Science.gov

Sample records for patient record system

  1. 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.

  2. Applicability of different types of Patient Records for Patient Recruitment Systems.

    PubMed

    Schreiweis, Björn; Bergh, Björn

    2015-01-01

    Patient records--types of Electronic Medical Records--are implemented to support patient recruitment. Different types of patient records have not yet been analyzed as to the number of Patient Recruitment System requirements can be found in each type of patient record. According to our analysis, personal electronic health records (PEHRs) tend to allow for most requirements to be found.

  3. TeleMed: A distributed virtual patient record system

    SciTech Connect

    Forslund, D.W.; Phillips, R.L.; Kilman, D.G.; Cook, J.L.

    1996-06-01

    TeleMed is a distributed diagnosis and analysis system, which permits physicians who are not collocated to consult on the status of a patient. The patient`s record is dynamically constructed from data that may reside at several sites but which can be quickly assembled for viewing by pointing to the patient`s name. Then, a graphical patient record appears, through which consulting physicians can retrieve textual and radiographic data with a single mouse click. TeleMed uses modern distributed object technology and emerging telecollaboration tools. The authors describe in this paper some of the motivation for this change, what they mean by a virtual patient record, and some results of some early implementations of a virtual patient record.

  4. Medical record keeping and system performance in orthopaedic trauma patients.

    PubMed

    Cosic, Filip; Kimmel, Lara; Edwards, Elton

    2016-02-18

    Objective The medical record is critical for documentation and communication between healthcare professionals. The aim of the present study was to evaluate important aspects of the orthopaedic medical record and system performance to determine whether any deficiencies exist in these areas.Methods Review of 200 medical records of surgically treated traumatic lower limb injury patients was undertaken. The operative report, discharge summary and first and second outpatient reviews were evaluated.Results In all cases, an operative report was completed by a senior surgeon. Weight-bearing status was adequately documented in 91% of reports. Discharge summaries were completed for 82.5% of admissions, with 87.3% of these having instructions reflective of those in the operative report. Of first and second outpatient reviews, 69% and 73%, respectively, occurred within 1 week of the requested time. Previously documented management plans were changed in 30% of reviews. At 6-months post-operatively, 42% of patients had been reviewed by a member of their operating team.Discussion Orthopaedic medical record documentation remains an area for improvement. In addition, hospital out-patient systems perform suboptimally and may affect patient outcomes.What is known about the topic? Medical records are an essential tool in modern medical practice. Despite the importance of comprehensive documentation in the medical record, numerous examples of poor documentation have been demonstrated, including substandard documentation during consultant ward rounds by junior doctors leading to a breakdown in healthcare professional communication and potential patient mismanagement. Further inadequacies of medical record documentation have been demonstrated in surgical discharge notes, with complete and correct documentation reported to be as low as 65%.What does this paper add? Standards of patient care should be constantly monitored and deficiencies identified in order to implement a remedy and close

  5. Privacy protections afforded by computer-based patient record systems.

    PubMed

    Amatayakul, M

    1996-05-01

    Computer-based patient record (CPR) systems can afford greater protection of private health information. Key factors that enhance security of CPR systems include the capability to identify the user, verify authorization, determine legitimacy of use, restrict retrieval to only specific "need-to-know" information, encrypt access mechanisms and content, and track all access. The public demands greater protections for computer systems than for paper-based systems. Coupled with appropriate internal management controls and federal preemptive privacy law, breaches of confidentiality from CPRs would occur virtually through the only means that cannot be safeguarded: human communication.

  6. A clerking tool for the patient record system.

    PubMed

    McDermott, D; Heathfield, H; Kirby, J

    1995-01-01

    1. BACKGROUND. The goal of the PEN&PAD (Elderly Care) project is to develop a patient record system to assist the many different professionals that care for patients in a hospital setting. At the core of the project is the use of structured data which can be reused in a variety of ways--both within the system for further manipulation and display, and externally for auditing and statistical purposes. To accommodate these needs, a compositional method of data entry called Structured Data Entry (SDE) was used in this application. SDE was developed in an earlier project PEN&PAD (GP)(1). Our application utilizes a network representation of the medical semantics that can be queried to obtain what is sensible to "say" about a particular concept. This functionality is contained within a separate application known as the Terminology Server (TeS), which has been developed within the GALEN project (2). The client application (the patient record system) requests information from the TeS which can then be used to produce compositional data entry forms that require the user to choose values for given attributes (e.g., if information pertaining to chest pain were being recorded, the attribute 'location' and a choice of possible values i.e., 'left' 'right' and 'bilateral' might appear on the form). Given the importance of capturing clinical information in a highly structured format, SDE is a valuable tool. However, its long term success depends on a very comprehensive model of the medical terminology corpus. This component is currently being studied by the GALEN team. 2. CURRENT WORK. We are developing a clerking tool to be used to create records for the newly admitted patient. The clinician seeks to identify a patient's problems based on physical examination and information obtained through conversation with the patient. Patients are usually admitted with a presenting complaint and obtaining more information about this complaint is an important part of the clerking process. While

  7. Development of the electronic patient record system based on problem oriented system.

    PubMed

    Uto, Yumiko; Iwaanakuchi, Takashi; Muranaga, Fuminori; Kumamoto, Ichiro

    2013-01-01

    In Japan, POS (problem oriented system) is recommended in the clinical guideline. Therefore, the records are mainly made by SOAP. We developed a system mainly with a function which enabled our staff members of all kinds of professions including doctors to enter the patients' clinical information as an identical record, regardless if they were outpatients or inpatients, and to observe the contents chronologically. This electric patient record system is called "e-kanja recording system". On this system, all staff members in the medical team can now share the same information. Moreover, the contents can be reviewed by colleagues; the quality of records has been improved as it is evaluated by the others.

  8. Electronic patient record and archive of records in Cardio.net system for telecardiology.

    PubMed

    Sierdziński, Janusz; Karpiński, Grzegorz

    2003-01-01

    In modern medicine the well structured patient data set, fast access to it and reporting capability become an important question. With the dynamic development of information technology (IT) such question is solved via building electronic patient record (EPR) archives. We then obtain fast access to patient data, diagnostic and treatment protocols etc. It results in more efficient, better and cheaper treatment. The aim of the work was to design a uniform Electronic Patient Record, implemented in cardio.net system for telecardiology allowing the co-operation among regional hospitals and reference centers. It includes questionnaires for demographic data and questionnaires supporting doctor's work (initial diagnosis, final diagnosis, history and physical, ECG at the discharge, applied treatment, additional tests, drugs, daily and periodical reports). The browser is implemented in EPR archive to facilitate data retrieval. Several tools for creating EPR and EPR archive were used such as: XML, PHP, Java Script and MySQL. The separate question is the security of data on WWW server. The security is ensured via Security Socket Layer (SSL) protocols and other tools. EPR in Cardio.net system is a module enabling the co-work of many physicians and the communication among different medical centers.

  9. Accelerometer recorder and display system for ambulatory patients

    NASA Astrophysics Data System (ADS)

    Berka, Martin; Żyliński, Marek; Niewiadomski, Wiktor; Cybulski, Gerard

    2015-09-01

    This paper presents the design of a compact, wearable, rechargeable acceleration recorder to support long-term monitoring of ambulatory patients with motor disorders, and of software to display and analyze its output. The device consists of a microcontroller, operational amplifier, accelerometer, SD card, indicator LED, rechargeable battery, and associated minor components. It can operate for over a day without charging and can continuously collect data for three weeks without downloading to an outside system, as currently configured. With slight modifications, this period could be extended to several months. The accompanying software provides flexible visualization of the acceleration data over long periods, basic file operations and compression for easier archiving, annotation of segments of interest, and functions for calculation of various parameters and detection of immobility and vibration frequencies. Applications in analysis of gait and other movements are discussed.

  10. A Patient Record-Filing System for Family Practice

    PubMed Central

    Levitt, Cheryl

    1988-01-01

    The efficient storage and easy retrieval of quality records are a central concern of good family practice. Many physicians starting out in practice have difficulty choosing a practical and lasting system for storing their records. Some who have established practices are installing computers in their offices and finding that their filing systems are worn, outdated, and incompatible with computerized systems. This article describes a new filing system installed simultaneously with a new computer system in a family-practice teaching centre. The approach adopted solved all identifiable problems and is applicable in family practices of all sizes.

  11. Installing and Implementing a Computer-based Patient Record System in Sub-Saharan Africa: The Mosoriot Medical Record System

    PubMed Central

    Rotich, Joseph K.; Hannan, Terry J.; Smith, Faye E.; Bii, John; Odero, Wilson W.; Vu, Nguyen; Mamlin, Burke W.; Mamlin, Joseph J.; Einterz, Robert M.; Tierney, William M.

