnostic interpretation with clinical information, beyond that provided in the examination indication, can add significantly to the specificity of a radiologist's interpretation. Responsibilities of the radiologist include, but are not limited to, protocoling examinations, interpreting studies, chart review, peer review, writing notes, placing orders, and communicating with referring providers. Most of the aforementioned activities are not PACS-centric and require a login to one or more additional applications. Consolidation of these tasks for completion through a single interface can simplify workflow, save time, and potentially reduce the incidence of errors. Here, the authors describe diagnostic radiology workflow that leverages the electronic health record to significantly add to a radiologist's ability to be part of the health care team, provide relevant interpretations, and improve efficiency and quality. PMID:26603098

  8. Electronic health records: new opportunities for clinical research.

    PubMed

    Coorevits, P; Sundgren, M; Klein, G O; Bahr, A; Claerhout, B; Daniel, C; Dugas, M; Dupont, D; Schmidt, A; Singleton, P; De Moor, G; Kalra, D

    2013-12-01

    Clinical research is on the threshold of a new era in which electronic health records (EHRs) are gaining an important novel supporting role. Whilst EHRs used for routine clinical care have some limitations at present, as discussed in this review, new improved systems and emerging research infrastructures are being developed to ensure that EHRs can be used for secondary purposes such as clinical research, including the design and execution of clinical trials for new medicines. EHR systems should be able to exchange information through the use of recently published international standards for their interoperability and clinically validated information structures (such as archetypes and international health terminologies), to ensure consistent and more complete recording and sharing of data for various patient groups. Such systems will counteract the obstacles of differing clinical languages and styles of documentation as well as the recognized incompleteness of routine records. Here, we discuss some of the legal and ethical concerns of clinical research data reuse and technical security measures that can enable such research while protecting privacy. In the emerging research landscape, cooperation infrastructures are being built where research projects can utilize the availability of patient data from federated EHR systems from many different sites, as well as in international multilingual settings. Amongst several initiatives described, the EHR4CR project offers a promising method for clinical research. One of the first achievements of this project was the development of a protocol feasibility prototype which is used for finding patients eligible for clinical trials from multiple sources. PMID:23952476

  9. A personally controlled electronic health record for Australia

    PubMed Central

    Pearce, Christopher; Bainbridge, Michael

    2014-01-01

    Objective On July 1, 2012 Australia launched a personally controlled electronic health record (PCEHR) designed around the needs of consumers. Using a distributed model and leveraging key component national eHealth infrastructure, the PCEHR is designed to enable sharing of any health information about a patient with them and any other health practitioner involved in their care to whom the patient allows access. This paper discusses the consumer-facing part of the program. Method Design of the system was through stakeholder consultation and the development of detailed requirements, followed by clinical design assurance. Results Patients are able to access any posted information through a web-accessible ‘consumer portal.’ Within the portal they are able to assert access controls on all or part of their record. The portal includes areas for consumers to record their own personal information. Discussion The PCEHR has the potential to transform the ability of patients to actively engage in their own healthcare, and to enable the emerging partnership model of health and healthcare in medicine. The ability to access health information traditionally kept within the closed walls of institutions also raises challenges for the profession, both in the language clinicians choose and the ethical issues raised by the changed roles and responsibilities. Conclusions The PCEHR is aimed at connecting all participants and their interventions, and is intended to become a system-wide activity. PMID:24650635

  10. 36 CFR 1225.24 - When can an agency apply previously approved schedules to electronic records?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... previously approved schedules to electronic records? 1225.24 Section 1225.24 Parks, Forests, and Public... can an agency apply previously approved schedules to electronic records? If the conditions specified... may apply a previously approved schedule for hard copy records to electronic versions of the...

  11. 36 CFR 1235.48 - What documentation must agencies transfer with electronic records?

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... agencies transfer with electronic records? 1235.48 Section 1235.48 Parks, Forests, and Public Property... agencies transfer with electronic records? (a) General. Agencies must transfer documentation adequate to identify, service, and interpret the permanent electronic records This documentation must include...

  12. 36 CFR 1235.50 - What specifications and standards for transfer apply to electronic records?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Language (SGML) or XML tags. (e) Electronic mail, scanned images of textual records, portable document... standards for transfer apply to electronic records? 1235.50 Section 1235.50 Parks, Forests, and Public... and standards for transfer apply to electronic records? (a) General. (1) Agencies must...

  13. 36 CFR 1235.48 - What documentation must agencies transfer with electronic records?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... documentation for the following types of electronic records: (i) E-mail messages with attachments; (ii) Scanned... agencies transfer with electronic records? 1235.48 Section 1235.48 Parks, Forests, and Public Property... agencies transfer with electronic records? (a) General. Agencies must transfer documentation adequate...

  14. Grasping the Nettle: The Evolution of Australian Archives Electronic Records Policy.

    ERIC Educational Resources Information Center

    O'Shea, Greg

    1997-01-01

    Examines issues in electronic records management from an archival perspective and illustrates points by referring to policy development at the Australian Archives. Describes the Australian Archives; outlines its strategy for managing electronic records; discusses policy response; preservation of format versus virtual records; and records creation,…

  15. Relational Machine Learning for Electronic Health Record-Driven Phenotyping

    PubMed Central

    Peissig, Peggy L.; Costa, Vitor Santos; Caldwell, Michael D.; Rottscheit, Carla; Berg, Richard L.; Mendonca, Eneida A.; Page, David

    2014-01-01

    Objective Electronic health records (EHR) offer medical and pharmacogenomics research unprecedented opportunities to identify and classify patients at risk. EHRs are collections of highly inter-dependent records that include biological, anatomical, physiological, and behavioral observations. They comprise a patient’s clinical phenome, where each patient has thousands of date-stamped records distributed across many relational tables. Development of EHR computer-based phenotyping algorithms require time and medical insight from clinical experts, who most often can only review a small patient subset representative of the total EHR records, to identify phenotype features. In this research we evaluate whether relational machine learning (ML) using Inductive Logic Programming (ILP) can contribute to addressing these issues as a viable approach for EHR-based phenotyping. Methods Two relational learning ILP approaches and three well-known WEKA (Waikato Environment for Knowledge Analysis) implementations of non-relational approaches (PART, J48, and JRIP) were used to develop models for nine phenotypes. International Classification of Diseases, Ninth Revision (ICD-9) coded EHR data were used to select training cohorts for the development of each phenotypic model. Accuracy, precision, recall, F-Measure, and Area Under the Receiver Operating Characteristic (AUROC) curve statistics were measured for each phenotypic model based on independent manually verified test cohorts. A two-sided binomial distribution test (sign test) compared the five ML approaches across phenotypes for statistical significance. Results We developed an approach to automatically label training examples using ICD-9 diagnosis codes for the ML approaches being evaluated. Nine phenotypic models for each MLapproach were evaluated, resulting in better overall model performance in AUROC using ILP when compared to PART (p=0.039), J48 (p=0.003) and JRIP (p=0.003). Discussion ILP has the potential to improve

  16. Open source cardiology electronic health record development for DIGICARDIAC implementation

    NASA Astrophysics Data System (ADS)

    Dugarte, Nelson; Medina, Rubén.; Huiracocha, Lourdes; Rojas, Rubén.

    2015-12-01

    This article presents the development of a Cardiology Electronic Health Record (CEHR) system. Software consists of a structured algorithm designed under Health Level-7 (HL7) international standards. Novelty of the system is the integration of high resolution ECG (HRECG) signal acquisition and processing tools, patient information management tools and telecardiology tools. Acquisition tools are for management and control of the DIGICARDIAC electrocardiograph functions. Processing tools allow management of HRECG signal analysis searching for indicative patterns of cardiovascular pathologies. Telecardiology tools incorporation allows system communication with other health care centers decreasing access time to the patient information. CEHR system was completely developed using open source software. Preliminary results of process validation showed the system efficiency.

  17. Change Management – Recommendations for Successful Electronic Medical Records Implementation

    PubMed Central

    Shoolin, J.S.

    2010-01-01

    Summary Change is difficult and managing change even more so. With the advent of Electronic Medical Records (EMRs) and the difficulty of its acceptance, understanding physician’s attitudes and the psychology of change management is imperative. While many authors describe change management theories, one comes nearest to describing this particularly difficult transition. In 1969, Elizabeth Kübler-Ross wrote her seminal treatise, On Death and Dying, detailing the psychological changes terminally ill patients undergo. Her grieving model is a template to examine the impact of change. By following a physician through the EMR maze, understanding the difficulties he/she perceives and developing a plan other change agents are able to use, the paper gives practical recommendations to EMR change management. PMID:23616842

  18. Role prediction using Electronic Medical Record system audits.

    PubMed

    Zhang, Wen; Gunter, Carl A; Liebovitz, David; Tian, Jian; Malin, Bradley

    2011-01-01

    Electronic Medical Records (EMRs) provide convenient access to patient data for parties who should have it, but, unless managed properly, may also provide it to those who should not. Distinguishing the two is a core security challenge for EMRs. Strategies proposed to address these problems include Role Based Access Control (RBAC), which assigns collections of privileges called roles to users, and Experience Based Access Management (EBAM), which analyzes audit logs to determine access rights. In this paper, we integrate RBAC and EBAM through an algorithm, called Roll-Up, to manage roles effectively. In doing so, we introduce the concept of "role prediction" to identify roles from audit data. We apply the algorithm to three months of logs from Northwestern Memorial Hospital's Cerner system with approximately 8000 users and 140 roles. We demonstrate that existing roles can be predicted with 50% accuracy and intelligent grouping of roles through Roll-Up can facilitate 65% accuracy.

  19. Forward secure digital signature for electronic medical records.

    PubMed

    Yu, Yao-Chang; Huang, To-Yeh; Hou, Ting-Wei

    2012-04-01

    The Technology Safeguard in Health Insurance Portability and Accountability Act (HIPAA) Title II has addressed a way to maintain the integrity and non-repudiation of Electronic Medical Record (EMR). One of the important cryptographic technologies is mentioned in the ACT is digital signature; however, the ordinary digital signature (e.g. DSA, RSA, GQ...) has an inherent weakness: if the key (certificate) is updated, than all signatures, even the ones generated before the update, are no longer trustworthy. Unfortunately, the current most frequently used digital signature schemes are categorized into the ordinary digital signature scheme; therefore, the objective of this paper is to analyze the shortcoming of using ordinary digital signatures in EMR and to propose a method to use forward secure digital signature to sign EMR to ensure that the past EMR signatures remain trustworthy while the key (certificate) is updated.

  20. A system of electronic records developed by a children's hospice.

    PubMed

    Menezes, Antoinette; Esplen, Polly; Bartlett, Paul; Turner, Bridget; Keel, Mike; Etherington, Veronica; Conisbee, Elaine; Plant, Antonia; Haslam, Val; England, Julie

    2007-05-01

    This paper describes the development, implementation and dissemination of an electronic data collection system for children's hospices in the UK. In 1999, CHASE Hospice Care for Children (CHASE) began providing support for life-limited children and their families in their own homes across south-west London, Surrey and West Sussex. CHASE community team is multidisciplinary and original members of the team had to create all of the necessary administrative systems for collecting and storing information about referrals and care provided to children and their families. The community team had the foresight to record activity statistics from day one of the service. The team worked together to identify information routinely collected that could usefully be stored on a computer database and a simple solution was created for this purpose using Microsoft Access version 2. CHASE was in a privileged position because the commitment to use information technology came from people providing care to children and their families.

  1. Archetype Development Process of Electronic Health Record of Minas Gerais.

    PubMed

    Abreu Maia, Thais; Fernandes De Muylder, Cristiana; Mendonça Queiroga, Rodrigo

    2015-01-01

    The Electronic Health Record (EHR) supports health systems and aims to reduce fragmentation, which will enable continuity of patient care. The paper's main objective is to define the steps, roles and artifacts for an archetype development process (ADP) for the EHR at the Brazilian National Health System (SUS) in the State of Minas Gerais (MG). This study was conducted using qualitative analysis based upon an applied case. It had an exploratory purpose metodologically defined in four stages: literature review; descriptive comparison; proposition of an archetype development process and proof of concept. The proof of concept showed that the proposed ADP ensures the archetype quality and supports the semantic interoperability in SUS to improve clinical safety and the continuity of patient care.

  2. Ethical issues in electronic health records: A general overview

    PubMed Central

    Ozair, Fouzia F.; Jamshed, Nayer; Sharma, Amit; Aggarwal, Praveen

    2015-01-01

    Electronic health record (EHR) is increasingly being implemented in many developing countries. It is the need of the hour because it improves the quality of health care and is also cost-effective. Technologies can introduce some hazards hence safety of information in the system is a real challenge. Recent news of security breaches has put a question mark on this system. Despite its increased usefulness, and increasing enthusiasm in its adoption, not much attention is being paid to the ethical issues that might arise. Securing EHR with an encrypted password is a probable option. The purpose of this article is to discuss the various ethical issues arising in the use of the EHRs and their possible solutions. PMID:25878950

  3. Electronic Health Record Use a Bitter Pill for Many Physicians

    PubMed Central

    Meigs, Stephen L.; Solomon, Michael

    2016-01-01

    Electronic health record (EHR) adoption among office-based physician practices in the United States has increased significantly in the past decade. However, the challenges of using EHRs have resulted in growing dissatisfaction with the systems among many of these physicians. The purpose of this qualitative multiple-case study was to increase understanding of physician perceptions regarding the value of using EHR technology. Important findings included the belief among physicians that EHR systems need to be more user-friendly and adaptable to individual clinic workflow preferences, physician beliefs that lack of interoperability among EHRs is a major barrier to meaningful use of the systems, and physician beliefs that EHR use does not improve the quality of care provided to patients. These findings suggest that although government initiatives to encourage EHR adoption among office-based physician practices have produced positive results, additional support may be required in the future to maintain this momentum. PMID:26903782

  4. Leveraging the Cloud for Electronic Health Record Access

    PubMed Central

    Coats, Brian; Acharya, Subrata

    2014-01-01

    Healthcare providers are under increasing pressure to enable widespread access to their electronic health record (EHR) systems for the patients they serve; the meaningful use incentive programs are perhaps the most significant driver encouraging this access. Elsewhere, the cloud has become extremely efficient and successful at establishing digital identities for individuals and making them interoperable across heterogeneous systems. As the healthcare industry contemplates providing patients access to their EHRs, the solution should leverage existing cloud investment, not duplicate it. Through an analysis of industry standards and similar work being performed in other industries, a trust framework has been derived for exchanging identity information. This research lays out a comprehensive structure that healthcare providers can easily use to integrate their EHRs with the cloud for identity validation, while meeting compliance guidelines for security and privacy. Further, this research has been implemented at a large regional hospital, yielding immediate and tangible improvements. PMID:24808814

  5. Leveraging the cloud for electronic health record access.

    PubMed

    Coats, Brian; Acharya, Subrata

    2014-01-01

    Healthcare providers are under increasing pressure to enable widespread access to their electronic health record (EHR) systems for the patients they serve; the meaningful use incentive programs are perhaps the most significant driver encouraging this access. Elsewhere, the cloud has become extremely efficient and successful at establishing digital identities for individuals and making them interoperable across heterogeneous systems. As the healthcare industry contemplates providing patients access to their EHRs, the solution should leverage existing cloud investment, not duplicate it. Through an analysis of industry standards and similar work being performed in other industries, a trust framework has been derived for exchanging identity information. This research lays out a comprehensive structure that healthcare providers can easily use to integrate their EHRs with the cloud for identity validation, while meeting compliance guidelines for security and privacy. Further, this research has been implemented at a large regional hospital, yielding immediate and tangible improvements. PMID:24808814

  6. Electronic health record functionality needed to better support primary care.

    PubMed

    Krist, Alex H; Beasley, John W; Crosson, Jesse C; Kibbe, David C; Klinkman, Michael S; Lehmann, Christoph U; Fox, Chester H; Mitchell, Jason M; Mold, James W; Pace, Wilson D; Peterson, Kevin A; Phillips, Robert L; Post, Robert; Puro, Jon; Raddock, Michael; Simkus, Ray; Waldren, Steven E

    2014-01-01

    Electronic health records (EHRs) must support primary care clinicians and patients, yet many clinicians remain dissatisfied with their system. This article presents a consensus statement about gaps in current EHR functionality and needed enhancements to support primary care. The Institute of Medicine primary care attributes were used to define needs and meaningful use (MU) objectives to define EHR functionality. Current objectives remain focused on disease rather than the whole person, ignoring factors such as personal risks, behaviors, family structure, and occupational and environmental influences. Primary care needs EHRs to move beyond documentation to interpreting and tracking information over time, as well as patient-partnering activities, support for team-based care, population-management tools that deliver care, and reduced documentation burden. While stage 3 MU's focus on outcomes is laudable, enhanced functionality is still needed, including EHR modifications, expanded use of patient portals, seamless integration with external applications, and advancement of national infrastructure and policies. PMID:24431335

  7. Cardiovascular disease documentation and counseling in electronic medical records.

    PubMed

    Bae, Jaeyong; Huerta, Timothy R; Ford, Eric W

    2016-07-01

    The purpose of this paper is to explore the relationship between clinical reminders generated by electronic medical record (EMR) systems and providers giving prevention counseling to patients at-risk for cardiovascular disease (CVD). Data were extracted from the 2012 National Ambulatory Medical Care Survey (NAMCS). Results indicate that the providers routinely using clinical reminders are significantly more likely to document height and weight data to determine risk and provide the recommended counseling to patients that merit the intervention. The findings are important for policymakers and managers that have been promoting the adoption of more sophisticated EMR decision support functionalities across the care delivery spectrum. In particular, the ability to intervene prior to negative health events is an important feature of the movement to improve care quality and reduce costs. PMID:27002255

  8. Virtual medical scribes: making electronic medical records work for you.

    PubMed

    Brady, Kevin; Shariff, Afser

    2013-01-01

    There is increasing buzz around the term "medical scribe" in healthcare today. Medical scribes help meet the growing electronic medical record (EMR) data entry challenge healthcare providers face. Medical scribes reduce providers' paperwork burden, increase a medical practice's net margins, and reduce stress levels for doctors and their staff. They do this by charting patient encounters in real-time during patient examinations, thus reducing significantly the data entry workload that EMRs place on providers. Medical scribes can work onsite or offsite from a HIPAA-secure location, the latter being known as "virtual medical scribes." This article explores the uses and benefits of scribes to give you the background to employ them effectively in your clinic or hospital.

  9. [Automated anesthesia billing by electronic anesthesia record keeping system].

    PubMed

    Okamura, A; Murayama, H; Sato, N; Kemmotsu, O

    1999-08-01

    There has been loss of anesthesia fee by errors of filling out billing sheets manually. A large loss of anesthesia fee was pointed out by the audit during the past several years. In order to prevent these billing error, we have developed an automated anesthesia billing system combined with an electronic anesthesia record keeping (EARK) system. The system derives all the anesthesia cost-related parameters from the EARK database and calculates anesthesia fee according to the logic of the Japanese health care insurance system. After implementing the system, anesthesiologists and circulating nurses became free from filling out billing sheets. The accuracy of the automated billing was proved by the comparison with hand filled sheets. The survey showed that the system prevented 2.5 million yen of billing loss in a month. Such an economic impact of the system proves the rationale of an EARK as a cost containment tool.

  10. Technological trends in health care: electronic health record.

    PubMed

    Abraham, Sam

    2010-01-01

    The most relevant technological trend affecting health care organizations and physician services is the electronic health record (EHR). Billions of dollars from the federal government stimulus bill are available for investment toward EHR. Based on the government directives, it is evident EHR has to be a high-priority technological intervention in health care organizations. Addressed in the following pages are the effects of the EHR trend on financial and human resources; analysis of advantages and disadvantages of EHR; action steps involved in implementing EHR, and a timeline for implementation. Medical facilities that do not meet the timetable for using EHR will likely experience reduction of Medicare payments. This article also identifies the strengths, weaknesses, opportunities, and threats of the EHR and steps to be taken by hospitals and physician medical groups to receive stimulus payment.

  11. Electronic Health Records and the Evolution of Diabetes Care

    PubMed Central

    Patel, Vishal; Reed, Mary E.; Grant, Richard W.

    2015-01-01

    Adoption of electronic health records (EHRs) has increased dramatically since the 2009 implementation of the Health Information Technology for Economic and Clinical Health (HITECH) Act. The latest data from the Centers for Disease Control and Prevention (CDC) indicate that the majority of U.S. hospitals and nearly half of U.S. health care professionals have implemented an EHR with advanced functionality.1 The goals of the HITECH act were not only to incentivize the adoption of EHRs, but also to increase the quality, safety, and efficiency of health care by promoting the concept of “meaningful use.”2,3 The stepwise implementation of “meaningful use” is now entering the latter stages with a focus on improving patient outcomes.4 PMID:25711684

  12. The University of Washington electronic medical record experience.

    PubMed

    Welton, Nanette J

    2010-07-01

    The Health Sciences Library at the University of Washington initiated and continues to develop a role in the electronic medical record, starting with the development of the first integrated web-based interface, called MINDscape. An Integrated Academic Information Management System (IAIMS) grant in 1992 began the process, which also led to the development of a clinical medical librarian position. Over the years, the librarian's role in the clinical environment became more established, and with the advent of clinical online resources, it offered further opportunities for librarians to provide the expertise needed to incorporate the appropriate resources. The collaborative journey continues as librarians, now able to directly access the EMRs, provide information about what resources to use and where best to place them and design how best to provide notes or feedback to clinicians.

  13. Disrupting Electronic Health Records Systems: The Next Generation

    PubMed Central

    Marshall, Jeffrey David; Lai, Yuan

    2015-01-01

    The health care system suffers from both inefficient and ineffective use of data. Data are suboptimally displayed to users, undernetworked, underutilized, and wasted. Errors, inefficiencies, and increased costs occur on the basis of unavailable data in a system that does not coordinate the exchange of information, or adequately support its use. Clinicians’ schedules are stretched to the limit and yet the system in which they work exerts little effort to streamline and support carefully engineered care processes. Information for decision-making is difficult to access in the context of hurried real-time workflows. This paper explores and addresses these issues to formulate an improved design for clinical workflow, information exchange, and decision making based on the use of electronic health records. PMID:26500106

  14. Electronic health records and support for primary care teamwork

    PubMed Central

    Draper, Kevin; Gourevitch, Rebecca; Cross, Dori A.; Scholle, Sarah Hudson

    2015-01-01

    Objective Consensus that enhanced teamwork is necessary for efficient and effective primary care delivery is growing. We sought to identify how electronic health records (EHRs) facilitate and pose challenges to primary care teams as well as how practices are overcoming these challenges. Methods Practices in this qualitative study were selected from those recognized as patient-centered medical homes via the National Committee for Quality Assurance 2011 tool, which included a section on practice teamwork. We interviewed 63 respondents, ranging from physicians to front-desk staff, from 27 primary care practices ranging in size, type, geography, and population size. Results EHRs were found to facilitate communication and task delegation in primary care teams through instant messaging, task management software, and the ability to create evidence-based templates for symptom-specific data collection from patients by medical assistants and nurses (which can offload work from physicians). Areas where respondents felt that electronic medical record EHR functionalities were weakest and posed challenges to teamwork included the lack of integrated care manager software and care plans in EHRs, poor practice registry functionality and interoperability, and inadequate ease of tracking patient data in the EHR over time. Discussion Practices developed solutions for some of the challenges they faced when attempting to use EHRs to support teamwork but wanted more permanent vendor and policy solutions for other challenges. Conclusions EHR vendors in the United States need to work alongside practicing primary care teams to create more clinically useful EHRs that support dynamic care plans, integrated care management software, more functional and interoperable practice registries, and greater ease of data tracking over time. PMID:25627278

  15. Progress in electronic medical record adoption in Canada

    PubMed Central

    Chang, Feng; Gupta, Nishi

    2015-01-01

    Objective To determine the rate of adoption of electronic medical records (EMRs) by physicians across Canada, provincial incentives, and perceived benefits of and barriers to EMR adoption. Data sources Data on EMR adoption in Canada were collected from CINAHL, MEDLINE, PubMed, EMBASE, the Cochrane Library, the Health Council of Canada, Canada Health Infoway, government websites, regional EMR associations, and health professional association websites. Study selection After removal of duplicate articles, 236 documents were found matching the original search. After using the filter Canada, 12 documents remained. Additional documents were obtained from each province’s EMR website and from the Canada Health Infoway website. Synthesis Since 2006, Canadian EMR adoption rates have increased from about 20% of practitioners to an estimated 62% of practitioners in 2013, with substantial regional disparities ranging from roughly 40% of physicians in New Brunswick and Quebec to more than 75% of physicians in Alberta. Provincial incentives vary widely but appear to have only a weak relationship with the rate of adoption. Many adopters use only a fraction of their software’s available functions. User-cited benefits to adoption include time savings, improved record keeping, heightened patient safety, and confidence in retrieved data when EMRs are used efficiently. Barriers to adoption include financial and time constraints, lack of knowledgeable support personnel, and lack of interoperability with hospital and pharmacy systems. Conclusion Canadian physicians remain at the stage of EMR adoption. Progression in EMR use requires experienced, knowledgeable technical support during implementation, and financial support for the transcription of patient data from paper to electronic media. The interoperability of EMR offerings for hospitals, pharmacies, and clinics is the rate-limiting factor in achieving a unified EMR solution for Canada. PMID:27035020

  16. A Pharmacy Blueprint for Electronic Medical Record Implementation Success

    PubMed Central

    Bach, David S.; Risko, Kenneth R.; Farber, Margo S.; Polk, Gregory J.

    2015-01-01

    Objective: Implementation of an integrated, electronic medical record (EMR) has been promoted as a means of improving patient safety and quality. While there are a few reports of such processes that incorporate computerized prescriber order entry, pharmacy verification, an electronic medication administration record (eMAR), point-of-care barcode scanning, and clinical decision support, there are no published reports on how a pharmacy department can best participate in implementing such a process across a multihospital health care system. Method: This article relates the experience of the design, build, deployment, and maintenance of an integrated EMR solution from the pharmacy perspective. It describes a 9-month planning and build phase and the subsequent rollout at 8 hospitals over the following 13 months. Results: Key components to success are identified, as well as a set of guiding principles that proved invaluable in decision making and dispute resolution. Labor/personnel requirements for the various stages of the process are discussed, as are issues involving medication workflow analysis, drug database considerations, the development of clinical order sets, and incorporation of bar-code scanning of medications. Recommended implementation and maintenance strategies are presented, and the impact of EMR implementation on the pharmacy practice model and revenue analysis are examined. Conclusion: Adherence to the principles and practices outlined in this article can assist pharmacy administrators and clinicians during all medication-related phases of the development, implementation, and maintenance of an EMR solution. Furthermore, review and incorporation of some or all of practices presented may help ease the process and ensure its success. PMID:26405340

  17. Hospital financial position and the adoption of electronic health records.

    PubMed

    Ginn, Gregory O; Shen, Jay J; Moseley, Charles B

    2011-01-01

    The objective of this study was to examine the relationship between financial position and adoption of electronic health records (EHRs) in 2442 acute care hospitals. The study was cross-sectional and utilized a general linear mixed model with the multinomial distribution specification for data analysis. We verified the results by also running a multinomial logistic regression model. To measure our variables, we used data from (1) the 2007 American Hospital Association (AHA) electronic health record implementation survey, (2) the 2006 Centers for Medicare and Medicaid Cost Reports, and (3) the 2006 AHA Annual Survey containing organizational and operational data. Our dependent variable was an ordinal variable with three levels used to indicate the extent of EHR adoption by hospitals. Our independent variables were five financial ratios: (1) net days revenue in accounts receivable, (2) total margin, (3) the equity multiplier, (4) total asset turnover, and (5) the ratio of total payroll to total expenses. For control variables, we used (1) bed size, (2) ownership type, (3) teaching affiliation, (4) system membership, (5) network participation, (6) fulltime equivalent nurses per adjusted average daily census, (7) average daily census per staffed bed, (8) Medicare patients percentage, (9) Medicaid patients percentage, (10) capitation-based reimbursement, and (11) nonconcentrated market. Only liquidity was significant and positively associated with EHR adoption. Asset turnover ratio was significant but, unexpectedly, was negatively associated with EHR adoption. However, many control variables, most notably bed size, showed significant positive associations with EHR adoption. Thus, it seems that hospitals adopt EHRs as a strategic move to better align themselves with their environment. PMID:21991681

  18. Hospital financial position and the adoption of electronic health records.

    PubMed

    Ginn, Gregory O; Shen, Jay J; Moseley, Charles B

    2011-01-01

    The objective of this study was to examine the relationship between financial position and adoption of electronic health records (EHRs) in 2442 acute care hospitals. The study was cross-sectional and utilized a general linear mixed model with the multinomial distribution specification for data analysis. We verified the results by also running a multinomial logistic regression model. To measure our variables, we used data from (1) the 2007 American Hospital Association (AHA) electronic health record implementation survey, (2) the 2006 Centers for Medicare and Medicaid Cost Reports, and (3) the 2006 AHA Annual Survey containing organizational and operational data. Our dependent variable was an ordinal variable with three levels used to indicate the extent of EHR adoption by hospitals. Our independent variables were five financial ratios: (1) net days revenue in accounts receivable, (2) total margin, (3) the equity multiplier, (4) total asset turnover, and (5) the ratio of total payroll to total expenses. For control variables, we used (1) bed size, (2) ownership type, (3) teaching affiliation, (4) system membership, (5) network participation, (6) fulltime equivalent nurses per adjusted average daily census, (7) average daily census per staffed bed, (8) Medicare patients percentage, (9) Medicaid patients percentage, (10) capitation-based reimbursement, and (11) nonconcentrated market. Only liquidity was significant and positively associated with EHR adoption. Asset turnover ratio was significant but, unexpectedly, was negatively associated with EHR adoption. However, many control variables, most notably bed size, showed significant positive associations with EHR adoption. Thus, it seems that hospitals adopt EHRs as a strategic move to better align themselves with their environment.

  19. Learning Relational Policies from Electronic Health Record Access Logs

    PubMed Central

    Malin, Bradley; Nyemba, Steve; Paulett, John

    2011-01-01

    Modern healthcare organizations (HCOs) are composed of complex dynamic teams to ensure clinical operations are executed in a quick and competent manner. At the same time, the fluid nature of such environments hinders administrators' efforts to define access control policies that appropriately balance patient privacy and healthcare functions. Manual efforts to define these policies are labor-intensive and error-prone, often resulting in systems that endow certain care providers with overly broad access to patients' medical records while restricting other providers from legitimate and timely use. In this work, we propose an alternative method to generate these policies by automatically mining usage patterns from electronic health record (EHR) systems. EHR systems are increasingly being integrated into clinical environments and our approach is designed to be generalizable across HCOs, thus assisting in the design and evaluation of local access control policies. Our technique, which is grounded in data mining and social network analysis theory, extracts a statistical model of the organization from the access logs of its EHRs. In doing so, our approach enables the review of predefined policies, as well as the discovery of unknown behaviors. We evaluate our approach with five months of access logs from the Vanderbilt University Medical Center and confirm the existence of stable social structures and intuitive business operations. Additionally, we demonstrate that there is significant turnover in the interactions between users in the HCO and that policies learned at the department level afford greater stability over time. PMID:21277996

  20. Use of electronic medical records in oncology outcomes research.

    PubMed

    Kanas, Gena; Morimoto, Libby; Mowat, Fionna; O'Malley, Cynthia; Fryzek, Jon; Nordyke, Robert

    2010-01-01

    Oncology outcomes research could benefit from the use of an oncology-specific electronic medical record (EMR) network. The benefits and challenges of using EMR in general health research have been investigated; however, the utility of EMR for oncology outcomes research has not been explored. Compared to current available oncology databases and registries, an oncology-specific EMR could provide comprehensive and accurate information on clinical diagnoses, personal and medical histories, planned and actual treatment regimens, and post-treatment outcomes, to address research questions from patients, policy makers, the pharmaceutical industry, and clinicians/researchers. Specific challenges related to structural (eg, interoperability, data format/entry), clinical (eg, maintenance and continuity of records, variety of coding schemes), and research-related (eg, missing data, generalizability, privacy) issues must be addressed when building an oncology-specific EMR system. Researchers should engage with medical professional groups to guide development of EMR systems that would ultimately help improve the quality of cancer care through oncology outcomes research.

  1. Open source electronic health records and chronic disease management

    PubMed Central

    Goldwater, Jason C; Kwon, Nancy J; Nathanson, Ashley; Muckle, Alison E; Brown, Alexa; Cornejo, Kerri

    2014-01-01

    Objective To study and report on the use of open source electronic health records (EHR) to assist with chronic care management within safety net medical settings, such as community health centers (CHC). Methods and Materials The study was conducted by NORC at the University of Chicago from April to September 2010. The NORC team undertook a comprehensive environmental scan, including a literature review, a dozen key informant interviews using a semistructured protocol, and a series of site visits to CHC that currently use an open source EHR. Results Two of the sites chosen by NORC were actively using an open source EHR to assist in the redesign of their care delivery system to support more effective chronic disease management. This included incorporating the chronic care model into an CHC and using the EHR to help facilitate its elements, such as care teams for patients, in addition to maintaining health records on indigent populations, such as tuberculosis status on homeless patients. Discussion The ability to modify the open-source EHR to adapt to the CHC environment and leverage the ecosystem of providers and users to assist in this process provided significant advantages in chronic care management. Improvements in diabetes management, controlled hypertension and increases in tuberculosis vaccinations were assisted through the use of these open source systems. Conclusions The flexibility and adaptability of open source EHR demonstrated its utility and viability in the provision of necessary and needed chronic disease care among populations served by CHC. PMID:23813566

  2. Automated methods for the summarization of electronic health records

    PubMed Central

    Elhadad, Noémie

    2015-01-01

    Objectives This review examines work on automated summarization of electronic health record (EHR) data and in particular, individual patient record summarization. We organize the published research and highlight methodological challenges in the area of EHR summarization implementation. Target audience The target audience for this review includes researchers, designers, and informaticians who are concerned about the problem of information overload in the clinical setting as well as both users and developers of clinical summarization systems. Scope Automated summarization has been a long-studied subject in the fields of natural language processing and human–computer interaction, but the translation of summarization and visualization methods to the complexity of the clinical workflow is slow moving. We assess work in aggregating and visualizing patient information with a particular focus on methods for detecting and removing redundancy, describing temporality, determining salience, accounting for missing data, and taking advantage of encoded clinical knowledge. We identify and discuss open challenges critical to the implementation and use of robust EHR summarization systems. PMID:25882031

  3. Electronic health record usability: analysis of the user-centered design processes of eleven electronic health record vendors.