    2003-01-01

    The authors implemented an electronic medical record system in a rural Kenyan health center. Visit data are recorded on a paper encounter form, eliminating duplicate documentation in multiple clinic logbooks. Data are entered into an MS-Access database supported by redundant power systems. The system was initiated in February 2001, and 10,000 visit records were entered for 6,190 patients in six months. The authors present a summary of the clinics visited, diagnoses made, drugs prescribed, and tests performed. After system implementation, patient visits were 22% shorter. They spent 58% less time with providers (p < 0.001) and 38% less time waiting (p = 0.06). Clinic personnel spent 50% less time interacting with patients, two thirds less time interacting with each other, and more time in personal activities. This simple electronic medical record system has bridged the “digital divide.” Financial and technical sustainability by Kenyans will be key to its future use and development. PMID:12668697

  12. Description of the computer-based patient record and computer-based patient record system. CPRI Work Group on CPR Description.

    PubMed

    1996-01-01

    Computer-based patient records and computer-based patient record systems support health care effectiveness and efficiency with appropriate safeguards for confidentiality. Achieving a health information infrastructure with computer-based patient records supported by fully integrated computer-based patient record systems is obviously a process of incremental steps. However, CPRI believes significant benefits in health care delivery are certain to be realized over the full course of this process.

  13. A web-based rapid prototyping and clinical conversational system that complements electronic patient record system.

    PubMed

    Kim, J H; Ferziger, R; Kawaloff, H B; Sands, D Z; Safran, C; Slack, W V

    2001-01-01

    Even the most extensive hospital information system cannot support all the complex and ever-changing demands associated with a clinical database, such as providing department or personal data forms, and rating scales. Well-designed clinical dialogue programs may facilitate direct interaction of patients with their medical records. Incorporation of extensive and loosely structured clinical data into an existing medical record system is an essential step towards a comprehensive clinical information system, and can best be achieved when the practitioner and the patient directly enter the contents. We have developed a rapid prototyping and clinical conversational system that complements the electronic medical record system, with its generic data structure and standard communication interfaces based on Web technology. We believe our approach can enhance collaboration between consumer-oriented and provider-oriented information systems.

  14. Comparing the security risks of paper-based and computerized patient record systems

    NASA Astrophysics Data System (ADS)

    Collmann, Jeff R.; Meissner, Marion C.; Tohme, Walid G.; Winchester, James F.; Mun, Seong K.

    1997-05-01

    How should hospital administrators compare the security risks of paper-based and computerized patient record systems. There is a general tendency to assume that because computer networks potentially provide broad access to hospital archives, computerized patient records are less secure than paper records and increase the risk of breaches of patient confidentiality. This assumption is ill-founded on two grounds. Reasons exist to say that the computerized patient record provides better access to patient information while enhancing overall information system security. A range of options with different trade-offs between access and security exist in both paper-based and computerized records management systems. The relative accessibility and security of any particular patient record management system depends, therefore, on administrative choice, not simply on the intrinsic features of paper or computerized information management systems.

  15. Childrens Hospital Integrated Patient Electronic Record System Continuation (CHIPERS)

    DTIC Science & Technology

    2015-12-01

    testing  CDS  in  the  Newborn  ICU  with  prolonged  and  complex   nutritional   needs  (Specific  Aim  2)  as...more complex, time-sensitive areas such as the management of patients with severe sepsis/shock, or patients with complex nutritional needs, is unknown...spans minutes to hours. We are also testing CDS in the Newborn ICU with prolonged and complex nutritional needs (Specific Aim 2) as these patients

  16. Childrens Hospital Integrated Patient Electronic Record System Continuation (CHIPERS)

    DTIC Science & Technology

    2015-12-01

    patients  with   sepsis  (Pediatric  Intensive  Care  Unit,  Emergency  Department,  Ward,  and   Hematology /Oncology).    These...specific   need  to  focus  on   hematology  oncology  department,  residents   and  the  antibiotic  table   “I  think

  17. [Automated anesthesia record system].

    PubMed

    Zhu, Tao; Liu, Jin

    2005-12-01

    Based on Client/Server architecture, a software of automated anesthesia record system running under Windows operation system and networks has been developed and programmed with Microsoft Visual C++ 6.0, Visual Basic 6.0 and SQL Server. The system can deal with patient's information throughout the anesthesia. It can collect and integrate the data from several kinds of medical equipment such as monitor, infusion pump and anesthesia machine automatically and real-time. After that, the system presents the anesthesia sheets automatically. The record system makes the anesthesia record more accurate and integral and can raise the anesthesiologist's working efficiency.

  18. Body posture recognition and turning recording system for the care of bed bound patients.

    PubMed

    Hsiao, Rong-Shue; Mi, Zhenqiang; Yang, Bo-Ru; Kau, Lih-Jen; Bitew, Mekuanint Agegnehu; Li, Tzu-Yu

    2015-01-01

    This paper proposes body posture recognition and turning recording system for assisting the care of bed bound patients in nursing homes. The system continuously detects the patient's body posture and records the length of time for each body posture. If the patient remains in the same body posture long enough to develop pressure ulcers, the system notifies caregivers to change the patient's body posture. The objective of recording is to provide the log of body turning for querying of patients' family members. In order to accurately detect patient's body posture, we developed a novel pressure sensing pad which contains force sensing resistor sensors. Based on the proposed pressure sensing pad, we developed a bed posture recognition module which includes a bed posture recognition algorithm. The algorithm is based on fuzzy theory. The body posture recognition algorithm can detect the patient's bed posture whether it is right lateral decubitus, left lateral decubitus, or supine. The detected information of patient's body posture can be then transmitted to the server of healthcare center by the communication module to perform the functions of recording and notification. Experimental results showed that the average posture recognition accuracy for our proposed module is 92%.

  19. Perinatal computerized patient record and archiving systems: pitfalls and enhancements for implementing a successful computerized medical record.

    PubMed

    Kelly, C S

    1999-03-01

    Interest in purchasing and installing a perinatal computerized patient record (CPR) and archiving system is growing in the United States as a result of increased patient satisfaction demands, cost containment, and quality improvement. Perinatal nurses are commonly charged with researching available computer software and hardware, making purchasing decisions, developing menus and forms, orienting users, and maintaining and upgrading systems. The decision to chart and archive by computer as well as installation and maintenance issues mandate that nurses increase their computer-related knowledge. The article reviews information related to CPR capabilities and rationales for purchase decisions, implementation and staff development issues, ergonomic and maintenance considerations, and realistic expectations of a CPR to provide perinatal nurses who are involved in purchasing, implementing, and maintaining these systems with a timely understanding of important elements that they need to know to make this effort successful.

  20. [Electronic patient records and teleophthalmology : part 1: introduction to the various systems and standards].

    PubMed

    Schargus, M; Michelson, G; Grehn, F

    2011-05-01

    Electronic storage of patient-related data will replace paper-based patient records in the near future. Some steps in medical practice can even now not be achieved without electronic data processing. Both systems, conventional paper-based and electronic-based records, have advantages and disadvantages which have to be taken into consideration. The advantages of electronic-based records are e.g. good availability of data, structured storage of data, scientific analysis of long-term data and possible data exchange with colleagues in the context of teleconsultation systems. Problems have to be solved in the field of data security, initial high investment costs and time consumption in learning to use the system as well as in incompatibility of existing IT systems.

  1. Systemic lupus erythematosus and cardiac risk factors: medical record documentation and patient adherence.

    PubMed

    Bengtsson, C; Bengtsson, Aa; Costenbader, Kh; Jönsen, A; Rantapää-Dahlqvist, S; Sturfelt, G; Nived, O

    2011-10-01

    This study explores patients' knowledge of cardiac risk factors (CRFs), analyses how information and advice about CRFs are documented in clinical practice, and assesses patient adherence to received instructions to decrease CRFs. Systemic lupus erythematosus (SLE) patients with ≥ 4 ACR criteria participated through completing a validated cardiovascular health questionnaire (CHQ). Kappa statistics were used to compare medical records with the self-reported CHQ (agreement) and to evaluate adherence. Two hundred and eleven (72%) of the known patients with SLE participated. The mean age of the patients was 55 years. More than 70% of the SLE patients considered hypertension, obesity, smoking and hypercholesterolaemia to be very important CRFs. The agreement between medical record documentation and patients' reports was moderate for hypertension, overweight and hypercholesterolaemia (kappa 0.42-0.60) but substantial for diabetes (kappa 0.66). Patients' self-reported adherence to advice they had received regarding medication was substantial to perfect (kappa 0.65-1.0). For lifestyle changes in patients with hypertension and overweight, adherence was only fair to moderate (kappa 0.13-0.47). Swedish SLE patients' awareness of traditional CRFs was good in this study. However, the agreement between patients' self-reports and medical record documentation of CRF profiles, and patients' adherence to medical advice to CRF profiles, could be improved.

  2. 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.

  3. Statistical disclosure control architectures for patient records in biomedical information systems.

    PubMed

    Elliot, M; Purdam, K; Smith, D

    2008-02-01

    Patient record data are potentially highly sensitive and their secondary use raises both ethical and data protection issues. Disclosure of patient data could cause serious difficulties for the medical profession and be potentially damaging for individual patients and clinicians. Yet at the same time patient records are a hugely valuable resource in terms of clinical research and patient treatment. A secure, remote access system for such data would therefore provide numerous benefits. In this paper we outline the statistical disclosure risks posed by patient record data in the context of establishing a grid based medical data repository. We review good practice in existing patient databases, outline a scenario model for assessing risk and suggest a new model for statistical disclosure control of patient data. The architecture and the research method we have described have general relevance for any remote data access system where maximizing both data utility and security is a priority, and has specific relevance to medical data and bioinformatics. It can straightforwardly be integrated into data access and analysis tools.

  4. Lack of recording of systemic lupus erythematosus in the death certificates of lupus patients.

    PubMed

    Calvo-Alén, J; Alarcón, G S; Campbell, R; Fernández, M; Reveille, J D; Cooper, G S

    2005-09-01

    To determine to what extent the diagnosis of systemic lupus erythematosus (SLE) in deceased lupus patients is under-reported in death certificates, and the patient characteristics associated with such an occurrence. The death certificates of 76 of the 81 deceased SLE patients from two US lupus cohorts (LUMINA for Lupus in Minorities: Nature vs Nurture and CLU for Carolina Lupus Study), including 570 and 265 patients, respectively, were obtained from the Offices of Vital Statistics of the states where the patients died (Alabama, Georgia, North Carolina, South Carolina, Tennessee and Texas). Both cohorts included patients with SLE as per the American College of Rheumatology criteria, aged > or =16 yr, and disease duration at enrolment of < or =5 yr. The median duration of follow-up in each cohort at the time of these analyses ranged from 38.1 to 53.0 months. Standard univariable analyses were performed comparing patients with SLE recorded anywhere in the death certificate and those without it. A multivariable logistic regression model was performed to identify the variables independently associated with not recording SLE in death certificates. In 30 (40%) death certificates, SLE was not recorded anywhere in the death certificate. In univariable analyses, older age was associated with lack of recording of SLE in death certificates [mean age (standard deviation) 50.9 (15.6) years and 39.1 (18.6) yr among those for whom SLE was omitted and included on the death certificates, respectively, P = 0.005]. Patients without health insurance, those dying of a cardiovascular event and those of Caucasian ethnicity were also more likely to be in the non-recorded group. In the multivariable analysis, variables independently associated with not recording SLE as cause of death were older age [odds ratio = (95% confidence interval) 1.043 (1.005-1.083 per yr increase); P = 0.023] and lack of health insurance [4.649 (1.152-18.768); P = 0.031]. A high proportion of SLE diagnoses are not

  5. Toward secure distribution of electronic health records: quantitative feasibility study on secure E-mail systems for sharing patient records.

    PubMed

    Gomi, Yuichiro; Nogawa, Hiroki; Tanaka, Hiroshi

    2005-12-01

    If the quality and efficiency of medical services are to be ensured, electronic health records (EHR) and EHR-supporting infrastructure must be prevalent. Many hospitals, however, have EHR systems for their internal use only, and the standardization process for the exchange of medical information is still in process. This standardization process addresses information security and is considering public key infrastructure (PKI) as one security measure, but PKI is rarely used by medical practioners because of its poor user-friendliness. Here we propose an effective use of the identity-based encryption (IBE) system as a security measure. This system enables us to send encrypted and signed messages without requiring the receiver to get a public key, and it enables us to deliver secured messages to ambiguous receivers like those to whom letters of reference are sent. We evaluated the feasibility of this technology by using the analytic hierarchy process, which is an effective analysis tool when selection and judgment depend on nonquantitative psychological factors, to analyze the results of an experiment in which medical workers used E-mail agents with and without PKI and IBE. We found that medical practioners and researchers avoid using PKI because of its poor user-friendliness and instead use IBE even though it is harder to install. We therefore think IBE would encourage medical institutions to share patient records.

  6. Multicenter Patient Records Research

    PubMed Central

    Behlen, Fred M.; Johnson, Stephen B.

    1999-01-01

    The expanding health information infrastructure offers the promise of new medical knowledge drawn from patient records. Such promise will never be fulfilled, however, unless researchers first address policy issues regarding the rights and interests of both the patients and the institutions who hold their records. In this article, the authors analyze the interests of patients and institutions in light of public policy and institutional needs. They conclude that the multicenter study, with Institutional Review Board approval of each study at each site, protects the interests of both. “Anonymity” is no panacea, since patient records are so rich in information that they can never be truly anonymous. Researchers must earn and respect the trust of the public, as responsible stewards of facts about patients' lives. The authors find that computer security tools are needed to administer multicenter patient records studies and describe simple approaches that can be implemented using commercial database products. PMID:10579601

  7. Building a Diabetes Registry from the Veterans Health Administration's Computerized Patient Record System

    PubMed Central

    F. O. Kern, Elizabeth; Beischel, Scott; Stalnaker, Randal; Aron, David C.; Kirsh, Susan R.; Watts, Sharon A.

    2008-01-01

    Background Little information is available describing how to implement a disease registry from an electronic patient record system. The aim of this report is to describe the technology, methods, and utility of a diabetes registry populated by the Veterans Health Information Systems Architecture (VistA), which underlies the computerized patient record system of the Veterans Health Administration (VHA) in Veteran Affairs Integrated Service Network 10 (VISN 10). Methods VISN 10 data from VistA were mapped to a relational SQL-based data system using KB_SQL software. Operational definitions for diabetes, active clinical management, and responsible providers were used to create views of patient-level data in the diabetes registry. Query Analyzer was used to access the data views directly. Semicustomizable reports were created by linking the diabetes registry to a Web page using Microsoft asp.net2. A retrospective observational study design was used to analyze trends in the process of care and outcomes. Results Since October 2001, 81,227 patients with diabetes have enrolled in VISN 10: approximately 42,000 are currently under active management by VISN 10 providers. By tracking primary care visits, we assigned 91% to a clinic group responsible for diabetes care. In the Cleveland Veterans Affairs Medical Center (VAMC), the frequency of mean annual hemoglobin A1c levels ≥9% has declined significantly over 5 years. Almost 4000 patients have been seen in diabetes intervention programs in the Cleveland VAMC over the past 4 years. Conclusions A diabetes registry can be populated from the database underlying the VHA electronic patient record database system and linked to Web-based and ad hoc queries useful for quality improvement. PMID:19885172

  8. Assessing the safety features of electronic patient medication record systems used in community pharmacies in England.

    PubMed

    Ojeleye, Oluwagbemileke; Avery, Anthony J; Boyd, Matthew J

    2014-08-01

    To evaluate the ability of electronic patient medication record (ePMR) systems used in community pharmacies in England to detect and alert users about clinical hazards, errors and other safety problems. Between September 2012 and November 2012, direct on-site observational data about the performance of ePMR systems were collected from nine sites. Twenty-eight scenarios were developed by consensus agreement between a general practitioner and two community pharmacists. Each scenario was entered into the ePMR system, and the results obtained from the assessment of six unique systems in nine sites, in terms of the presence or absence of an alert, were recorded onto a prespecified form. None of the systems produced the correct responses for all of the 28 scenarios tested. Only two systems provided an alert to penicillin sensitivity. No dose or frequency check was observed when processing a prescription for methotrexate. One system did not warn about nonsuitability of aspirin prescribed to a child of 14 years of age. In another system, it was not possible to record a patient's pregnancy status. None of the six systems provided any warning for diclofenac overdose, high initiation dose of morphine sulfate or significant dose increase. Only one of the systems did not produce any spurious alerts. The performance of the ePMR systems tested was variable and suboptimal. The findings suggest the need for minimum specifications and standards for ePMR systems to ensure consistency of performance. © 2014 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of The British Pharmacological Society.

  9. Predicting length of stay from an electronic patient record system: a primary total knee replacement example.

    PubMed

    Carter, Evelene M; Potts, Henry W W

    2014-04-04

    To investigate whether factors can be identified that significantly affect hospital length of stay from those available in an electronic patient record system, using primary total knee replacements as an example. To investigate whether a model can be produced to predict the length of stay based on these factors to help resource planning and patient expectations on their length of stay. Data were extracted from the electronic patient record system for discharges from primary total knee operations from January 2007 to December 2011 (n=2,130) at one UK hospital and analysed for their effect on length of stay using Mann-Whitney and Kruskal-Wallis tests for discrete data and Spearman's correlation coefficient for continuous data. Models for predicting length of stay for primary total knee replacements were tested using the Poisson regression and the negative binomial modelling techniques. Factors found to have a significant effect on length of stay were age, gender, consultant, discharge destination, deprivation and ethnicity. Applying a negative binomial model to these variables was successful. The model predicted the length of stay of those patients who stayed 4-6 days (~50% of admissions) with 75% accuracy within 2 days (model data). Overall, the model predicted the total days stayed over 5 years to be only 88 days more than actual, a 6.9% uplift (test data). Valuable information can be found about length of stay from the analysis of variables easily extracted from an electronic patient record system. Models can be successfully created to help improve resource planning and from which a simple decision support system can be produced to help patient expectation on their length of stay.