    PubMed

    Ratwani, Raj M; Fairbanks, Rollin J; Hettinger, A Zachary; Benda, Natalie C

    2015-11-01

    The usability of electronic health records (EHRs) continues to be a point of dissatisfaction for providers, despite certification requirements from the Office of the National Coordinator that require EHR vendors to employ a user-centered design (UCD) process. To better understand factors that contribute to poor usability, a research team visited 11 different EHR vendors in order to analyze their UCD processes and discover the specific challenges that vendors faced as they sought to integrate UCD with their EHR development. Our analysis demonstrates a diverse range of vendors' UCD practices that fall into 3 categories: well-developed UCD, basic UCD, and misconceptions of UCD. Specific challenges to practicing UCD include conducting contextually rich studies of clinical workflow, recruiting participants for usability studies, and having support from leadership within the vendor organization. The results of the study provide novel insights for how to improve usability practices of EHR vendors.

  4. [The electronic health record: computerised provider order entry and the electronic instruction document as new functionalities].

    PubMed

    Derikx, Joep P M; Erdkamp, Frans L G; Hoofwijk, A G M

    2013-01-01

    An electronic health record (EHR) should provide 4 key functionalities: (a) documenting patient data; (b) facilitating computerised provider order entry; (c) displaying the results of diagnostic research; and (d) providing support for healthcare providers in the clinical decision-making process.- Computerised provider order entry into the EHR enables the electronic receipt and transfer of orders to ancillary departments, which can take the place of handwritten orders.- By classifying the computer provider order entries according to disorders, digital care pathways can be created. Such care pathways could result in faster and improved diagnostics.- Communicating by means of an electronic instruction document that is linked to a computerised provider order entry facilitates the provision of healthcare in a safer, more efficient and auditable manner.- The implementation of a full-scale EHR has been delayed as a result of economic, technical and legal barriers, as well as some resistance by physicians.

  5. Determinants of primary care nurses' intention to adopt an electronic health record in their clinical practice.

    PubMed

    Leblanc, Genevieve; Gagnon, Marie-Pierre; Sanderson, Duncan

    2012-09-01

    A provincial electronic health record is being developed in the Province of Quebec (and in all other provinces in Canada), and authorities hope that it will enable a safer and more efficient healthcare system for citizens. However, the expected benefits can occur only if healthcare professionals, including nurses, adopt this technology. Although attention to the use of the electronic health record by nurses is growing, better understanding of nurses' intention to use an electronic health record is needed and could help managers to better plan its implementation. This study examined the factors that influence primary care nurses' intention to adopt the provincial electronic health record, since intention influences electronic health record use and implementation success. Using a modified version of Ajzen's Theory of Planned Theory of Planned Behavior, a questionnaire was developed and pretested. Questionnaires were distributed to 199 primary care nurses. Multiple hierarchical regression indicated that the Theory of Planned Behavior variables explained 58% of the variance in nurses' intention to adopt an electronic health record. The strong intention to adopt the electronic health record is mainly determined by perceived behavioral control, normative beliefs, and attitudes. The implications of the study are that healthcare managers could facilitate adoption of an electronic health record by strengthening nurses' intention to adopt the electronic health record, which in turn can be influenced through interventions oriented toward the belief that using an electronic health record will improve the quality of patient care. PMID:22592453

  6. Missed Policy Opportunities to Advance Health Equity by Recording Demographic Data in Electronic Health Records

    PubMed Central

    Dawes, Daniel E.; Holden, Kisha B.; Mack, Dominic

    2015-01-01

    The science of eliminating health disparities is complex and dependent on demographic data. The Health Information Technology for Economic and Clinical Health Act (HITECH) encourages the adoption of electronic health records and requires basic demographic data collection; however, current data generated are insufficient to address known health disparities in vulnerable populations, including individuals from diverse racial and ethnic backgrounds, with disabilities, and with diverse sexual identities. We conducted an administrative history of HITECH and identified gaps between the policy objective and required measure. We identified 20 opportunities for change and 5 changes, 2 of which required the collection of less data. Until health care demographic data collection requirements are consistent with public health requirements, the national goal of eliminating health disparities cannot be realized. PMID:25905840

  7. Data-Driven Information Extraction from Chinese Electronic Medical Records

    PubMed Central

    Zhao, Tianwan; Ge, Chen; Gao, Weiguo; Wei, Jia; Zhu, Kenny Q.

    2015-01-01

    Objective This study aims to propose a data-driven framework that takes unstructured free text narratives in Chinese Electronic Medical Records (EMRs) as input and converts them into structured time-event-description triples, where the description is either an elaboration or an outcome of the medical event. Materials and Methods Our framework uses a hybrid approach. It consists of constructing cross-domain core medical lexica, an unsupervised, iterative algorithm to accrue more accurate terms into the lexica, rules to address Chinese writing conventions and temporal descriptors, and a Support Vector Machine (SVM) algorithm that innovatively utilizes Normalized Google Distance (NGD) to estimate the correlation between medical events and their descriptions. Results The effectiveness of the framework was demonstrated with a dataset of 24,817 de-identified Chinese EMRs. The cross-domain medical lexica were capable of recognizing terms with an F1-score of 0.896. 98.5% of recorded medical events were linked to temporal descriptors. The NGD SVM description-event matching achieved an F1-score of 0.874. The end-to-end time-event-description extraction of our framework achieved an F1-score of 0.846. Discussion In terms of named entity recognition, the proposed framework outperforms state-of-the-art supervised learning algorithms (F1-score: 0.896 vs. 0.886). In event-description association, the NGD SVM is superior to SVM using only local context and semantic features (F1-score: 0.874 vs. 0.838). Conclusions The framework is data-driven, weakly supervised, and robust against the variations and noises that tend to occur in a large corpus. It addresses Chinese medical writing conventions and variations in writing styles through patterns used for discovering new terms and rules for updating the lexica. PMID:26295801

  8. High resolution analytical transmission electron microscopy of magnetic recording media

    NASA Astrophysics Data System (ADS)

    Risner, Juliet Danielle

    Since the invention of the hard disk drive in 1954, the density of bits per disk has increased exponentially. This trend is partly due to improvements to the magnetic recording media. In current hard disks, each bit is approximately 0.04 mum in its smallest dimension and comprises ˜100 hexagonal close packed Co-alloy magnetic grains. These grains have magnetic "easy" axes oriented longitudinally, or parallel to the film plane. Future recording media have easy axes oriented perpendicular to the film plane. Perpendicular media are expected to provide continued increases in storage density above the limit of longitudinal media. Quantum-mechanical exchange coupling between magnetic grains degrades the signal-to-noise ratio (SNR) and limits storage density in both media types. Controlling exchange coupling is possible by creating nonmagnetic grain boundaries which compositionally isolate the magnetic grains. High-resolution analytical transmission electron microscopy (TEM) is required to study these media because of their nano-scale grains and grain boundaries. Examining the microstructure and elemental distribution in these films at near atomic level is paramount to understanding their magnetic performance. The microstructure and elemental distribution in longitudinal and perpendicular media were examined using high resolution analytical TEM techniques, such as energy-filtered TEM (EFTEM), energy-dispersive x-ray spectroscopy (EDS) using a 1.5 nm electron probe, and spectrum imaging with a scanning TEM. These techniques successfully determined how grain boundary Cr segregation varies with grain orientation in longitudinal media. Boundaries misoriented by 0° and 90° commonly occur and were found to have minimal Cr segregation, which limits storage density improvement in these media. Analytical TEM techniques applied to oxygen-enriched perpendicular media, fabricated using different deposition methods, effectively related microstructure and composition to magnetic

  9. Consumers' Perceptions of Patient-Accessible Electronic Medical Records

    PubMed Central

    Vaughon, Wendy L; Czaja, Sara J; Levy, Joslyn; Rockoff, Maxine L

    2013-01-01

    Background Electronic health information (eHealth) tools for patients, including patient-accessible electronic medical records (patient portals), are proliferating in health care delivery systems nationally. However, there has been very limited study of the perceived utility and functionality of portals, as well as limited assessment of these systems by vulnerable (low education level, racial/ethnic minority) consumers. Objective The objective of the study was to identify vulnerable consumers’ response to patient portals, their perceived utility and value, as well as their reactions to specific portal functions. Methods This qualitative study used 4 focus groups with 28 low education level, English-speaking consumers in June and July 2010, in New York City. Results Participants included 10 males and 18 females, ranging in age from 21-63 years; 19 non-Hispanic black, 7 Hispanic, 1 non-Hispanic White and 1 Other. None of the participants had higher than a high school level education, and 13 had less than a high school education. All participants had experience with computers and 26 used the Internet. Major themes were enhanced consumer engagement/patient empowerment, extending the doctor’s visit/enhancing communication with health care providers, literacy and health literacy factors, improved prevention and health maintenance, and privacy and security concerns. Consumers were also asked to comment on a number of key portal features. Consumers were most positive about features that increased convenience, such as making appointments and refilling prescriptions. Consumers raised concerns about a number of potential barriers to usage, such as complex language, complex visual layouts, and poor usability features. Conclusions Most consumers were enthusiastic about patient portals and perceived that they had great utility and value. Study findings suggest that for patient portals to be effective for all consumers, portals must be designed to be easy to read, visually

  10. Adoption Factors of the Electronic Health Record: A Systematic Review

    PubMed Central

    2016-01-01

    Background The Health Information Technology for Economic and Clinical Health (HITECH) was a significant piece of legislation in America that served as a catalyst for the adoption of health information technology. Following implementation of the HITECH Act, Health Information Technology (HIT) experienced broad adoption of Electronic Health Records (EHR), despite skepticism exhibited by many providers for the transition to an electronic system. A thorough review of EHR adoption facilitator and barriers provides ongoing support for the continuation of EHR implementation across various health care structures, possibly leading to a reduction in associated economic expenditures. Objective The purpose of this review is to compile a current and comprehensive list of facilitators and barriers to the adoption of the EHR in the United States. Methods Authors searched Cumulative Index of Nursing and Allied Health Literature (CINAHL) and MEDLINE, 01/01/2012–09/01/2015, core clinical/academic journals, MEDLINE full text, and evaluated only articles germane to our research objective. Team members selected a final list of articles through consensus meetings (n=31). Multiple research team members thoroughly read each article to confirm applicability and study conclusions, thereby increasing validity. Results Group members identified common facilitators and barriers associated with the EHR adoption process. In total, 25 adoption facilitators were identified in the literature occurring 109 times; the majority of which were efficiency, hospital size, quality, access to data, perceived value, and ability to transfer information. A total of 23 barriers to adoption were identified in the literature, appearing 95 times; the majority of which were cost, time consuming, perception of uselessness, transition of data, facility location, and implementation issues. Conclusions The 25 facilitators and 23 barriers to the adoption of the EHR continue to reveal a preoccupation on cost, despite

  11. Key success factors behind electronic medical record adoption in Thailand.

    PubMed

    Narattharaksa, Kanida; Speece, Mark; Newton, Charles; Bulyalert, Damrongsak

    2016-09-19

    Purpose The purpose of this paper is to investigate the elements that health care personnel in Thailand believe are necessary for successful adoption of electronic medical record (EMR) systems. Design/methodology/approach Initial qualitative in-depth interviews with physicians to adapt key elements from the literature to the Thai context. The 12 elements identified included things related to managing the implementation and to IT expertise. The nationwide survey was supported by the Ministry of Public Health and returned 1,069 usable questionnaires (response rate 42 percent) from a range of medical personnel. Findings The key elements clearly separated into a managerial dimension and an IT dimension. All were considered fairly important, but managerial expertise was more critical. In particular, there should be clear EMR project goals and scope, adequate budget allocation, clinical staff must be involved in implementation, and the IT should facilitate good electronic communication. Research limitations/implications Thailand is representative of middle-income developing countries, but there is no guarantee findings can be generalized. National policies differ, as do economic structures of health care industries. The focus is on management at the organizational level, but future research must also examine macro-level issues, as well as gain more depth into thinking of individual health care personnel. Practical implications Technical issues of EMR implementation are certainly important. However, it is clear actual adoption and use of the system also depends very heavily on managerial issues. Originality/value Most research on EMR implementation has been in developed countries, and has often focussed more on technical issues rather than examining managerial issues closely. Health IT is also critical in developing economies, and management of health IT implementation must be well understood. PMID:27681029

  12. Key success factors behind electronic medical record adoption in Thailand.

    PubMed

    Narattharaksa, Kanida; Speece, Mark; Newton, Charles; Bulyalert, Damrongsak

    2016-09-19

    Purpose The purpose of this paper is to investigate the elements that health care personnel in Thailand believe are necessary for successful adoption of electronic medical record (EMR) systems. Design/methodology/approach Initial qualitative in-depth interviews with physicians to adapt key elements from the literature to the Thai context. The 12 elements identified included things related to managing the implementation and to IT expertise. The nationwide survey was supported by the Ministry of Public Health and returned 1,069 usable questionnaires (response rate 42 percent) from a range of medical personnel. Findings The key elements clearly separated into a managerial dimension and an IT dimension. All were considered fairly important, but managerial expertise was more critical. In particular, there should be clear EMR project goals and scope, adequate budget allocation, clinical staff must be involved in implementation, and the IT should facilitate good electronic communication. Research limitations/implications Thailand is representative of middle-income developing countries, but there is no guarantee findings can be generalized. National policies differ, as do economic structures of health care industries. The focus is on management at the organizational level, but future research must also examine macro-level issues, as well as gain more depth into thinking of individual health care personnel. Practical implications Technical issues of EMR implementation are certainly important. However, it is clear actual adoption and use of the system also depends very heavily on managerial issues. Originality/value Most research on EMR implementation has been in developed countries, and has often focussed more on technical issues rather than examining managerial issues closely. Health IT is also critical in developing economies, and management of health IT implementation must be well understood.

  13. Authorisation and access control for electronic health record systems.

    PubMed

    Blobel, Bernd

    2004-03-31

    Enabling the shared care paradigm, centralised or even decentralised electronic health record (EHR) systems increasingly become core applications in hospital information systems and health networks. For realising multipurpose use and reuse as well as inter-operability at knowledge level, EHR have to meet special architectural requirements. The component-oriented and model-based architecture should meet international standards. Especially in extended health networks realising inter-organisational communication and co-operation, authorisation cannot be organised at user level anymore. Therefore, models, methods and tools must be established to allow formal and structured policy definition, policy agreements, role definition, authorisation and access control. Based on the author's international engagement in EHR architecture and security standards referring to the revision of CEN ENV 13606, the GEHR/open EHR approach, HL7 and CORBA, models for health-specific and EHR-related roles, for authorisation management and access control have been developed. The basic concept is the separation of structural roles defining organisational entity-to-entity relationships and enabling specific acts on the one hand, and functional roles bound to specific activities and realising rights and duties on the other hand. Aggregation of organisational, functional, informational and technological components follows specific rules. Using UML and XML, the principles as well as some examples for analysis, design, implementation and maintenance of policy and authorisation management as well as access control have been practically implemented. PMID:15066555

  14. Characterization of Statin Dose-response within Electronic Medical Records

    PubMed Central

    Wei, Wei-Qi; Feng, Qiping; Jiang, Lan; Waitara, Magarya S.; Iwuchukwu, Otito F.; Roden, Dan M.; Jiang, Min; Xu, Hua; Krauss, Ronald M.; Rotter, Jerome I.; Nickerson, Deborah A.; Davis, Robert L.; Berg, Richard L.; Peissig, Peggy L.; McCarty, Catherine A.; Wilke, Russell A.; Denny, Joshua C.

    2013-01-01

    Efforts to define the genetic architecture underlying variable statin response have met with limited success possibly because previous studies were limited to effect based on one-single-dose. We leveraged electronic medical records (EMRs) to extract potency (ED50) and efficacy (Emax) of statin dose-response curves and tested them for association with 144 pre-selected variants. Two large biobanks were used to construct dose-response curves for 2,026 (simvastatin) and 2,252 subjects (atorvastatin). Atorvastatin was more efficacious, more potent, and demonstrated less inter-individual variability than simvastatin. A pharmacodynamic variant emerging from randomized trials (PRDM16) was associated with Emax for both. For atorvastatin, Emax was 51.7 mg/dl in homozygous for the minor allele versus 75.0 mg/dl for those homozygous for the major allele. We also identified several loci associated with ED50. The extraction of rigorously defined traits from EMRs for pharmacogenetic studies represents a promising approach to further understand of genetic factors contributing to drug response. PMID:24096969

  15. Authorisation and access control for electronic health record systems.

    PubMed

    Blobel, Bernd

    2004-03-31

    Enabling the shared care paradigm, centralised or even decentralised electronic health record (EHR) systems increasingly become core applications in hospital information systems and health networks. For realising multipurpose use and reuse as well as inter-operability at knowledge level, EHR have to meet special architectural requirements. The component-oriented and model-based architecture should meet international standards. Especially in extended health networks realising inter-organisational communication and co-operation, authorisation cannot be organised at user level anymore. Therefore, models, methods and tools must be established to allow formal and structured policy definition, policy agreements, role definition, authorisation and access control. Based on the author's international engagement in EHR architecture and security standards referring to the revision of CEN ENV 13606, the GEHR/open EHR approach, HL7 and CORBA, models for health-specific and EHR-related roles, for authorisation management and access control have been developed. The basic concept is the separation of structural roles defining organisational entity-to-entity relationships and enabling specific acts on the one hand, and functional roles bound to specific activities and realising rights and duties on the other hand. Aggregation of organisational, functional, informational and technological components follows specific rules. Using UML and XML, the principles as well as some examples for analysis, design, implementation and maintenance of policy and authorisation management as well as access control have been practically implemented.

  16. “Big Data” and the Electronic Health Record

    PubMed Central

    Ross, M. K.; Wei, Wei

    2014-01-01

    Summary Objectives Implementation of Electronic Health Record (EHR) systems continues to expand. The massive number of patient encounters results in high amounts of stored data. Transforming clinical data into knowledge to improve patient care has been the goal of biomedical informatics professionals for many decades, and this work is now increasingly recognized outside our field. In reviewing the literature for the past three years, we focus on “big data” in the context of EHR systems and we report on some examples of how secondary use of data has been put into practice. Methods We searched PubMed database for articles from January 1, 2011 to November 1, 2013. We initiated the search with keywords related to “big data” and EHR. We identified relevant articles and additional keywords from the retrieved articles were added. Based on the new keywords, more articles were retrieved and we manually narrowed down the set utilizing predefined inclusion and exclusion criteria. Results Our final review includes articles categorized into the themes of data mining (pharmacovigilance, phenotyping, natural language processing), data application and integration (clinical decision support, personal monitoring, social media), and privacy and security. Conclusion The increasing adoption of EHR systems worldwide makes it possible to capture large amounts of clinical data. There is an increasing number of articles addressing the theme of “big data”, and the concepts associated with these articles vary. The next step is to transform healthcare big data into actionable knowledge. PMID:25123728

  17. Modelling and implementing electronic health records in Denmark.

    PubMed

    Bernstein, Knut; Bruun-Rasmussen, Morten; Vingtoft, Søren; Andersen, Stig Kjaer; Nøhr, Christian

    2005-03-01

    The Danish Health IT strategy [Danish Ministry of Interior and Health, National Strategy for IT in the Health Sector 2003-2007, Copenhagen, 2003 (in Danish). http://www.im.dk/publikationer/itstrategi/itstrategi.pdf. notes that integration between electronic health records (EHR) systems has a high priority. A prerequisite for real integration and semantic interoperability is agreement of the data content and the information models. The National Board of Health is working on a common model for EHR, and its adoption is now being promoted through pilot projects. At the same time, several development and implementation projects are taking place at a regional level. These EHRs are built on information models from different vendors and are based on different integration platforms. The Danish EHR observatory, which has been monitoring the development of EHRs in Denmark since 1998, has analysed the challenges of using different information models and integration platforms. This paper also maps the development in Denmark to the new paradigms in modelling techniques and integration technology. PMID:15694627

  18. Development of Mobile Platform Integrated with Existing Electronic Medical Records

    PubMed Central

    Kim, YoungAh; Kang, Simon; Kim, Kyungduk; Kim, Jun

    2014-01-01

    Objectives This paper describes a mobile Electronic Medical Record (EMR) platform designed to manage and utilize the existing EMR and mobile application with optimized resources. Methods We structured the mEMR to reuse services of retrieval and storage in mobile app environments that have already proven to have no problem working with EMRs. A new mobile architecture-based mobile solution was developed in four steps: the construction of a server and its architecture; screen layout and storyboard making; screen user interface design and development; and a pilot test and step-by-step deployment. This mobile architecture consists of two parts, the server-side area and the client-side area. In the server-side area, it performs the roles of service management for EMR and documents and for information exchange. Furthermore, it performs menu allocation depending on user permission and automatic clinical document architecture document conversion. Results Currently, Severance Hospital operates an iOS-compatible mobile solution based on this mobile architecture and provides stable service without additional resources, dealing with dynamic changes of EMR templates. Conclusions The proposed mobile solution should go hand in hand with the existing EMR system, and it can be a cost-effective solution if a quality EMR system is operated steadily with this solution. Thus, we expect this example to be shared with hospitals that currently plan to deploy mobile solutions. PMID:25152837

  19. CADe System Integrated within the Electronic Health Record

    PubMed Central

    Vállez, Noelia; Déniz, Óscar; Fernández, María del Milagro; Pastor, Carlos; Rienda, Miguel Ángel; Esteve, Pablo; Arias, María

    2013-01-01

    The latest technological advances and information support systems for clinics and hospitals produce a wide range of possibilities in the storage and retrieval of an ever-growing amount of clinical information as well as in detection and diagnosis. In this work, an Electronic Health Record (EHR) combined with a Computer Aided Detection (CADe) system for breast cancer diagnosis has been implemented. Our objective is to provide to radiologists a comprehensive working environment that facilitates the integration, the image visualization, and the use of aided tools within the EHR. For this reason, a development methodology based on hardware and software system features in addition to system requirements must be present during the whole development process. This will lead to a complete environment for displaying, editing, and reporting results not only for the patient information but also for their medical images in standardised formats such as DICOM and DICOM-SR. As a result, we obtain a CADe system which helps in detecting breast cancer using mammograms and is completely integrated into an EHR. PMID:24151586

  20. Clinical Research Informatics and Electronic Health Record Data

    PubMed Central

    Horvath, M. M.; Rusincovitch, S. A.

    2014-01-01

    Summary Objectives The goal of this survey is to discuss the impact of the growing availability of electronic health record (EHR) data on the evolving field of Clinical Research Informatics (CRI), which is the union of biomedical research and informatics. Results Major challenges for the use of EHR-derived data for research include the lack of standard methods for ensuring that data quality, completeness, and provenance are sufficient to assess the appropriateness of its use for research. Areas that need continued emphasis include methods for integrating data from heterogeneous sources, guidelines (including explicit phenotype definitions) for using these data in both pragmatic clinical trials and observational investigations, strong data governance to better understand and control quality of enterprise data, and promotion of national standards for representing and using clinical data. Conclusions The use of EHR data has become a priority in CRI. Awareness of underlying clinical data collection processes will be essential in order to leverage these data for clinical research and patient care, and will require multi-disciplinary teams representing clinical research, informatics, and healthcare operations. Considerations for the use of EHR data provide a starting point for practical applications and a CRI research agenda, which will be facilitated by CRI’s key role in the infrastructure of a learning healthcare system. PMID:25123746

  1. An electronic health record-enabled obesity database

    PubMed Central

    2012-01-01

    Background The effectiveness of weight loss therapies is commonly measured using body mass index and other obesity-related variables. Although these data are often stored in electronic health records (EHRs) and potentially very accessible, few studies on obesity and weight loss have used data derived from EHRs. We developed processes for obtaining data from the EHR in order to construct a database on patients undergoing Roux-en-Y gastric bypass (RYGB) surgery. Methods Clinical data obtained as part of standard of care in a bariatric surgery program at an integrated health delivery system were extracted from the EHR and deposited into a data warehouse. Data files were extracted, cleaned, and stored in research datasets. To illustrate the utility of the data, Kaplan-Meier analysis was used to estimate length of post-operative follow-up. Results Demographic, laboratory, medication, co-morbidity, and survey data were obtained from 2028 patients who had undergone RYGB at the same institution since 2004. Pre-and post-operative diagnostic and prescribing information were available on all patients, while survey laboratory data were available on a majority of patients. The number of patients with post-operative laboratory test results varied by test. Based on Kaplan-Meier estimates, over 74% of patients had post-operative weight data available at 4 years. Conclusion A variety of EHR-derived data related to obesity can be efficiently obtained and used to study important outcomes following RYGB. PMID:22640398

  2. Using Electronic Health Record Systems in Diabetes Care: Emerging Practices

    PubMed Central

    Veinot, Tiffany C.; Zheng, Kai; Lowery, Julie C.; Souden, Maria; Keith, Rosalind

    2013-01-01

    While there has been considerable attention devoted to the deployment of electronic health record (EHR) systems, there has been far less attention given to their appropriation for use in clinical encounters — particularly in the context of complex, chronic illness. The Department of Veterans’ Affairs (VA) has been at the forefront of EHR adoption and, as such, provides a unique opportunity to examine a mature EHR system in widespread use. Moreover, with a high prevalence of diabetes in its patient population, the VA provides a useful platform for examining EHR use in the context of chronic disease care. We conducted a sequential, exploratory qualitative study at two VA Medical Centers in the Midwest. First, we conducted observations of 64 clinical consultations with diabetes patients. These observations involved 31 different health care providers. Second, using insights from these observations, we conducted in-depth, semi-structured interviews with 39 health care providers focusing on their use of information in diabetes patient care. Field notes and interview transcripts were analyzed using a grounded theory approach. Our analysis generated several categories of EHR use in clinical encounters: priming, structuring, assessing, informing, and continuing. We also outline some mismatches between EHR system design and VA diabetes care practices. We conclude by discussing implications of these emergent system uses for improving the software design of EHRs to better support chronic disease care, as well as for our understanding of the integration of technologies in health care. PMID:25264545

  3. Measuring Nursing Value from the Electronic Health Record.

    PubMed

    Welton, John M; Harper, Ellen M

    2016-01-01

    We report the findings of a big data nursing value expert group made up of 14 members of the nursing informatics, leadership, academic and research communities within the United States tasked with 1. Defining nursing value, 2. Developing a common data model and metrics for nursing care value, and 3. Developing nursing business intelligence tools using the nursing value data set. This work is a component of the Big Data and Nursing Knowledge Development conference series sponsored by the University Of Minnesota School Of Nursing. The panel met by conference calls for fourteen 1.5 hour sessions for a total of 21 total hours of interaction from August 2014 through May 2015. Primary deliverables from the bit data expert group were: development and publication of definitions and metrics for nursing value; construction of a common data model to extract key data from electronic health records; and measures of nursing costs and finance to provide a basis for developing nursing business intelligence and analysis systems. PMID:27332163

  4. Information Discovery on Electronic Health Records Using Authority Flow Techniques

    PubMed Central

    2010-01-01

    Background As the use of electronic health records (EHRs) becomes more widespread, so does the need to search and provide effective information discovery within them. Querying by keyword has emerged as one of the most effective paradigms for searching. Most work in this area is based on traditional Information Retrieval (IR) techniques, where each document is compared individually against the query. We compare the effectiveness of two fundamentally different techniques for keyword search of EHRs. Methods We built two ranking systems. The traditional BM25 system exploits the EHRs' content without regard to association among entities within. The Clinical ObjectRank (CO) system exploits the entities' associations in EHRs using an authority-flow algorithm to discover the most relevant entities. BM25 and CO were deployed on an EHR dataset of the cardiovascular division of Miami Children's Hospital. Using sequences of keywords as queries, sensitivity and specificity were measured by two physicians for a set of 11 queries related to congenital cardiac disease. Results Our pilot evaluation showed that CO outperforms BM25 in terms of sensitivity (65% vs. 38%) by 71% on average, while maintaining the specificity (64% vs. 61%). The evaluation was done by two physicians. Conclusions Authority-flow techniques can greatly improve the detection of relevant information in EHRs and hence deserve further study. PMID:20969780

  5. First steps towards semantic descriptions of electronic laboratory notebook records

    PubMed Central

    2013-01-01

    In order to exploit the vast body of currently inaccessible chemical information held in Electronic Laboratory Notebooks (ELNs) it is necessary not only to make it available but also to develop protocols for discovery, access and ultimately automatic processing. An aim of the Dial-a-Molecule Grand Challenge Network is to be able to draw on the body of accumulated chemical knowledge in order to predict or optimize the outcome of reactions. Accordingly the Network drew up a working group comprising informaticians, software developers and stakeholders from industry and academia to develop protocols and mechanisms to access and process ELN records. The work presented here constitutes the first stage of this process by proposing a tiered metadata system of knowledge, information and processing where each in turn addresses a) discovery, indexing and citation b) context and access to additional information and c) content access and manipulation. A compact set of metadata terms, called the elnItemManifest, has been derived and caters for the knowledge layer of this model. The elnItemManifest has been encoded as an XML schema and some use cases are presented to demonstrate the potential of this approach. PMID:24360292

  6. Public trust and privacy in shared electronic health records.

    PubMed

    Rynning, Elisabeth

    2007-07-01

    The development of information and communication technology in health care, also called eHealth, is expected to improve patient safety and facilitate more efficient use of limited resources. The introduction of electronic health records (EHRs) can make possible immediate, even automatic transfer of patient data, for health care as well as other purposes, across any kind of institutional, regional or national border. Data can thus be shared and used more effectively for quality assurance, disease surveillance, public health monitoring and research. eHealth may also facilitate patient access to health information and medical treatment, and is seen as an effective tool for patient empowerment. At the same time, eHealth solutions may jeopardize both patient safety and patients' rights, unless carefully designed and used with discretion. The success of EHR systems will depend on public trust in their compatibility with fundamental rights, such as privacy and confidentiality. Shared European EHR systems require interoperability not only with regard to technological and semantic standards, but also concerning legal, social and cultural aspects. Since the area of privacy and medical confidentiality is far from harmonized across Europe, we are faced with a diversity that will make fully shared EHR systems a considerable challenge.

  7. A critical pathway for electronic medical record selection.

    PubMed

    Holbrook, A; Keshavjee, K; Langton, K; Troyan, S; Millar, S; Olantunji, S; Pray, M; Tytus, R; Ford, P T

    2001-01-01

    Electronic medical records (EMRs) are increasingly becoming a necessary tool in health care. Given their potential to influence every aspect of health care, there has been surprisingly little rigorous research applied to this important piece of emerging health technology. An initial phase of the COMPETE study, which is examining the impact of EMRs on efficiency, quality of care and privacy concerns, involved a rigorous "critical pathway" approach to EMR selection for the study. A multidisciplinary team with clinical, technical and research expertise led an 8-stage evaluation process with direct input from user physicians at each stage. An iterative sequence of review of EMR specifications and features, live product demonstrations, site visits, and negotiations with vendors led to a progressive narrowing of the field of eligible EMR systems. Final scoring was based on 3 main themes of clinical usability, data quality and support/vendor issues. We believe that a rigorous, multidisciplinary process such as this is required to maximize success of any EMR implementation project.

  8. Benefits and drawbacks of electronic health record systems

    PubMed Central

    Menachemi, Nir; Collum, Taleah H

    2011-01-01

    The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 that was signed into law as part of the “stimulus package” represents the largest US initiative to date that is designed to encourage widespread use of electronic health records (EHRs). In light of the changes anticipated from this policy initiative, the purpose of this paper is to review and summarize the literature on the benefits and drawbacks of EHR systems. Much of the literature has focused on key EHR functionalities, including clinical decision support systems, computerized order entry systems, and health information exchange. Our paper describes the potential benefits of EHRs that include clinical outcomes (eg, improved quality, reduced medical errors), organizational outcomes (eg, financial and operational benefits), and societal outcomes (eg, improved ability to conduct research, improved population health, reduced costs). Despite these benefits, studies in the literature highlight drawbacks associated with EHRs, which include the high upfront acquisition costs, ongoing maintenance costs, and disruptions to workflows that contribute to temporary losses in productivity that are the result of learning a new system. Moreover, EHRs are associated with potential perceived privacy concerns among patients, which are further addressed legislatively in the HITECH Act. Overall, experts and policymakers believe that significant benefits to patients and society can be realized when EHRs are widely adopted and used in a “meaningful” way. PMID:22312227

  9. CADe system integrated within the electronic health record.

    PubMed

    Vállez, Noelia; Bueno, Gloria; Déniz, Óscar; Fernández, María del Milagro; Pastor, Carlos; Rienda, Miguel Ángel; Esteve, Pablo; Arias, María

    2013-01-01

    The latest technological advances and information support systems for clinics and hospitals produce a wide range of possibilities in the storage and retrieval of an ever-growing amount of clinical information as well as in detection and diagnosis. In this work, an Electronic Health Record (EHR) combined with a Computer Aided Detection (CADe) system for breast cancer diagnosis has been implemented. Our objective is to provide to radiologists a comprehensive working environment that facilitates the integration, the image visualization, and the use of aided tools within the EHR. For this reason, a development methodology based on hardware and software system features in addition to system requirements must be present during the whole development process. This will lead to a complete environment for displaying, editing, and reporting results not only for the patient information but also for their medical images in standardised formats such as DICOM and DICOM-SR. As a result, we obtain a CADe system which helps in detecting breast cancer using mammograms and is completely integrated into an EHR.