  10. Integrating case-based reasoning with an electronic patient record system.

    PubMed

    van den Branden, Martijn; Wiratunga, Nirmalie; Burton, Dean; Craw, Susan

    2011-02-01

    Electronic patient records (EPRs) contain a wealth of patient-related data and capture clinical problem-solving experiences and decisions. Excelicare is such a system which is also a platform for the national generic clinical system in the UK. This paper presents, ExcelicareCBR, a case-based reasoning (CBR) system which has been developed to complement Excelicare. Objective of this work is to integrate CBR to support clinical decision making by harnessing electronic patient records for clinical experience reuse. CBR is a proven problem solving methodology in which past solutions are reused to solve new problems. A key challenge that we address in this paper is how to extract and represent a case from an EPR. Using an example from the lung cancer domain we demonstrate our generic case representation approach where Excelicare fields are mapped to case features. Once the case base is populated with cases containing data from the EPRs database a standard weighted k-nearest neighbour algorithm combined with a genetic algorithm based feature weighting mechanism is used for case retrieval and reuse. We conclude that incorporating case authoring functionality and a generic retrieval mechanism were key to successful integration of ExcelicareCBR. This paper also demonstrates how the application of CBR can enable sharing of lessons learned through the retrieval and reuse of EPRs captured as cases in a case base. Copyright © 2010 Elsevier B.V. All rights reserved.

  11. Time accuracy of a radio frequency identification patient tracking system for recording operating room timestamps.

    PubMed

    Marjamaa, Riitta A; Torkki, Paulus M; Torkki, Markus I; Kirvelä, Olli A

    2006-04-01

    A patient tracking system is a promising tool for managing patient flow and improving efficiency in the operating room. Wireless location systems, using infrared or radio frequency transmitters, can automatically timestamp key events, thereby decreasing the need for manual data input. In this study, we measured the accuracy and precision of automatically documented timestamps compared with manual recording. Each patient scheduled for urgent surgery was given an active radio frequency/infrared transmitter. The prototype software tracked the patient throughout the perioperative process, automatically documenting the timestamps. Both automatic and traditional data entry were compared with the reference data. The absolute value of median error was 64% smaller (P < 0.01), and the average quartile deviation of error was 69% smaller in automatic documentation. The average delay between an activity and the documentation was 80 seconds in automatic documentation and 735 seconds in manual documentation. Both the accuracy and the precision were better in automatic documentation and the data were immediately available. Automatic documentation with the Indoor Positioning System can help in managing patient flow and in increasing transparency with faster availability and better accuracy of data.

  12. A web based prototype system for patient use confirming Taiwan electronic medical-record templates.

    PubMed

    Hu, Chiu-Ming; Jian, Wen-Shan; Chang, Po-Lun; Hsu, Chien-Yeh

    2005-01-01

    Taiwanese Department of Health (DOH) proposed the basic format template of electronic medical records (EMR), for the reference of healthcare institutions nationwide. It facilitates the establishment of EMR in healthcare institutions and the foundation of the sharing and exchange center of EMR. We use this basic content format template as the data exchange carrier, and build a EMR prototype system by using web-based XML structured documents, which can thoroughly show the information needed by patients and healthcare institutions, offer web browser inverted exclamation mark|s HTML-style viewing, provide people and institutions with the operation interface for browsing and downloading relevant medical record formats, and realize the dream that people can actually own their EMR.

  13. An electronic health record to support patients and institutions of the health care system.

    PubMed

    Uckert, Frank; Müller, Marcel Lucas; Bürkle, Thomas; Prokosch, Hans-Ulrich

    2004-08-24

    The department of Medical Informatics of the University Hospital Münster and the Gesakon GmbH (an university offspring) initiated the cooperative development of an electronic health record (EHR) called "akteonline.de" in 2000. From 2001 onwards several clinics of the university hospital have already offered this EHR (within pilot projects) as an additional service to selected subsets of their patients. Based on the experiences of those pilot projects the system architecture and the basic data model underwent several evolutionary enhancements, e.g. implementations of electronic interfaces to other clinical systems (considering for example data interchange methods like the Clinical Document Architecture - standardized within the HL7 group - and also interfacing architectures of German GP systems, such as VCS and D2D). "akteonline.de" in its current structure supports patients as well as health care professionals and aims at providing a collaborative health information system which perfectly supports the clinical workflow even across institutional boundaries and including the patient himself. Since such an EHR needs to strictly fulfill high data security and data protection requirements, a complex authorization and access control component has been included. Furthermore the EHR data are encrypted within the database itself and during their transfer across the internet.

  14. Electronic recording of transfusion-related patient observations: a comparison of two bedside systems.

    PubMed

    Staples, S; Noel, S; Watkinson, P; Murphy, M F

    2017-09-27

    Vital sign observations should be monitored before, during and after transfusion to enable adverse events to be identified, but surveys in the UK show poor compliance with good practice. At the Oxford University Hospitals, there are two electronic bedside processes for recording observations; BloodTrack Tx (Haemonetics Corp.), the routine electronic transfusion process and a locally developed process, the System for Electronic Nursing Documentation (SEND) with integrated 'track and trigger' calculation for monitoring vital signs. The purpose of this study was to evaluate the conduct of patient observation monitoring for blood transfusion using two electronic bedside processes. This study examined the observations recorded during 200 single red cell unit transfusions. 186/200 (93%) transfusions had pretransfusion observations recorded using BloodTrack Tx. Mid-transfusion checks were performed during 133/200 (67%) of transfusions, of these checks most (87/200 (44%)) were documented as 'no apparent change' in observations. End transfusion observations were performed using BloodTrack Tx in 178/200 (89%). Both systems were frequently used, and staff had a preference for using SEND first for documenting the pretransfusion observations (102/116 (88%)) and at the end of a transfusion (75/115 (65%)). Electronic bedside systems result in improved monitoring of transfusion-related observations compared to manual processes based on data from UK surveys. There is increasing use of electronic systems in clinical practice; linkage between these two systems would prevent wasteful duplication of observations and could provide improved early warning of adverse events to transfusion compared to manual processes. © 2017 International Society of Blood Transfusion.

  15. Expert systems, security and quality assurance: implications of patient records as data-space.

    PubMed

    Kluge, E H

    2001-01-01

    The concept of data-space is fruitful in trying to understand the ethical rights and duties that surround the treatment of patient records. However, it also provides a solution to three apparently unconnected problems: the construction of expert diagnostic systems, the development of an internal security element within the sphere of permitted data-access for health care professionals, and the development of a professional quality assurance mechanism. This paper presents a model of how these diverse aims may be achieved. It does so by developing the notion of the logical form of data within a data-space and by showing how the path taken by a health care professional through a profession-relative data-space can provide checks for the security, quality and appropriateness of the path itself. The result is important in that it provides an integrated method for information specialists to meet their fiduciary obligations towards the patients whose records are in their care, and towards the institutions that employ them.

  16. 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…

  17. 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…

  18. Work system barriers to patient, provider, and caregiver use of personal health records: A systematic review.

    PubMed

    Thompson, Morgan J; Reilly, Jeremiah D; Valdez, Rupa S

    2016-05-01

    This review applied a human factors/ergonomics (HF/E) paradigm to assess individual, work system/unit, organization, and external environment factors generating barriers to patient, provider, and informal caregiver personal health record (PHR) use. The literature search was conducted using five electronic databases for the timeframe January 2000 to October 2013, resulting in 4865 citations. Two authors independently coded included articles (n = 60). Fifty-five, ten and five articles reported barriers to patient, provider and caregiver PHR use, respectively. Barriers centered around 20 subfactors. The most frequently noted were needs, biases, beliefs, and mood (n = 35) and technology functions and features (n = 32). The HF/E paradigm was effective in framing the assessment of factors creating barriers to PHR use. Design efforts should address literacy, interoperability, access to health information, and secure messaging. A deeper understanding of the interactions between work systems and the role of organization and external environment factors is required. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  19. 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.

  20. Wireless connection of continuous glucose monitoring system to the electronic patient record

    NASA Astrophysics Data System (ADS)

    Murakami, Alexandre; Gutierrez, Marco A.; Lage, Silvia G.; Rebelo, Marina S.; Granja, Luiz A. R.; Ramires, Jose A. F.

    2005-04-01

    The control of blood sugar level (BSL) at near-normal levels has been documented to reduce both acute and chronic complications of diabetes mellitus. Recent studies suggested, the reduction of mortality in a surgical intensive care unit (ICU), when the BSL are maintained at normal levels. Despite of the benefits appointed by these and others clinical studies, the strict BSL control in critically ill patients suffers from some difficulties: a) medical staff need to measure and control the patient"s BSL using blood sample at least every hour. This is a complex and time consuming task; b) the inaccuracy of standard capillary glucose monitoring (fingerstick) in hypotensive patients and, if frequently used to sample arterial or venous blood, may lead to excess phlebotomy; c) there is no validated procedure for continuously monitoring of BSL levels. This study used the MiniMed CGMS in ill patients at ICU to send, in real-time, BSL values to a Web-Based Electronic Patient Record. The BSL values are parsed and delivered through a wireless network as an HL7 message. The HL7 messages with BSL values are collected, stored into the Electronic Patient Record and presented into a bed-side monitor at the ICU together with other relevant patient information.

  1. A method for extracting electronic patient record data from practice management software systems used in veterinary practice.

    PubMed

    Jones-Diette, Julie S; Brennan, Marnie L; Cobb, Malcolm; Doit, Hannah; Dean, Rachel S

    2016-10-21

    Data extracted from electronic patient records (EPRs) within practice management software systems are increasingly used in veterinary research. The use of real patient data gives the potential to generate research that can readily be applied to clinical practice. The use of veterinary EPRs for research in the United Kingdom is hindered by the number of different Practice Management System (PMS) providers used by practices, as obtaining and combining data from different systems electronically can be problematic. The use of extensible mark up language (XML) to extract clinical data for research would potentially resolve the compatibility issues between systems. The aim of this study was to establish and validate a method for the extraction of small animal patient records from a veterinary PMS that could potentially be used across multiple systems. An XML schema was designed to extract clinical information from EPRs. The schema was tested and validated in a test system, and was then tested in a real small animal practice where data was extracted for 16 weeks. A 10 % sample of the extracted records was then compared to paper copies provided by the practice. All 21 fields encoded by the XML schema, from all of the records in the test system, were extracted with 100 % accuracy. Over the 18 week data collection period 4946 records, from 1279 patients, were extracted from the small animal practice. The 10 % printed records checked and compared with the XML extracted records demonstrated all required data was present. No unrequired, sensitive information e.g. costs or services/products or personal client information was extracted. This is the first time a method for data extraction from EPRs in veterinary practice using an XML schema has been reported in the United Kingdom. This is an efficient and accurate way of extracting data which could be applied to all PMSs nationally and internationally.

  2. Acute cervico-facial infection in Scotland 2010: patterns of presentation, patient demographics and recording of systemic involvement.

    PubMed

    Byers, J; Lowe, T; Goodall, C A

    2012-10-01

    Acute bacterial cervicofacial infection is a common problem that is most often secondary to dental infection. Most cases present as localised abscesses but some may be associated with serious morbidity including scarring, embarrassment of the airway, SIRS (systemic inflammatory response syndrome), and sepsis syndrome. Fourteen oral surgery or maxillofacial surgery units in Scotland took part in a clinical audit of acute infection during two four-week cycles (August and November) in 2010. Information regarding the patients, signs and symptoms, and management was recorded. Training material was distributed between cycles with information on SIRS, sepsis, and the prescription of antibiotics. Overall, 140 patients presented with acute infection. There was an equal sex distribution and ages ranged from 5 to 87 years. There was an association with deprivation and 36% of patients were from the lowest socioeconomic quintile. Most infections were dental (n=120, 86%), and patients presented with pain and swelling (n=120, 86% and n=134, 96%, respectively) Twenty-three patients (16%) met the criteria for SIRS. A further 23 (16%) had at least one positive SIRS marker with incomplete recording of the remaining markers. Twenty-six patients (19%) had no recorded SIRS markers. Cervicofacial infection can be associated with serious morbidity and mortality, which may be better managed if the systemic signs and symptoms of sepsis are recognised and recorded at presentation. This study showed that the recording of signs of sepsis was variable even with training. Further training of junior staff to recognise severe acute bacterial infection may improve management.

  3. [Patient medication record in pharmacy: development of specialized information system and possibilities of its application in Lithuanian community pharmacies].

    PubMed

    Skyrius, Vaidas; Kapocius, Kestutis; Radziūnas, Raimondas

    2003-01-01

    To examine whether the managers of Lithuanian community pharmacies need a special information system for the creation of patients' medication record in the pharmacy. To design the system and to analyze the possibilities of its application. RESEARCH MATERIALS AND METHODS: In order to determine the need for a specialized information system a questionnaire-based survey of pharmacies managers was used. During the development of information system the detailed requirements analysis was performed and basing on this analysis the architecture of the system and its user interface were designed. System was built using "Microsoft Access 2000" and "Visual Basic 6" development tools. Survey revealed that managers of community pharmacies require an information system for the creation of patients' medication record in the pharmacy. The design of the system was prepared and the initial version was built. Examinations of the developed system showed that it could be used to form the patient information database, which would improve the quality of service. The developed information system or its analogue should be used in community pharmacies because absence of the patients medical records database makes it impossible to implement the recommendations of good pharmacy practice.

  4. 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…

  5. 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…

  6. Towards Standardized Patient Data Exchange: Integrating a FHIR Based API for the Open Medical Record System.

    PubMed

    Kasthurirathne, Suranga N; Mamlin, Burke; Grieve, Grahame; Biondich, Paul

    2015-01-01

    Interoperability is essential to address limitations caused by the ad hoc implementation of clinical information systems and the distributed nature of modern medical care. The HL7 V2 and V3 standards have played a significant role in ensuring interoperability for healthcare. FHIR is a next generation standard created to address fundamental limitations in HL7 V2 and V3. FHIR is particularly relevant to OpenMRS, an Open Source Medical Record System widely used across emerging economies. FHIR has the potential to allow OpenMRS to move away from a bespoke, application specific API to a standards based API. We describe efforts to design and implement a FHIR based API for the OpenMRS platform. Lessons learned from this effort were used to define long term plans to transition from the legacy OpenMRS API to a FHIR based API that greatly reduces the learning curve for developers and helps enhance adhernce to standards.

  7. Development of a peer review system using patient records for outcome evaluation of medical education: reliability analysis.

    PubMed

    Kameoka, Junichi; Okubo, Tomoya; Koguma, Emi; Takahashi, Fumie; Ishii, Seiichi; Kanatsuka, Hiroshi

    2014-01-01

    In addition to input evaluation (education delivered at school) and output evaluation (students' capability at graduation), the methods for outcome evaluation (performance after graduation) of medical education need to be established. One approach is a review of medical records, which, however, has been met with difficulties because of poor inter-rater reliability. Here, we attempted to develop a peer review system of medical records with high inter-rater reliability. We randomly selected 112 patients (and finally selected 110 after removing two ineligible patients) who visited (and were hospitalized in) one of the four general hospitals in the Tohoku region of Japan between 2008 and 2012. Four reviewers, who were well-trained general internists from outside the Tohoku region, visited the hospitals independently and evaluated outpatient medical records based on an evaluation sheet that consisted of 14 items (3-point scale) for record keeping and 15 items (5-point scale) for quality of care. The mean total score was 84.1 ± 7.7. Cronbach's alpha for these items was 0.798. Single measure and average measure intraclass correlations for the reviewers were 0.733 (95% confidence interval: 0.720-0.745) and 0.917 (95% confidence interval: 0.912-0.921), respectively. An exploratory factor analysis revealed six factors: history taking, physical examination, clinical reasoning, management and outcome, rhetoric, and patient relationship. In conclusion, we have developed a peer review system of medical records with high inter-rater reliability, which may enable us, with further validity analysis, to measure quality of patient care as an outcome evaluation of medical education in the future.

  8. Designing a system for patients controlling providers' access to their electronic health records: organizational and technical challenges.

    PubMed

    Leventhal, Jeremy C; Cummins, Jonathan A; Schwartz, Peter H; Martin, Douglas K; Tierney, William M

    2015-01-01

    Electronic health records (EHRs) are proliferating, and financial incentives encourage their use. Applying Fair Information Practice principles to EHRs necessitates balancing patients' rights to control their personal information with providers' data needs to deliver safe, high-quality care. We describe the technical and organizational challenges faced in capturing patients' preferences for patient-controlled EHR access and applying those preferences to an existing EHR. We established an online system for capturing patients' preferences for who could view their EHRs (listing all participating clinic providers individually and categorically-physicians, nurses, other staff) and what data to redact (none, all, or by specific categories of sensitive data or patient age). We then modified existing data-viewing software serving a state-wide health information exchange and a large urban health system and its primary care clinics to allow patients' preferences to guide data displays to providers. Patients could allow or restrict data displays to all clinicians and staff in a demonstration primary care clinic, categories of providers (physicians, nurses, others), or individual providers. They could also restrict access to all EHR data or any or all of five categories of sensitive data (mental and reproductive health, sexually transmitted diseases, HIV/AIDS, and substance abuse) and for specific patient ages. The EHR viewer displayed data via reports, data flowsheets, and coded and free text data displayed by Google-like searches. Unless patients recorded restrictions, by default all requested data were displayed to all providers. Data patients wanted restricted were not displayed, with no indication they were redacted. Technical barriers prevented redacting restricted information in free textnotes. The program allowed providers to hit a "Break the Glass" button to override patients' restrictions, recording the date, time, and next screen viewed. Establishing patient

  9. A synchronization system for the analysis of biomedical signals recorded with different devices from mechanically ventilated patients.

    PubMed

    Camacho, Alejandro; Hernández, A Mauricio; Londoño, Zulma; Serna, Leidy Y; Mañanas, Miguel A

    2012-01-01

    Conducting research associated with mechanically ventilated patients often requires the recording of several biomedical signals to dispose of multiple sources of information to perform a robust analysis. This is especially important in the analysis of the relationship between pressure, volume and flow, signals available from mechanical ventilators, and other biopotentials such as the electromyogram of respiratory muscles, intrinsically related with the ventilatory process, but not commonly recorded in the clinical practice. Despite the usefulness of recording signals from multiple sources, few medical devices include the possibility of synchronizing its data with other provided by different biomedical equipment and some may use inaccurate sampling frequencies. Even thought a variant or inaccurate sampling rate does not affect the monitoring of critical patients, it restricts the study of simultaneous related events useful in research of respiratory system activity. In this article a device for temporal synchronization of signals recorded from multiple biomedical devices is described as well as its application in the study of patients undergoing mechanical ventilation with research purposes.