  10. Electronic Personal Health Record Use Among Nurses in the Nursing Informatics Community.

    PubMed

    Gartrell, Kyungsook; Trinkoff, Alison M; Storr, Carla L; Wilson, Marisa L

    2015-07-01

    An electronic personal health record is a patient-centric tool that enables patients to securely access, manage, and share their health information with healthcare providers. It is presumed the nursing informatics community would be early adopters of electronic personal health record, yet no studies have been identified that examine the personal adoption of electronic personal health record's for their own healthcare. For this study, we sampled nurse members of the American Medical Informatics Association and the Healthcare Information and Management Systems Society with 183 responding. Multiple logistic regression analysis was used to identify those factors associated with electronic personal health record use. Overall, 72% were electronic personal health record users. Users tended to be older (aged >50 years), be more highly educated (72% master's or doctoral degrees), and hold positions as clinical informatics specialists or chief nursing informatics officers. Those whose healthcare providers used electronic health records were significantly more likely to use electronic personal health records (odds ratio, 5.99; 95% confidence interval, 1.40-25.61). Electronic personal health record users were significantly less concerned about privacy of health information online than nonusers (odds ratio, 0.32; 95% confidence interval, 0.14-0.70) adjusted for ethnicity, race, and practice region. Informatics nurses, with their patient-centered view of technology, are in prime position to influence development of electronic personal health records. Our findings can inform policy efforts to encourage informatics and other professional nursing groups to become leaders and users of electronic personal health record; such use could help them endorse and engage patients to use electronic personal health records. Having champions with expertise in and enthusiasm for the new technology can promote the adoptionof electronic personal health records among healthcare providers as well as

  11. Electronic Personal Health Record Use Among Nurses in the Nursing Informatics Community.

    PubMed

    Gartrell, Kyungsook; Trinkoff, Alison M; Storr, Carla L; Wilson, Marisa L

    2015-07-01

    An electronic personal health record is a patient-centric tool that enables patients to securely access, manage, and share their health information with healthcare providers. It is presumed the nursing informatics community would be early adopters of electronic personal health record, yet no studies have been identified that examine the personal adoption of electronic personal health record's for their own healthcare. For this study, we sampled nurse members of the American Medical Informatics Association and the Healthcare Information and Management Systems Society with 183 responding. Multiple logistic regression analysis was used to identify those factors associated with electronic personal health record use. Overall, 72% were electronic personal health record users. Users tended to be older (aged >50 years), be more highly educated (72% master's or doctoral degrees), and hold positions as clinical informatics specialists or chief nursing informatics officers. Those whose healthcare providers used electronic health records were significantly more likely to use electronic personal health records (odds ratio, 5.99; 95% confidence interval, 1.40-25.61). Electronic personal health record users were significantly less concerned about privacy of health information online than nonusers (odds ratio, 0.32; 95% confidence interval, 0.14-0.70) adjusted for ethnicity, race, and practice region. Informatics nurses, with their patient-centered view of technology, are in prime position to influence development of electronic personal health records. Our findings can inform policy efforts to encourage informatics and other professional nursing groups to become leaders and users of electronic personal health record; such use could help them endorse and engage patients to use electronic personal health records. Having champions with expertise in and enthusiasm for the new technology can promote the adoptionof electronic personal health records among healthcare providers as well as

  12. Optical Trajectories and the Informational Basis of Fly Ball Catching

    ERIC Educational Resources Information Center

    Marken, Richard S.

    2005-01-01

    D. M. Shaffer and M. K. McBeath (see record 2002-02027-006) plotted the optical trajectories of uncatchable fly balls and concluded that linear optical trajectory is the informational basis of the actions taken to catch these balls. P. McLeod, N. Reed, and Z. Dienes (see record 2002-11140-016) replotted these trajectories in terms of changes in…

  13. Osteoporosis guideline implementation in family medicine using electronic medical records

    PubMed Central

    Pritchard, Janet; Karampatos, Sarah; Ioannidis, George; Adachi, Jonathan; Thabane, Lehana; Nash, Lynn; Mehan, Upe; Kozak, Joseph; Feldman, Sid; Hirsch, Steve; Jovaisas, Algis V.; Cheung, Angela; Lohfeld, Lynne; Papaioannou, Alexandra

    2016-01-01

    Abstract Objective To identify family physicians’ learning needs related to osteoporosis care; determine family physicians’ preferred modes of learning; and identify barriers to using electronic medical records (EMRs) to implement osteoporosis guidelines in practice. Design Web-based survey. Setting Ontario. Participants Family physicians. Main outcome measures Quantitative and qualitative data about learning needs related to osteoporosis diagnosis and management; preferred mode of learning about guidelines; and barriers to using EMRs to implement guidelines. Results Of the 12 332 family physicians invited to participate in the survey, 8.5% and 7.0% provided partial or fully completed surveys, respectively. More than 80% of respondents agreed that the priority areas for education were as follows: selecting laboratory tests for secondary osteoporosis and interpreting the test results; interpreting bone mineral density results; determining appropriate circumstances for ordering anterior-posterior lumbar spine x-ray scans; and understanding duration, types, and adverse effects of pharmacotherapy. Qualitative analysis revealed that managing moderate-risk patients was a learning need. Continuing medical education was the preferred mode of learning. Approximately 80% of respondents agreed that the scarcity of EMR tools to aid in guideline implementation was a barrier to using guidelines, and 50% of respondents agreed that if EMR-embedded tools were available, time would limit their ability to use them. Conclusion This survey identified key diagnostic- and treatment-related topics in osteoporosis care that should be the focus of future continuing professional development for family physicians. Developers of EMR tools, physicians, and researchers aiming to implement guidelines to improve osteoporosis care should consider the potential barriers indicated in this study.

  14. Anonymization of DICOM electronic medical records for radiation therapy.

    PubMed

    Newhauser, Wayne; Jones, Timothy; Swerdloff, Stuart; Newhauser, Warren; Cilia, Mark; Carver, Robert; Halloran, Andy; Zhang, Rui

    2014-10-01

    Electronic medical records (EMR) and treatment plans are used in research on patient outcomes and radiation effects. In many situations researchers must remove protected health information (PHI) from EMRs. The literature contains several studies describing the anonymization of generic Digital Imaging and Communication in Medicine (DICOM) files and DICOM image sets but no publications were found that discuss the anonymization of DICOM radiation therapy plans, a key component of an EMR in a cancer clinic. In addition to this we were unable to find a commercial software tool that met the minimum requirements for anonymization and preservation of data integrity for radiation therapy research. The purpose of this study was to develop a prototype software code to meet the requirements for the anonymization of radiation therapy treatment plans and to develop a way to validate that code and demonstrate that it properly anonymized treatment plans and preserved data integrity. We extended an open-source code to process all relevant PHI and to allow for the automatic anonymization of multiple EMRs. The prototype code successfully anonymized multiple treatment plans in less than 1min/patient. We also tested commercial optical character recognition (OCR) algorithms for the detection of burned-in text on the images, but they were unable to reliably recognize text. In addition, we developed and tested an image filtering algorithm that allowed us to isolate and redact alpha-numeric text from a test radiograph. Validation tests verified that PHI was anonymized and data integrity, such as the relationship between DICOM unique identifiers (UID) was preserved. PMID:25147130

  15. Physicians, Patients, and the Electronic Health Record: An Ethnographic Analysis

    PubMed Central

    Ventres, William; Kooienga, Sarah; Vuckovic, Nancy; Marlin, Ryan; Nygren, Peggy; Stewart, Valerie

    2006-01-01

    PURPOSE Little is known about the effects of the electronic health record (EHR) on physician-patient encounters. The objectives of this study were to identify the factors that influence the manner by which physicians use the EHR with patients. METHODS This ethnographic study included 4 qualitative components: 80 hours of participant observation in 4 primary care offices in the Pacific Northwest; individual interviews with 52 patients, 12 office staff members, 23 physicians, and 1 nurse-practitioner; videotaped reviews of 29 clinical encounters; and 5 focus-group interviews with physicians and computer advocates. The main outcome measures were factors that influence how physicians use the EHR. Researchers qualitatively derived these factors through serial reviews of data. RESULTS This study identified 14 factors that influence how EHRs are used and perceived in medical practice today. These factors were categorized into 4 thematic domains: (1) spatial—effect of the physical presence and location of EHRs on interactions between physicians and patients; (2) relational—perceptions of physicians and patients about the EHR and how those perceptions affected its use; (3) educational—issues of developing physicians’ proficiency with and improving patients’ understandings about EHR use; and (4) structural—institutional and technological forces that influence how physicians perceived their use of EHR. CONCLUSIONS This study found that the introduction of EHRs into practice influences multiple cognitive and social dimensions of the clinical encounter. It brings into focus important questions that through further inquiry can determine how to make best use of the EHR to enhance therapeutic relationships. PMID:16569715

  16. Factors in medical student beliefs about electronic health record use.

    PubMed

    Harle, Christopher A; Gruber, Laura A; Dewar, Marvin A

    2014-01-01

    Healthcare providers' ongoing investment in electronic health records (EHRs) necessitates an understanding of physicians' expectations about using EHRs. Such understanding may aid educators and administrators when utilizing scarce resources during EHR training and implementation activities. This study aimed to link individual medical student characteristics to their perceptions of EHRs' ease of use and usefulness. This study employed a cross-sectional survey of 126 third-year medical students at a large southeastern university. Using a questionnaire designed for this study and containing previously validated items, the study team measured and related students' expectations about EHR ease of use and usefulness to their computer self-efficacy, openness to change, personality traits, and demographic characteristics. On a seven-point scale, men reported, on average, ease-of-use scores that were 0.71 higher than women's (p < .001). Also, increased computer self-efficacy related to higher expectations of EHR ease of use (p < .01) and usefulness (p < .05). Openness-to-change scores were also associated with higher expectations of EHR ease of use (p < .01) and usefulness (p < .001). Finally, a more conscientious personality was positively associated with EHR ease of use (p < .01). Our findings suggest that medical educators and administrators may consider targeting EHR management strategies on the basis of individual differences. Enhanced training and support interventions may be helpful to women or to clinicians with lower computer self-efficacy, lower openness to change, or less conscientious personalities. Also, current and future physicians who rate higher in terms of self-efficacy, openness to change, or conscientiousness may be useful as champions of EHR use among their peers.

  17. Chapter 13: Mining Electronic Health Records in the Genomics Era

    PubMed Central

    Denny, Joshua C.

    2012-01-01

    Abstract: The combination of improved genomic analysis methods, decreasing genotyping costs, and increasing computing resources has led to an explosion of clinical genomic knowledge in the last decade. Similarly, healthcare systems are increasingly adopting robust electronic health record (EHR) systems that not only can improve health care, but also contain a vast repository of disease and treatment data that could be mined for genomic research. Indeed, institutions are creating EHR-linked DNA biobanks to enable genomic and pharmacogenomic research, using EHR data for phenotypic information. However, EHRs are designed primarily for clinical care, not research, so reuse of clinical EHR data for research purposes can be challenging. Difficulties in use of EHR data include: data availability, missing data, incorrect data, and vast quantities of unstructured narrative text data. Structured information includes billing codes, most laboratory reports, and other variables such as physiologic measurements and demographic information. Significant information, however, remains locked within EHR narrative text documents, including clinical notes and certain categories of test results, such as pathology and radiology reports. For relatively rare observations, combinations of simple free-text searches and billing codes may prove adequate when followed by manual chart review. However, to extract the large cohorts necessary for genome-wide association studies, natural language processing methods to process narrative text data may be needed. Combinations of structured and unstructured textual data can be mined to generate high-validity collections of cases and controls for a given condition. Once high-quality cases and controls are identified, EHR-derived cases can be used for genomic discovery and validation. Since EHR data includes a broad sampling of clinically-relevant phenotypic information, it may enable multiple genomic investigations upon a single set of genotyped

  18. Interactions between finfish aquaculture and lobster catches in a sheltered bay.

    PubMed

    Loucks, Ronald H; Smith, Ruth E; Fisher, E Brian

    2014-11-15

    Interactions between open-net pen finfish aquaculture and lobster catches in a sheltered bay in Nova Scotia, Canada, were investigated using fishermen's participatory research in annual lobster trap surveys over seven years. Fishermen recorded lobster catches during the last two weeks of May from 2007 to 2013. Catches for each trap haul were recorded separately for ovigerous and market-sized lobsters. Catch trends within the bay were compared to regional trends. Results of correlation analyses indicated that ovigerous catch trends were strongly affected by the fish farm's feeding/fallow periods. There was no significant correlation between trends for bay and LFA lobster landings. Patterns of lobster catch per unit effort extending over considerable distance in Port Mouton Bay appear to be influenced by proximity to the fish farm regardless of year-to-year variation in water temperatures and weather conditions. Odours and habitat changes surrounding open-net pen finfish operations are potential factors affecting lobster displacement.

  19. Interactions between finfish aquaculture and lobster catches in a sheltered bay.

    PubMed

    Loucks, Ronald H; Smith, Ruth E; Fisher, E Brian

    2014-11-15

    Interactions between open-net pen finfish aquaculture and lobster catches in a sheltered bay in Nova Scotia, Canada, were investigated using fishermen's participatory research in annual lobster trap surveys over seven years. Fishermen recorded lobster catches during the last two weeks of May from 2007 to 2013. Catches for each trap haul were recorded separately for ovigerous and market-sized lobsters. Catch trends within the bay were compared to regional trends. Results of correlation analyses indicated that ovigerous catch trends were strongly affected by the fish farm's feeding/fallow periods. There was no significant correlation between trends for bay and LFA lobster landings. Patterns of lobster catch per unit effort extending over considerable distance in Port Mouton Bay appear to be influenced by proximity to the fish farm regardless of year-to-year variation in water temperatures and weather conditions. Odours and habitat changes surrounding open-net pen finfish operations are potential factors affecting lobster displacement. PMID:25242235

  20. "Catch a Star !"

    NASA Astrophysics Data System (ADS)

    2002-05-01

    ESO and EAAE Launch Web-based Educational Programme for Europe's Schools Catch a star!... and discover all its secrets! This is the full title of an innovative educational project, launched today by the European Southern Observatory (ESO) and the European Association for Astronomy Education (EAAE). It welcomes all students in Europe's schools to an exciting web-based programme with a competition. It takes place within the context of the EC-sponsored European Week of Science and Technology (EWST) - 2002 . This unique project revolves around a web-based competition and is centred on astronomy. It is specifically conceived to stimulate the interest of young people in various aspects of this well-known field of science, but will also be of interest to the broad public. What is "Catch a Star!" about? [Go to Catch a Star Website] The programme features useful components from the world of research, but it is specifically tailored to (high-)school students. Younger participants are also welcome. Groups of up to four persons (e.g., three students and one teacher) have to select an astronomical object - a bright star, a distant galaxy, a beautiful comet, a planet or a moon in the solar system, or some other celestial body. Like detectives, they must then endeavour to find as much information as possible about "their" object. This information may be about the position and visibility in the sky, the physical and chemical characteristics, particular historical aspects, related mythology and sky lore, etc. They can use any source available, the web, books, newspaper and magazine articles, CDs etc. for this work. The group members must prepare a (short) summarising report about this investigation and "their" object, with their own ideas and conclusions, and send it to ESO (email address: eduinfo@eso.org). A jury, consisting of specialists from ESO and the EAAE, will carefully evaluate these reports. All projects that are found to fulfill the stipulated requirements, including a

  1. Perfusion Electronic Record Documentation Using Epic Systems Software.

    PubMed

    Riley, Jeffrey B; Justison, George A

    2015-12-01

    The authors comment on Steffens and Gunser's article describing the University of Wisconsin adoption of the Epic anesthesia record to include perfusion information from the cardiopulmonary bypass patient experience. We highlight the current-day lessons and the valuable quality and safety principles the Wisconsin-Epic model anesthesia-perfusion record provides.

  2. Toward Developing a Framework of Cost Elements for Preserving Authentic Electronic Records into Perpetuity.

    ERIC Educational Resources Information Center

    Sanett, Shelby

    2002-01-01

    Proposes that a cost model specific to preserving authentic electronic records be developed. Topics include financial challenges of processes involved in preserving electronic records; financial management tools to support the decision-making processes that archives and libraries use; digital resources and data types; and baseline requirements…

  3. 29 CFR 2520.107-1 - Use of electronic media for maintenance and retention of records.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Use of electronic media for maintenance and retention of....107-1 Use of electronic media for maintenance and retention of records. (a) Scope and purpose... media for the maintenance and retention of records required to be kept under sections 107 and 209...

  4. 29 CFR 2520.107-1 - Use of electronic media for maintenance and retention of records.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Use of electronic media for maintenance and retention of....107-1 Use of electronic media for maintenance and retention of records. (a) Scope and purpose... media for the maintenance and retention of records required to be kept under sections 107 and 209...

  5. 29 CFR 2520.107-1 - Use of electronic media for maintenance and retention of records.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Use of electronic media for maintenance and retention of....107-1 Use of electronic media for maintenance and retention of records. (a) Scope and purpose... media for the maintenance and retention of records required to be kept under sections 107 and 209...

  6. 29 CFR 2520.107-1 - Use of electronic media for maintenance and retention of records.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Use of electronic media for maintenance and retention of....107-1 Use of electronic media for maintenance and retention of records. (a) Scope and purpose... media for the maintenance and retention of records required to be kept under sections 107 and 209...

  7. 29 CFR 2520.107-1 - Use of electronic media for maintenance and retention of records.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Use of electronic media for maintenance and retention of....107-1 Use of electronic media for maintenance and retention of records. (a) Scope and purpose... media for the maintenance and retention of records required to be kept under sections 107 and 209...

  8. 36 CFR 1235.48 - What documentation must agencies transfer with electronic records?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... NARA Form 14097, Technical Description for Transfer of Electronic Records, for magnetic tape media, and... 11, 1994 (3 CFR, 1995 Comp., p. 882) (Federal geographic data standards are available at http://www... documentation for the following types of electronic records: (i) E-mail messages with attachments; (ii)...

  9. Impact of an electronic medication administration record on medication administration efficiency and errors.

    PubMed

    McComas, Jeffery; Riingen, Michelle; Chae Kim, Son

    2014-12-01

    The study aims were to evaluate the impact of electronic medication administration record implementation on medication administration efficiency and occurrence of medication errors as well as to identify the predictors of medication administration efficiency in an acute care setting. A prospective, observational study utilizing time-and-motion technique was conducted before and after electronic medication administration record implementation in November 2011. A total of 156 cases of medication administration activities (78 pre- and 78 post-electronic medication administration record) involving 38 nurses were observed at the point of care. A separate retrospective review of the hospital Midas+ medication error database was also performed to collect the rates and origin of medication errors for 6 months before and after electronic medication administration record implementation. The mean medication administration time actually increased from 11.3 to 14.4 minutes post-electronic medication administration record (P = .039). In a multivariate analysis, electronic medication administration record was not a predictor of medication administration time, but the distractions/interruptions during medication administration process were significant predictors. The mean hospital-wide medication errors significantly decreased from 11.0 to 5.3 events per month post-electronic medication administration record (P = .034). Although no improvement in medication administration efficiency was observed, electronic medication administration record improved the quality of care with a significant decrease in medication errors.

  10. Electronic health records in an occupational health setting-Part II. Global deployment.

    PubMed

    Bey, Jean M; de Magalhães, Josiane S; Bojórquez, Lorena; Lin, Karen

    2013-03-01

    Electronic medical record systems are being used by more multi-national corporations. This article describes one corporation's considerations and process in successfully deploying a global electronic medical record system to international facilities in Brazil, Mexico, Singapore, and Taiwan. This article summarizes feedback from the experiences of occupational health nurse superusers in these countries. PMID:23452128

  11. Electronic health records in an occupational health setting-Part II. Global deployment.

    PubMed

    Bey, Jean M; de Magalhães, Josiane S; Bojórquez, Lorena; Lin, Karen

    2013-03-01

    Electronic medical record systems are being used by more multi-national corporations. This article describes one corporation's considerations and process in successfully deploying a global electronic medical record system to international facilities in Brazil, Mexico, Singapore, and Taiwan. This article summarizes feedback from the experiences of occupational health nurse superusers in these countries.

  12. Healthcare risk management challenges created by federal regulation of electronic medical records and care management.

    PubMed

    Hofert, James; Bossen, Roy; Schramm, Linnea; Dowell, Michael

    2013-01-01

    Health information technology (HIT) continues to evolve at an ever accelerating pace. Recent federal legislation has encouraged the widespread adoption of electronic record systems in the healthcare environment.(1) The federal government recognizes that advanced electronic health record (EHR) systems with clinical decision support (CDS) functionalities have the potential to offer numerous benefits to the quality of patient care.(2.)

  13. Ethical, legal, and social implications of incorporating genomic information into electronic health records

    PubMed Central

    Hazin, Ribhi; Brothers, Kyle B.; Malin, Bradley A.; Koenig, Barbara A.; Sanderson, Saskia C.; Rothstein, Mark A.; Williams, Marc S.; Clayton, Ellen W.; Kullo, Iftikhar J.

    2014-01-01

    The inclusion of genomic data in the electronic health record raises important ethical, legal, and social issues. In this article, we highlight these challenges and discuss potential solutions. We provide a brief background on the current state of electronic health records in the context of genomic medicine, discuss the importance of equitable access to genome-enabled electronic health records, and consider the potential use of electronic health records for improving genomic literacy in patients and providers. We highlight the importance of privacy, access, and security, and of determining which genomic information is included in the electronic health record. Finally, we discuss the challenges of reporting incidental findings, storing and reinterpreting genomic data, and nondocumentation and duty to warn family members at potential genetic risk. PMID:24030434

  14. Ethical, legal, and social implications of incorporating genomic information into electronic health records.

    PubMed

    Hazin, Ribhi; Brothers, Kyle B; Malin, Bradley A; Koenig, Barbara A; Sanderson, Saskia C; Rothstein, Mark A; Williams, Marc S; Clayton, Ellen W; Kullo, Iftikhar J

    2013-10-01

    The inclusion of genomic data in the electronic health record raises important ethical, legal, and social issues. In this article, we highlight these challenges and discuss potential solutions. We provide a brief background on the current state of electronic health records in the context of genomic medicine, discuss the importance of equitable access to genome-enabled electronic health records, and consider the potential use of electronic health records for improving genomic literacy in patients and providers. We highlight the importance of privacy, access, and security, and of determining which genomic information is included in the electronic health record. Finally, we discuss the challenges of reporting incidental findings, storing and reinterpreting genomic data, and nondocumentation and duty to warn family members at potential genetic risk.

  15. Estimating historical eastern North Pacific blue whale catches using spatial calling patterns.

    PubMed

    Monnahan, Cole C; Branch, Trevor A; Stafford, Kathleen M; Ivashchenko, Yulia V; Oleson, Erin M

    2014-01-01

    Blue whales (Balaenoptera musculus) were exploited extensively around the world and remain endangered. In the North Pacific their population structure is unclear and current status unknown, with the exception of a well-studied eastern North Pacific (ENP) population. Despite existing abundance estimates for the ENP population, it is difficult to estimate pre-exploitation abundance levels and gauge their recovery because historical catches of the ENP population are difficult to separate from catches of other populations in the North Pacific. We collated previously unreported Soviet catches and combined these with known catches to form the most current estimates of North Pacific blue whale catches. We split these conflated catches using recorded acoustic calls from throughout the North Pacific, the knowledge that the ENP population produces a different call than blue whales in the western North Pacific (WNP). The catches were split by estimating spatiotemporal occurrence of blue whales with generalized additive models fitted to acoustic call patterns, which predict the probability a catch belonged to the ENP population based on the proportion of calls of each population recorded by latitude, longitude, and month. When applied to the conflated historical catches, which totaled 9,773, we estimate that ENP blue whale catches totaled 3,411 (95% range 2,593 to 4,114) from 1905-1971, and amounted to 35% (95% range 27% to 42%) of all catches in the North Pacific. Thus most catches in the North Pacific were for WNP blue whales, totaling 6,362 (95% range 5,659 to 7,180). The uncertainty in the acoustic data influence the results substantially more than uncertainty in catch locations and dates, but the results are fairly insensitive to the ecological assumptions made in the analysis. The results of this study provide information for future studies investigating the recovery of these populations and the impact of continuing and future sources of anthropogenic mortality. PMID

  16. Estimating historical eastern North Pacific blue whale catches using spatial calling patterns.

    PubMed

    Monnahan, Cole C; Branch, Trevor A; Stafford, Kathleen M; Ivashchenko, Yulia V; Oleson, Erin M

    2014-01-01

    Blue whales (Balaenoptera musculus) were exploited extensively around the world and remain endangered. In the North Pacific their population structure is unclear and current status unknown, with the exception of a well-studied eastern North Pacific (ENP) population. Despite existing abundance estimates for the ENP population, it is difficult to estimate pre-exploitation abundance levels and gauge their recovery because historical catches of the ENP population are difficult to separate from catches of other populations in the North Pacific. We collated previously unreported Soviet catches and combined these with known catches to form the most current estimates of North Pacific blue whale catches. We split these conflated catches using recorded acoustic calls from throughout the North Pacific, the knowledge that the ENP population produces a different call than blue whales in the western North Pacific (WNP). The catches were split by estimating spatiotemporal occurrence of blue whales with generalized additive models fitted to acoustic call patterns, which predict the probability a catch belonged to the ENP population based on the proportion of calls of each population recorded by latitude, longitude, and month. When applied to the conflated historical catches, which totaled 9,773, we estimate that ENP blue whale catches totaled 3,411 (95% range 2,593 to 4,114) from 1905-1971, and amounted to 35% (95% range 27% to 42%) of all catches in the North Pacific. Thus most catches in the North Pacific were for WNP blue whales, totaling 6,362 (95% range 5,659 to 7,180). The uncertainty in the acoustic data influence the results substantially more than uncertainty in catch locations and dates, but the results are fairly insensitive to the ecological assumptions made in the analysis. The results of this study provide information for future studies investigating the recovery of these populations and the impact of continuing and future sources of anthropogenic mortality.

  17. Framework and Policy Recommendations for the Exchange and Preservation of Electronic Records.

    ERIC Educational Resources Information Center

    Law, Margaret H.; Rosen, Bruce K.

    The objectives of this project were to assist the National Archives and Records Administration (NARA) in developing a policy for the representation, transfer, access, and preservation of electronic records of permanent value. A lack of attention to the management, retention, and selective preservation of these machine-readable records will result…

  18. Linking human anatomy to knowledge bases: a visual front end for electronic medical records.

    PubMed

    Dickson, Stewart; Pouchard, Line; Ward, Richard; Atkins, Gary; Cole, Martin; Lorensen, Bill; Ade, Alexander

    2005-01-01

    A new concept of a visual electronic medical record is presented based on developments ongoing in the Defense Advanced Research Projects Agency Virtual Soldier Project. This new concept is based on the holographic medical electronic representation (Holomer) and on data formats being developed to support this. The Holomer is being developed in two different visualization environments, one of which is suitable for prototyping the visual electronic medical record. The advantages of a visual approach as a front end for electronic medical records are discussed and specific implementations are presented. PMID:15718802

  19. "Catch a Star !"

    NASA Astrophysics Data System (ADS)

    2002-05-01

    ESO and EAAE Launch Web-based Educational Programme for Europe's Schools Catch a star!... and discover all its secrets! This is the full title of an innovative educational project, launched today by the European Southern Observatory (ESO) and the European Association for Astronomy Education (EAAE). It welcomes all students in Europe's schools to an exciting web-based programme with a competition. It takes place within the context of the EC-sponsored European Week of Science and Technology (EWST) - 2002 . This unique project revolves around a web-based competition and is centred on astronomy. It is specifically conceived to stimulate the interest of young people in various aspects of this well-known field of science, but will also be of interest to the broad public. What is "Catch a Star!" about? [Go to Catch a Star Website] The programme features useful components from the world of research, but it is specifically tailored to (high-)school students. Younger participants are also welcome. Groups of up to four persons (e.g., three students and one teacher) have to select an astronomical object - a bright star, a distant galaxy, a beautiful comet, a planet or a moon in the solar system, or some other celestial body. Like detectives, they must then endeavour to find as much information as possible about "their" object. This information may be about the position and visibility in the sky, the physical and chemical characteristics, particular historical aspects, related mythology and sky lore, etc. They can use any source available, the web, books, newspaper and magazine articles, CDs etc. for this work. The group members must prepare a (short) summarising report about this investigation and "their" object, with their own ideas and conclusions, and send it to ESO (email address: eduinfo@eso.org). A jury, consisting of specialists from ESO and the EAAE, will carefully evaluate these reports. All projects that are found to fulfill the stipulated requirements, including a

  20. Electronic Health Record-Related Safety Concerns: A Cross-Sectional Survey of Electronic Health Record Users

    PubMed Central

    Pajunen, Tuuli; Saranto, Kaija; Lehtonen, Lasse

    2016-01-01

    Background The rapid expansion in the use of electronic health records (EHR) has increased the number of medical errors originating in health information systems (HIS). The sociotechnical approach helps in understanding risks in the development, implementation, and use of EHR and health information technology (HIT) while accounting for complex interactions of technology within the health care system. Objective This study addresses two important questions: (1) “which of the common EHR error types are associated with perceived high- and extreme-risk severity ratings among EHR users?”, and (2) “which variables are associated with high- and extreme-risk severity ratings?” Methods This study was a quantitative, non-experimental, descriptive study of EHR users. We conducted a cross-sectional web-based questionnaire study at the largest hospital district in Finland. Statistical tests included the reliability of the summative scales tested with Cronbach’s alpha. Logistic regression served to assess the association of the independent variables to each of the eight risk factors examined. Results A total of 2864 eligible respondents provided the final data. Almost half of the respondents reported a high level of risk related to the error type “extended EHR unavailability”. The lowest overall risk level was associated with “selecting incorrectly from a list of items”. In multivariate analyses, profession and clinical unit proved to be the strongest predictors for high perceived risk. Physicians perceived risk levels to be the highest (P<.001 in six of eight error types), while emergency departments, operating rooms, and procedure units were associated with higher perceived risk levels (P<.001 in four of eight error types). Previous participation in eLearning courses on EHR-use was associated with lower risk for some of the risk factors. Conclusions Based on a large number of Finnish EHR users in hospitals, this study indicates that HIT safety hazards should

  1. 50 CFR 660.18 - Certification and decertification procedures for catch monitors and catch monitor providers.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... procedures for catch monitors and catch monitor providers. 660.18 Section 660.18 Wildlife and Fisheries... and decertification procedures for catch monitors and catch monitor providers. (a) Certification official. The Regional Administrator (or a designee) will designate a NMFS catch monitor...

  2. The effect of electronic patient records on hepatitis B vaccination completion rates at a genitourinary medicine clinic.

    PubMed

    Kuria, Patrick; Brook, Gary; McSorley, John

    2016-05-01

    The study was conducted to assess whether the introduction of an electronic patient records-based system affected hepatitis B vaccination completion rates and post-vaccination return rates, when compared to a paper-based system. Data were gathered for three groups of patients: those commencing vaccination (a) when paper records were in use (paper records group), (b) after electronic patient records were introduced (basic electronic patient records group) and (c) after electronic patient records were enhanced with recall (enhanced electronic patient records group). Compared to the paper records group, the third dose completion rates for patients managed using electronic patient records did not differ significantly: 74/119 (62.2%) paper vs. 58/98 (59.2%) basic electronic patient records, p = 0.652 and 89/130 (68.5%) enhanced electronic patient records, p = 0.298. On sub-group analysis, completion rates in patients of black ethnicity in the enhanced electronic patient records group were significantly higher than those in the paper records group: 16/19 (84.2%) enhanced electronic patient records vs. 11/23 (47.8%) paper, p = 0.014. Patients in the enhanced electronic patient records group were more likely than those in the paper records group to attend for measurement of hepatitis B surface antibody levels: 61/130 (46.9%) vs. 39/119 (32.8%), p = 0.023.

  3. Validity of electronic diet recording nutrient estimates compared to dietitian analysis of diet records: A randomized controlled trial

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: Dietary intake assessment with diet records (DR) is a standard research and practice tool in nutrition. Manual entry and analysis of DR is time-consuming and expensive. New electronic tools for diet entry by clients and research participants may reduce the cost and effort of nutrient int...

  4. Sharing electronic medical records across multiple heterogeneous and competing institutions.

    PubMed Central

    Kohane, I. S.; van Wingerde, F. J.; Fackler, J. C.; Cimino, C.; Kilbridge, P.; Murphy, S.; Chueh, H.; Rind, D.; Safran, C.; Barnett, O.; Szolovits, P.

    1996-01-01

    Most early reports of implemented World-Wide Web (W3) medical record systems describe single institution architectures. We describe W3-EMRS, a multi-institutional architecture, and its implementation. Thorny problems in data sharing underlined by the W3-EMRS project are reviewed. PMID:8947738

  5. Electronic Record Systems and Individual Privacy. Federal Government Information Technology.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Office of Technology Assessment.

    This report considers the privacy issues raised by the growth of the new technology being applied to the personal information collected, maintained, and disseminated by the Federal Government. Four major areas are addressed: (1) technological developments relevant to government record systems; (2) current and prospective Federal agency use of…

  6. [An electronic medical record information system of DICOM-RT module-based in radiation therapy].

    PubMed

    Xia, Deguo; Zhou, Linghong; Lei, Li

    2012-06-01

    Electronic medical records (EMR) is the clinical diagnosis, guiding intervention and digital medical service record of outpatient, hospital patients (or care object) in medical institution. And it is the complete, detailed clinical information resource which has produced and recorded in all previous medical treatments. Radiotherapy electronic medical records contain texts, images and graphics, therefore the information is more complicated. This paper proposes an EMR information system based on DICOM-RT standard, through the use of seven objects of DICOM-RT to achieve the information exchange and sharing between different systems, equipments, convenient radiotherapy treatment data management, improve the efficiency of radiation treatment.

  7. An electronic device to record consensual reflex in human pupil.

    PubMed

    Pinheiro, H M; Costa, R M; Camilo, E N R; Gang, Hua

    2015-01-01

    Examination of the pupil offers an objective evaluation of visual function as well as the vegetative pathways to the eye. This work proposes the development of an effective method and a portable device to test the consensual pupillary reflex. The first results demonstrate the success of a new device construction and methodology to record the consensual reflex with different stimulus, in a situation of complete blockage of light.

  8. Fine-Grained Access Control for Electronic Health Record Systems

    NASA Astrophysics Data System (ADS)

    Hue, Pham Thi Bach; Wohlgemuth, Sven; Echizen, Isao; Thuy, Dong Thi Bich; Thuc, Nguyen Dinh

    There needs to be a strategy for securing the privacy of patients when exchanging health records between various entities over the Internet. Despite the fact that health care providers such as Google Health and Microsoft Corp.'s Health Vault comply with the U.S Health Insurance Portability and Accountability Act (HIPAA), the privacy of patients is still at risk. Several encryption schemes and access control mechanisms have been suggested to protect the disclosure of a patient's health record especially from unauthorized entities. However, by implementing these approaches, data owners are not capable of controlling and protecting the disclosure of the individual sensitive attributes of their health records. This raises the need to adopt a secure mechanism to protect personal information against unauthorized disclosure. Therefore, we propose a new Fine-grained Access Control (FGAC) mechanism that is based on subkeys, which would allow a data owner to further control the access to his data at the column-level. We also propose a new mechanism to efficiently reduce the number of keys maintained by a data owner in cases when the users have different access privileges to different columns of the data being shared.