  10. Enhancing patient safety and quality of care by improving the usability of electronic health record systems: recommendations from AMIA.

    PubMed

    Middleton, Blackford; Bloomrosen, Meryl; Dente, Mark A; Hashmat, Bill; Koppel, Ross; Overhage, J Marc; Payne, Thomas H; Rosenbloom, S Trent; Weaver, Charlotte; Zhang, Jiajie

    2013-06-01

    In response to mounting evidence that use of electronic medical record systems may cause unintended consequences, and even patient harm, the AMIA Board of Directors convened a Task Force on Usability to examine evidence from the literature and make recommendations. This task force was composed of representatives from both academic settings and vendors of electronic health record (EHR) systems. After a careful review of the literature and of vendor experiences with EHR design and implementation, the task force developed 10 recommendations in four areas: (1) human factors health information technology (IT) research, (2) health IT policy, (3) industry recommendations, and (4) recommendations for the clinician end-user of EHR software. These AMIA recommendations are intended to stimulate informed debate, provide a plan to increase understanding of the impact of usability on the effective use of health IT, and lead to safer and higher quality care with the adoption of useful and usable EHR systems.

  11. Enhancing patient safety and quality of care by improving the usability of electronic health record systems: recommendations from AMIA

    PubMed Central

    Middleton, Blackford; Bloomrosen, Meryl; Dente, Mark A; Hashmat, Bill; Koppel, Ross; Overhage, J Marc; Payne, Thomas H; Rosenbloom, S Trent; Weaver, Charlotte; Zhang, Jiajie

    2013-01-01

    In response to mounting evidence that use of electronic medical record systems may cause unintended consequences, and even patient harm, the AMIA Board of Directors convened a Task Force on Usability to examine evidence from the literature and make recommendations. This task force was composed of representatives from both academic settings and vendors of electronic health record (EHR) systems. After a careful review of the literature and of vendor experiences with EHR design and implementation, the task force developed 10 recommendations in four areas: (1) human factors health information technology (IT) research, (2) health IT policy, (3) industry recommendations, and (4) recommendations for the clinician end-user of EHR software. These AMIA recommendations are intended to stimulate informed debate, provide a plan to increase understanding of the impact of usability on the effective use of health IT, and lead to safer and higher quality care with the adoption of useful and usable EHR systems. PMID:23355463

  12. Implementation of Indigenous Electronic Medical Record System to Facilitate Care of Sickle Cell Disease Patients in Chhattisgarh

    PubMed Central

    Choubey, Mona; Mishra, Hrishikesh; Soni, Khushboo

    2016-01-01

    Introduction Sickle cell disease (SCD) is prevalent in central India including Chhattisgarh. Screening for SCD is being carried out by Government of Chhattisgarh. Electronic Medical Record (EMR) system was developed and implemented in two phases. Aim Aim was to use informatics techniques and indigenously develop EMR system to improve the care of SCD patients in Chhattisgarh. EMR systems had to be developed to store and manage: i) huge data generated through state wide screening for SCD; ii) clinical data for SCD patients attending the outpatient department (OPD) of institute. Materials and Methods ‘State Wide Screening Data Interface’ (SWSDI) was designed and implemented for storing and managing data generated through screening program. Further, ‘Sickle Cell Patients Temporal Data Management System’ (SCPTDMS) was developed and implemented for storing, managing and analysing sickle cell disease patients’ data at OPD. Both systems were developed using VB.Net and MS SQL Server 2012. Results Till April 2015, SWSDI has data of 1294558 persons, out of which 121819 and 4087 persons are carriers and patients of sickle cell disease respectively. Similarly till June 2015, SCPTDMS has data of 3760 persons, of which 923 are sickle cell disease patients (SS) and 1355 are sickle cell carriers (AS). Conclusion Both systems are proving to be useful in efficient storage, management and analysis of data for clinical and research purposes. The systems are an example of beneficial usage of medical informatics solutions for managing large data at community level. PMID:27042486

  13. Internet patient records: new techniques.

    PubMed

    Brelstaff, G; Moehrs, S; Anedda, P; Tuveri, M; Zanetti, G

    2001-01-01

    The ease by which the Internet is able to distribute information to geographically-distant users on a wide variety of computers makes it an obvious candidate for a technological solution for electronic patient record systems. Indeed, second-generation Internet technologies such as the ones described in this article--XML (eXtensible Markup Language), XSL (eXtensible Style Language), DOM (Document Object Model), CSS (Cascading Style Sheet), JavaScript, and JavaBeans--may significantly reduce the complexity of the development of distributed healthcare systems. The demonstration of an experimental Electronic Patient Record (EPR) system built from those technologies that can support viewing of medical imaging exams and graphically-rich clinical reporting tools, while conforming to the newly emerging XML standard for digital documents. In particular, we aim to promote rapid prototyping of new reports by clinical specialists. We have built a prototype EPR client, InfoDOM, that runs in both the popular web browsers. In this second version it receives each EPR as an XML record served via the secure SSL (Secure Socket Layer) protocol. JavaBean software components manipulate the XML to store it and then to transform it into a variety of useful clinical views. First a web page summary for the patient is produced. From that web page other JavaBeans can be launched. In particular, we have developed a medical imaging exam Viewer and a clinical Reporter bean parameterized appropriately for the particular patient and exam in question. Both present particular views of the XML data. The Viewer reads image sequences from a patient-specified network URL on a PACS (Picture Archiving and Communications System) server and presents them in a user-controllable animated sequence, while the Reporter provides a configurable anatomical map of the site of the pathology, from which individual "reportlets" can be launched. The specification of these reportlets is achieved using standard HTML forms

  14. Internet Patient Records: new techniques

    PubMed Central

    Moehrs, Sascha; Anedda, Paolo; Tuveri, Massimiliano; Zanetti, Gianluigi

    2001-01-01

    Background The ease by which the Internet is able to distribute information to geographically-distant users on a wide variety of computers makes it an obvious candidate for a technological solution for electronic patient record systems. Indeed, second-generation Internet technologies such as the ones described in this article - XML (eXtensible Markup Language), XSL (eXtensible Style Language), DOM (Document Object Model), CSS (Cascading Style Sheet), JavaScript, and JavaBeans - may significantly reduce the complexity of the development of distributed healthcare systems. Objective The demonstration of an experimental Electronic Patient Record (EPR) system built from those technologies that can support viewing of medical imaging exams and graphically-rich clinical reporting tools, while conforming to the newly emerging XML standard for digital documents. In particular, we aim to promote rapid prototyping of new reports by clinical specialists. Methods We have built a prototype EPR client, InfoDOM, that runs in both the popular web browsers. In this second version it receives each EPR as an XML record served via the secure SSL (Secure Socket Layer) protocol. JavaBean software components manipulate the XML to store it and then to transform it into a variety of useful clinical views. First a web page summary for the patient is produced. From that web page other JavaBeans can be launched. In particular, we have developed a medical imaging exam Viewer and a clinical Reporter bean parameterized appropriately for the particular patient and exam in question. Both present particular views of the XML data. The Viewer reads image sequences from a patient-specified network URL on a PACS (Picture Archiving and Communications System) server and presents them in a user-controllable animated sequence, while the Reporter provides a configurable anatomical map of the site of the pathology, from which individual "reportlets" can be launched. The specification of these reportlets is

  15. Patient access to medical records.

    PubMed

    Mair, J L

    1996-01-01

    The issue of, and access to, medical records has been a contentious matter for some years in Australia. The recent High Court decision of Breen v Williams has clarified the law nationwide. The High Court confirmed that the ownership of medical records is vested in the creator of the records. The High Court further held that a patient has no right at law to access his or her medical records in the absence of any statute granting such a right, or other legal process.

  16. Tolerability of central nervous system symptoms among HIV-1 infected efavirenz users: analysis of patient electronic medical record data.

    PubMed

    Rosenblatt, Lisa; Broder, Michael S; Bentley, Tanya G K; Chang, Eunice; Reddy, Sheila R; Papoyan, Elya; Myers, Joel

    2017-02-01

    Efavirenz (EFV) is a non-nucleoside reverse transcriptase inhibitor indicated for treatment of HIV-1 infection. Despite concern over EFV tolerability in clinical trials and practice, particularly related to central nervous system (CNS) adverse events, some observational studies have shown high rates of EFV continuation at one year and low rates of CNS-related EFV substitution. The objective of this study was to further examine the real-world rate of CNS-related EFV discontinuation in antiretroviral therapy naïve HIV-1 patients. This retrospective cohort study used a nationally representative electronic medical records database to identify HIV-1 patients ≥12 years old, treated with a 1st-line EFV-based regimen (single or combination antiretroviral tablet) from 1 January 2009 to 30 June 2013. Patients without prior record of EFV use during 6-month baseline (i.e., antiretroviral therapy naïve) were followed 12 months post-medication initiation. CNS-related EFV discontinuation was defined as evidence of a switch to a replacement antiretroviral coupled with record of a CNS symptom within 30 days prior, absent lab evidence of virologic failure. We identified 1742 1st-line EFV patients. Mean age was 48 years, 22.7% were female, and 8.1% had a prior report of CNS symptoms. The first year, overall discontinuation rate among new users of EFV was 16.2%. Ten percent of patients (n = 174) reported a CNS symptom and 1.1% (n = 19) discontinued EFV due to CNS symptoms: insomnia (n = 12), headache (n = 5), impaired concentration (n = 1), and somnolence (n = 1). The frequency of CNS symptoms was similar for patients who discontinued EFV compared to those who did not (10.3 vs. 9.9%; P = .86). Our study found that EFV discontinuation due to CNS symptoms was low, consistent with prior reports.