  9. The visual guidance of catching.

    PubMed

    Savelsbergh, G J; Whiting, H T; Pijpers, J R; van Santvoord, A A

    1993-01-01

    In order to explore the nature and amount of information in the optic array used by subjects required to carry out one-handed catching actions, the optical expansion pattern (using a deflating ball) and the duration of viewing time (using liquid crystal spectacles) of the ball were varied. Subjects were required to catch luminous balls (two of constant physical size and one of changing physical size during approach) attached to a pendulum in a totally dark room, while the liquid spectacles were closed at 0, 100, 200 or 300 ms before hand-ball contact. The results confirmed previous findings that the timing of the catching action is based on retinal expansion information and that conclusion was strengthened when an additional dependent variable (time of the maximal opening velocity of the grasp) was used. Further, for the viewing time duration manipulations, the time of the maximal closing velocity of the hand was later, while no effect was found on the time of the maximal opening velocity, when the last 300 ms of the trajectory of the ball was occluded. Adjustments to the catching action in response to the different ball sizes under the 0 ms condition differed significantly from the adjustments under the 300 ms condition. Both findings point to the importance of relative optical expansion information, available between 300 and 200 ms before ball-hand contact, in maintaining a (relatively) continuous perception-action coupling in the act of catching.

  10. Correction of electronic record for weighing bucket precipitation gauge measurements

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Electronic sensors generate valuable streams of forcing and validation data for hydrologic models, but are often subject to noise, which must be removed as part of model input and testing database development. We developed Automated Precipitation Correction Program (APCP) for weighting bucket preci...

  11. Record High Power Terahertz Radiation from Relativistic Electrons

    SciTech Connect

    G.L. Carr; Michael C. Martin; Wayne R. McKinney; Kevin Jordan; George R. Neil; Gwyn P. Williams

    2002-03-01

    Calculations and measurements confirm the production of coherent broadband THz radiation from relativistic electrons with an average power of nearly 20 watts. The radiation has qualities closely analogous to the THz radiation produced by ultrafast laser techniques (spatially coherent, short duration pulses with transform-limited spectral content). But in contrast to conventional THz radiation, the intensity is many orders of magnitude greater due to a relativistic enhancement. The absorption and dispersive properties of materials in this spectral range provide contrast for a unique type of imaging [1,2]. The striking improvement in power reported here could revolutionize this application by allowing full-field, real-time image capture. High peak and average power THz sources are also critical in driving new non-linear phenomena with excellent signal to noise, and for pump-probe studies of dynamical properties of novel materials, both of which are central to future high-speed electronic devices [3,4]. It should also be useful for studies of molecular vibrations and rotations, low frequency protein motions, phonons, superconductor bandgaps, electronic scattering and collective electronic excitations (e.g., charge density waves).

  12. Cutaneous Recording and Stimulation of Muscles Using Organic Electronic Textiles.

    PubMed

    Papaiordanidou, Maria; Takamatsu, Seiichi; Rezaei-Mazinani, Shahab; Lonjaret, Thomas; Martin, Alain; Ismailova, Esma

    2016-08-01

    Electronic textiles are an emerging field providing novel and non-intrusive solutions for healthcare. Conducting polymer-coated textiles enable a new generation of fully organic surface electrodes for electrophysiological evaluations. Textile electrodes are able to assess high quality muscular monitoring and to perform transcutaneous electrical stimulation. PMID:27242014

  13. Hot electron pump: a plasmonic rectifying antenna (Presentation Recording)

    NASA Astrophysics Data System (ADS)

    Yanik, Ahmet A.; Hossain, Golam I.

    2015-09-01

    Plasmonic nanostructures have been widely explored to improve absorption efficiency of conventional solar cells, either by employing them as a light scatterer, or as a source of local field enhancement. Unavoidable ohmic loss associated with the plasmonic metal nanostructures in visible spectrum, limits the efficiency improvement of photovoltaic devices by employing this local photon density of states (LDOS) engineering approach. Instead of using plasmonic structures as efficiency improving layer, recently, there has been a growing interest in exploring plasmoinc nanoparticle as the active medium for photovoltaic device. By extracting hot electrons that are created in metallic nanoparticles in a non-radiative Landau decay of surface plasmons, many novel plasmonic photovoltaic devices have been proposed. Moreover, these hot electrons in metal nanoparticles promises high efficiency with a spectral response that is not limited by the band gap of the semiconductors (active material of conventional solar cell). In this work, we will show a novel photovoltaic configuration of plasmonic nanoparticle that acts as an antenna by capturing free space ultrahigh frequency electromagnetic wave and rectify them through an ultrafast hot electron pump and eventually inject DC current in the contact of the device. We will introduce a bottom-up quantum mechanical approach model to explain fundamental physical processes involved in this hot electron pump rectifying antenna and it's ultrafast dynamics. Our model is based on non-equilibrium Green's function formalism, a robust theoretical framework to investigate transport and design nanoscale electronic devices. We will demonstrate some fundamental limitations that go the very foundations of quantum mechanics.

  14. 50 CFR 660.17 - Catch monitors and catch monitor service providers. [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) FISHERIES OFF WEST COAST STATES West Coast Groundfish Fisheries § 660.17 Catch monitors and catch monitor service providers....

  15. Electronic Medical Record and Quality Ratings of Long Term Care Facilities Long-Term Care Facility Characteristics and Reasons and Barriers for Adoption of Electronic Medical Record

    ERIC Educational Resources Information Center

    Daniels, Cheryl Andrea

    2013-01-01

    With the growing elderly population, compounded by the retirement of the babyboomers, the need for long-term care (LTC) facilities is expected to grow. An area of great concern for those that are seeking a home for their family member is the quality of care provided by the nursing home to the residents. Electronic medical records (EMR) are often…

  16. 76 FR 40454 - Proposed Information Collection (VSO Access to VHA Electronic Health Records) Activity; Comment...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-08

    ... AFFAIRS Proposed Information Collection (VSO Access to VHA Electronic Health Records) Activity; Comment Request AGENCY: Veterans Health Administration, Department of Veterans Affairs. ACTION: Notice. SUMMARY: The Veterans Health Administration (VHA) is announcing an opportunity for public comment on...

  17. Record Storage Systems: From Paper Based Files to Electronic Image Systems.

    ERIC Educational Resources Information Center

    Gregory, Bob; Lonabocker, Louise

    1986-01-01

    Alternative methods of storing and handling the registrar's records are described, and their relative advantages and disadvantages are noted. The methods include paper files, micrographics (computer output microfilm and source document microfilm), and electronic image systems. (MSE)

  18. Electronic health records: Is it a risk worth taking in healthcare delivery?

    PubMed Central

    Raposo, Vera Lúcia

    2015-01-01

    The electronic health record represents a major change in healthcare delivery, either for health professionals and health institutions, either for patients. In this essay we will mainly focus on its consequences regarding patient safety and medical liability. In this particular domain the electronic health record has dual effects: on one side prevents medical errors and, in this sense, promotes patient safety and protects the doctor from lawsuits; but, on the other side, when not used properly, it may also generate other kind of errors, potentially threatening patient safety and, therefore, increasing the risk of juridical liability for the physician. This paper intends to underline the main human errors, technologic mistakes and medical faults that may occur while using the electronic health record and the ways to overcome them, also explaining how the electronic health record may be used in court during a judicial proceeding. PMID:26693253

  19. Assessing electronic health record systems in emergency departments: Using a decision analytic Bayesian model.

    PubMed

    Ben-Assuli, Ofir; Leshno, Moshe

    2016-09-01

    In the last decade, health providers have implemented information systems to improve accuracy in medical diagnosis and decision-making. This article evaluates the impact of an electronic health record on emergency department physicians' diagnosis and admission decisions. A decision analytic approach using a decision tree was constructed to model the admission decision process to assess the added value of medical information retrieved from the electronic health record. Using a Bayesian statistical model, this method was evaluated on two coronary artery disease scenarios. The results show that the cases of coronary artery disease were better diagnosed when the electronic health record was consulted and led to more informed admission decisions. Furthermore, the value of medical information required for a specific admission decision in emergency departments could be quantified. The findings support the notion that physicians and patient healthcare can benefit from implementing electronic health record systems in emergency departments.

  20. Mitigating by-catch of diamondback terrapins in crab pots

    USGS Publications Warehouse

    Hart, Kristen M.; Crowder, Larry B.

    2011-01-01

    Chronic by-catch of diamondback terrapins (Malaclemys terrapin) in blue crab (Callinectes sapidus) pots is a concern for terrapin conservation along the United States Atlantic and Gulf of Mexico coasts. Despite the availability of by-catch reduction devices (BRDs) for crab pots, adoption of BRDs has not been mandated and by-catch of terrapins continues. We conducted experimental fishing studies in North Carolina's year-round blue crab fishery from 2000 to 2004 to evaluate the ability of various BRDs to reduce terrapin by-catch without a concomitant reduction in the catch of blue crabs. In 4,822 crab pot days fished, we recorded only 21 terrapin captures. Estimated capture rates were 0.003 terrapins/pot per day in hard crab experimental fishing and 0.008 terrapins/pot per day in peeler experimental fishing. All terrapin captures occurred from April to mid-May within 321.4 m of the shoreline. Longer soak times produced more dead terrapins, with 4 live and 4 dead during hard crab experimental fishing and 11 live and 2 dead during peeler experimental fishing. The 4.0-cm BRDs in fall and 4.5-cm and 5.0-cm BRDs in spring reduced the catch of legal-sized male hard crabs by 26.6%, 21.2%, and 5.7%, respectively. Only the 5.0-cm BRDs did not significantly affect the catch of legal-sized hard male crabs. However, BRDs had no measurable effect on catch of target crabs in the peeler crab fishery. Our results identify 3 complementary and economically feasible tools for blue crab fishery managers to exclude terrapins from commercially fished crab pots in North Carolina: 1) gear modifications (e.g., BRDs); 2) distance-to-shore restrictions; and 3) time-of-year regulations. These measures combined could provide a reduction in terrapin by-catch of up to 95% without a significant reduction in target crab catch.

  1. Integration of radiographic images with an electronic medical record.

    PubMed Central

    Overhage, J. M.; Aisen, A.; Barnes, M.; Tucker, M.; McDonald, C. J.

    2001-01-01

    Radiographic images are important and expensive diagnostic tests. However, the provider caring for the patient often does not review the images directly due to time constraints. Institutions can use picture archiving and communications systems to make images more available to the provider, but this may not be the best solution. We integrated radiographic image review into the Regenstrief Medical Record System in order to address this problem. To achieve adequate performance, we store JPEG compressed images directly in the RMRS. Currently, physicians review about 5% of all radiographic studies using the RMRS image review function. PMID:11825241

  2. To Catch a Cheat

    ERIC Educational Resources Information Center

    Jacob, Brian A.; Levitt, Steven D.

    2004-01-01

    This article describes the results of a three-year investigation into cheating by school personnel. The goals of this research were to measure the prevalence of cheating by teachers and administrators and to analyze the factors that predict cheating. Using data on test scores and student records from the Chicago Public Schools, the authors…

  3. Record Low NEP in the Hot-Electron Titanium Nanobolometers

    NASA Technical Reports Server (NTRS)

    Karasik, Boris S.; Olaya, David; Wei, Jian; Pereverzev, Sergey; Gershenson, Michael E.; Kawamura, Jonathan H.; McGrath, William R.; Sergeev, Andrei V.

    2006-01-01

    We are developing hot-electron superconducting transition-edge sensors (TES) capable of counting THz photons and operating at T = 0.3K. We fabricated superconducting Ti nanosensors with Nb contacts with a volume of approx. 3x10(exp -3) cu microns on planar Si substrate and have measured the thermal conductance due to the weak electron-phonon coupling in the material G = 4x10(exp -14) W/K at 0.3 K. The corresponding phonon-noise NEP = 3x10(exp -19) W/Hz(sup 1/2). Detection of single optical photons (1550nm and 670nm wavelength) has been demonstrated for larger devices and yielded the thermal time constants of 30 microsec at 145 mK and of 25 microsec at 190 mK. This Hot-Electron Direct Detector (HEDD) is expected to have a sufficient energy resolution for detecting individual photons with (nu) > 1 THz where NEP approx. 3x10(exp -20) W/Hz(sup 1/2) is needed for spectroscopy in space.

  4. Content barriers to pediatric uptake of electronic health records.

    PubMed

    Gracy, Delaney; Weisman, Jeb; Grant, Roy; Pruitt, Jennifer; Brito, Arturo

    2012-01-01

    EHR systems provide significant opportunities to enhance pediatric care. Well-constructed clinical content, HIE, automated reminders and alerts, and reporting at practice, community, and public health levels are available in several current systems and products. However, the general focus on inpatient and adult populations in the design and marketing of these systems should be seen as a significant barrier to EHR adoption among pediatric primary care providers. Weight-based medication dosing, specialty growth charts, units of measurement and time, and measures to address minor consent and adolescent confidentiality are not universal in quality and availability to the pediatric practice. However, there are opportunities for pediatricians to provide input and to clearly state minimum requirements when dealing with vendors or when government agencies (eg, ONCHIT and AHRQ) seek comment on standards, practices, and expectations. This article uses cases and examples to describe some areas in which pediatricians should take an active role to advocate for pediatric-appropriate EHR tools. Virtually every child born and cared for in the United States today will have their data and information recorded in an EHR. The quality of the information and the HIT in which it is recorded can affect the care they get as children, and the information they carry into adulthood.

  5. Stakeholder engagement: a key component of integrating genomic information into electronic health records.

    PubMed

    Hartzler, Andrea; McCarty, Catherine A; Rasmussen, Luke V; Williams, Marc S; Brilliant, Murray; Bowton, Erica A; Clayton, Ellen Wright; Faucett, William A; Ferryman, Kadija; Field, Julie R; Fullerton, Stephanie M; Horowitz, Carol R; Koenig, Barbara A; McCormick, Jennifer B; Ralston, James D; Sanderson, Saskia C; Smith, Maureen E; Trinidad, Susan Brown

    2013-10-01

    Integrating genomic information into clinical care and the electronic health record can facilitate personalized medicine through genetically guided clinical decision support. Stakeholder involvement is critical to the success of these implementation efforts. Prior work on implementation of clinical information systems provides broad guidance to inform effective engagement strategies. We add to this evidence-based recommendations that are specific to issues at the intersection of genomics and the electronic health record. We describe stakeholder engagement strategies employed by the Electronic Medical Records and Genomics Network, a national consortium of US research institutions funded by the National Human Genome Research Institute to develop, disseminate, and apply approaches that combine genomic and electronic health record data. Through select examples drawn from sites of the Electronic Medical Records and Genomics Network, we illustrate a continuum of engagement strategies to inform genomic integration into commercial and homegrown electronic health records across a range of health-care settings. We frame engagement as activities to consult, involve, and partner with key stakeholder groups throughout specific phases of health information technology implementation. Our aim is to provide insights into engagement strategies to guide genomic integration based on our unique network experiences and lessons learned within the broader context of implementation research in biomedical informatics. On the basis of our collective experience, we describe key stakeholder practices, challenges, and considerations for successful genomic integration to support personalized medicine.

  6. 21 CFR 1304.06 - Records and reports for electronic prescriptions.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 9 2013-04-01 2013-04-01 false Records and reports for electronic prescriptions. 1304.06 Section 1304.06 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE RECORDS... and application service provider must retain a copy of any security incident report filed with...

  7. 21 CFR 1304.06 - Records and reports for electronic prescriptions.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 9 2012-04-01 2012-04-01 false Records and reports for electronic prescriptions. 1304.06 Section 1304.06 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE RECORDS... and application service provider must retain a copy of any security incident report filed with...

  8. Urban Alabama Physicians and the Electronic Medical Record: A Qualitative Study

    ERIC Educational Resources Information Center

    Tiggle, Michele

    2012-01-01

    The electronic medical record (EMR) is an information technology tool supporting the examination, treatment, and care of a patient. The EMR allows physicians to view a patient's record showing current medications, a history of visits from health care providers with notes from those visits, a problem list, a functional status assessment, a…

  9. Preservation Strategies for Electronic Records: Where We Are Now--Obliquity and Squint?

    ERIC Educational Resources Information Center

    Cloonan, Michele V.; Sanett, Shelby

    2002-01-01

    Reports on an international survey of the activities of 13 institutions and projects that employ or are exploring strategies to preserve authentic electronic records. Topics include preservation techniques; selection for preservation; staffing configurations; cost modeling; access to preserved records; and policymaking. Appendices include…

  10. Nurses' Perceptions of Nursing Care Documentation in the Electronic Health Record

    ERIC Educational Resources Information Center

    Jensen, Tracey A.

    2013-01-01

    Electronic health records (EHRs) will soon become the standard for documenting nursing care. The EHR holds the promise of rapid access to complete records of a patient's encounter with the healthcare system. It is the expectation that healthcare providers input essential data that communicates important patient information to support quality…

  11. Simulated electronic heterodyne recording and processing of pulsed-laser holograms

    NASA Technical Reports Server (NTRS)

    Decker, A. J.

    1979-01-01

    The electronic recording of pulsed-laser holograms is proposed. The polarization sensitivity of each resolution element of the detector is controlled independently to add an arbitrary phase to the image waves. This method which can be used to simulate heterodyne recording and to process three-dimensional optical images, is based on a similar method for heterodyne recording and processing of continuous-wave holograms.

  12. 48 CFR 2452.204-70 - Preservation of, and access to, contract records (tangible and electronically stored information...

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... access to, contract records (tangible and electronically stored information (ESI) formats). 2452.204-70... Preservation of, and access to, contract records (tangible and electronically stored information (ESI) formats... Records (Tangible and Electronically Stored Information (ESI) Formats) (DEC 2012) (a) For the purposes...

  13. 48 CFR 2452.204-70 - Preservation of, and access to, contract records (tangible and electronically stored information...

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... access to, contract records (tangible and electronically stored information (ESI) formats). 2452.204-70... Preservation of, and access to, contract records (tangible and electronically stored information (ESI) formats... Records (Tangible and Electronically Stored Information (ESI) Formats) (DEC 2012) (a) For the purposes...

  14. Protection of electronic health records (EHRs) in cloud.

    PubMed

    Alabdulatif, Abdulatif; Khalil, Ibrahim; Mai, Vu

    2013-01-01

    EHR technology has come into widespread use and has attracted attention in healthcare institutions as well as in research. Cloud services are used to build efficient EHR systems and obtain the greatest benefits of EHR implementation. Many issues relating to building an ideal EHR system in the cloud, especially the tradeoff between flexibility and security, have recently surfaced. The privacy of patient records in cloud platforms is still a point of contention. In this research, we are going to improve the management of access control by restricting participants' access through the use of distinct encrypted parameters for each participant in the cloud-based database. Also, we implement and improve an existing secure index search algorithm to enhance the efficiency of information control and flow through a cloud-based EHR system. At the final stage, we contribute to the design of reliable, flexible and secure access control, enabling quick access to EHR information. PMID:24110656

  15. Protection of electronic health records (EHRs) in cloud.

    PubMed

    Alabdulatif, Abdulatif; Khalil, Ibrahim; Mai, Vu

    2013-01-01

    EHR technology has come into widespread use and has attracted attention in healthcare institutions as well as in research. Cloud services are used to build efficient EHR systems and obtain the greatest benefits of EHR implementation. Many issues relating to building an ideal EHR system in the cloud, especially the tradeoff between flexibility and security, have recently surfaced. The privacy of patient records in cloud platforms is still a point of contention. In this research, we are going to improve the management of access control by restricting participants' access through the use of distinct encrypted parameters for each participant in the cloud-based database. Also, we implement and improve an existing secure index search algorithm to enhance the efficiency of information control and flow through a cloud-based EHR system. At the final stage, we contribute to the design of reliable, flexible and secure access control, enabling quick access to EHR information.

  16. Electronic personal maternity records: Both web and smartphone services.

    PubMed

    Chang, Chung-Wei; Ma, Tien-Yan; Choi, Mei-San; Hsu, Yu-Yun; Tsai, Yi-Jing; Hou, Ting-Wei

    2015-08-01

    This study develops an antenatal care information system to assist women during pregnancy. We designed and implemented the system as both a web-based service and a multi-platform application for smartphones and tablets. The proposed system has three novel features: (1) web-based maternity records, which contains concise explanations of various antenatal screening and diagnostic tests; (2) self-care journals, which allow pregnant women to keep track of their gestational weight gains, blood pressure, fetal movements, and contractions; and (3) health education, which automatically presents detailed information on antenatal care and other pregnancy-related knowledge according to the women's gestational age. A survey was conducted among pregnant women to evaluate the usability and acceptance of the proposed system. In order to prove that the antenatal care was effective, clinical outcomes should be provided and the results are focused on a usability evaluation.

  17. Electronic personal maternity records: Both web and smartphone services.

    PubMed

    Chang, Chung-Wei; Ma, Tien-Yan; Choi, Mei-San; Hsu, Yu-Yun; Tsai, Yi-Jing; Hou, Ting-Wei

    2015-08-01

    This study develops an antenatal care information system to assist women during pregnancy. We designed and implemented the system as both a web-based service and a multi-platform application for smartphones and tablets. The proposed system has three novel features: (1) web-based maternity records, which contains concise explanations of various antenatal screening and diagnostic tests; (2) self-care journals, which allow pregnant women to keep track of their gestational weight gains, blood pressure, fetal movements, and contractions; and (3) health education, which automatically presents detailed information on antenatal care and other pregnancy-related knowledge according to the women's gestational age. A survey was conducted among pregnant women to evaluate the usability and acceptance of the proposed system. In order to prove that the antenatal care was effective, clinical outcomes should be provided and the results are focused on a usability evaluation. PMID:26004998

  18. Records for Electronic Databases in the Online Catalog at Middle Tennessee State University

    ERIC Educational Resources Information Center

    Geckle, Beverly J.; Pozzebon, Mary Ellen; Williams, Jo

    2008-01-01

    This article recounts a project at the Middle Tennessee State University library to include records for electronic databases in the online catalog. Although electronic databases are accessible via the library's Databases A-Z list and related subject guides, cataloging these resources also provides access via the online catalog, allowing more of…

  19. Electronic Systems and Records Management in the Information Age: An Introduction.

    ERIC Educational Resources Information Center

    Cox, Richard J.

    1997-01-01

    Presents a statement of requirements developed by the University of Pittsburgh School of Information Science ensuring the preservation of evidence in electronic form. Although specifically addressing electronic record-keeping systems, the requirements are also applicable to manual or hybrid systems. (PEN)

  20. The Past and Future of the Electronic Dental Record from the Practitioners' View.

    ERIC Educational Resources Information Center

    Neiburger, E. J.; Diehl, M. C.

    1991-01-01

    Future dental practice is seen to include not only the electronic dental record (EDR) but a fully electronic clinical dental documentation package, computer-assisted diagnostic support, and digital imaging. The EDR's development since the 1970s is reviewed. Specific suggestions are made concerning hardware, software, administration, and practical…

  1. Electronic stethoscope with frequency shaping and infrasonic recording capabilities.

    PubMed

    Gordon, E S; Lagerwerff, J M

    1976-03-01

    A small electronic stethoscope with variable frequency response characteristics has been developed for aerospace and research applications. The system includes a specially designed piezoelectric pickup and amplifier with an overall frequency response from 0.7 to 5,000 HZ (-3 dB points) and selective bass and treble boost or cut of up to 15 dB. A steep slope, high pass filter can be switched in for ordinary clinical auscultation without overload distortion from strong infrasonic signal inputs. A commercial stethoscope-type headset, selected for best overall response, is used which can adequately handle up to 100 mW of audio power delivered from the amplifier. The active components of the amplifier consist of only four opamp-type integrated circuits. PMID:1244193

  2. Can Social Cognitive Theories Help Us Understand Nurses' Use of Electronic Health Records?

    PubMed

    Strudwick, Gillian; Booth, Richard; Mistry, Kartini

    2016-04-01

    Electronic health record implementations have accelerated in clinical settings around the world in an effort to improve patient safety and enhance efficiencies related to care delivery. As the largest group of healthcare professionals globally, nurses play an important role in the use of these records and ensuring their benefits are realized. Social cognitive theories such as the Theory of Reasoned Action, Theory of Planned Behaviour, and the Technology Acceptance Model have been developed to explain behavior. Given that variation in nurses' electronic health record utilization may influence the degree to which benefits are realized, the aim of this article is to explore how the use of these social cognitive theories may assist organizations implementing electronic health records to facilitate deeper-level adoption of this type of clinical technology.

  3. Can Social Cognitive Theories Help Us Understand Nurses' Use of Electronic Health Records?

    PubMed

    Strudwick, Gillian; Booth, Richard; Mistry, Kartini

    2016-04-01

    Electronic health record implementations have accelerated in clinical settings around the world in an effort to improve patient safety and enhance efficiencies related to care delivery. As the largest group of healthcare professionals globally, nurses play an important role in the use of these records and ensuring their benefits are realized. Social cognitive theories such as the Theory of Reasoned Action, Theory of Planned Behaviour, and the Technology Acceptance Model have been developed to explain behavior. Given that variation in nurses' electronic health record utilization may influence the degree to which benefits are realized, the aim of this article is to explore how the use of these social cognitive theories may assist organizations implementing electronic health records to facilitate deeper-level adoption of this type of clinical technology. PMID:26844529

  4. Passing and Catching in Rugby.

    ERIC Educational Resources Information Center

    Namudu, Mike M.

    This booklet contains the fundamentals for rugby at the primary school level. It deals primarily with passing and catching the ball. It contains instructions on (1) holding the ball for passing, (2) passing the ball to the left--standing, (3) passing the ball to the left--running, (4) making a switch pass, (5) the scrum half's normal pass, (6) the…

  5. Is patient confidentiality compromised with the electronic health record?: a position paper.

    PubMed

    Wallace, Ilse M

    2015-02-01

    In order for electronic health records to fulfill their expected benefits, protection of privacy of patient information is key. Lack of trust in confidentiality can lead to reluctance in disclosing all relevant information, which could have grave consequences. This position paper contemplates whether patient confidentiality is compromised by electronic health records. The position that confidentiality is compromised was supported by the four bioethical principles and argued that despite laws and various safeguards to protect patients' confidentiality, numerous data breaches have occurred. The position that confidentiality is not compromised was supported by virtue ethics and a utilitarian viewpoint and argued that safeguards keep information confidential and the public feels relatively safe with the electronic health record. The article concludes with an ethically superior position that confidentiality is compromised with the electronic health record. Although organizational and governmental ways of enhancing the confidentiality of patient information within the electronic health record facilitate confidentiality, the ultimate responsibility of maintaining confidentiality rests with the individual end-users and their ethical code of conduct. The American Nurses Association Code of Ethics for nurses calls for nurses to be watchful with data security in electronic communications.

  6. A patient-controlled journal for an electronic medical record: issues and challenges.

    PubMed

    Wald, Jonathan S; Middleton, Blackford; Bloom, Amy; Walmsley, Dan; Gleason, Mary; Nelson, Elizabeth; Li, Qi; Epstein, Marianna; Volk, Lynn; Bates, David W

    2004-01-01

    Partners Healthcare System, Boston, MA, has developed a patient Web portal that features a patient-controlled electronic "journal" to allow patients to interact with their physician's electronic medical record. Patients can view and respond to health reminders, critique electronic chart information maintained by their doctor's office, enter additional clinical information, and prepare information summaries before an office visit. Creating shared information resources to support a collaborative care model required analysis of the business, architectural, and workflow requirements of the patient-controlled clinical portal and the physician-controlled electronic medical record system. In this paper we describe the challenges in aligning the two systems and serving the different user groups. Coupling the Patient Gateway system, serving over 8700 patients of 90 physicians as of September, 2003, with the Longitudinal Medical Record system, serving over 4000 physicians, has required a clear definition of user goals and workflow, well-defined interfaces, and careful consideration of system assumptions to succeed.

  7. Electronic Records Administration at the Savannah River Plant

    SciTech Connect

    Hudson, B.J.

    1987-01-01

    The Savannah River Plant (SRP), which is operated by DuPont for the Department of Energy (DOE), is faced with the problem of providing ready access to information. A sitewide information network has been installed implementing electronic mail (ALL-IN-1) and various other office automation features. However, users need access to information contained in manuals, earlier research reports, and technical publications located in the central files. Planning is underway to procure a document and information storage and retrieval system linked to the sitewide information network. The system should provide retrieval of image scans of any document via full text and keyword searching of current and archived documents. Old documents will be input to the system through a high-speed image scanning system and optical disk storage. Optical character recognition (OCR) will be performed on these images and the resulting text stored in a document search and retrieval system. A user will utilize the search system to identify the documents needed, and retrieve either the text only from the search system or the image scan from the optical storage system.

  8. Electronic Documentation Support Tools and Text Duplication in the Electronic Medical Record

    ERIC Educational Resources Information Center

    Wrenn, Jesse

    2010-01-01

    In order to ease the burden of electronic note entry on physicians, electronic documentation support tools have been developed to assist in note authoring. There is little evidence of the effects of these tools on attributes of clinical documentation, including document quality. Furthermore, the resultant abundance of duplicated text and…

  9. The role of frontline RNs in the selection of an electronic medical record business partner.

    PubMed

    Wilhoit, Kathryn; Mustain, Jane; King, Marjorie

    2006-01-01

    Frontline RNs knowledgeable in the strategic objectives of their organization made a difference in the selection of an electronic medical record business partner for a large, complex healthcare system. Their impact was significant because of the chief nurse executive's personal articulation of the organization's strategic goals and of her investment in their education. These factors provided the frontline RNs with a foundational base of knowledge about a variety of electronic medical record systems. The preparation and exposure enabled the frontline RNs to make a valuable contribution to the selection of an electronic medical record business partner. The RNs were a major force in affecting philosophical change from the organization's original pursuit of "best-of-breed" interfaced systems to a fully integrated, "best-of-class" vendor business partner. The learning experiences of the frontline RNs are explored to answer the following question: Why must frontline RNs play a key role in this process? PMID:16849913

  10. Using the Electronic Health Record in Nursing Research: Challenges and Opportunities.

    PubMed

    Samuels, Joanne G; McGrath, Robert J; Fetzer, Susan J; Mittal, Prashant; Bourgoine, Derek

    2015-10-01

    Changes in the patient record from the paper to the electronic health record format present challenges and opportunities for the nurse researcher. Current use of data from the electronic health record is in a state of flux. Novel data analytic techniques and massive data sets provide new opportunities for nursing science. Realization of a strong electronic data output future relies on meeting challenges of system use and operability, data presentation, and privacy. Nurse researchers need to rethink aspects of proposal development. Joining ongoing national efforts aimed at creating usable data output is encouraged as a means to affect system design. Working to address challenges and embrace opportunities will help grow the science in a way that answers important patient care questions. PMID:25819698

  11. The role of frontline RNs in the selection of an electronic medical record business partner.

    PubMed

    Wilhoit, Kathryn; Mustain, Jane; King, Marjorie

    2006-01-01

    Frontline RNs knowledgeable in the strategic objectives of their organization made a difference in the selection of an electronic medical record business partner for a large, complex healthcare system. Their impact was significant because of the chief nurse executive's personal articulation of the organization's strategic goals and of her investment in their education. These factors provided the frontline RNs with a foundational base of knowledge about a variety of electronic medical record systems. The preparation and exposure enabled the frontline RNs to make a valuable contribution to the selection of an electronic medical record business partner. The RNs were a major force in affecting philosophical change from the organization's original pursuit of "best-of-breed" interfaced systems to a fully integrated, "best-of-class" vendor business partner. The learning experiences of the frontline RNs are explored to answer the following question: Why must frontline RNs play a key role in this process?

  12. Method for automatic escalation of access rights to the electronic health record.

    PubMed

    Hansen, Frode Orbeck; Fensli, Rune

    2006-01-01

    In an emergency situation, it can be vital for rescuing personnel to have access to fragmented parts of patients Electronic Health Record (EHR) shared between patients and health care services. In such situations, can Spatial Role Based Access Control combined with measurements of vital sign parameters recorded from a wireless monitoring system used by the patient and patient's physiological situation be used to facilitate for medical personnel automatic access to parts of the EHR.

  13. CTEPP STANDARD OPERATING PROCEDURE FOR MAINTAINING AND RECORDING ELECTRONIC CHAIN-OF-CUSTODY (SOP-4.11)

    EPA Science Inventory

    The method for maintaining and recording electronic Chain-of-Custody (CoC) Records for CTEPP samples is summarized in this SOP. The CoC Records that will be logged electronically include the creation of a sample's identification code, bar code labels, and hard-copy CoC document...

  14. 36 CFR 1236.28 - What additional requirements apply to the selection and maintenance of electronic records storage...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... restored. All other magnetic computer tape media which might have been affected by the same cause (i.e... apply to the selection and maintenance of electronic records storage media for permanent records? 1236... What additional requirements apply to the selection and maintenance of electronic records storage...

  15. 29 CFR 4000.54 - May I dispose of original paper records if I keep electronic copies?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false May I dispose of original paper records if I keep electronic copies? 4000.54 Section 4000.54 Labor Regulations Relating to Labor (Continued) PENSION BENEFIT GUARANTY CORPORATION GENERAL FILING, ISSUANCE, COMPUTATION OF TIME, AND RECORD RETENTION Electronic Means of Record Retention § 4000.54 May I dispose...

  16. Is Canada ready for patient accessible electronic health records? A national scan

    PubMed Central

    Urowitz, Sara; Wiljer, David; Apatu, Emma; Eysenbach, Gunther; DeLenardo, Claudette; Harth, Tamara; Pai, Howard; Leonard, Kevin J

    2008-01-01

    Background Access to personal health information through the electronic health record (EHR) is an innovative means to enable people to be active participants in their own health care. Currently this is not an available option for consumers of health. The absence of a key technology, the EHR, is a significant obstacle to providing patient accessible electronic records. To assess the readiness for the implementation and adoption of EHRs in Canada, a national scan was conducted to determine organizational readiness and willingness for patient accessible electronic records. Methods A survey was conducted of Chief Executive Officers (CEOs) of Canadian public and acute care hospitals. Results Two hundred thirteen emails were sent to CEOs of Canadian general and acute care hospitals, with a 39% response rate. Over half (54.2%) of hospitals had some sort of EHR, but few had a record that was predominately electronic. Financial resources were identified as the most important barrier to providing patients access to their EHR and there was a divergence in perceptions from healthcare providers and what they thought patients would want in terms of access to the EHR, with providers being less willing to provide access and patients desire for greater access to the full record. Conclusion As the use of EHRs becomes more commonplace, organizations should explore the possibility of responding to patient needs for clinical information by providing access to their EHR. The best way to achieve this is still being debated. PMID:18652695

  17. Catching a Falling Star

    NASA Astrophysics Data System (ADS)

    2004-07-01

    , etc. This image was obtained by MASCOT on August 25, 2002 and shows a meteor caught in the act. (Note that this is not the meteor whose spectrum was recorded). The Milky Way is also clearly visible in the centre. A popular saying states that when you see a meteor, you may make a wish. While astronomers cannot promise that it will be realised, a team of astronomers [1] have indeed seen a dream come true! On May 12, 2002, they were lucky to record the spectrum of a bright meteor when it happened - by sheer chance and against all reasonable odds - to cross the narrow slit of the FORS1 instrument on the ESO Very Large Telescope. At the time of this unlikely event, the telescope was performing a series of 20-minute spectroscopic exposures of a supernova in a distant galaxy in order to establish constraints on the dark energy content of the Universe (see e.g. ESO PR 21/98). Thanks to its enormous light-collecting and magnifying power, the VLT recorded the spectrum of the meteor trail perpendicular to its path on one of these exposures. "We really hit the jackpot", says ESO astronomer Emmanuel Jehin: "Chances of capturing a meteor in the narrow slit of the FORS1 spectrograph are about as big as for me winning the national lottery." Meteor spectra have on occasion been obtained serendipitously during photographic star spectra surveys. But this is now maybe the only meteor spectrum recorded with a large telescope and a modern spectrograph. The spectrum covers the wavelength range from 637 to 1050 nm, which is dominated by emissions from air atoms and molecules in the meteor path and teach us about the collision processes in the wake of a meteoroid. The rapid motion of the meteor across the sky resulted in a very brief exposure while crossing the narrow spectrograph slit - only 1/50 of a millisecond! - and despite the relative brightness of the meteor it was only thanks to the VLT's great light-gathering power that any record was procured. The meteor was estimated at magnitude

  18. Focusing on Patient Safety: the Challenge of Securely Sharing Electronic Medical Records in Complex Care Continuums.

    PubMed

    Key, Diana; Ferneini, Elie M

    2015-09-01

    The Patient Protection and Affordable Care Act's (PPACA) regulated approach to inclusive provision of care will increase the challenge health care administrators face ensuring secure communication and secure sharing of electronic medical records between divisions and care subcontractors. This analysis includes a summary overview of the PPACA; the Health Care and Education Reconciliation Act (HCERA) of 2010; and required Essential Health Benefits (EHB). The analysis integrates an overview of how secure communication and secure sharing of electronic medical records will be essential to clinical outcomes across complex care continuums; as well as the actionable strategies health care leadership can employ to overcome associated IT security challenges.

  19. Electron holography of magnetic field generated by a magnetic recording head.

    PubMed

    Goto, Takayuki; Jeong, Jong Seok; Xia, Weixing; Akase, Zentaro; Shindo, Daisuke; Hirata, Kei

    2013-06-01

    The magnetic field generated by a magnetic recording head is evaluated using electron holography. A magnetic recording head, which is connected to an electric current source, is set on the specimen holder of a transmission electron microscope. Reconstructed phase images of the region around the magnetic pole show the change in the magnetic field distribution corresponding to the electric current applied to the coil of the head. A simulation of the magnetic field, which is conducted using the finite element method, reveals good agreement with the experimental observations.

  20. A study on agent-based secure scheme for electronic medical record system.

    PubMed

    Chen, Tzer-Long; Chung, Yu-Fang; Lin, Frank Y S

    2012-06-01

    Patient records, including doctors' diagnoses of diseases, trace of treatments and patients' conditions, nursing actions, and examination results from allied health profession departments, are the most important medical records of patients in medical systems. With patient records, medical staff can instantly understand the entire medical information of a patient so that, according to the patient's conditions, more accurate diagnoses and more appropriate in-depth treatments can be provided. Nevertheless, in such a modern society with booming information technologies, traditional paper-based patient records have faced a lot of problems, such as lack of uniform formats, low data mobility, slow data transfer, illegible handwritings, enormous and insufficient storage space, difficulty of conservation, being easily damaged, and low transferability. To improve such drawbacks, reduce medical costs, and advance medical quality, paper-based patient records are modified into electronic medical records and reformed into electronic patient records. However, since electronic patient records used in various hospitals are diverse and different, in consideration of cost, it is rather difficult to establish a compatible and complete integrated electronic patient records system to unify patient records from heterogeneous systems in hospitals. Moreover, as the booming of the Internet, it is no longer necessary to build an integrated system. Instead, doctors can instantly look up patients' complete information through the Internet access to electronic patient records as well as avoid the above difficulties. Nonetheless, the major problem of accessing to electronic patient records cross-hospital systems exists in the security of transmitting and accessing to the records in case of unauthorized medical personnels intercepting or stealing the information. This study applies the Mobile Agent scheme to cope with the problem. Since a Mobile Agent is a program, which can move among hosts and

  1. Electronic heterodyne recording and processing of optical holograms using phase modulated reference waves

    NASA Technical Reports Server (NTRS)

    Decker, A. J.; Pao, Y.-H.; Claspy, P. C.

    1978-01-01

    The use of a phase-modulated reference wave for the electronic heterodyne recording and processing of a hologram is described. Heterodyne recording is used to eliminate the self-interference terms of a hologram and to create a Leith-Upatnieks hologram with coaxial object and reference waves. Phase modulation is also shown to be the foundation of a multiple-view hologram system. When combined with hologram scale transformations, heterodyne recording is the key to general optical processing. Spatial filtering is treated as an example.

  2. Performance analysis of distributed and centralized models for electronic medical record exchanges.

    PubMed

    Huang, Ean-Wen; Lee, Chiung-San; Jiang, Wey-Wen; Chiou, Shwu-Fen; Liu, Fei-Ying; Liou, Der-Ming

    2007-01-01

    Electronic medical record exchanges can save time and reduce cost by eliminating redundant data and typing errors. The major steps of record exchange consist of querying information from database, encoding data into messages, and sending and decoding messages. Three medical-record-exchange models were proposed in the past, including the distributed, centralized, and indexed models. In this paper, the queuing theory is applied to evaluate the performance of the three models. We estimate the service time for each queue of the CPU, database and network, and predict the response time, probable bottlenecks and system capacities of each model.

  3. A CORBA-based integration of distributed electronic healthcare records using the synapses approach.

    PubMed

    Grimson, J; Grimson, W; Berry, D; Stephens, G; Felton, E; Kalra, D; Toussaint, P; Weier, O W

    1998-09-01

    The ability to exchange in a meaningful, secure, and simple fashion relevant healthcare data about patients is seen as vital in the context of efficient and cost-effective shared or team-based care. The electronic healthcare record (EHCR) lies at the heart of this information exchange, and it follows that there is an urgent need to address the ability to share EHCR's or parts of records between carers and across distributed health information systems. This paper presents the Synapses approach to sharing based on a standardized shared record, the Federated Healthcare Record, which is implemented in an open and flexible manner using the Common Object Request Broker Architecture (CORBA). The architecture of the Federated Healthcare Record is based on the architecture proposed by the Technical Committee 251 of the European Committee for Standardization.

  4. An electronic health record driven algorithm to identify incident antidepressant medication users

    PubMed Central

    Bobo, William V; Pathak, Jyotishman; Kremers, Hilal Maradit; Yawn, Barbara P; Brue, Scott M; Stoppel, Cynthia J; Croarkin, Paul E; St Sauver, Jennifer; Frye, Mark A; Rocca, Walter A

    2014-01-01

    Objective We validated an algorithm designed to identify new or prevalent users of antidepressant medications via population-based drug prescription records. Patients and methods We obtained population-based drug prescription records for the entire Olmsted County, Minnesota, population from 2011 to 2012 (N=149 629) using the existing electronic medical records linkage infrastructure of the Rochester Epidemiology Project (REP). We selected electronically a random sample of 200 new antidepressant users stratified by age and sex. The algorithm required the exclusion of antidepressant use in the 6 months preceding the date of the first qualifying antidepressant prescription (index date). Medical records were manually reviewed and adjudicated to calculate the positive predictive value (PPV). We also manually reviewed the records of a random sample of 200 antihistamine users who did not meet the case definition of new antidepressant user to estimate the negative predictive value (NPV). Results 161 of the 198 subjects electronically identified as new antidepressant users were confirmed by manual record review (PPV 81.3%). Restricting the definition of new users to subjects who were prescribed typical starting doses of each agent for treating major depression in non-geriatric adults resulted in an increase in the PPV (90.9%). Extending the time windows with no antidepressant use preceding the index date resulted in only modest increases in PPV. The manual abstraction of medical records of 200 antihistamine users yielded an NPV of 98.5%. Conclusions Our study confirms that REP prescription records can be used to identify prevalent and incident users of antidepressants in the Olmsted County, Minnesota, population. PMID:24780720

  5. Security Requirements for a Lifelong Electronic Health Record System: An Opinion

    PubMed Central

    Wainer, J; Campos, C.J.R; Salinas, M.D.U; Sigulem, D

    2008-01-01

    This article discusses the authors' views on the security requirements of a central, unique electronic health record. The requirements are based on the well-known principles of confidentiality and integrity and the less discussed principles of control and legal value. The article does not discuss any technical or legal solutions to the requirements proposed herein. PMID:19415143

  6. Developing a Systematic Architecture Approach for Designing an Enhanced Electronic Medical Record (EEMR) System

    ERIC Educational Resources Information Center

    Aldukheil, Maher A.

    2013-01-01

    The Healthcare industry is characterized by its complexity in delivering care to the patients. Accordingly, healthcare organizations adopt and implement Information Technology (IT) solutions to manage complexity, improve quality of care, and transform to a fully integrated and digitized environment. Electronic Medical Records (EMR), which is…

  7. Impact of Electronic Health Records on Nurses' Information Seeking and Discriminating Skills for Critical Thinking

    ERIC Educational Resources Information Center

    Jackson, Adria S.

    2013-01-01

    In February 2009, the United States government passed into law the Health Information Technology for Economic and Clinical Health Act (HITECH) and the American Recovery and Reinvestment Act (ARRA) providing incentive money for hospitals and care providers to implement a certified electronic health record (EHR) in order to promote the adoption and…

  8. Worth a thousand words: Integrating clinical photographs into an electronic medical record.

    PubMed

    Beard, H R; Hamid, K S

    2014-03-01

    Technological advances have made clinical photographs ubiquitous but the tremendous value of images is often burdened by concerns that are both legitimate and unsubstantiated. Compliant photos dramatically improve patient value and should be encouraged after adequate institutional preparation. As healthcare networks continue to transition to electronic medical records, clinicians and administrators should outline reasonable policies to integrate photos safely.

  9. Electronic Medical Records and Their Impact on Resident and Medical Student Education

    ERIC Educational Resources Information Center

    Keenan, Craig R.; Nguyen, Hien H.; Srinivasan, Malathi

    2006-01-01

    Objective: Electronic medical records (EMRs) are becoming prevalent and integral tools for residents and medical students. EMRs can integrate point-of-service information delivery within the context of patient care. Though it may be an educational tool, little is known about how EMR technology is currently used for medical learners. Method: The…

  10. Acceptance and Usage of Electronic Health Record Systems in Small Medical Practices

    ERIC Educational Resources Information Center

    Tannan, Ritu

    2012-01-01

    One of the objectives of the U.S. government has been the development of a nationwide health information infrastructure, including adoption and use of an electronic health records (EHR) system. However, a 2008 survey conducted by the National Center for Health Statistics indicated a 41.5% usage of the EHR system by physicians in office-based…

  11. 75 FR 44313 - Medicare and Medicaid Programs; Electronic Health Record Incentive Program

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-28

    ... rule (75 FR 1844), entitled ``Medicare and Medicaid Programs; Electronic Health Record Incentive... technology are coordinated. In the interim final rule published on January 13, 2010 (75 FR 2014) entitled... related proposed rule published on March 10, 2010, (75 FR 11328) entitled ``Proposed Establishment...

  12. Hospital Electronic Health Record Adoption and Its Influence on Postoperative Sepsis

    ERIC Educational Resources Information Center

    Fareed, Naleef

    2013-01-01

    Electronic Health Record (EHR) systems could make healthcare delivery safer by providing benefits such as timely access to accurate and complete patient information, advances in diagnosis and coordination of care, and enhancements for monitoring patient vitals. This study explored the nature of EHR adoption in U.S. hospitals and their patient…

  13. Nurse Educators' Consensus Opinion on Using an Academic Electronic Health Record: A Delphi Study

    ERIC Educational Resources Information Center

    Hanson, Darlene S.

    2013-01-01

    The purpose of this study was to determine the opinions of nurse educators in the state of North Dakota (ND) who were using the academic Electronic Health Record (EHR) known as SimChart. In this dissertation research study, factors that either hindered or facilitated the introduction of SimChart in nursing programs in ND were examined.…

  14. Health Care Professionals' Perceptions of the Use of Electronic Medical Records

    ERIC Educational Resources Information Center

    Adeyeye, Adebisi

    2015-01-01

    Electronic medical record (EMR) use has improved significantly in health care organizations. However, many barriers and factors influence the success of EMR implementation and adoption. The purpose of the descriptive qualitative single-case study was to explore health care professionals' perceptions of the use of EMRs at a hospital division of a…

  15. Strategies Nurse Managers Used to Offset Challenges during Electronic Medical Records Implementation: A Case Study

    ERIC Educational Resources Information Center

    Easterling, Latasha

    2015-01-01

    The purpose of this qualitative, descriptive case study was to discover successful approaches used, by nurse managers, to reduce barriers during the implementation of electronic medical record system in one hospital. Fourteen nurse managers were interviewed from an academic health science center in Mississippi. A pilot study was conducted to…

  16. Behavioral Health Providers and Electronic Health Records: An Exploratory Beliefs Elicitation and Segmentation Study

    ERIC Educational Resources Information Center

    Shank, Nancy

    2011-01-01

    The widespread adoption of electronic health records (EHRs) is a public policy strategy to improve healthcare quality and reduce accelerating health care costs. Much research has focused on medical providers' perceptions of EHRs, but little is known about those of behavioral health providers. This research was informed by the theory of reasoned…

  17. Technical Limitations of Electronic Health Records in Community Health Centers: Implications on Ambulatory Care Quality

    ERIC Educational Resources Information Center

    West, Christopher E.

    2010-01-01

    Research objectives: This dissertation examines the state of development of each of the eight core electronic health record (EHR) functionalities as described by the IOM and describes how the current state of these functionalities limit quality improvement efforts in ambulatory care settings. There is a great deal of literature describing both the…

  18. Automated Methods to Extract Patient New Information from Clinical Notes in Electronic Health Record Systems

    ERIC Educational Resources Information Center

    Zhang, Rui

    2013-01-01

    The widespread adoption of Electronic Health Record (EHR) has resulted in rapid text proliferation within clinical care. Clinicians' use of copying and pasting functions in EHR systems further compounds this by creating a large amount of redundant clinical information in clinical documents. A mixture of redundant information (especially outdated…

  19. Implementation of an Electronic Health Records System in a Small Clinic: The Viewpoint of Clinic Staff

    ERIC Educational Resources Information Center

    Carayon, Pascale; Smith, Paul; Hundt, Ann Schoofs; Kuruchittham, Vipat; Li, Qian

    2009-01-01

    In this study, we examined the implementation of an electronic health records (EHR) system in a small family practice clinic. We used three data collection instruments to evaluate user experience, work pattern changes, and organisational changes related to the implementation and use of the EHR system: (1) an EHR user survey, (2) interviews with…

  20. A Correlational Analysis: Electronic Health Records (EHR) and Quality of Care in Critical Access Hospitals

    ERIC Educational Resources Information Center

    Khan, Arshia A.

    2012-01-01

    Driven by the compulsion to improve the evident paucity in quality of care, especially in critical access hospitals in the United States, policy makers, healthcare providers, and administrators have taken the advise of researchers suggesting the integration of technology in healthcare. The Electronic Health Record (EHR) System composed of multiple…

  1. Characterization of Help Desk issues After the Implementation of an Emergency Department Electronic Health Record.

    PubMed

    Capurro, Daniel; Soto, Mauricio; Giacaman, Patricio; Catalán, Silvia

    2015-01-01

    Electronic health records (EHRs) can produce significant disruption when first implemented. Successful implementations depend on the availability of technical and clinical support. We present a description of the frequency and types of issues raised during the first 12 months after the implementation of an EHR at a teaching hospital in Santiago, Chile. PMID:26262177

  2. Examining the Relationship between Electronic Health Record Interoperability and Quality Management

    ERIC Educational Resources Information Center

    Purcell, Bernice M.

    2013-01-01

    A lack of interoperability impairs data quality among health care providers' electronic health record (EHR) systems. The problem is whether the International Organization for Standardization (ISO) 9000 principles relate to the problem of interoperability in implementation of EHR systems. The purpose of the nonexperimental quantitative…

  3. Student nurses and the electronic medical record: a partnership of academia and healthcare.

    PubMed

    Bowers, Anna Mary; Kavanagh, Joan; Gregorich, Tom; Shumway, Julia; Campbell, Yolanda; Stafford, Susan

    2011-12-01

    The advent of the electronic medical record has brought a new challenge to nursing education. Although most nursing students are proficient in data entry and computer skills, they often do not comprehend how the information they enter becomes a vital component of interdisciplinary team communication. Furthermore, the electronic medical record becomes a repository for information that can be retrieved for the purpose of decision support. Developed by the Cleveland Clinic, the Deans' Roundtable, and University Hospitals of Cleveland, the Student Nurse Portal provides a means of assisting the student to understand how data entered into the computer transforms into information and knowledge, resulting in the wisdom that enables healthcare workers to provide optimal patient care. Current courses present the purpose of the electronic medical record and its roleas a powerful communication tool, but future courses will also help the student develop data entry and retrieval skills. Hosted on the Cleveland Clinic servers and available to students around-the-clock from any computer with Internet access, students have found the Student Nurse Portal to be a valuable tool in preparing for the use of the electronic medical record during their clinical experiences.

  4. Electronically Recorded Music as a Communication Medium: A Structural Analysis with Selected Bibliography.

    ERIC Educational Resources Information Center

    Jorgensen, Earl; Mabry, Edward A.

    During the past decade, the influence of electronically recorded music and the message it transmits have caused media scholars to reexamine and modify the theories upon which the basic process of communication is dependent. While the five primary functions (source, transmitter, channel, receiver, and destination) remain unchanged, an additional…

  5. Understanding Clinician Information Demands and Synthesis of Clinical Documents in Electronic Health Record Systems

    ERIC Educational Resources Information Center

    Farri, Oladimeji Feyisetan

    2012-01-01

    Large quantities of redundant clinical data are usually transferred from one clinical document to another, making the review of such documents cognitively burdensome and potentially error-prone. Inadequate designs of electronic health record (EHR) clinical document user interfaces probably contribute to the difficulties clinicians experience while…

  6. Evolution of Medication Administration Workflow in Implementing Electronic Health Record System

    ERIC Educational Resources Information Center

    Huang, Yuan-Han

    2013-01-01

    This study focused on the clinical workflow evolutions when implementing the health information technology (HIT). The study especially emphasized on administrating medication when the electronic health record (EHR) systems were adopted at rural healthcare facilities. Mixed-mode research methods, such as survey, observation, and focus group, were…

  7. Develop security architecture for both in-house healthcare information systems and electronic patient record

    NASA Astrophysics Data System (ADS)

    Zhang, Jianguo; Chen, Xiaomeng; Zhuang, Jun; Jiang, Jianrong; Zhang, Xiaoyan; Wu, Dongqing; Huang, H. K.

    2003-05-01

    In this paper, we presented a new security approach to provide security measures and features in both healthcare information systems (PACS, RIS/HIS), and electronic patient record (EPR). We introduced two security components, certificate authoring (CA) system and patient record digital signature management (DSPR) system, as well as electronic envelope technology, into the current hospital healthcare information infrastructure to provide security measures and functions such as confidential or privacy, authenticity, integrity, reliability, non-repudiation, and authentication for in-house healthcare information systems daily operating, and EPR exchanging among the hospitals or healthcare administration levels, and the DSPR component manages the all the digital signatures of patient medical records signed through using an-symmetry key encryption technologies. The electronic envelopes used for EPR exchanging are created based on the information of signers, digital signatures, and identifications of patient records stored in CAS and DSMS, as well as the destinations and the remote users. The CAS and DSMS were developed and integrated into a RIS-integrated PACS, and the integration of these new security components is seamless and painless. The electronic envelopes designed for EPR were used successfully in multimedia data transmission.

  8. Electronic Medical Records Adoption and Usage among Osteopathic Physicians in New York State

    ERIC Educational Resources Information Center

    Rosenthal, Jon I.

    2012-01-01

    In 2010, the U.S. Department of Health and Human Services Office of the National Coordinator for Health Information Technology reported a slow rate of adoption of electronic medical records. The present research sought to explore possible reasons for this situation by examining factors that distinguished between users and nonusers of electronic…

  9. Organizational Learning and Large-Scale Change: Adoption of Electronic Medical Records

    ERIC Educational Resources Information Center

    Chavis, Virginia D.

    2010-01-01

    Despite implementation of electronic medical record (EMR) systems in the United States and other countries, there is no organizational development model that addresses medical professionals' attitudes toward technology adoption in a learning organization. The purpose of this study was to assess whether a model would change those attitudes toward…

  10. The Role of Electronic Health Records in Structuring Nursing Handoff Communication and Maintaining Situation Awareness

    ERIC Educational Resources Information Center

    Alghenaimi, Said

    2012-01-01

    In healthcare institutions, work must continue 24 hours a day, 7 days a week. A team of nurses is needed to provide around-the-clock patient care, and this process requires transfer of patient care responsibilities, a process known as a "handoff." The present study explored the role of electronic health records in structuring handoff…

  11. An Evaluation of Authentic Learning in an Electronic Medical Records System

    ERIC Educational Resources Information Center

    Stuart, Sandra L.

    2013-01-01

    This study examined participants' perceptions of the effectiveness of a new job-training program designed to enhance the authentic learning in adult learners using an electronic medical records system at a naval health clinic. This job-training program lacked data about participants' perceptions of this learning process by which to gauge its…

  12. A real time Teleconsultation System for Sharing an Oncologic Web-based Electronic Medical Record.

    PubMed

    Forti, Stefano; Galvagni, Michele; Galligioni, Enzo; Eccher, Claudio

    2005-01-01

    This poster presents an innovative real-time Teleconsultation System for synchronized navigation of the pages of a web-based Oncological Electronic Medical Record, designed to provide clinicians a cooperative work tool supporting the oncologic patient management between different hospitals. The system embeds additional tools supporting the discussion: digital whiteboard, chat and a digital audio channel.

  13. Principles for Information Technology Investment in U.S. Federal Electronic Records Management.

    ERIC Educational Resources Information Center

    Van Wingen, Rachel Senner; Hathorn, Fred; Sprehe, J. Timothy

    1999-01-01

    The United States Environmental Protection Agency (EPA) underwent a business process reengineering (BPR) exercise with respect to future co-location of previously separate regulatory docket facilities. Their experience suggests that future mandatory electronic records management (ERM) requirements will cause federal agencies to take a more…

  14. Organizational Leader Sensemaking in Healthcare Process Changes: The Development of the Electronic Medical Records Expectation Questionnaire

    ERIC Educational Resources Information Center

    Riesenmy, Kelly Rouse

    2011-01-01

    Physicians play a unique role in the adoption of electronic medical records (EMR) within the healthcare organization. As leaders, they are responsible for setting the standards for this new technology within their sphere of influence while concurrently being required to learn and integrate EMR into their own workflow and process as the recipients…

  15. Electronic Health Record Adoption as a Function of Success: Implications for Meaningful Use

    ERIC Educational Resources Information Center

    Naser, Riyad J.

    2012-01-01

    Successful electronic health records (EHR) implementation has the potential to transform the entire care delivery process across the enterprise. However, the rate of EHR implementation and use among physicians has been slow. Different factors have been reported in the literature that may hinder adoption of EHR. Identifying and managing these…

  16. The urban underserved: Attitudes toward gaining full access to electronic medical records

    PubMed Central

    Dhanireddy, Shireesha; Walker, Jan; Reisch, Lisa; Oster, Natalia; Delbanco, Thomas; Elmore, Joann

    2012-01-01

    Background As the use of electronic medical records (EMRs) spreads, health care organizations are increasingly offering patients online access to their medical records. Studies evaluating patient attitudes toward viewing elements of their records through secure, electronic patient portals have generally not included medically underserved patients or those with HIV/AIDS. The goal of this study was to gain insight into such patients’ attitudes toward online access to their medical records, including their doctors’ visit notes. Methods Qualitative study of four focus groups with adult patients in general adult medicine and HIV clinics at a large county hospital. Transcripts were analyzed for themes using an immersion/crystallization approach. Results Patients’ baseline understanding of the health record was limited. Perceived benefits of online access were improved patient understanding of health and disease, convenience, empowerment, and a stronger relationship with their provider. Concerns included threats to privacy, worries about being unable to understand their record, fear that the computer would replace direct provider contact, and hesitancy about potential demands on a provider’s time. Patients also recommended providing online visit reminders, links to credible health information, and assistance for paying bills. Conclusion Despite their initial lack of knowledge of the health record, focus group participants were overwhelmingly positive about the prospect of online access to medical records. However, they worried about potential loss of privacy and interference with the patient-provider relationship. As EMRs increasingly offer patients open access to their medical records, vulnerable patient groups will likely join others in desiring and adopting such change, but may need targeted support during times of transition. PMID:22738155

  17. Using an iconic language to improve access to electronic medical records in general medicine.

    PubMed

    Simon, Christian; Hassler, Sylvain; Beuscart-Zephir, Marie-Catherine; Favre, Madeleine; Venot, Alain; Duclos, Catherine; Lamy, Jean-Baptiste

    2014-01-01

    Physicians have difficulties to access and analyse information in a medical record. In a previous work on drug databanks, we have shown that with an iconic language as VCM, an icon-based presentation can help physicians to access medical information. Our objective, herein, is to study whether VCM can be used in an electronic medical record for facilitating physician access in general practice. We identify the data and the functionalities of an electronic medical record that could benefit from VCM icons representing clinical findings, patient history, etc. We also present a preliminary evaluation of this new icon-focused interface. We conclude by discussing the results like the assessment of the user's satisfaction and pointing out the importance of coding data.

  18. Design of an Electronic Reminder System for Supporting the Integerity of Nursing Records.

    PubMed

    Chen, Chien-Min; Hou, I-Ching; Chen, Hsiao-Ping; Weng, Yung-Ching

    2016-01-01

    The integrity of electronic nursing records (ENRs) stands for the quality of medical records. But patients' conditions are varied (e.g. not every patient had wound or need fall prevention), to achieve the integrity of ENRs depends much on clinical nurses' attention. Our study site, an one 2,300-bed hospital in northern Taiwan, there are a total of 20 ENRs including nursing assessments, nursing care plan, discharge planning etc. implemented in the whole hospital before 2014. It become important to help clinical nurses to decrease their human recall burden to complete these records. Thus, the purpose of this study was to design an ENRs reminder system (NRS) to facilitate nursing recording process. The research team consisted of an ENR engineer, a clinical head nurse and a nursing informatics specialist began to investigate NRS through three phases (e.g. information requirements; design and implementation). In early 2014, a qualitative research method was used to identify NRS information requirements through both groups (e.g. clinical nurses and their head nurses) focus interviews. According to the their requirements, one prototype was created by the nursing informatics specialist. Then the engineer used Microsoft Visual Studio 2012, C#, and Oracle to designed a web-based NRS (Figure 1). Then the integrity reminder system which including a total of twelve electronic nursing records was designed and the preliminary accuracy validation of the system was 100%. NRS could be used to support nursing recording process and prepared for implementing in the following phase.

  19. Who Said It? Establishing Professional Attribution among Authors of Veterans’ Electronic Health Records

    PubMed Central

    Reeves, Ruth M.; FitzHenry, Fern; Brown, Steve H.; Kotter, Kristen; Gobbel, Glenn T.; Montella, Diane; Murff, Harvey J.; Speroff, Ted; Matheny, Michael E.

    2012-01-01

    Background A practical data point for assessing information quality and value in the Electronic Health Record (EHR) is the professional category of the EHR author. We evaluated and compared free form electronic signatures against LOINC note titles in categorizing the profession of EHR authors. Methods A random 1000 clinical document sample was selected and divided into 500 document sets for training and testing. The gold standard for provider classification was generated by dual clinician manual review, disagreements resolved by a third reviewer. Text matching algorithms composed of document titles and author electronic signatures for provider classification were developed on the training set. Results Overall, detection of professional classification by note titles alone resulted in 76.1% sensitivity and 69.4% specificity. The aggregate of note titles with electronic signatures resulted in 95.7% sensitivity and 98.5% specificity. Conclusions Note titles alone provided fair professional classification. Inclusion of author electronic signatures significantly boosted classification performance. PMID:23304349

  20. CKD as a Model for Improving Chronic Disease Care through Electronic Health Records.

    PubMed

    Drawz, Paul E; Archdeacon, Patrick; McDonald, Clement J; Powe, Neil R; Smith, Kimberly A; Norton, Jenna; Williams, Desmond E; Patel, Uptal D; Narva, Andrew

    2015-08-01

    Electronic health records have the potential to improve the care of patients with chronic medical conditions. CKD provides a unique opportunity to show this potential: the disease is common in the United States, there is significant room to improve CKD detection and management, CKD and its related conditions are defined primarily by objective laboratory data, CKD care requires collaboration by a diverse team of health care professionals, and improved access to CKD-related data would enable identification of a group of patients at high risk for multiple adverse outcomes. However, to realize the potential for improvement in CKD-related care, electronic health records will need to provide optimal functionality for providers and patients and interoperability across multiple health care settings. The goal of the National Kidney Disease Education Program Health Information Technology Working Group is to enable and support the widespread interoperability of data related to kidney health among health care software applications to optimize CKD detection and management. Over the course of the last 2 years, group members met to identify general strategies for using electronic health records to improve care for patients with CKD. This paper discusses these strategies and provides general goals for appropriate incorporation of CKD-related data into electronic health records and corresponding design features that may facilitate (1) optimal care of individual patients with CKD through improved access to clinical information and decision support, (2) clinical quality improvement through enhanced population management capabilities, (3) CKD surveillance to improve public health through wider availability of population-level CKD data, and (4) research to improve CKD management practices through efficiencies in study recruitment and data collection. Although these strategies may be most effectively applied in the setting of CKD, because it is primarily defined by laboratory

  1. Linking guidelines to Electronic Health Record design for improved chronic disease management.

    PubMed

    Barretto, Sistine A; Warren, Jim; Goodchild, Andrew; Bird, Linda; Heard, Sam; Stumptner, Markus

    2003-01-01

    The promise of electronic decision support to promote evidence based practice remains elusive in the context of chronic disease management. We examine the problem of achieving a close relationship of Electronic Health Record (EHR) content to other components of a clinical information system (guidelines, decision support and workflow), particularly linking the decisions made by providers back to the guidelines. We use the openEHR architecture, which allows extension of a core Reference Model via Archetypes to refine the detailed information recording options for specific classes of encounter. We illustrate the use of openEHR for tracking the relationship of a series of clinical encounters to a guideline via a case study of guideline-compliant treatment of hypertension in diabetes. This case study shows the contribution guideline content can have on problem-specific EHR structure and demonstrates the potential for a constructive interaction of electronic decision support and the EHR.

  2. Effectiveness of an electronic inpatient medication record in reducing medication errors in Singapore.

    PubMed

    Choo, Janet; Johnston, Linda; Manias, Elizabeth

    2014-06-01

    This study examined the effectiveness of an inpatient electronic medication record system in reducing medication errors in Singaporean hospitals. This pre- and post-intervention study involving a control group was undertaken in two Singaporean acute care hospitals. In one hospital the inpatient electronic medication record system was implemented while in another hospital the paper-based medication record system was used. The mean incidence difference in medication errors of 0.06 between pre-intervention (0.72 per 1000 patient days) and post-intervention (0.78 per 1000 patient days) for the two hospitals was not statistically significant (95%, CI: [0.26, 0.20]). The mean incidence differences in medication errors relating to prescription, dispensing, and administration were also not statistically different. Common system failures involved a lack of medication knowledge by health professionals and a lack of a systematic approach in identifying correct dosages. There was no difference in the incidence of medication errors following the introduction of the electronic medication record system. More work is needed on how this system can reduce medication error rates and improve medication safety.

  3. Deepening Thermocline Displaces Salmon Catch On The Oregon Coast

    NASA Astrophysics Data System (ADS)

    Harrison, C. S.; Lawson, P.

    2015-12-01

    Establishing a linkage between fish stock distributions and physical oceanography at a fine scale provides insights into the dynamic nature of near-shore ocean habitats. Characterization of habitat preferences adds to our understanding of the ecosystem, and may improve forecasts of distribution for harvest management. The Project CROOS (Collaborative Research on Oregon Ocean Salmon) Chinook salmon catch data set represents an unprecedented high-resolution record of catch location and depth, with associated in-situ temperature measurements and stock identification derived from genetic data. Here we connect this data set with physical ocean observations to gain understanding of how circulation affects salmon catch distributions. The CROOS observations were combined with remote and in situ observations of temperature, as well as a data assimilative regional ocean model that incorporates satellite and HF radar data. Across the CROOS data set, catch is primarily located within the upwelling front over the seamounts and reef structures associated with Heceta and Stonewall Banks along the shelf break. In late September of 2014 the anomalously warm "blob" began to arrive on the Oregon coast coincident with a strong downwelling event. At this time the thermocline deepened from 20 to 40 m, associated with a deepening of salmon catch depth. A cold "bulb" of water over Heceta Bank may have provided a thermal refuge for salmon during the initial onshore movement of the anomalously warm water. These observations suggest that a warming ocean, and regional warming events in particular, will have large effects on fish distributions at local and regional scales, in turn impacting fisheries.