  17. Minimally disruptive medicine is needed for patients with multimorbidity: time to develop computerised medical record systems to meet this requirement.

    PubMed

    Schattner, Peter; Barker, Fiona; de Lusignan, Simon

    2015-02-19

    Minimally disruptive medicine (MDM) is proposed as a method for more appropriately managing people with multiple chronic disease. Much clinical management is currently single disease focussed, with people with multimorbidity being managed according to multiple single disease guidelines. Current initiatives to improve care include education about individual conditions and creating an environment where multiple guidelines might be simultaneously supported. The patient-centred medical home (PCMH) is an example of the latter. However, educational programmes and PCMH may increase the burden on patients. The cumulative workload for patients in managing the impact of multiple disease-specific guidelines is only relatively recently recognised. There is an intellectual vacuum as to how best to manage multimorbidity and how informatics might support implementing MDM. There is currently no alternative to multiple single-condition- specific guidelines and a lack of certainty, should the treatment burden need to be reduced, as to which guideline might be 'dropped'. The best information about multimorbidity is recorded in primary care computerised medical record (CMR) systems and in an increasing number of integrated care organisations. CMR systems have the potential to flag individuals who might be in greatest need. However, CMR systems may also provide insights into whether there are ameliorating factors that might make it easier for them to be resilient to the burden of care. Data from such CMR systems might be used to develop the evidence base about how to better manage multimorbidity. There is potential for these information systems to help reduce the management burden on patients and clinicians. However, substantial investment in research-driven CMR development is needed if we are to achieve this.

  18. Monitoring Reasons for Encounter via an Electronic Patient Record System: the Case of a Rural Practice Initiative

    PubMed Central

    Klinis, Spyridon; Markaki, Adelais; Kounalakis, Dimitrios; Symvoulakis, Emmanouil K.

    2012-01-01

    The objective of this brief communication was to tabulate common reasons for encounter in a Greek rural general practice, as result of a recently adopted electronic patient record (EPR) application. Twenty encounter reasons accounted for 3,797 visits (61% of all patient encounters), whereas 565 other reasons accounted for the remaining 2,429 visits (39%). Number one reason for encounter was health maintenance or disease prevention seeking services, including screening examinations for malignancies, immunization and provision of medical opinion reports. Hypertension, lipid disorder and ischemic heart disease without angina were among the most common reasons for seeking care. A strengths/weaknesses/opportunities/threats (SWOT) analysis on the key role of an EPR system in collecting data from rural and remote primary health care settings is also presented. PMID:23091407

  19. Implementing an interprofessional patient record.

    PubMed

    Griffiths, Paul; Anderson, Alan; Coyne, Clare; Beastall, Helen; Hill, Joanne

    2011-04-01

    This paper describes the implementation of an interprofessional patient record (IPPR) at Sheffield Teaching Hospitals NHS Foundation Trust (STHFT). The IPPR was a two-year project, commencing in May 2008, aimed at creating a single IPPR to which all staff contribute. Prior to the IPPR, records were profession specific with nursing, medical and therapy staff keeping separate ones. This paper describes the process for the project including the stakeholder engagement plan, the development of IPPR standards, the education and training programme and the key measures used to assess implementation. The staff survey and clinical audit data suggest that the IPPR was successfully implemented with many of the perceived benefits realised. The keys to success of this major change project were: time spent engaging clinical staff, board level support, the appointment of a dedicated project team and the involvement and support of many staff involved in patient records throughout STHFT.

  20. Application of KinectTM and wireless technology for patient data recording and viewing system in the course of surgery

    NASA Astrophysics Data System (ADS)

    Ong, Aira Patrice R.; Bugtai, Nilo T.; Aldaba, Luis Miguel M.; Madrangca, Astrid Valeska H.; Que, Giselle V.; Que, Miles Frederick L.; Tan, Kean Anderson. S.

    2017-02-01

    In modern operating room (OR) conditions, a patient's computed tomography (CT) or magnetic resonance imaging (MRI) scans are some of the most important resources during surgical procedures. In practice, the surgeon is impelled to scrub out and back in every time he needs to scroll through scan images in mid-operation. To prevent leaving the operating table, many surgeons rely on assistants or nurses and give instructions to manipulate the computer for them, which can be cumbersome and frustrating. As a motivation for this study, the use of touchless (non-contact) gesture-based interface in medical practice is incorporated to have aseptic interactions with the computer systems and with the patient's data. The system presented in this paper is composed of three main parts: the Trek Ai-Ball Camera, the Microsoft Kinect™, and the computer software. The incorporation of these components and the developed software allows the user to perform 13 hand gestures, which have been tested to be 100 percent accurate. Based on the results of the tests performed on the system performance, the conclusions made regarding the time efficiency of the viewing system, the quality and the safety of the recording system has gained positive feedback from consulting doctors.

  1. Why facilitate patient access to medical records.

    PubMed

    Ferreira, Ana; Correia, Ana; Silva, Ana; Corte, Ana; Pinto, Ana; Saavedra, Ana; Pereira, Ana Luís; Pereira, Ana Filipa; Cruz-Correia, Ricardo; Antunes, Luís Filipe

    2007-01-01

    The wider use of healthcare information systems and the easier integration and sharing of patient clinical information can facilitate a wider access to medical records. The main goal of this paper is to perform a systematic review to analyze published work that studied the impact of facilitating patients' access to their medical record. Moreover, this review includes the analysis of the potential benefits and drawbacks on patient attitudes, doctor-patient relationship and on medical practice. In order to fill a gap in terms of the electronic medical record (EMR) impact within this issue, this review will focus on the use of EMR for patients to access their medical records as well as the advantages and disadvantages that this can bring. The articles included in the study were identified using MEDLINE and Scopus databases and revised according to their title and abstract and, afterwards, their full text was read considering inclusion and exclusion criteria. From the 165 articles obtained in MEDLINE a total of 12 articles were selected. From Scopus, 2 articles were obtained, so a total of 14 articles were included in the review. The studies revealed that patients' access to medical records can be beneficial for both patients and doctors, since it enhances communication between them whilst helping patients to better understand their health condition. The drawbacks (for instance causing confusion and anxiety to patients) seem to be minimal. However, patients continue to show concerns about confidentiality and understanding what is written in their records. The studies showed that the use of EMR can bring several advantages in terms of security solutions as well as improving the correctness and completeness of the patient records.

  2. Children’s Hospital Integrated Patient Electronic Record System (CHIPERS) Continuation

    DTIC Science & Technology

    2012-10-01

    decision support, electronic health record, pediatric critical care, neonatal intensive care 17 HFlori@mail.cho.org     3       Table of Contents...and/or shock with the ACCM and  CHRCO Clinical Guidelines for Hemodynamic Support of  Neonates  and Children with  Severe Sepsis and Septic Shock...Hospital & Research Center Oakland Clinical Guidelines for Hemodynamic Support of  Neonates  and Children with Severe Sepsis and Septic Shock. We will

  3. DSN telemetry system data records

    NASA Technical Reports Server (NTRS)

    Gatz, E. C.

    1976-01-01

    The DSN telemetry system now includes the capability to provide a complete magnetic tape record, within 24 hours of reception, of all telemetry data received from a spacecraft. This record, the intermediate data record, is processed and generated almost entirely automatically, and provides a detailed accounting of any missing data.

  4. A Standards-Based Architecture Proposal for Integrating Patient mHealth Apps to Electronic Health Record Systems.

    PubMed

    Marceglia, S; Fontelo, P; Rossi, E; Ackerman, M J

    2015-01-01

    Mobile health Applications (mHealth Apps) are opening the way to patients' responsible and active involvement with their own healthcare management. However, apart from Apps allowing patient's access to their electronic health records (EHRs), mHealth Apps are currently developed as dedicated "island systems". Although much work has been done on patient's access to EHRs, transfer of information from mHealth Apps to EHR systems is still low. This study proposes a standards-based architecture that can be adopted by mHealth Apps to exchange information with EHRs to support better quality of care. Following the definition of requirements for the EHR/mHealth App information exchange recently proposed, and after reviewing current standards, we designed the architecture for EHR/mHealth App integration. Then, as a case study, we modeled a system based on the proposed architecture aimed to support home monitoring for congestive heart failure patients. We simulated such process using, on the EHR side, OpenMRS, an open source longitudinal EHR and, on the mHealth App side, the iOS platform. The integration architecture was based on the bi-directional exchange of standard documents (clinical document architecture rel2 - CDA2). In the process, the clinician "prescribes" the home monitoring procedures by creating a CDA2 prescription in the EHR that is sent, encrypted and de-identified, to the mHealth App to create the monitoring calendar. At the scheduled time, the App alerts the patient to start the monitoring. After the measurements are done, the App generates a structured CDA2-compliant monitoring report and sends it to the EHR, thus avoiding local storage. The proposed architecture, even if validated only in a simulation environment, represents a step forward in the integration of personal mHealth Apps into the larger health-IT ecosystem, allowing the bi-directional data exchange between patients and healthcare professionals, supporting the patient's engagement in self

  5. CLAIM (CLinical Accounting InforMation)--an XML-based data exchange standard for connecting electronic medical record systems to patient accounting systems.