  4. Implementation of the Zambia Electronic Perinatal Record System for comprehensive prenatal and delivery care

    PubMed Central

    Chi, Benjamin H.; Vwalika, Bellington; Killam, William P.; Wamalume, Chibesa; Giganti, Mark J.; Mbewe, Reuben; Stringer, Elizabeth M.; Chintu, Namwinga T.; Putta, Nande B.; Liu, Katherine C.; Chibwesha, Carla J.; Rouse, Dwight J.; Stringer, Jeffrey S.A.

    2011-01-01

    Objective To characterize prenatal and delivery care in an urban African setting. Methods The Zambia Electronic Perinatal Record System (ZEPRS) was implemented to record demographic characteristics, past medical and obstetric history, prenatal care, and delivery and newborn care for pregnant women across 25 facilities in the Lusaka public health sector. Results From June 1, 2007, to January 31, 2010, 115 552 pregnant women had prenatal and delivery information recorded in ZEPRS. Median gestation age at first prenatal visit was 23 weeks (interquartile range [IQR] 19–26). Syphilis screening was documented in 95 663 (83%) pregnancies: 2449 (2.6%) women tested positive, of whom 1589 (64.9%) were treated appropriately. 111 108 (96%) women agreed to HIV testing, of whom 22% were diagnosed with HIV. Overall, 112 813 (98%) of recorded pregnancies resulted in a live birth, and 2739 (2%) in a stillbirth. The median gestational age was 38 weeks (IQR 35–40) at delivery; the median birth weight of newborns was 3000 g (IQR 2700–3300 g). Conclusion The results demonstrate the feasibility of using a comprehensive electronic medical record in an urban African setting, and highlight its important role in ongoing efforts to improve clinical care. PMID:21315347

  5. Patients want granular privacy control over health information in electronic medical records

    PubMed Central

    Caine, Kelly; Hanania, Rima

    2013-01-01

    Objective To assess patients’ desire for granular level privacy control over which personal health information should be shared, with whom, and for what purpose; and whether these preferences vary based on sensitivity of health information. Materials and methods A card task for matching health information with providers, questionnaire, and interview with 30 patients whose health information is stored in an electronic medical record system. Most patients’ records contained sensitive health information. Results No patients reported that they would prefer to share all information stored in an electronic medical record (EMR) with all potential recipients. Sharing preferences varied by type of information (EMR data element) and recipient (eg, primary care provider), and overall sharing preferences varied by participant. Patients with and without sensitive records preferred less sharing of sensitive versus less-sensitive information. Discussion Patients expressed sharing preferences consistent with a desire for granular privacy control over which health information should be shared with whom and expressed differences in sharing preferences for sensitive versus less-sensitive EMR data. The pattern of results may be used by designers to generate privacy-preserving EMR systems including interfaces for patients to express privacy and sharing preferences. Conclusions To maintain the level of privacy afforded by medical records and to achieve alignment with patients’ preferences, patients should have granular privacy control over information contained in their EMR. PMID:23184192

  6. Electronic patient records for dental school clinics: more than paperless systems.

    PubMed

    Atkinson, Jane C; Zeller, Gregory G; Shah, Chhaya

    2002-05-01

    The Electronic Patient Record (EPR) or "computer-based medical record" is defined by the Patient Record Institute as "a repository for patient information with one health-care enterprise that is supported by digital computer input and integrated with other information sources." The information technology revolution coupled with everyday use of computers in clinical dentistry has created new demand for electronic patient records. Ultimately, the EPR should improve health care quality. The major short-term disadvantage is cost, including software, equipment, training, and personnel time involved in the associated business process re-engineering. An internal review committee with expertise in information technology and/or database management evaluated commercially available software in light of the unique needs of academic dental facilities. This paper discusses their deficiencies and suggests areas for improvement. The dental profession should develop a more common record with standard diagnostic codes and clinical outcome measures to make the EPR more useful for clinical research and improve the quality of care. PMID:12056768

  7. 5 CFR 1600.23 - Catch-up contributions.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 3 2014-01-01 2014-01-01 false Catch-up contributions. 1600.23 Section... Catch-up contributions. (a) A participant may make traditional catch-up contributions or Roth catch-up... annual limit on catch-up contributions contained in section 414(v) the Internal Revenue Code. (b)...

  8. 5 CFR 1600.23 - Catch-up contributions.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Catch-up contributions. 1600.23 Section... Catch-up contributions. (a) A participant may make traditional catch-up contributions or Roth catch-up... annual limit on catch-up contributions contained in section 414(v) the Internal Revenue Code. (b)...

  9. The Electronic Medical Records and Genomics (eMERGE) Network: past, present, and future

    PubMed Central

    Gottesman, Omri; Kuivaniemi, Helena; Tromp, Gerard; Faucett, W. Andrew; Li, Rongling; Manolio, Teri A.; Sanderson, Saskia C.; Kannry, Joseph; Zinberg, Randi; Basford, Melissa A.; Brilliant, Murray; Carey, David J.; Chisholm, Rex L.; Chute, Christopher G.; Connolly, John J.; Crosslin, David; Denny, Joshua C.; Gallego, Carlos J.; Haines, Jonathan L.; Hakonarson, Hakon; Harley, John; Jarvik, Gail P.; Kohane, Isaac; Kullo, Iftikhar J.; Larson, Eric B.; McCarty, Catherine; Ritchie, Marylyn D.; Roden, Dan M.; Smith, Maureen E.; Böttinger, Erwin P.; Williams, Marc S.

    2013-01-01

    The Electronic Medical Records and Genomics Network is a National Human Genome Research Institute–funded consortium engaged in the development of methods and best practices for using the electronic medical record as a tool for genomic research. Now in its sixth year and second funding cycle, and comprising nine research groups and a coordinating center, the network has played a major role in validating the concept that clinical data derived from electronic medical records can be used successfully for genomic research. Current work is advancing knowledge in multiple disciplines at the intersection of genomics and health-care informatics, particularly for electronic phenotyping, genome-wide association studies, genomic medicine implementation, and the ethical and regulatory issues associated with genomics research and returning results to study participants. Here, we describe the evolution, accomplishments, opportunities, and challenges of the network from its inception as a five-group consortium focused on genotype–phenotype associations for genomic discovery to its current form as a nine-group consortium pivoting toward the implementation of genomic medicine. Genet Med 15 10, 761–771. PMID:23743551

  10. The Electronic Medical Records and Genomics (eMERGE) Network: past, present, and future.

    PubMed

    Gottesman, Omri; Kuivaniemi, Helena; Tromp, Gerard; Faucett, W Andrew; Li, Rongling; Manolio, Teri A; Sanderson, Saskia C; Kannry, Joseph; Zinberg, Randi; Basford, Melissa A; Brilliant, Murray; Carey, David J; Chisholm, Rex L; Chute, Christopher G; Connolly, John J; Crosslin, David; Denny, Joshua C; Gallego, Carlos J; Haines, Jonathan L; Hakonarson, Hakon; Harley, John; Jarvik, Gail P; Kohane, Isaac; Kullo, Iftikhar J; Larson, Eric B; McCarty, Catherine; Ritchie, Marylyn D; Roden, Dan M; Smith, Maureen E; Böttinger, Erwin P; Williams, Marc S

    2013-10-01

    The Electronic Medical Records and Genomics Network is a National Human Genome Research Institute-funded consortium engaged in the development of methods and best practices for using the electronic medical record as a tool for genomic research. Now in its sixth year and second funding cycle, and comprising nine research groups and a coordinating center, the network has played a major role in validating the concept that clinical data derived from electronic medical records can be used successfully for genomic research. Current work is advancing knowledge in multiple disciplines at the intersection of genomics and health-care informatics, particularly for electronic phenotyping, genome-wide association studies, genomic medicine implementation, and the ethical and regulatory issues associated with genomics research and returning results to study participants. Here, we describe the evolution, accomplishments, opportunities, and challenges of the network from its inception as a five-group consortium focused on genotype-phenotype associations for genomic discovery to its current form as a nine-group consortium pivoting toward the implementation of genomic medicine.

  11. The Electronic Medical Records and Genomics (eMERGE) Network: past, present, and future.

    PubMed

    Gottesman, Omri; Kuivaniemi, Helena; Tromp, Gerard; Faucett, W Andrew; Li, Rongling; Manolio, Teri A; Sanderson, Saskia C; Kannry, Joseph; Zinberg, Randi; Basford, Melissa A; Brilliant, Murray; Carey, David J; Chisholm, Rex L; Chute, Christopher G; Connolly, John J; Crosslin, David; Denny, Joshua C; Gallego, Carlos J; Haines, Jonathan L; Hakonarson, Hakon; Harley, John; Jarvik, Gail P; Kohane, Isaac; Kullo, Iftikhar J; Larson, Eric B; McCarty, Catherine; Ritchie, Marylyn D; Roden, Dan M; Smith, Maureen E; Böttinger, Erwin P; Williams, Marc S

    2013-10-01

    The Electronic Medical Records and Genomics Network is a National Human Genome Research Institute-funded consortium engaged in the development of methods and best practices for using the electronic medical record as a tool for genomic research. Now in its sixth year and second funding cycle, and comprising nine research groups and a coordinating center, the network has played a major role in validating the concept that clinical data derived from electronic medical records can be used successfully for genomic research. Current work is advancing knowledge in multiple disciplines at the intersection of genomics and health-care informatics, particularly for electronic phenotyping, genome-wide association studies, genomic medicine implementation, and the ethical and regulatory issues associated with genomics research and returning results to study participants. Here, we describe the evolution, accomplishments, opportunities, and challenges of the network from its inception as a five-group consortium focused on genotype-phenotype associations for genomic discovery to its current form as a nine-group consortium pivoting toward the implementation of genomic medicine. PMID:23743551

  12. A study of general practitioners’ perspectives on electronic medical records systems in NHSScotland

    PubMed Central

    2013-01-01

    Background Primary care doctors in NHSScotland have been using electronic medical records within their practices routinely for many years. The Scottish Health Executive eHealth strategy (2008-2011) has recently brought radical changes to the primary care computing landscape in Scotland: an information system (GPASS) which was provided free-of-charge by NHSScotland to a majority of GP practices has now been replaced by systems provided by two approved commercial providers. The transition to new electronic medical records had to be completed nationally across all health-boards by March 2012. Methods We carried out 25 in-depth semi-structured interviews with primary care doctors to elucidate GPs’ perspectives on their practice information systems and collect more general information on management processes in the patient surgical pathway in NHSScotland. We undertook a thematic analysis of interviewees’ responses, using Normalisation Process Theory as the underpinning conceptual framework. Results The majority of GPs’ interviewed considered that electronic medical records are an integral and essential element of their work during the consultation, playing a key role in facilitating integrated and continuity of care for patients and making clinical information more accessible. However, GPs expressed a number of reservations about various system functionalities – for example: in relation to usability, system navigation and information visualisation. Conclusion Our study highlights that while electronic information systems are perceived as having important benefits, there remains substantial scope to improve GPs’ interaction and overall satisfaction with these systems. Iterative user-centred improvements combined with additional training in the use of technology would promote an increased understanding, familiarity and command of the range of functionalities of electronic medical records among primary care doctors. PMID:23688255

  13. Developing and Implementing Patients' Full-Scale Electronic Access to Their Health Record.

    PubMed

    Sørensen, Tove; Johansen, Monika A

    2016-01-01

    To increase patients' empowerment and involvement in their own health, several countries has decided to provide patients with electronic access to their health record. This paper reports on the main findings from sub-studies and pilots prior to the implementation of patients' access to their medical records in large-scale in the Northern Norway Region. The largest pilot included nearly 500 patients. Data for the participatory design process was collected through questionnaires and interviews. The results revealed that the service in general functioned as expected. The patients reported that they would continue to use the service, recommend it to others, and generally had no problems in understanding the content. PMID:27577347

  14. Building a national electronic medical record exchange system - experiences in Taiwan.

    PubMed

    Li, Yu-Chuan Jack; Yen, Ju-Chuan; Chiu, Wen-Ta; Jian, Wen-Shan; Syed-Abdul, Shabbir; Hsu, Min-Huei

    2015-08-01

    There are currently 501 hospitals and about 20,000 clinics in Taiwan. The National Health Insurance (NHI) system, which is operated by the NHI Administration, uses a single-payer system and covers 99.9% of the nation's total population of 23,000,000. Taiwan's NHI provides people with a high degree of freedom in choosing their medical care options. However, there is the potential concern that the available medical resources will be overused. The number of doctor consultations per person per year is about 15. Duplication of laboratory tests and prescriptions are not rare either. Building an electronic medical record exchange system is a good method of solving these problems and of improving continuity in health care. In November 2009, Taiwan's Executive Yuan passed the 'Plan for accelerating the implementation of electronic medical record systems in medical institutions' (2010-2012; a 3-year plan). According to this plan, a patient can, at any hospital in Taiwan, by using his/her health insurance IC card and physician's medical professional IC card, upon signing a written agreement, retrieve all important medical records for the past 6 months from other participating hospitals. The focus of this plan is to establish the National Electronic Medical Record Exchange Centre (EEC). A hospital's information system will be connected to the EEC through an electronic medical record (EMR) gateway. The hospital will convert the medical records for the past 6 months in its EMR system into standardized files and save them on the EMR gateway. The most important functions of the EEC are to generate an index of all the XML files on the EMR gateways of all hospitals, and to provide search and retrieval services for hospitals and clinics. The EEC provides four standard inter-institution EMR retrieval services covering medical imaging reports, laboratory test reports, discharge summaries, and outpatient records. In this system, we adopted the Health Level 7 (HL7) Clinical Document

  15. Attitude Towards Health Information Privacy and Electronic Health Records Among Urban Sri Lankan Adults.

    PubMed

    Tissera, Shaluni R; Silva, S N

    2016-01-01

    Sri Lanka is planning to move towards an Electronic Health Record (EHR) system. This research argues that the public preparedness should be considered in order to implement a functioning and an effective EHR system in a country. When asked about how concerned the participants were about the security of their health records, 40.5% stated they were concerned and 38.8% were very concerned. They were asked to rate the 'level of trust' they have on health institutes in Sri Lanka on a scale from 1 to 10 (1 lowest level of trust and 10 highest), 66.1% rated at level 5 or less. PMID:27332453

  16. A Probabilistic Reasoning Method for Predicting the Progression of Clinical Findings from Electronic Medical Records

    PubMed Central

    Goodwin, Travis; Harabagiu, Sanda M.

    2015-01-01

    In this paper, we present a probabilistic reasoning method capable of generating predictions of the progression of clinical findings (CFs) reported in the narrative portion of electronic medical records. This method benefits from a probabilistic knowledge representation made possible by a graphical model. The knowledge encoded in the graphical model considers not only the CFs extracted from the clinical narratives, but also their chronological ordering (CO) made possible by a temporal inference technique described in this paper. Our experiments indicate that the predictions about the progression of CFs achieve high performance given the COs induced from patient records. PMID:26306238

  17. Building a national electronic medical record exchange system - experiences in Taiwan.

    PubMed

    Li, Yu-Chuan Jack; Yen, Ju-Chuan; Chiu, Wen-Ta; Jian, Wen-Shan; Syed-Abdul, Shabbir; Hsu, Min-Huei

    2015-08-01

    There are currently 501 hospitals and about 20,000 clinics in Taiwan. The National Health Insurance (NHI) system, which is operated by the NHI Administration, uses a single-payer system and covers 99.9% of the nation's total population of 23,000,000. Taiwan's NHI provides people with a high degree of freedom in choosing their medical care options. However, there is the potential concern that the available medical resources will be overused. The number of doctor consultations per person per year is about 15. Duplication of laboratory tests and prescriptions are not rare either. Building an electronic medical record exchange system is a good method of solving these problems and of improving continuity in health care. In November 2009, Taiwan's Executive Yuan passed the 'Plan for accelerating the implementation of electronic medical record systems in medical institutions' (2010-2012; a 3-year plan). According to this plan, a patient can, at any hospital in Taiwan, by using his/her health insurance IC card and physician's medical professional IC card, upon signing a written agreement, retrieve all important medical records for the past 6 months from other participating hospitals. The focus of this plan is to establish the National Electronic Medical Record Exchange Centre (EEC). A hospital's information system will be connected to the EEC through an electronic medical record (EMR) gateway. The hospital will convert the medical records for the past 6 months in its EMR system into standardized files and save them on the EMR gateway. The most important functions of the EEC are to generate an index of all the XML files on the EMR gateways of all hospitals, and to provide search and retrieval services for hospitals and clinics. The EEC provides four standard inter-institution EMR retrieval services covering medical imaging reports, laboratory test reports, discharge summaries, and outpatient records. In this system, we adopted the Health Level 7 (HL7) Clinical Document

  18. A Formative and Summative Evaluation of an Electronic Health Record in Community Nursing

    PubMed Central

    Doran, Diane; Bloomberg, Lawrence S.; Reid-Haughian, Cheryl; Cafazzo, Joseph

    2012-01-01

    Implementation of an electronic health record (EHR) system is generally believed to improve the quality of patient care. However due to the variability of systems and users, there is little agreement on successful implementation. The purpose of this research is to evaluate the implementation of a BlackBerry hosted application enabling wireless documentation and access to electronic decision support resources in one home care agency in Ontario. Through mixed-methods including surveys, corporate data collection and interviews, this study investigates nurses’ perceptions of barriers and facilitators to adoption of the electronic clinical information system. Early results highlight usability, organizational culture, evidence-based practice, and factors influencing nurses’ adaptation of this electronic clinical information system. PMID:24199063

  19. A formative and summative evaluation of an electronic health record in community nursing.

    PubMed

    Doran, Diane; Bloomberg, Lawrence S; Reid-Haughian, Cheryl; Cafazzo, Joseph

    2012-01-01

    Implementation of an electronic health record (EHR) system is generally believed to improve the quality of patient care. However due to the variability of systems and users, there is little agreement on successful implementation. The purpose of this research is to evaluate the implementation of a BlackBerry hosted application enabling wireless documentation and access to electronic decision support resources in one home care agency in Ontario. Through mixed-methods including surveys, corporate data collection and interviews, this study investigates nurses' perceptions of barriers and facilitators to adoption of the electronic clinical information system. Early results highlight usability, organizational culture, evidence-based practice, and factors influencing nurses' adaptation of this electronic clinical information system. PMID:24199063

  20. Visualizing collaborative electronic health record usage for hospitalized patients with heart failure

    PubMed Central

    Carson, Matthew B; Lee, Young Ji; Schneider, Daniel H; Skeehan, Connor T; Scholtens, Denise M

    2015-01-01

    Objective To visualize and describe collaborative electronic health record (EHR) usage for hospitalized patients with heart failure. Materials and methods We identified records of patients with heart failure and all associated healthcare provider record usage through queries of the Northwestern Medicine Enterprise Data Warehouse. We constructed a network by equating access and updates of a patient’s EHR to a provider-patient interaction. We then considered shared patient record access as the basis for a second network that we termed the provider collaboration network. We calculated network statistics, the modularity of provider interactions, and provider cliques. Results We identified 548 patient records accessed by 5113 healthcare providers in 2012. The provider collaboration network had 1504 nodes and 83 998 edges. We identified 7 major provider collaboration modules. Average clique size was 87.9 providers. We used a graph database to demonstrate an ad hoc query of our provider-patient network. Discussion Our analysis suggests a large number of healthcare providers across a wide variety of professions access records of patients with heart failure during their hospital stay. This shared record access tends to take place not only in a pairwise manner but also among large groups of providers. Conclusion EHRs encode valuable interactions, implicitly or explicitly, between patients and providers. Network analysis provided strong evidence of multidisciplinary record access of patients with heart failure across teams of 100+ providers. Further investigation may lead to clearer understanding of how record access information can be used to strategically guide care coordination for patients hospitalized for heart failure. PMID:25710558

  1. Relationships between Electronic Information Media and Records Management Practices: Results of a Survey of United Nations Organizations. A Rand Note.

    ERIC Educational Resources Information Center

    Bikson, T. K.; Schieber, L.

    A Technical Panel on Electronic Records Management (TP/REM), which was established by the Advisory Committee for the Co-ordination of Information Systems (ACCIS), conducted a survey of existing electronic records management practices and standards related to new information and communication technologies and their interrelationships within the…

  2. The Impact of Electronic Health Records on Healthcare Professional's Beliefs and Attitudes toward Face to Face Communication

    ERIC Educational Resources Information Center

    Nickles, Kenneth Patrick

    2012-01-01

    The impact of electronic health records on healthcare professional's beliefs and attitudes toward face to face communication during patient and provider interactions was examined. Quantitative survey research assessed user attitudes towards an electronic health record system and revealed that healthcare professionals from a wide range of…

  3. Exploring the Relationships between the Electronic Health Record System Components and Patient Outcomes in an Acute Hospital Setting

    ERIC Educational Resources Information Center

    Wiggley, Shirley L.

    2011-01-01

    Purpose: The purpose of this study was to examine the relationship between the electronic health record system components and patient outcomes in an acute hospital setting, given that the current presidential administration has earmarked nearly $50 billion to the implementation of the electronic health record. The relationship between the…

  4. Assessment of the Need to Integrate Academic Electronic Medical Records Into the Undergraduate Clinical Practicum: A Focus Group Interview.

    PubMed

    Choi, Mona; Park, Joon Ho; Lee, Hyeong Suk

    2016-06-01

    As healthcare systems demand that nurses be competent in using electronic medical records for patient care, the integration of electronic medical records into nursing curricula has become necessary. The purpose of this study was to explore how students, new nurses, clinical instructors, and faculty perceive the integration of academic electronic medical records into the undergraduate clinical practicum. From January to February 2014, four focus group interviews with 18 participants were conducted based on purposive sampling. Content analysis was used on the unabridged transcripts to extract themes and develop meaningful categories. Three major themes and eight subthemes were revealed from the focus group interviews. The major themes were "electronic medical record as a learning tool for clinical practicum," "essential functions of academic electronic medical records," and "expected outcomes of academic electronic medical record." Participants expected academic electronic medical records to enhance students' nursing informatics competencies. The findings of this study can inform the process of developing academic electronic medical records for clinical practicum, which will then augment students' informatics competencies. PMID:27081757

  5. 41 CFR 102-118.80 - Who is responsible for keeping my agency's electronic commerce transportation billing records?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... keeping my agency's electronic commerce transportation billing records? 102-118.80 Section 102-118.80... Transportation and Transportation Services § 102-118.80 Who is responsible for keeping my agency's electronic commerce transportation billing records? Your agency's internal financial regulations will...

  6. Electronic medical record in the simulation hospital: does it improve accuracy in charting vital signs, intake, and output?

    PubMed

    Mountain, Carel; Redd, Roxanne; O'Leary-Kelly, Colleen; Giles, Kim

    2015-04-01

    Nursing care delivery has shifted in response to the introduction of electronic health records. Adequate education using computerized documentation heavily influences a nurse's ability to navigate and utilize electronic medical records. The risk for treatment error increases when a bedside nurse lacks the correct knowledge and skills regarding electronic medical record documentation. Prelicensure nursing education should introduce electronic medical record documentation and provide a method for feedback from instructors to ensure proper understanding and use of this technology. RN preceptors evaluated two groups of associate degree nursing students to determine if introduction of electronic medical record in the simulation hospital increased accuracy in documenting vital signs, intake, and output in the actual clinical setting. During simulation, the first group of students documented using traditional paper and pen; the second group used an academic electronic medical record. Preceptors evaluated each group during their clinical rotations at two local inpatient facilities. RN preceptors provided information by responding to a 10-question Likert scale survey regarding the use of student electronic medical record documentation during the 120-hour inpatient preceptor rotation. The implementation of the electronic medical record into the simulation hospital, although a complex undertaking, provided students a safe and supportive environment in which to practice using technology and receive feedback from faculty regarding accurate documentation.

  7. Solving Electronic Records Management (ERM) Issues for Government Websites: Policies, Practices, and Strategies. Conference Report on Questionnaire and Participant Discussion.

    ERIC Educational Resources Information Center

    Lazar, Jonathan; McClure, Charles R.; Sprehe, J. Timothy

    The purpose of the conference was to review the current legal issues, policies, and practices in Federal ERM electronic records; learn specific strategies and solutions for managing electronic records on Web sites; exchange ideas and share information for Web site ERM; and contribute to the development of ERM policies and guidelines for the…

  8. Electronic health record meets digital library: a new environment for achieving an old goal.

    PubMed

    Humphreys, B L

    2000-01-01

    Linking the electronic health record to the digital library is a Web-era reformulation of the long-standing informatics goal of seamless integration of automated clinical data and relevant knowledge-based information to support informed decisions. The spread of the Internet, the development of the World Wide Web, and converging format standards for electronic health data and digital publications make effective linking increasingly feasible. Some existing systems link electronic health data and knowledge-based information in limited settings or limited ways. Yet many challenging informatics research problems remain to be solved before flexible and seamless linking becomes a reality and before systems become capable of delivering the specific piece of information needed at the time and place a decision must be made. Connecting the electronic health record to the digital library also requires positive resolution of important policy issues, including health data privacy, government encouragement of high-speed communications, electronic intellectual property rights, and standards for health data and for digital libraries. Both the research problems and the policy issues should be important priorities for the field of medical informatics.

  9. An analysis of the paper-based health record: information content and its implications for electronic patient records.

    PubMed

    Geiger, G; Merrilees, K; Walo, R; Gordon, D; Kunov, H

    1995-01-01

    An analysis of paper-based charting was carried out at Sunnybrook Health Sciences Center as a prelude to developing a strategic plan to implement an electronic patient record. A relational model of the Sunnybrook paper chart was developed, describing each of its forms in terms of specific data fields. Three hundred and forty nine different forms are in current use at Sunnybrook, containing 64 types of data fields such as Patient Demographics, Vital Signs, and Doctor's Orders. The extent of data field duplication at the level of hospital forms was significant. A Patient Demographics field was present on all forms and on all pages of a patient's chart, as would be expected. Twenty seven other fields were duplicated on more than ten different forms, including Working Diagnosis which was present on 110 forms, History of Past Illness on 42 forms, and History of Present Illness on 32 forms. Current Medications were recorded on 32 forms and Allergy fields were present on 29 separate forms. Only five data fields of the total 64 were present on only one form. The duplication of data fields within complete patient charts was then examined to confirm that data field duplication was occurring within the actual healthcare delivery process. Using the relational model of the charting system, 143 acute care in-patient encounters were abstracted into the database. The charts were selected randomly from each of the hospital inpatient services. The numbers and types of forms within each chart were recorded, amounting to 18,654 physical pages and using 165 of the different forms. The average in-patient encounter within the model was 130.4 pages long, with a minimum of 27 pages, a maximum of 559 pages, and containing on average 25.8 different forms. The duplication of data fields within actual charts followed a pattern similar to the duplication found on the forms. Initial diagnosis was present on an average of 20.4 pages within the charts, with a minimum of 2 pages and a maximum of

  10. The Impacts of Electronic Health Record Implementation on the Health Care Workforce.

    PubMed

    Zeng, Xiaoming

    2016-01-01

    Health care organizations at various levels are transitioning into the new electronic era by implementing and adopting electronic health record systems. New job roles will be needed for this transition, and some current job roles will inevitably become obsolete due to the change. In addition to training new personnel to fill these new roles, the focus should also be on equipping the current health care workforce with knowledge and skills in health information technology and health informatics that will support their work and improve quality of care. PMID:26961833

  11. A model for consent-based privilege management in personal electronic health records.

    PubMed

    Heinze, Oliver; Bergh, Björn

    2014-01-01

    One of the biggest issues in the domain of standardized, regional, crossinstitutional, personal, electronic health records is the privilege management. While many health information exchange projects use IHE-based architectures there are still unsolved questions regarding the restricting parameters a patient can use in the electronic consent configuring access control. This work determines these parameters, derives an information model of privilege management, introduces a set representation of the model and shows how to apply them to EHR architectures. The introduced model can serve as framework for health information exchanges using a consent-based privilege management. The set representation can help to understand the complexity of consent representations. PMID:25160217

  12. Disciplined doctors: the electronic medical record and physicians' changing relationship to medical knowledge.

    PubMed

    Reich, Adam

    2012-04-01

    This study explores the effects of the electronic medical record (EMR) on the power of the medical profession. It is based on twenty-five in-depth interviews with administrators and physicians across three departments of a large, U.S. integrated health system, as well as ethnographic observation, all of which took place between September of 2009 and December of 2010. While scholarship on professional power has tended toward the opposite poles of professional dominance and deprofessionalization or proletarianization, I find that doctors' interactions with the EMR reconcile these perspectives by making physicians' professional identities consistent with their subordination to bureaucratic authority. After examining the electronic medical record as a disciplinary technology, the paper analyzes variation in the extent to which practitioners' professional identities are reconciled with bureaucratic subordination across the different departments studies.

  13. Security of electronic mental health communication and record-keeping in the digital age.

    PubMed

    Elhai, Jon D; Frueh, B Christopher

    2016-02-01

    The mental health field has seen a trend in recent years of the increased use of information technology, including mobile phones, tablets, and laptop computers, to facilitate clinical treatment delivery to individual patients and for record keeping. However, little attention has been paid to ensuring that electronic communication with patients is private and secure. This is despite potentially deleterious consequences of a data breach, which are reported in the news media very frequently in modern times. In this article, we present typical security concerns associated with using technology in clinical services or research. We also discuss enhancing the privacy and security of electronic communication with clinical patients and research participants. We offer practical, easy-to-use software application solutions for clinicians and researchers to secure patient communication and records. We discuss such issues as using encrypted wireless networks, secure e-mail, encrypted messaging and videoconferencing, privacy on social networks, and others.

  14. Security of electronic mental health communication and record-keeping in the digital age.

    PubMed

    Elhai, Jon D; Frueh, B Christopher

    2016-02-01

    The mental health field has seen a trend in recent years of the increased use of information technology, including mobile phones, tablets, and laptop computers, to facilitate clinical treatment delivery to individual patients and for record keeping. However, little attention has been paid to ensuring that electronic communication with patients is private and secure. This is despite potentially deleterious consequences of a data breach, which are reported in the news media very frequently in modern times. In this article, we present typical security concerns associated with using technology in clinical services or research. We also discuss enhancing the privacy and security of electronic communication with clinical patients and research participants. We offer practical, easy-to-use software application solutions for clinicians and researchers to secure patient communication and records. We discuss such issues as using encrypted wireless networks, secure e-mail, encrypted messaging and videoconferencing, privacy on social networks, and others. PMID:26301860

  15. Photopolymer material sensitized by xanthene dyes for holographic recording using forbidden singlet–triplet electronic transitions

    NASA Astrophysics Data System (ADS)

    Shelkovnikov, Vladimir; Vasiljev, Evgeny; Russkih, Vladimlen; Berezhnaya, Viktoria

    2016-07-01

    A new holographic photopolymer material is developed. The photopolymer material is sensitized by dyes of xanthene and thioxanthene series which contain iodine and bromine heavy atoms. Holographic recording was carried out during excitation of forbidden singlet–triplet electron transitions of dyes. Thioerythrosin triethylammonium was identified as the most effective sensitizer among a number of tested dyes. The spectral absorption area of the singlet–triplet electronic transition of the dye is conveyed in the red spectral range from 600 to 700 nm. The sensitivity of the photopolymer material to radiation with 633 nm wavelength is 180 mJ cm‑2. Optimization of concentration of the main components of the photopolymer compositions was carried out in order to achieve maximum efficiency of holographic recording.

  16. Development of a clinical information tool for the electronic medical record: a case study*

    PubMed Central

    Epstein, Barbara A; Wessel, Charles B; Yarger, Frances; LaDue, John; Fiorillo, Anthony B

    2010-01-01

    Question: What is the process of developing a clinical information tool to be embedded in the electronic health record of a very large and diverse academic medical center? Setting: The development took place at the University of Pittsburgh Health Sciences Library System. Method: The clinical information tool developed is a search box with subject tabs to provide quick access to designated full-text information resources. Each subject tab offers a federated search of a different pool of resources. Search results are organized “on the fly” into meaningful categories using clustering technology and are directly accessible from the results page. Results: After more than a year of discussion and planning, a clinical information tool was embedded in the academic medical center's electronic health record. Conclusion: The library successfully developed a clinical information tool, called Clinical-e, for use at the point of care. Future development will refine the tool and evaluate its impact and effectiveness. PMID:20648256

  17. Mobile health platform for pressure ulcer monitoring with electronic health record integration.

    PubMed

    Rodrigues, Joel J P C; Pedro, Luís M C C; Vardasca, Tomé; de la Torre-Díez, Isabel; Martins, Henrique M G

    2013-12-01

    Pressure ulcers frequently occur in patients with limited mobility, for example, people with advanced age and patients wearing casts or prostheses. Mobile information communication technologies can help implement ulcer care protocols and the monitoring of patients with high risk, thus preventing or improving these conditions. This article presents a mobile pressure ulcer monitoring platform (mULCER), which helps control a patient's ulcer status during all stages of treatment. Beside its stand-alone version, it can be integrated with electronic health record systems as mULCER synchronizes ulcer data with any electronic health record system using HL7 standards. It serves as a tool to integrate nursing care among hospital departments and institutions. mULCER was experimented with in different mobile devices such as LG Optimus One P500, Samsung Galaxy Tab, HTC Magic, Samsung Galaxy S, and Samsung Galaxy i5700, taking into account the user's experience of different screen sizes and processing characteristics.

  18. Identification and Progression of Heart Disease Risk Factors in Diabetic Patients from Longitudinal Electronic Health Records

    PubMed Central

    Jonnagaddala, Jitendra; Liaw, Siaw-Teng; Ray, Pradeep; Kumar, Manish; Dai, Hong-Jie; Hsu, Chien-Yeh

    2015-01-01

    Heart disease is the leading cause of death worldwide. Therefore, assessing the risk of its occurrence is a crucial step in predicting serious cardiac events. Identifying heart disease risk factors and tracking their progression is a preliminary step in heart disease risk assessment. A large number of studies have reported the use of risk factor data collected prospectively. Electronic health record systems are a great resource of the required risk factor data. Unfortunately, most of the valuable information on risk factor data is buried in the form of unstructured clinical notes in electronic health records. In this study, we present an information extraction system to extract related information on heart disease risk factors from unstructured clinical notes using a hybrid approach. The hybrid approach employs both machine learning and rule-based clinical text mining techniques. The developed system achieved an overall microaveraged F-score of 0.8302. PMID:26380290

  19. MDPHnet: secure, distributed sharing of electronic health record data for public health surveillance, evaluation, and planning.

    PubMed

    Vogel, Joshua; Brown, Jeffrey S; Land, Thomas; Platt, Richard; Klompas, Michael

    2014-12-01

    Electronic health record systems contain clinically detailed data from large populations of patients that could significantly enrich public health surveillance. Clinical practices' security, privacy, and proprietary concerns, however, have limited their willingness to share these data with public health agencies. We describe a novel distributed network for public health surveillance called MDPHnet. The system allows the Massachusetts Department of Public Health (MDPH) to initiate custom queries against participating practices' electronic health records while the data remain behind each practice's firewall. Practices can review proposed queries before execution and approve query results before releasing them to the health department. MDPH is using the system for routine surveillance for priority conditions and to evaluate the impact of public health interventions. PMID:25322301

  20. The impact of electronic health records on client safety in aged care homes.

    PubMed

    Jiang, Tao; Yu, Ping

    2014-01-01

    This study collects and critically reviews the published literature to synthesize the risk factors for client safety in residential aged care and the potential contributions of electronic health records to reducing these risks. Three major types of risk factors for client safety were identified: risk factors related to the person's health; those related to the health and aged care system serving the person and those related to human error. Multiple strategies at all levels of an aged care organization are needed to reduce risks and improve client safety. Electronic health records can be one of the effective organizational mechanisms because it improves access to better information and integrates intelligent functions to support point-of-care decision making.

  1. Phase-change recording medium that enables ultrahigh-density electron-beam data storage

    SciTech Connect

    Gibson, G.A.; Chaiken, A.; Nauka, K.; Yang, C.C.; Davidson, R.; Holden, A.; Bicknell, R.; Yeh, B.S; Chen, J.; Liao, H.; Subramanian, S.; Schut, D.; Jasinski, J.; Liliental-Weber, Z.

    2005-01-31

    An ultrahigh-density electron-beam-based data storage medium is described that consists of a diode formed by growing an InSe/GaSe phase-change bilayer film epitaxially on silicon. Bits are recorded as amorphous regions in the InSe layer and are detected via the current induced in the diode by a scanned electron beam. This signal current is modulated by differences in the electrical properties of the amorphous and crystalline states. The success of this recording scheme results from the remarkable ability of layered III-VI materials, such as InSe, to maintain useful electrical properties at their surfaces after repeated cycles of amorphization and recrystallization.

  2. Electronic Health Record Mid-Parental Height Auto-Calculator for Growth Assessment in Primary Care.

    PubMed

    Lipman, Terri H; Cousounis, Pamela; Grundmeier, Robert W; Massey, James; Cucchiara, Andrew J; Stallings, Virginia A; Grimberg, Adda

    2016-10-01

    Primary care providers are charged with distinguishing children with an underlying growth problem from those with healthy variant short stature. Knowing the heights of the biological parents aids in making that decision. This study sought to determine the feasibility and functionality of an electronic mid-parental height (MPH) auto-calculator in the clinical assessment of child growth in a pediatric primary care setting. Clinicians completed surveys for 62% of 6803 children (mean height 13 ± 7 percentile) with recorded parent heights. Collecting parent height data required <30 seconds in 91% of encounters. The MPH tool confirmed clinicians' initial growth assessment in 79% of cases and changed it in 4%; the remainder did not use the tool. Clinicians who changed assessment were more likely (P < .0001) to pursue more comprehensive evaluation. The MPH tool was a quick, functional resource as a component of an electronic health record system in actual, busy, pediatric primary care practices.

  3. [ELGA--the electronic health record in the light of data protection and data security].

    PubMed

    Ströher, Alexander; Honekamp, Wilfried

    2011-07-01

    The introduction of an electronic health record (ELGA) is a subject discussed for a long time in Austria. Another big step toward ELGA is made at the end of 2010 on the pilot project e-medication in three model regions; other projects should follow. In addition, projects of the ELGA structure are sped up on the part of the ELGA GmbH to install the base of a functioning electronic health record. Unfortunately, many of these initiatives take place, so to speak, secretly, so that in the consciousness of the general public - and that includes not only patients but also physicians and other healthcare providers - always concerns about protection and security of such a storage of health data arouse. In this article the bases of the planned act are discussed taking into account the data protection and data security. PMID:21858632

  4. A Proposal for Electronic Medical Records in U.S. Primary Care

    PubMed Central

    Bates, David W.; Ebell, Mark; Gotlieb, Edward; Zapp, John; Mullins, H.C.

    2003-01-01

    Delivery of excellent primary care—central to overall medical care—demands that providers have the necessary information when they give care. This paper, developed by the National Alliance for Primary Care Informatics, a collaborative group sponsored by a number of primary care societies, argues that providers’ and patients’ information and decision support needs can be satisfied only if primary care providers use electronic medical records (EMRs). Although robust EMRs are now available, only about 5% of U.S. primary care providers use them. Recently, with only modest investments, Australia, New Zealand, and England have achieved major breakthroughs in implementing EMRs in primary care. Substantial benefits realizable through routine use of electronic medical records include improved quality, safety, and efficiency, along with increased ability to conduct education and research. Nevertheless, barriers to adoption exist and must be overcome. Implementing specific policies can accelerate utilization of EMRs in the U.S. PMID:12509352

  5. Catching a Cold When It's Warm

    MedlinePlus

    ... our exit disclaimer . Subscribe Catching a Cold When It’s Warm What’s the Deal with Summertime Sniffles? Most ... be more unfair than catching a cold when it’s warm? How can cold symptoms arise when it’s ...

  6. Practicing preventive ethics, protecting patients: challenges of the electronic health record.

    PubMed

    Satkoske, Valerie B; Parker, Lisa S

    2010-01-01

    Implementation of guidelines regarding breaches of electronic health information requires an anticipatory stance and physician and patient education regarding security and monitoring measures and methods of redress. Adopting a preventive ethics, rather than a crisis management, model may also increase physician awareness of how the information they choose to include and privilege within the health record may expose patients to added harms if not done mindfully.

  7. Cloud-based Electronic Health Records for Real-time, Region-specific Influenza Surveillance

    PubMed Central

    Santillana, M.; Nguyen, A. T.; Louie, T.; Zink, A.; Gray, J.; Sung, I.; Brownstein, J. S.

    2016-01-01

    Accurate real-time monitoring systems of influenza outbreaks help public health officials make informed decisions that may help save lives. We show that information extracted from cloud-based electronic health records databases, in combination with machine learning techniques and historical epidemiological information, have the potential to accurately and reliably provide near real-time regional estimates of flu outbreaks in the United States. PMID:27165494

  8. Everyday ethical dilemmas arising with electronic record use in primary care.

    PubMed

    Balka, Ellen; Tolar, Marianne

    2011-01-01

    The introduction of electronic medical record systems (EMRs) into primary care settings alters work practices, introduces new challenges, and new roles. In the process of integrating an EMR into a primary care setting, clinic staff faced ethical challenges in their everyday work practices resulting from workarounds undertaken to compensate for a poor fit between system design and work practices, issues related to system access, and governance gaps. Examples of these issues are presented, and implications for system design are discussed.

  9. Technology and Health Care: Efficiency, Frustration, and Disconnect in the Transition to Electronic Medical Records

    PubMed Central

    Magsamen-Conrad, Kate; Checton, Maria

    2014-01-01

    This study investigates one medical facility's transition to electronic medical records (becoming “paperless”). We utilized face-to-face interviews to investigate the transition process with one implementer (the vice president of the medical facility) and three stakeholders from one of the four offices (an assistant office manager, a nurse, and a medical technician). We discuss the dominant themes of efficiency, frustration, and disconnect as well as conclusions and implications. PMID:25729754

  10. A pragmatic method for electronic medical record-based observational studies: developing an electronic medical records retrieval system for clinical research

    PubMed Central

    Yamamoto, Keiichi; Sumi, Eriko; Yamazaki, Toru; Asai, Keita; Yamori, Masashi; Teramukai, Satoshi; Bessho, Kazuhisa; Yokode, Masayuki; Fukushima, Masanori

    2012-01-01

    Objective The use of electronic medical record (EMR) data is necessary to improve clinical research efficiency. However, it is not easy to identify patients who meet research eligibility criteria and collect the necessary information from EMRs because the data collection process must integrate various techniques, including the development of a data warehouse and translation of eligibility criteria into computable criteria. This research aimed to demonstrate an electronic medical records retrieval system (ERS) and an example of a hospital-based cohort study that identified both patients and exposure with an ERS. We also evaluated the feasibility and usefulness of the method. Design The system was developed and evaluated. Participants In total, 800 000 cases of clinical information stored in EMRs at our hospital were used. Primary and secondary outcome measures The feasibility and usefulness of the ERS, the method to convert text from eligible criteria to computable criteria, and a confirmation method to increase research data accuracy. Results To comprehensively and efficiently collect information from patients participating in clinical research, we developed an ERS. To create the ERS database, we designed a multidimensional data model optimised for patient identification. We also devised practical methods to translate narrative eligibility criteria into computable parameters. We applied the system to an actual hospital-based cohort study performed at our hospital and converted the test results into computable criteria. Based on this information, we identified eligible patients and extracted data necessary for confirmation by our investigators and for statistical analyses with our ERS. Conclusions We propose a pragmatic methodology to identify patients from EMRs who meet clinical research eligibility criteria. Our ERS allowed for the efficient collection of information on the eligibility of a given patient, reduced the labour required from the investigators and

  11. THE CHALLENGES IN USING ELECTRONIC HEALTH RECORDS FOR PHARMACOGENOMICS AND PRECISION MEDICINE RESEARCH.

    PubMed

    Laper, Sarah M; Restrepo, Nicole A; Crawford, Dana C

    2016-01-01

    Access and utilization of electronic health records with extensive medication lists and genetic profiles is rapidly advancing discoveries in pharmacogenomics. In this study, we analyzed ~116,000 variants on the Illumina Metabochip for response to antihypertensive and lipid lowering medications in African American adults from BioVU, the Vanderbilt University Medical Center's biorepository linked to de-identified electronic health records. Our study population included individuals who were prescribed an antihypertensive or lipid lowering medication, and who had both pre- and post-medication blood pressure or low-density lipoprotein cholesterol (LDL-C) measurements, respectively. Among those with pre- and post-medication systolic and diastolic blood pressure measurements (n=2,268), the average change in systolic and diastolic blood pressure was -0.6 mg Hg and -0.8 mm Hg, respectively. Among those with pre- and post-medication LDL-C measurements (n=1,244), the average change in LDL-C was -26.3 mg/dL. SNPs were tested for an association with change and percent change in blood pressure or blood levels of LDL-C. After adjustment for multiple testing, we did not observe any significant associations, and we were not able to replicate previously reported associations, such as in APOE and LPA, from the literature. The present study illustrates the benefits and challenges with using electronic health records linked to biorepositories for pharmacogenomic studies.

  12. Factors influencing nursing students' acceptance of electronic health records for nursing education (EHRNE) software program.

    PubMed

    Kowitlawakul, Yanika; Chan, Sally Wai Chi; Pulcini, Joyce; Wang, Wenru

    2015-01-01

    The Institute of Medicine (IOM) and the Health Information Technology Act (2009) in America had recommended that electronic health records (EHRs) should be fully adopted by 2014. This has urged educational institutions to prepare healthcare professionals to be competent in using electronic health records (EHRs) while they are in schools. To equip nursing students with competency in using EHRs, an electronic health record for nursing education (EHRNE) has been developed and integrated it into nursing curricula. The purposes of the study were to investigate the factors influencing nursing students' acceptance of the EHRs in nursing education using the extended Technology Acceptance Model with self-efficacy as a conceptual framework. The study is a descriptive study design using self-reported questionnaires with 212 student participants. The IBM SPSS and AMOS 22.0 were used to analyze the data. The results showed that attitude toward using the EHRNE was the most influential factor on students' acceptance. The preliminary findings suggested that to enhance the students' acceptance of the EHRNE, cultivation of a positive attitude toward using this EHR as well as increasing the perceived usefulness is very important. Also, the study's framework could be used in guiding learning health informatics and be applied to nursing students.

  13. Impact of electronic health record (EHR) reminder on human papillomavirus (HPV) vaccine initiation and timely completion

    PubMed Central

    Ruffin, Mack T.; Plegue, Melissa A.; Rockwell, Pamela G.; Young, Alisa P.; Patel, Divya A.; Yeazel, Mark W.

    2016-01-01

    Background Initiation and timely completion of the HPV vaccine in young women is critical. We compared initiation and completion of HPV vaccine among women in two community-based networks with electronic health records: one with a prompt and reminder system (prompted cohort) and one without (unprompted cohort). Methods Female patients aged 9–26 years seen between March 1, 2007 and January 25, 2010 were used as retrospective cohorts. Patient demographics and vaccination dates were extracted from the electronic health record. Results Patients eligible for the vaccine included 6019 from the prompted cohort and 9096 from the unprompted cohort. Mean age at initiation was 17.3 years in prompted cohort and 18.1 years at unprompted cohort with significantly more (p<0.001) patients initiating in the prompted cohort (34.9%) compared to the unprompted cohort (21.5%). African Americans age 9–18 years with three or more visits during the observation period were significantly more likely to initiate in the prompted cohort (p<0.001). Prompted cohort was significantly more (p<0.001) likely to complete the vaccine series timely compared to unprompted cohort. Conclusion More patients age 9–26 years initiated and timely completed the HPV vaccine series in clinics using an electronic health record system with prompts compared to clinics without prompts. PMID:25957365

  14. What does validation of cases in electronic record databases mean? The potential contribution of free text.

    PubMed

    Nicholson, Amanda; Tate, Anne Rosemary; Koeling, Rob; Cassell, Jackie A

    2011-03-01

    Electronic health records are increasingly used for research. The definition of cases or endpoints often relies on the use of coded diagnostic data, using a pre-selected group of codes. Validation of these cases, as 'true' cases of the disease, is crucial. There are, however, ambiguities in what is meant by validation in the context of electronic records. Validation usually implies comparison of a definition against a gold standard of diagnosis and the ability to identify false negatives ('true' cases which were not detected) as well as false positives (detected cases which did not have the condition). We argue that two separate concepts of validation are often conflated in existing studies. Firstly, whether the GP thought the patient was suffering from a particular condition (which we term confirmation or internal validation) and secondly, whether the patient really had the condition (external validation). Few studies have the ability to detect false negatives who have not received a diagnostic code. Natural language processing is likely to open up the use of free text within the electronic record which will facilitate both the validation of the coded diagnosis and searching for false negatives.

  15. The impact of using electronic patient records on practices of reading and writing.

    PubMed

    Laitinen, Heleena; Kaunonen, Marja; Åstedt-Kurki, Paivi

    2014-12-01

    The aim of this study was to investigate the use of electronic patient records in daily practice. In four wards of a large hospital district in Finland, N = 43 patients' care and activities were observed and analysed in terms of the Grounded Theory method. The findings revealed that using electronic patient records created a particular process of writing and reading. Wireless technology enabled simultaneous patient involvement and point-of-care documentation, additionally supporting real-time reading. Remote and retrospective documentation was distant in terms of both space and time. The remoteness caused double documentation, reduced accuracy and less-efficient use of time. 'Non-reading' practices were witnessed in retrospective reading, causing delays in patient care and increase in workload. Similarly, if documentation was insufficient or non-existent, the consequences were found to be detrimental to the patients. The use of an electronic patient record system has a significant impact on patient care. Therefore, it is crucial to develop wireless technology and interdisciplinary collaboration in order to improve and support high-quality patient care.

  16. Bringing electronic patient records into health professional education: towards an integrative framework.

    PubMed

    Kushniruk, Andre W; Borycki, Elizabeth M; Armstrong, Brian; Joe, Ron; Otto, Tony

    2009-01-01

    In this paper we discuss our approach for integrating electronic patient records into health professional education. Electronic patient record (EPR) use is increasing globally. The EPR is considered the cornerstone of the modernization and streamlining of healthcare worldwide. However, despite the importance of the EPR, health professional education in much of the world provides health professional students (who will become the practicing health professionals of the future) with limited access or knowledge about the EPR. New ways of exposing students to EPRs will be needed in order to ensure that health professionals will adopt and use this complex technology wisely and effect the positive benefits EPRs are expected to bring to healthcare globally. In this paper we describe: (a) a framework we have developed for integrating EPRs into health professional education and (b) an innovative Web portal, known as the University of Victoria Electronic Health Record (EHR) Educational Portal (which houses a number of EPRs) that can be used to explore the integration of EPRs in health professional education. It is hoped that adoption and use of EPRs will ultimately be improved through the use of the portal to allow students virtual and ubiquitous access to example EPRs, coupled with principled educational approaches for integrating EPR technology into health professional curricula.

  17. Realization of a universal patient identifier for electronic medical records through biometric technology.

    PubMed

    Leonard, D C; Pons, Alexander P; Asfour, Shihab S

    2009-07-01

    The technology exists for the migration of healthcare data from its archaic paper-based system to an electronic one, and, once in digital form, to be transported anywhere in the world in a matter of seconds. The advent of universally accessible healthcare data has benefited all participants, but one of the outstanding problems that must be addressed is how the creation of a standardized nationwide electronic healthcare record system in the United States would uniquely identify and match a composite of an individual's recorded healthcare information to an identified individual patients out of approximately 300 million people to a 1:1 match. To date, a few solutions to this problem have been proposed that are limited in their effectiveness. We propose the use of biometric technology within our fingerprint, iris, retina scan, and DNA (FIRD) framework, which is a multiphase system whose primary phase is a multilayer consisting of these four types of biometric identifiers: 1) fingerprint; 2) iris; 3) retina scan; and 4) DNA. In addition, it also consists of additional phases of integration, consolidation, and data discrepancy functions to solve the unique association of a patient to their medical data distinctively. This would allow a patient to have real-time access to all of their recorded healthcare information electronically whenever it is necessary, securely with minimal effort, greater effectiveness, and ease. PMID:19273015

  18. Innovative information visualization of electronic health record data: a systematic review

    PubMed Central

    West, Vivian L; Borland, David; Hammond, W Ed

    2015-01-01

    Objective This study investigates the use of visualization techniques reported between 1996 and 2013 and evaluates innovative approaches to information visualization of electronic health record (EHR) data for knowledge discovery. Methods An electronic literature search was conducted May–July 2013 using MEDLINE and Web of Knowledge, supplemented by citation searching, gray literature searching, and reference list reviews. General search terms were used to assure a comprehensive document search. Results Beginning with 891 articles, the number of articles was reduced by eliminating 191 duplicates. A matrix was developed for categorizing all abstracts and to assist with determining those to be excluded for review. Eighteen articles were included in the final analysis. Discussion Several visualization techniques have been extensively researched. The most mature system is LifeLines and its applications as LifeLines2, EventFlow, and LifeFlow. Initially, research focused on records from a single patient and visualization of the complex data related to one patient. Since 2010, the techniques under investigation are for use with large numbers of patient records and events. Most are linear and allow interaction through scaling and zooming to resize. Color, density, and filter techniques are commonly used for visualization. Conclusions With the burgeoning increase in the amount of electronic healthcare data, the potential for knowledge discovery is significant if data are managed in innovative and effective ways. We identify challenges discovered by previous EHR visualization research, which will help researchers who seek to design and improve visualization techniques. PMID:25336597

  19. Grasping in One-Handed Catching in Relation to Performance

    PubMed Central

    Cesqui, Benedetta; Russo, Marta; Lacquaniti, Francesco; d’Avella, Andrea

    2016-01-01

    Catching a flying ball involves bringing the hand to the aimed interception point at the right time, adjusting the hand posture to receive the incoming ball and to absorb the ball momentum, and closing the hand to ensure a stable grip. A small error in any of these actions can lead to a failure in catching the ball. Here we sought to gather new insights on what aspects of the catching movements affect the interceptive performance most. In particular, we wondered whether the errors occurred in bringing the hand to the interception point or in closing the fingers on the ball, and whether these two phases of interception differed between individuals. To this end, we characterized grasping and wrist movement kinematics of eleven participants attempting to catch a ball projected in space with different ball arrival heights and flight durations. The spatial position of the ball and of several markers placed on the participant’s arm were recorded by a motion capture system, the hand joint angles were recorded with an instrumented glove, and several movement features were extracted. All participants were able to intercept the ball trajectory (i.e. to touch the ball) in over 90% of cases, but they differed in the ability to grasp the ball (success rate varied between 2% and 85%). Similar temporal features were observed across individuals when they caught the ball. In particular, all participants adapted their wrist movements under varying temporal and arrival height constraints, they aligned the time of peak hand closing velocity to the time of hand-ball contact, and they maintained the same hand closing duration in the different experimental conditions. These movement features characterized successful trials, and hence allowed to evaluate the possible sources of errors underlying unsuccessful trials. Thus, inter-individual and inter-trial variability in the modulation of each kinematic feature were related to catching performance. We observed that different participants

  20. Grasping in One-Handed Catching in Relation to Performance.

    PubMed

    Cesqui, Benedetta; Russo, Marta; Lacquaniti, Francesco; d'Avella, Andrea

    2016-01-01

    Catching a flying ball involves bringing the hand to the aimed interception point at the right time, adjusting the hand posture to receive the incoming ball and to absorb the ball momentum, and closing the hand to ensure a stable grip. A small error in any of these actions can lead to a failure in catching the ball. Here we sought to gather new insights on what aspects of the catching movements affect the interceptive performance most. In particular, we wondered whether the errors occurred in bringing the hand to the interception point or in closing the fingers on the ball, and whether these two phases of interception differed between individuals. To this end, we characterized grasping and wrist movement kinematics of eleven participants attempting to catch a ball projected in space with different ball arrival heights and flight durations. The spatial position of the ball and of several markers placed on the participant's arm were recorded by a motion capture system, the hand joint angles were recorded with an instrumented glove, and several movement features were extracted. All participants were able to intercept the ball trajectory (i.e. to touch the ball) in over 90% of cases, but they differed in the ability to grasp the ball (success rate varied between 2% and 85%). Similar temporal features were observed across individuals when they caught the ball. In particular, all participants adapted their wrist movements under varying temporal and arrival height constraints, they aligned the time of peak hand closing velocity to the time of hand-ball contact, and they maintained the same hand closing duration in the different experimental conditions. These movement features characterized successful trials, and hence allowed to evaluate the possible sources of errors underlying unsuccessful trials. Thus, inter-individual and inter-trial variability in the modulation of each kinematic feature were related to catching performance. We observed that different participants

  1. Grasping in One-Handed Catching in Relation to Performance.

    PubMed

    Cesqui, Benedetta; Russo, Marta; Lacquaniti, Francesco; d'Avella, Andrea

    2016-01-01

    Catching a flying ball involves bringing the hand to the aimed interception point at the right time, adjusting the hand posture to receive the incoming ball and to absorb the ball momentum, and closing the hand to ensure a stable grip. A small error in any of these actions can lead to a failure in catching the ball. Here we sought to gather new insights on what aspects of the catching movements affect the interceptive performance most. In particular, we wondered whether the errors occurred in bringing the hand to the interception point or in closing the fingers on the ball, and whether these two phases of interception differed between individuals. To this end, we characterized grasping and wrist movement kinematics of eleven participants attempting to catch a ball projected in space with different ball arrival heights and flight durations. The spatial position of the ball and of several markers placed on the participant's arm were recorded by a motion capture system, the hand joint angles were recorded with an instrumented glove, and several movement features were extracted. All participants were able to intercept the ball trajectory (i.e. to touch the ball) in over 90% of cases, but they differed in the ability to grasp the ball (success rate varied between 2% and 85%). Similar temporal features were observed across individuals when they caught the ball. In particular, all participants adapted their wrist movements under varying temporal and arrival height constraints, they aligned the time of peak hand closing velocity to the time of hand-ball contact, and they maintained the same hand closing duration in the different experimental conditions. These movement features characterized successful trials, and hence allowed to evaluate the possible sources of errors underlying unsuccessful trials. Thus, inter-individual and inter-trial variability in the modulation of each kinematic feature were related to catching performance. We observed that different participants

  2. Improving the Effectiveness of Electronic Health Record-Based Referral Processes

    PubMed Central

    2012-01-01

    Electronic health records are increasingly being used to facilitate referral communication in the outpatient setting. However, despite support by technology, referral communication between primary care providers and specialists is often unsatisfactory and is unable to eliminate care delays. This may be in part due to lack of attention to how information and communication technology fits within the social environment of health care. Making electronic referral communication effective requires a multifaceted “socio-technical” approach. Using an 8-dimensional socio-technical model for health information technology as a framework, we describe ten recommendations that represent good clinical practices to design, develop, implement, improve, and monitor electronic referral communication in the outpatient setting. These recommendations were developed on the basis of our previous work, current literature, sound clinical practice, and a systems-based approach to understanding and implementing health information technology solutions. Recommendations are relevant to system designers, practicing clinicians, and other stakeholders considering use of electronic health records to support referral communication. PMID:22973874

  3. Improving the effectiveness of electronic health record-based referral processes.

    PubMed

    Esquivel, Adol; Sittig, Dean F; Murphy, Daniel R; Singh, Hardeep

    2012-01-01

    Electronic health records are increasingly being used to facilitate referral communication in the outpatient setting. However, despite support by technology, referral communication between primary care providers and specialists is often unsatisfactory and is unable to eliminate care delays. This may be in part due to lack of attention to how information and communication technology fits within the social environment of health care. Making electronic referral communication effective requires a multifaceted "socio-technical" approach. Using an 8-dimensional socio-technical model for health information technology as a framework, we describe ten recommendations that represent good clinical practices to design, develop, implement, improve, and monitor electronic referral communication in the outpatient setting. These recommendations were developed on the basis of our previous work, current literature, sound clinical practice, and a systems-based approach to understanding and implementing health information technology solutions. Recommendations are relevant to system designers, practicing clinicians, and other stakeholders considering use of electronic health records to support referral communication. PMID:22973874

  4. Can routine information from electronic patient records predict a future diagnosis of alcohol use disorder?

    PubMed Central

    Lid, Torgeir Gilje; Eide, Geir Egil; Dalen, Ingvild; Meland, Eivind

    2016-01-01

    Objective To explore whether information regarding potentially alcohol-related health incidents recorded in electronic patient records might aid in earlier identification of alcohol use disorders. Design We extracted potentially alcohol-related information in electronic patient records and tested if alcohol-related diagnoses, prescriptions of codeine, tramadol, ethylmorphine, and benzodiazepines; elevated levels of gamma-glutamyl-transferase (GGT), and mean cell volume (MCV); and new sick leave certificates predicted specific alcohol use disorder. Setting Nine general practitioner surgeries with varying size and stability. Subjects Totally 20,764 patients with active electronic patient record until data gathering and with a history of at least four years without a specific alcohol use disorder after turning 18 years of age. Methods The Cox proportional hazard analysis with time-dependent covariates of potential accumulated risks over the previous four years. Main outcome measures Time from inclusion until the first specific alcohol use disorder, defined by either an alcohol specific diagnostic code or a text fragment documenting an alcohol problem. Results In the unadjusted and adjusted Cox-regression with time-dependent covariates all variables were highly significant with adjusted hazard ratios ranging from 1.25 to 3.50. Addictive drugs, sick leaves, GGT, MCV and International Classification for Primary Care version 2 (ICPC-2), and International Classification of Diseases version 10 (ICD-10) diagnoses were analyzed. Elevated GGT and MCV, ICD-10-diagnoses, and gender demonstrated the highest hazard ratios. Conclusions Many frequent health problems are potential predictors of an increased risk or vulnerability for alcohol use disorders. However, due to the modest hazard ratios, we were unable to establish a clinically useful tool. Key Points Alcohol is potentially relevant for many health problems, but current strategies for identification and intervention in

  5. Pan-Canadian REspiratory STandards INitiative for Electronic Health Records (PRESTINE): 2011 National Forum Proceedings

    PubMed Central

    Lougheed, M Diane; Minard, Janice; Dworkin, Shari; Juurlink, Mary-Ann; Temple, Walley J; To, Teresa; Koehn, Marc; Van Dam, Anne; Boulet, Louis-Philippe

    2012-01-01

    In a novel knowledge translation initiative, the Government of Ontario’s Asthma Plan of Action funded the development of an Asthma Care Map to enable adherence with the Canadian Asthma Consensus Guidelines developed under the auspices of the Canadian Thoracic Society (CTS). Following its successful evaluation within the Primary Care Asthma Pilot Project, respiratory clinicians from the Asthma Research Unit, Queen’s University (Kingston, Ontario) are leading an initiative to incorporate standardized Asthma Care Map data elements into electronic health records in primary care in Ontario. Acknowledging that the issue of data standards affects all respiratory conditions, and all provinces and territories, the Government of Ontario approached the CTS Respiratory Guidelines Committee. At its meeting in September 2010, the CTS Respiratory Guidelines Committee agreed that developing and standardizing respiratory data elements for electronic health records are strategically important. In follow-up to that commitment, representatives from the CTS, the Lung Association, the Government of Ontario, the National Lung Health Framework and Canada Health Infoway came together to form a planning committee. The planning committee proposed a phased approach to inform stakeholders about the issue, and engage them in the development, implementation and evaluation of a standardized dataset. An environmental scan was completed in July 2011, which identified data definitions and standards currently available for clinical variables that are likely to be included in electronic medical records in primary care for diagnosis, management and patient education related to asthma and COPD. The scan, sponsored by the Government of Ontario, includes compliance with clinical nomenclatures such as SNOMED-CT® and LOINC®. To help launch and create momentum for this initiative, a national forum was convened on October 2 and 3, 2011, in Toronto, Ontario. The forum was designed to bring together key

  6. Pan-Canadian REspiratory STandards INitiative for Electronic Health Records (PRESTINE): 2011 national forum proceedings.

    PubMed

    Lougheed, M Diane; Minard, Janice; Dworkin, Shari; Juurlink, Mary-Ann; Temple, Walley J; To, Teresa; Koehn, Marc; Van Dam, Anne; Boulet, Louis-Philippe

    2012-01-01

    In a novel knowledge translation initiative, the Government of Ontario's Asthma Plan of Action funded the development of an Asthma Care Map to enable adherence with the Canadian Asthma Consensus Guidelines developed under the auspices of the Canadian Thoracic Society (CTS). Following its successful evaluation within the Primary Care Asthma Pilot Project, respiratory clinicians from the Asthma Research Unit, Queen's University (Kingston, Ontario) are leading an initiative to incorporate standardized Asthma Care Map data elements into electronic health records in primary care in Ontario. Acknowledging that the issue of data standards affects all respiratory conditions, and all provinces and territories, the Government of Ontario approached the CTS Respiratory Guidelines Committee. At its meeting in September 2010, the CTS Respiratory Guidelines Committee agreed that developing and standardizing respiratory data elements for electronic health records are strategically important. In follow-up to that commitment, representatives from the CTS, the Lung Association, the Government of Ontario, the National Lung Health Framework and Canada Health Infoway came together to form a planning committee. The planning committee proposed a phased approach to inform stakeholders about the issue, and engage them in the development, implementation and evaluation of a standardized dataset. An environmental scan was completed in July 2011, which identified data definitions and standards currently available for clinical variables that are likely to be included in electronic medical records in primary care for diagnosis, management and patient education related to asthma and COPD. The scan, sponsored by the Government of Ontario, includes compliance with clinical nomenclatures such as SNOMED-CT® and LOINC®. To help launch and create momentum for this initiative, a national forum was convened on October 2 and 3, 2011, in Toronto, Ontario. The forum was designed to bring together key

  7. New schemes for recording electron diffraction patterns of hexagonal and monoclinic crystals

    NASA Astrophysics Data System (ADS)

    Kyazumov, M. G.

    2014-07-01

    Some new schemes for recording electron diffraction patterns of hexagonal crystals rotating around the axes lying in the ( hk0) plane of the reciprocal lattice and monoclinic crystals rotating around the a and b axes of the direct lattice and the a* axis of the reciprocal lattice have been developed. Formulas for interpreting electron diffraction patterns are reported. The electron diffraction patterns obtained based on these schemes were used to solve the 2H and 3R polytypes of CdInGaS4 crystals and the 3R polytype of Zn1.5In3Se6 crystal with the parameters a = 4.046 and c = 59.292 Å, sp. gr. R3 m.

  8. Rapid progress or lengthy process? Electronic personal health records in mental health.

    PubMed

    Ennis, Liam; Rose, Diana; Callard, Felicity; Denis, Mike; Wykes, Til

    2011-01-01

    A major objective of many healthcare providers is to increase patients' participation in their own care. The introduction of electronic personal health records (ePHRs) may help to achieve this. An ePHR is an electronic database of an individual's health information, accessible to and maintained by the patient. ePHRs are very much in vogue, with an increasing number of studies reporting their potential utility as well as cost. However, the vast majority of these studies focus on general healthcare. Little attempt has been made to document the specific problems which might occur throughout the implementation of ePHRs in mental health. This review identifies such concerns through an electronic search of the literature. Several potential difficulties are highlighted and addressed, including access to information technology, identifying relevant populations and the handling of sensitive information. Special attention is paid to the concept of 'empowerment' and what this means in relation to ePHRs.

  9. A knowledge-based taxonomy of critical factors for adopting electronic health record systems by physicians: a systematic literature review

    PubMed Central

    2010-01-01

    Background The health care sector is an area of social and economic interest in several countries; therefore, there have been lots of efforts in the use of electronic health records. Nevertheless, there is evidence suggesting that these systems have not been adopted as it was expected, and although there are some proposals to support their adoption, the proposed support is not by means of information and communication technology which can provide automatic tools of support. The aim of this study is to identify the critical adoption factors for electronic health records by physicians and to use them as a guide to support their adoption process automatically. Methods This paper presents, based on the PRISMA statement, a systematic literature review in electronic databases with adoption studies of electronic health records published in English. Software applications that manage and process the data in the electronic health record have been considered, i.e.: computerized physician prescription, electronic medical records, and electronic capture of clinical data. Our review was conducted with the purpose of obtaining a taxonomy of the physicians main barriers for adopting electronic health records, that can be addressed by means of information and communication technology; in particular with the information technology roles of the knowledge management processes. Which take us to the question that we want to address in this work: "What are the critical adoption factors of electronic health records that can be supported by information and communication technology?". Reports from eight databases covering electronic health records adoption studies in the medical domain, in particular those focused on physicians, were analyzed. Results The review identifies two main issues: 1) a knowledge-based classification of critical factors for adopting electronic health records by physicians; and 2) the definition of a base for the design of a conceptual framework for supporting the

  10. Connecting knowledge resources to the veterinary electronic health record: opportunities for learning at point of care.

    PubMed

    Alpi, Kristine M; Burnett, Heidi A; Bryant, Sheila J; Anderson, Katherine M

    2011-01-01

    Electronic health records (EHRs) provide clinical learning opportunities through quick and contextual linkage of patient signalment, symptom, and diagnosis data with knowledge resources covering tests, drugs, conditions, procedures, and client instructions. This paper introduces the EHR standards for linkage and the partners-practitioners, content publishers, and software developers-necessary to leverage this possibility in veterinary medicine. The efforts of the American Animal Hospital Association (AAHA) Electronic Health Records Task Force to partner with veterinary practice management systems to improve the use of controlled vocabulary is a first step in the development of standards for sharing knowledge at the point of care. The Veterinary Medical Libraries Section (VMLS) of the Medical Library Association's Task Force on Connecting the Veterinary Health Record to Information Resources compiled a list of resources of potential use at point of care. Resource details were drawn from product Web sites and organized by a metric used to evaluate medical point-of-care resources. Additional information was gathered from questions sent by e-mail and follow-up interviews with two practitioners, a hospital network, two software developers, and three publishers. Veterinarians with electronic records use a variety of information resources that are not linked to their software. Systems lack the infrastructure to use the Infobutton standard that has been gaining popularity in human EHRs. While some veterinary knowledge resources are digital, publisher sites and responses do not indicate a Web-based linkage of veterinary resources with EHRs. In order to facilitate lifelong learning and evidence-based practice, veterinarians and educators of future practitioners must demonstrate to veterinary practice software developers and publishers a clinically-based need to connect knowledge resources to veterinary EHRs.

  11. Adoption of Electronic Personal Health Records in Canada: Perceptions of Stakeholders

    PubMed Central

    Gagnon, Marie-Pierre; Payne-Gagnon, Julie; Breton, Erik; Fortin, Jean-Paul; Khoury, Lara; Dolovich, Lisa; Price, David; Wiljer, David; Bartlett, Gillian; Archer, Norman

    2016-01-01

    Background: Healthcare stakeholders have a great interest in the adoption and use of electronic personal health records (ePHRs) because of the potential benefits associated with them. Little is known, however, about the level of adoption of ePHRs in Canada and there is limited evidence concerning their benefits and implications for the healthcare system. This study aimed to describe the current situation of ePHRs in Canada and explore stakeholder perceptions regarding barriers and facilitators to their adoption. Methods: Using a qualitative descriptive study design, we conducted semi-structured phone interviews between October 2013 and February 2014 with 35 individuals from seven Canadian provinces. The participants represented six stakeholder groups (patients, ePHR administrators, healthcare professionals, organizations interested in health technology development, government agencies, and researchers). A detailed summary of each interview was created and thematic analysis was conducted. Results: We observed that there was no consensual definition of ePHR in Canada. Factors that could influence ePHR adoption were related to knowledge (confusion with other electronic medical records [EMRs] and lack of awareness), system design (usability and relevance), user capacities and attitudes (patient health literacy, education and interest, support for professionals), environmental factors (government commitment, targeted populations) and legal and ethical issues (information control and custody, confidentiality, privacy and security). Conclusion: ePHRs are slowly entering the Canadian healthcare landscape but provinces do not seem well-prepared for the implementation of this type of record. Guidance is needed on critical issues regarding ePHRs, such as ePHR definition, data ownership, access to information and interoperability with other electronic health records (EHRs). Better guidance on these issues would provide a greater awareness of ePHRs and inform stakeholders

  12. Adoption of Electronic Personal Health Records in Canada: Perceptions of Stakeholders

    PubMed Central

    Gagnon, Marie-Pierre; Payne-Gagnon, Julie; Breton, Erik; Fortin, Jean-Paul; Khoury, Lara; Dolovich, Lisa; Price, David; Wiljer, David; Bartlett, Gillian; Archer, Norman

    2016-01-01

    Background: Healthcare stakeholders have a great interest in the adoption and use of electronic personal health records (ePHRs) because of the potential benefits associated with them. Little is known, however, about the level of adoption of ePHRs in Canada and there is limited evidence concerning their benefits and implications for the healthcare system. This study aimed to describe the current situation of ePHRs in Canada and explore stakeholder perceptions regarding barriers and facilitators to their adoption. Methods: Using a qualitative descriptive study design, we conducted semi-structured phone interviews between October 2013 and February 2014 with 35 individuals from seven Canadian provinces. The participants represented six stakeholder groups (patients, ePHR administrators, healthcare professionals, organizations interested in health technology development, government agencies, and researchers). A detailed summary of each interview was created and thematic analysis was conducted. Results: We observed that there was no consensual definition of ePHR in Canada. Factors that could influence ePHR adoption were related to knowledge (confusion with other electronic medical records [EMRs] and lack of awareness), system design (usability and relevance), user capacities and attitudes (patient health literacy, education and interest, support for professionals), environmental factors (government commitment, targeted populations) and legal and ethical issues (information control and custody, confidentiality, privacy and security). Conclusion: ePHRs are slowly entering the Canadian healthcare landscape but provinces do not seem well-prepared for the implementation of this type of record. Guidance is needed on critical issues regarding ePHRs, such as ePHR definition, data ownership, access to information and interoperability with other electronic health records (EHRs). Better guidance on these issues would provide a greater awareness of ePHRs and inform stakeholders

  13. Role of visual information in ball catching.

    PubMed

    Rosengren, K S; Pick, H L; von Hofsten, C

    1988-06-01

    The present study is concerned with the perceptual information about the body and space underlying the act of catching a ball. In a series of four experiments, subjects were asked to catch a luminous ball under various visual conditions. In general, catching in a normally illuminated room was contrasted with catching the luminous ball in an otherwise completely dark room. In the third and fourth experiments, intermediate conditions of visual information were included. The results suggest that it is possible to catch a ball with one hand when only the ball is visible, but performance is better when the subject has the benefit of a rich visual environment and two hands. The second experiment indicated that subject performance does improve with practice in the dark, but time spent in the darkened room itself doesn't result in a significant decrement in performance. Results of the third study suggest that vision of one's hand does not aid in the performance of this task whereas the presence of a minimal visual frame appears to aid performance. The final study examined the relation between catching performance and body sway under similar visual conditions. Results of this experiment imply that persons who exhibit relatively little postural sway in full-room lighting performed better at this catching task.

  14. School students "Catch a Star"!

    NASA Astrophysics Data System (ADS)

    2007-04-01

    School students from across Europe and beyond have won prizes in an astronomy competition, including the trip of a lifetime to one of the world's most powerful astronomical observatories, on a mountaintop in Chile. ESO, the European Organisation for Astronomical Research in the Southern Hemisphere, together with the European Association for Astronomy Education (EAAE), has just announced the winners of the 2007 "Catch a Star!" competition. ESO PR Photo 21/07 "Catch a Star!" is an international astronomy competition for school students, in which students are invited to 'become astronomers' and explore the Universe. The competition includes two categories for written projects on astronomical themes, to ensure that every student, whatever their level, has the chance to enter and win exciting prizes. For the artistically minded, "Catch a Star!" also includes an astronomy-themed artwork competition. Students from 22 countries submitted hundreds of written projects and pieces of artwork. "The standard of entries was most impressive, and made the jury's task of choosing winners both enjoyable and difficult! We hope that everyone, whether or not they won a prize, had fun taking part, and learnt some exciting things about our Universe", said Douglas Pierce-Price, Education Officer at ESO. The top prize, of a week-long trip to Chile to visit the ESO Very Large Telescope (VLT) on Paranal, was won by students Jan Mestan and Jan Kotek from Gymnazium Pisek in the Czech Republic, together with their teacher Marek Tyle. Their report on "Research and Observation of the Solar Eclipse" told how they had studied solar eclipses, and involved their fellow students in observations of an eclipse from their school in 2006. The team will travel to Chile and visit the ESO VLT - one of the world's most powerful optical/infrared telescopes - where they will meet astronomers and be present during a night of observations on the 2600m high Paranal mountaintop. "It's fantastic that we will see the

  15. Catching Comet's Particles in the Earth's Atmosphere by Using Balloons

    NASA Astrophysics Data System (ADS)

    Potashko, Oleksandr; Viso, Michel

    The project is intended to catch cometary particles in the atmosphere by using balloons. The investigation is based upon knowledge that the Earth crosses the comet’s tails during the year. One can catch these particles at different altitudes in the atmosphere. So, we will be able to gradually advance in the ability to launch balloons from low to high altitudes and try to catch particles from different comet tails. The maximum altitude that we have to reach is 40 km. Both methods - distance observation and cometary samples from mission Stardust testify to the presence of organic components in comet’s particles. It would be useful to know more details about this organic matter for astrobiology; besides, the factor poses danger to the Earth. Moreover, it is important to prove that it is possible to get fundamental scientific results at low cost. In the last 5 years launching balloons has become popular and this movement looks like hackers’ one - as most of them occur without launch permission to airspace. The popularity of ballooning is connected with low cost of balloon, GPS unit, video recording unit. If you use iPhone, you have a light solution with GPS, video, picture and control function in one unit. The price of balloon itself begins from $50; it depends on maximum altitude, payload weight and material. Many university teams realized balloon launching and reached even stratosphere at an altitude of 33 km. But most of them take only video and picture. Meanwhile, it is possible to carry out scientific experiments by ballooning, for example to collect comet particles. There is rich experience at the moment of the use of mineral, chemical and isotopic analysis techniques and data of the comet’s dust after successful landing of StarDust capsule with samples in 2006. Besides, we may use absolutely perfect material to catch particles in the atmosphere, which was used by cosmic missions such as Stardust and Japanese Hayabusa. As to balloon launches, we could use

  16. The languages of health in general practice electronic patient records: a Zipf’s law analysis

    PubMed Central

    2014-01-01

    Background Natural human languages show a power law behaviour in which word frequency (in any large enough corpus) is inversely proportional to word rank - Zipf’s law. We have therefore asked whether similar power law behaviours could be seen in data from electronic patient records. Results In order to examine this question, anonymised data were obtained from all general practices in Salford covering a seven year period and captured in the form of Read codes. It was found that data for patient diagnoses and procedures followed Zipf’s law. However, the medication data behaved very differently, looking much more like a referential index. We also observed differences in the statistical behaviour of the language used to describe patient diagnosis as a function of an anonymised GP practice identifier. Conclusions This works demonstrate that data from electronic patient records does follow Zipf’s law. We also found significant differences in Zipf’s law behaviour in data from different GP practices. This suggests that computational linguistic techniques could become a useful additional tool to help understand and monitor the data quality of health records. PMID:24410884

  17. Implications of Swedish National Regulatory Framework of the Patient Accessible Electronic Health Record.

    PubMed

    Scandurra, Isabella; Lyttkens, Leif; Eklund, Benny

    2016-01-01

    Online access to your own electronic health record is a controversial issue. In a Swedish county such eHealth service has been in operation since 2012 and it is now being widely deployed in the other counties. This first review presents work regarding current National Regulatory Framework (NRF) related to the public eHealth service Patient Accessible Electronic Health Record (PAEHR) and points out how electable paragraphs have been applied in different counties. Potential implications due to the different decisions made are discussed in terms of patient centricity and health information outcome. In current PAEHR, care providers have assessed differently how to apply the NRF. For the patients, this means that information gathered from the health record may be displayed differently, depending on where, when and why they seek treatment. When a patient visits different care providers such solution may cause confusion and its purpose may go lost. Consequently a revised NRF with less electable paragraphs is recommended, as well as adherence to the next NRF by all county councils. PMID:27577474

  18. Constraints on Biological Mechanism from Disease Comorbidity Using Electronic Medical Records and Database of Genetic Variants.

    PubMed

    Bagley, Steven C; Sirota, Marina; Chen, Richard; Butte, Atul J; Altman, Russ B

    2016-04-01

    Patterns of disease co-occurrence that deviate from statistical independence may represent important constraints on biological mechanism, which sometimes can be explained by shared genetics. In this work we study the relationship between disease co-occurrence and commonly shared genetic architecture of disease. Records of pairs of diseases were combined from two different electronic medical systems (Columbia, Stanford), and compared to a large database of published disease-associated genetic variants (VARIMED); data on 35 disorders were available across all three sources, which include medical records for over 1.2 million patients and variants from over 17,000 publications. Based on the sources in which they appeared, disease pairs were categorized as having predominant clinical, genetic, or both kinds of manifestations. Confounding effects of age on disease incidence were controlled for by only comparing diseases when they fall in the same cluster of similarly shaped incidence patterns. We find that disease pairs that are overrepresented in both electronic medical record systems and in VARIMED come from two main disease classes, autoimmune and neuropsychiatric. We furthermore identify specific genes that are shared within these disease groups. PMID:27115429

  19. Exploring the Frontier of Electronic Health Record Surveillance: The Case of Post-Operative Complications

    PubMed Central

    FitzHenry, Fern; Murff, Harvey J.; Matheny, Michael E.; Gentry, Nancy; Fielstein, Elliot M.; Brown, Steven H; Reeves, Ruth M; Aronsky, Dominik; Elkin, Peter L.; Messina, Vincent P.; Speroff, Theodore

    2013-01-01

    Background The aim of this study was to build electronic algorithms using a combination of structured data and natural language processing (NLP) of text notes for potential safety surveillance of nine post-operative complications. Methods Post-operative complications from six medical centers in the Southeastern United States were obtained from the Veterans Affairs Surgical Quality Improvement Program (VASQIP) registry. Development and test datasets were constructed using stratification by facility and date of procedure for patients with and without complication. Algorithms were developed from VASQIP outcome definitions using NLP coded concepts, regular expressions, and structured data. The VASQIP nurse reviewer served as the reference standard for evaluating sensitivity and specificity. The algorithms were designed in the development and evaluated in the test dataset. Results Sensitivity and specificity in the test set were 85% and 92% for acute renal failure, 80% and 93% for sepsis, 56% and 94% for deep vein thrombosis, 80% and 97% for pulmonary embolism, 88% and 89% for acute myocardial infarction, 88% and 92% for cardiac arrest, 80% and 90% for pneumonia, 95% and 80% for urinary tract infection, and 80% and 93% for wound infection, respectively. A third of the complications occurred outside of the hospital setting. Conclusions Computer algorithms on data extracted from the electronic health record produced respectable sensitivity and specificity across a large sample of patients seen in six different medical centers. This study demonstrates the utility of combining natural language processing with structured data for mining the information contained within the electronic health record. PMID:23673394

  20. Legal, ethical, and financial dilemmas in electronic health record adoption and use.

    PubMed

    Sittig, Dean F; Singh, Hardeep

    2011-04-01

    Electronic health records (EHRs) facilitate several innovations capable of reforming health care. Despite their promise, many currently unanswered legal, ethical, and financial questions threaten the widespread adoption and use of EHRs. Key legal dilemmas that must be addressed in the near-term pertain to the extent of clinicians' responsibilities for reviewing the entire computer-accessible clinical synopsis from multiple clinicians and institutions, the liabilities posed by overriding clinical decision support warnings and alerts, and mechanisms for clinicians to publically report potential EHR safety issues. Ethical dilemmas that need additional discussion relate to opt-out provisions that exclude patients from electronic record storage, sale of deidentified patient data by EHR vendors, adolescent control of access to their data, and use of electronic data repositories to redesign the nation's health care delivery and payment mechanisms on the basis of statistical analyses. Finally, one overwhelming financial question is who should pay for EHR implementation because most users and current owners of these systems will not receive the majority of benefits. The authors recommend that key stakeholders begin discussing these issues in a national forum. These actions can help identify and prioritize solutions to the key legal, ethical, and financial dilemmas discussed, so that widespread, safe, effective, interoperable EHRs can help transform health care. PMID:21422090

  1. Flexible timing of eye movements when catching a ball.

    PubMed

    López-Moliner, Joan; Brenner, Eli

    2016-01-01

    In ball games, one cannot direct ones gaze at the ball all the time because one must also judge other aspects of the game, such as other players' positions. We wanted to know whether there are times at which obtaining information about the ball is particularly beneficial for catching it. We recently found that people could catch successfully if they saw any part of the ball's flight except the very end, when sensory-motor delays make it impossible to use new information. Nevertheless, there may be a preferred time to see the ball. We examined when six catchers would choose to look at the ball if they had to both catch the ball and find out what to do with it while the ball was approaching. A catcher and a thrower continuously threw a ball back and forth. We recorded their hand movements, the catcher's eye movements, and the ball's path. While the ball was approaching the catcher, information was provided on a screen about how the catcher should throw the ball back to the thrower (its peak height). This information disappeared just before the catcher caught the ball. Initially there was a slight tendency to look at the ball before looking at the screen but, later, most catchers tended to look at the screen before looking at the ball. Rather than being particularly eager to see the ball at a certain time, people appear to adjust their eye movements to the combined requirements of the task.

  2. Flexible timing of eye movements when catching a ball.

    PubMed

    López-Moliner, Joan; Brenner, Eli

    2016-01-01

    In ball games, one cannot direct ones gaze at the ball all the time because one must also judge other aspects of the game, such as other players' positions. We wanted to know whether there are times at which obtaining information about the ball is particularly beneficial for catching it. We recently found that people could catch successfully if they saw any part of the ball's flight except the very end, when sensory-motor delays make it impossible to use new information. Nevertheless, there may be a preferred time to see the ball. We examined when six catchers would choose to look at the ball if they had to both catch the ball and find out what to do with it while the ball was approaching. A catcher and a thrower continuously threw a ball back and forth. We recorded their hand movements, the catcher's eye movements, and the ball's path. While the ball was approaching the catcher, information was provided on a screen about how the catcher should throw the ball back to the thrower (its peak height). This information disappeared just before the catcher caught the ball. Initially there was a slight tendency to look at the ball before looking at the screen but, later, most catchers tended to look at the screen before looking at the ball. Rather than being particularly eager to see the ball at a certain time, people appear to adjust their eye movements to the combined requirements of the task. PMID:26982371

  3. Point and counterpoint: patient control of access to data in their electronic health records.

    PubMed

    Caine, Kelly; Tierney, William M

    2015-01-01

    Information collection, storage, and management is central to the practice of health care. For centuries, patients' and providers' expectations kept medical records confidential between providers and patients. With the advent of electronic health records, patient health information has become more widely available to providers and health care managers and has broadened its potential use beyond individual patient care. Adhering to the principles of Fair Information Practice, including giving patients control over the availability and use of their individual health records, would improve care by fostering the sharing of sensitive information between patients and providers. However, adherence to such principles could put patients at risk for unsafe care as a result of both missed opportunities for providing needed care as well as provision of contraindicated care, as it would prevent health care providers from having full access to health information. Patients' expectations for the highest possible quality and safety of care, therefore, may be at odds with their desire to limit provider access to their health records. Conversely, provider expectations that patients would willingly seek care for embarrassing conditions and disclose sensitive information may be at odds with patients' information privacy rights. An open dialogue between patients and providers will be necessary to balance respect for patient rights with provider need for patient information.

  4. Progress along developmental tracks for electronic health records implementation in the United States

    PubMed Central

    Hollar, David W

    2009-01-01

    The development and implementation of electronic health records (EHR) have occurred slowly in the United States. To date, these approaches have, for the most part, followed four developmental tracks: (a) Enhancement of immunization registries and linkage with other health records to produce Child Health Profiles (CHP), (b) Regional Health Information Organization (RHIO) demonstration projects to link together patient medical records, (c) Insurance company projects linked to ICD-9 codes and patient records for cost-benefit assessments, and (d) Consortia of EHR developers collaborating to model systems requirements and standards for data linkage. Until recently, these separate efforts have been conducted in the very silos that they had intended to eliminate, and there is still considerable debate concerning health professionals access to as well as commitment to using EHR if these systems are provided. This paper will describe these four developmental tracks, patient rights and the legal environment for EHR, international comparisons, and future projections for EHR expansion across health networks in the United States. PMID:19291284

  5. Point and counterpoint: patient control of access to data in their electronic health records.

    PubMed

    Caine, Kelly; Tierney, William M

    2015-01-01

    Information collection, storage, and management is central to the practice of health care. For centuries, patients' and providers' expectations kept medical records confidential between providers and patients. With the advent of electronic health records, patient health information has become more widely available to providers and health care managers and has broadened its potential use beyond individual patient care. Adhering to the principles of Fair Information Practice, including giving patients control over the availability and use of their individual health records, would improve care by fostering the sharing of sensitive information between patients and providers. However, adherence to such principles could put patients at risk for unsafe care as a result of both missed opportunities for providing needed care as well as provision of contraindicated care, as it would prevent health care providers from having full access to health information. Patients' expectations for the highest possible quality and safety of care, therefore, may be at odds with their desire to limit provider access to their health records. Conversely, provider expectations that patients would willingly seek care for embarrassing conditions and disclose sensitive information may be at odds with patients' information privacy rights. An open dialogue between patients and providers will be necessary to balance respect for patient rights with provider need for patient information. PMID:25480723

  6. Identifying synonymy between SNOMED clinical terms of varying length using distributional analysis of electronic health records.

    PubMed

    Henriksson, Aron; Conway, Mike; Duneld, Martin; Chapman, Wendy W

    2013-01-01

    Medical terminologies and ontologies are important tools for natural language processing of health record narratives. To account for the variability of language use, synonyms need to be stored in a semantic resource as textual instantiations of a concept. Developing such resources manually is, however, prohibitively expensive and likely to result in low coverage. To facilitate and expedite the process of lexical resource development, distributional analysis of large corpora provides a powerful data-driven means of (semi-)automatically identifying semantic relations, including synonymy, between terms. In this paper, we demonstrate how distributional analysis of a large corpus of electronic health records - the MIMIC-II database - can be employed to extract synonyms of SNOMED CT preferred terms. A distinctive feature of our method is its ability to identify synonymous relations between terms of varying length.

  7. Identifying Synonymy between SNOMED Clinical Terms of Varying Length Using Distributional Analysis of Electronic Health Records

    PubMed Central

    Henriksson, Aron; Conway, Mike; Duneld, Martin; Chapman, Wendy W.

    2013-01-01

    Medical terminologies and ontologies are important tools for natural language processing of health record narratives. To account for the variability of language use, synonyms need to be stored in a semantic resource as textual instantiations of a concept. Developing such resources manually is, however, prohibitively expensive and likely to result in low coverage. To facilitate and expedite the process of lexical resource development, distributional analysis of large corpora provides a powerful data-driven means of (semi-)automatically identifying semantic relations, including synonymy, between terms. In this paper, we demonstrate how distributional analysis of a large corpus of electronic health records – the MIMIC-II database – can be employed to extract synonyms of SNOMED CT preferred terms. A distinctive feature of our method is its ability to identify synonymous relations between terms of varying length. PMID:24551362

  8. [Design and Implementation of a Mobile Operating Room Information Management System Based on Electronic Medical Record].

    PubMed

    Liu, Baozhen; Liu, Zhiguo; Wang, Xianwen

    2015-06-01

    A mobile operating room information management system with electronic medical record (EMR) is designed to improve work efficiency and to enhance the patient information sharing. In the operating room, this system acquires the information from various medical devices through the Client/Server (C/S) pattern, and automatically generates XML-based EMR. Outside the operating room, this system provides information access service by using the Browser/Server (B/S) pattern. Software test shows that this system can correctly collect medical information from equipment and clearly display the real-time waveform. By achieving surgery records with higher quality and sharing the information among mobile medical units, this system can effectively reduce doctors' workload and promote the information construction of the field hospital. PMID:26485982

  9. WIMAGINE: an implantable electronic platform for wireless 64-channel ECoG recording

    NASA Astrophysics Data System (ADS)

    Foerster, M.; Porcherot, J.; Robinet, S.; D'Errico, R.; Josselin, V.; Sauter, F.; Mestais, C.; Charvet, G.

    2013-05-01

    The WIMAGINE platform was developed as a proof of concept and first functional prototype of an implantable device for recording ECoG signals on a large number of electrodes. The designed system provides the means of recording wirelessly up to 64 ECoG channels. Two ASIC CINESIC32 ensure the amplification and digitization of the neurosignals which are then transmitted to a PC using a ZL70102 transceiver in the MICS band. An MSP430 handles the communication protocol, configures the ASICs and gives access to various sensor information. The electronics are packaged hermetically in a biocompatible titanium housing encapsulated medical grade silicone. The whole device is powered remotely over an inductive link at 13.56MHz and complies with the regulations applicable to class III AIMD.

  10. Development and Preliminary Evaluation of a Prototype of a Learning Electronic Medical Record System

    PubMed Central

    King, Andrew J.; Cooper, Gregory F.; Hochheiser, Harry; Clermont, Gilles; Visweswaran, Shyam

    2015-01-01

    Electronic medical records (EMRs) are capturing increasing amounts of data per patient. For clinicians to efficiently and accurately understand a patient’s clinical state, better ways are needed to determine when and how to display EMR data. We built a prototype system that records how physicians view EMR data, which we used to train models that predict which EMR data will be relevant in a given patient. We call this approach a Learning EMR (LEMR). A physician used the prototype to review 59 intensive care unit (ICU) patient cases. We used the data-access patterns from these cases to train logistic regression models that, when evaluated, had AUROC values as high as 0.92 and that averaged 0.73, supporting that the approach is promising. A preliminary usability study identified advantages of the system and a few concerns about implementation. Overall, 3 of 4 ICU physicians were enthusiastic about features of the prototype. PMID:26958296

  11. Image-based electronic patient records for secured collaborative medical applications.

    PubMed

    Zhang, Jianguo; Sun, Jianyong; Yang, Yuanyuan; Liang, Chenwen; Yao, Yihong; Cai, Weihua; Jin, Jin; Zhang, Guozhen; Sun, Kun

    2005-01-01

    We developed a Web-based system to interactively display image-based electronic patient records (EPR) for secured intranet and Internet collaborative medical applications. The system consists of four major components: EPR DICOM gateway (EPR-GW), Image-based EPR repository server (EPR-Server), Web Server and EPR DICOM viewer (EPR-Viewer). In the EPR-GW and EPR-Viewer, the security modules of Digital Signature and Authentication are integrated to perform the security processing on the EPR data with integrity and authenticity. The privacy of EPR in data communication and exchanging is provided by SSL/TLS-based secure communication. This presentation gave a new approach to create and manage image-based EPR from actual patient records, and also presented a way to use Web technology and DICOM standard to build an open architecture for collaborative medical applications. PMID:17282930

  12. Role-based access control through on-demand classification of electronic health record.

    PubMed

    Tiwari, Basant; Kumar, Abhay

    2015-01-01

    Electronic health records (EHR) provides convenient method to exchange medical information of patients between different healthcare providers. Access control mechanism in healthcare services characterises authorising users to access EHR records. Role Based Access Control helps to restrict EHRs to users in a certain role. Significant works have been carried out for access control since last one decade but little emphasis has been given to on-demand role based access control. Presented work achieved access control through physical data isolation which is more robust and secure. We propose an algorithm in which selective combination of policies for each user of the EHR database has been defined. We extend well known data mining technique 'classification' to group EHRs with respect to the given role. Algorithm works by taking various roles as class and defined their features as a vector. Here, features are used as a Feature Vector for classification to describe user authority. PMID:26559071

  13. Electronic health records approaches and challenges: a comparison between Malaysia and four East Asian countries.

    PubMed

    Abd Ghani, Mohd Khanapi; Bali, Rajeev K; Naguib, Raouf N G; Marshall, Ian M

    2008-01-01

    An integrated Lifetime Health Record (LHR) is fundamental for achieving seamless and continuous access to patient medical information and for the continuum of care. However, the aim has not yet been fully realised. The efforts are actively progressing around the globe. Every stage of the development of the LHR initiatives had presented peculiar challenges. The best lessons in life are those of someone else's experiences. This paper presents an overview of the development approaches undertaken by four East Asian countries in implementing a national Electronic Health Record (EHR) in the public health system. The major challenges elicited from the review including integration efforts, process reengineering, funding, people, and law and regulation will be presented, compared, discussed and used as lessons learned for the further development of the Malaysian integrated LHR.

  14. [Design and Implementation of a Mobile Operating Room Information Management System Based on Electronic Medical Record].

    PubMed

    Liu, Baozhen; Liu, Zhiguo; Wang, Xianwen

    2015-06-01

    A mobile operating room information management system with electronic medical record (EMR) is designed to improve work efficiency and to enhance the patient information sharing. In the operating room, this system acquires the information from various medical devices through the Client/Server (C/S) pattern, and automatically generates XML-based EMR. Outside the operating room, this system provides information access service by using the Browser/Server (B/S) pattern. Software test shows that this system can correctly collect medical information from equipment and clearly display the real-time waveform. By achieving surgery records with higher quality and sharing the information among mobile medical units, this system can effectively reduce doctors' workload and promote the information construction of the field hospital.

  15. National electronic health records and the digital disruption of moral orders.

    PubMed

    Garrety, Karin; McLoughlin, Ian; Wilson, Rob; Zelle, Gregor; Martin, Mike

    2014-01-01

    The digitalisation of patient health data to provide national electronic health record systems (NEHRS) is a major objective of many governments. Proponents claim that NEHRS will streamline care, reduce mistakes and cut costs. However, building these systems has proved highly problematic. Using recent developments in Australia as an example, we argue that a hitherto unexamined source of difficulty concerns the way NEHRS disrupt the moral orders governing the production, ownership, use of and responsibility for health records. Policies that pursue digitalisation as a self-evident 'solution' to problems in healthcare without due regard to these disruptions risk alienating key stakeholders. We propose a more emergent approach to the development and implementation of NEHRS that supports moral re-ordering around rights and responsibilities appropriate to the intentions of those involved in healthcare relationships. PMID:24560226

  16. National electronic health records and the digital disruption of moral orders.

    PubMed

    Garrety, Karin; McLoughlin, Ian; Wilson, Rob; Zelle, Gregor; Martin, Mike

    2014-01-01

    The digitalisation of patient health data to provide national electronic health record systems (NEHRS) is a major objective of many governments. Proponents claim that NEHRS will streamline care, reduce mistakes and cut costs. However, building these systems has proved highly problematic. Using recent developments in Australia as an example, we argue that a hitherto unexamined source of difficulty concerns the way NEHRS disrupt the moral orders governing the production, ownership, use of and responsibility for health records. Policies that pursue digitalisation as a self-evident 'solution' to problems in healthcare without due regard to these disruptions risk alienating key stakeholders. We propose a more emergent approach to the development and implementation of NEHRS that supports moral re-ordering around rights and responsibilities appropriate to the intentions of those involved in healthcare relationships.

  17. Role-based access control through on-demand classification of electronic health record.

    PubMed

    Tiwari, Basant; Kumar, Abhay

    2015-01-01

    Electronic health records (EHR) provides convenient method to exchange medical information of patients between different healthcare providers. Access control mechanism in healthcare services characterises authorising users to access EHR records. Role Based Access Control helps to restrict EHRs to users in a certain role. Significant works have been carried out for access control since last one decade but little emphasis has been given to on-demand role based access control. Presented work achieved access control through physical data isolation which is more robust and secure. We propose an algorithm in which selective combination of policies for each user of the EHR database has been defined. We extend well known data mining technique 'classification' to group EHRs with respect to the given role. Algorithm works by taking various roles as class and defined their features as a vector. Here, features are used as a Feature Vector for classification to describe user authority.

  18. Beyond information retrieval and electronic health record use: competencies in clinical informatics for medical education.

    PubMed

    Hersh, William R; Gorman, Paul N; Biagioli, Frances E; Mohan, Vishnu; Gold, Jeffrey A; Mejicano, George C

    2014-01-01

    Physicians in the 21st century will increasingly interact in diverse ways with information systems, requiring competence in many aspects of clinical informatics. In recent years, many medical school curricula have added content in information retrieval (search) and basic use of the electronic health record. However, this omits the growing number of other ways that physicians are interacting with information that includes activities such as clinical decision support, quality measurement and improvement, personal health records, telemedicine, and personalized medicine. We describe a process whereby six faculty members representing different perspectives came together to define competencies in clinical informatics for a curriculum transformation process occurring at Oregon Health & Science University. From the broad competencies, we also developed specific learning objectives and milestones, an implementation schedule, and mapping to general competency domains. We present our work to encourage debate and refinement as well as facilitate evaluation in this area.

  19. Hybridity as a process of technology's 'translation': customizing a national Electronic Patient Record.

    PubMed

    Petrakaki, Dimitra; Klecun, Ela

    2015-01-01

    This paper explores how national Electronic Patient Record (EPR) systems are customized in local settings and, in particular, how the context of their origin plays out with the context of their use. It shows how representations of healthcare organizations and of local clinical practice are built into EPR systems within a complex context whereby different stakeholder groups negotiate to produce an EPR package that aims to meet both local and generic needs. The paper draws from research into the implementation of the National Care Record Service, a part of the National Programme for Information Technology (NPfIT), in the English National Health Service (NHS). The paper makes two arguments. First, customization of national EPR is a distributed process that involves cycles of 'translation', which span across geographical, cultural and professional boundaries. Second, 'translation' is an inherently political process during which hybrid technology gets consolidated. The paper concludes, that hybrid technology opens up possibilities for standardization of healthcare. PMID:25461880

  20. Patients' consent preferences for research uses of information in electronic medical records: interview and survey data

    PubMed Central

    Willison, Donald J; Keshavjee, Karim; Nair, Kalpana; Goldsmith, Charlie; Holbrook, Anne M

    2003-01-01

    Objectives To assess patients' preferred method of consent for the use of information from electronic medical records for research. Design Interviews and a structured survey of patients in practices with electronic medical records. Setting Family practices in southern Ontario, Canada. Participants 123 patients: 17 were interviewed and 106 completed a survey. Main outcome measures Patients' opinions and concerns on use of information from their medical records for research and their preferences for method of consent. Results Most interviewees were willing to allow the use of their information for research purposes, although the majority preferred that consent was sought first. The seeking of consent was considered an important element of respect for the individual. Most interviewees made little distinction between identifiable and anonymised data. Research sponsored by private insurance firms generated the greatest concern, and research sponsored by foundation the least. Sponsorship by drug companies evoked negative responses during interview and positive responses in the survey. Conclusions Patients are willing to allow information from their medical records to be used for research, but most prefer to be asked for consent either verbally or in writing. What is already known on this topicLegislation is being introduced worldwide to restrict the circumstances under which personal information may be used for secondary purposes without consentLittle empirical information exists about patients' concerns over privacy and preferences for consent for use of such information for researchWhat this study addsPatients are willing to allow personal information to be used for research purposes but want to be actively consulted firstPatients make little distinction between identifiable and non-identifiable informationMost patients prefer a time limit for their consent PMID:12586673