    PubMed

    Guo, Jinqiu; Takada, Akira; Tanaka, Koji; Sato, Junzo; Suzuki, Muneou; Takahashi, Kiwamu; Daimon, Hiroyuki; Suzuki, Toshiaki; Nakashima, Yusei; Araki, Kenji; Yoshihara, Hiroyuki

    2005-08-01

    With the evolving and diverse electronic medical record (EMR) systems, there appears to be an ever greater need to link EMR systems and patient accounting systems with a standardized data exchange format. To this end, the CLinical Accounting InforMation (CLAIM) data exchange standard was developed. CLAIM is subordinate to the Medical Markup Language (MML) standard, which allows the exchange of medical data among different medical institutions. CLAIM uses eXtensible Markup Language (XML) as a meta-language. The current version, 2.1, inherited the basic structure of MML 2.x and contains two modules including information related to registration, appointment, procedure and charging. CLAIM 2.1 was implemented successfully in Japan in 2001. Consequently, it was confirmed that CLAIM could be used as an effective data exchange format between EMR systems and patient accounting systems.

  6. Risk of cancer in patients exposed to gabapentin in two electronic medical record systems.

    PubMed

    Irizarry, Michael C; Webb, David J; Boudiaf, Nada; Logie, John; Habel, Laurel A; Udaltsova, Natalia; Friedman, Gary D

    2012-02-01

    High doses of gabapentin were associated with pancreatic acinar cell tumors in male Wistar rats, but there is little published epidemiological data regarding gabapentin and carcinogenicity. We explored the association between gabapentin and cancer in a US medical care program and followed up nominally significant associations in a UK primary care database. In the US Kaiser Permanente Northern California (KPNC) health system, we performed nested case-control analyses of gabapentin and 55 cancer sites and all cancers combined using conditional logistic regression. Up to 10 controls were matched to each case on year of birth, sex, and year of cohort entry. No other covariates were included in models. Only dispensings for gabapentin 2 years or more before index date were considered. Nominally significant associations with an OR > 1.00 and p < 0.05 for three or more dispensings versus no dispensings were followed up by similar nested case-control analyses in the UK General Practice Research Database (GPRD), adjusting for potential indications for gabapentin and risk factors for the specific cancers. The following analyses had OR > 1.00 and p < 0.05 for three or more dispensings of gabapentin versus no dispensing (2-year lag) in KPNC and were also examined in the GPRD: all cancers, breast, lung and bronchus, urinary bladder, kidney/renal pelvis, stomach, anus/anal canal/anorectum, penis, and other nervous system. These cancers were not statistically significantly associated with gabapentin in the GPRD case-control studies (2-year lag). The GPRD and KPNC studies did not identify a statistically significant increased risk of pancreatic cancer with more than two prescriptions of gabapentin in the 2-year lagged analyses. The epidemiological data in a US cohort with up to 12 years of follow-up and a UK cohort with up to 15 years of follow-up do not support a carcinogenic effect of gabapentin use. However, the confidence intervals for some analyses were

  7. The risks and benefits of disclosing psychotherapy records to the legal system: What psychologists and patients need to know for informed consent.

    PubMed

    Borkosky, Bruce; Smith, Deirdre M

    2015-01-01

    When psychologists release patient records to the legal system, the typical practice is to obtain the patient's signature on a consent form, but rarely is a formal informed-consent obtained from the patient. Although psychologists are legally and ethically required to obtain informed consent for all services (including disclosure of records), there are a number of barriers to obtaining truly informed consent. Furthermore, compared to disclosures to nonlegal third parties, there are significantly greater risks when records are disclosed to the legal system. For these reasons, true informed consent should be obtained from the patient when records are disclosed to the legal system. A model for informed consent is proposed. This procedure should include a description of risks and benefits of disclosing or refusing to disclose by the psychotherapist, an opportunity to ask questions, and indication by the patient of a freely made choice. Both psychotherapist and patient share decision making responsibilities in our suggested model. The patient should be informed about potential harm to the therapeutic relationship, if applicable. Several recommendations for practice are described, including appropriate communications with attorneys and the legal system. A sample form, for use by psychotherapists, is included.

  8. A multimedia Electronic Patient Record (ePR) system for Image-Assisted Minimally Invasive Spinal Surgery

    PubMed Central

    Documet, Jorge; Le, Anh; Liu, Brent; Chiu, John; Huang, HK

    2009-01-01

    Purpose This paper presents the concept of bridging the gap between diagnostic images and image-assisted surgical treatment through the development of a one-stop multimedia electronic patient record (ePR) system that manages and distributes the real-time multimodality imaging and informatics data that assists the surgeon during all clinical phases of the operation from planning Intra-Op to post-care follow-up. We present the concept of this multimedia ePR for surgery by first focusing on Image-Assisted Minimally Invasive Spinal Surgery as a clinical application. Methods Three clinical Phases of Minimally Invasive Spinal Surgery workflow in Pre-Op, Intra-Op, and Post Op are discussed. The ePR architecture was developed based on the three-phased workflow, which includes the Pre-Op, Intra-Op, and Post-Op modules and four components comprising of the input integration unit, fault-tolerant gateway server, fault-tolerant ePR server, and the visualization and display. A prototype was built and deployed to a Minimally Invasive Spinal Surgery clinical site with user training and support for daily use. Summary A step-by step approach was introduced to develop a multi-media ePR system for Imaging-Assisted Minimally Invasive Spinal Surgery that includes images, clinical forms, waveforms, and textual data for planning the surgery, two real-time imaging techniques (digital fluoroscopic, DF) and endoscope video images (Endo), and more than half a dozen live vital signs of the patient during surgery. Clinical implementation experiences and challenges were also discussed. PMID:20033507

  9. Workarounds Emerging From Electronic Health Record System Usage: Consequences for Patient Safety, Effectiveness of Care, and Efficiency of Care.

    PubMed

    Blijleven, Vincent; Koelemeijer, Kitty; Wetzels, Marijntje; Jaspers, Monique

    2017-10-05

    Health care providers resort to informal temporary practices known as workarounds for handling exceptions to normal workflow unintendedly imposed by electronic health record systems (EHRs). Although workarounds may seem favorable at first sight, they are generally suboptimal and may jeopardize patient safety, effectiveness of care, and efficiency of care. Research into the scope and impact of EHR workarounds on patient care processes is scarce. This paper provides insight into the effects of EHR workarounds on organizational workflows and outcomes of care services by identifying EHR workarounds and determining their rationales, scope, and impact on health care providers' workflows, patient safety, effectiveness of care, and efficiency of care. Knowing the rationale of a workaround provides valuable clues about the source of origin of each workaround and how each workaround could most effectively be resolved. Knowing the scope and impact a workaround has on EHR-related safety, effectiveness, and efficiency provides insight into how to address related concerns. Direct observations and follow-up semistructured interviews with 31 physicians, 13 nurses, and 3 clerks and qualitative bottom-up coding techniques was used to identify, analyze, and classify EHR workarounds. The research was conducted within 3 specialties and settings at a large university hospital. Rationales were associated with work system components (persons, technology and tools, tasks, organization, and physical environment) of the Systems Engineering Initiative for Patient Safety (SEIPS) framework to reveal their source of origin as well as to determine the scope and the impact of each EHR workaround from a structure-process-outcome perspective. A total of 15 rationales for EHR workarounds were identified of which 5 were associated with persons, 4 with technology and tools, 4 with the organization, and 2 with the tasks. Three of these 15 rationales for EHR workarounds have not been identified in prior

  10. Technical challenges, past and future, in implementing THERESA: a one million patient, one billion item computer-based patient record and decision support system

    NASA Astrophysics Data System (ADS)

    Camp, Henry N.

    1996-02-01

    Challenges in implementing a computer-based patient record (CPR)--such as absolute data integrity, high availability, permanent on-line storage of very large complex records, rapid search times, ease of use, commercial viability, and portability to other hospitals and doctor's offices--are given along with their significance, the solutions, and their successes. The THERESA CPR has been used sine 1983 in direct patient care by a public hospital that is the primary care provider to 350,000 people. It has 1000 beds with 45,000 admissions and 750,000 outpatient visits annually. The system supports direct provider entry, including by physicians, of complete medical `documents'. Its demonstration site currently contains 1.1 billion data items on 1 million patients. It is also a clinical decision-aiding tool used for quality assurance and cost containment, for teaching as faculty and students can easily find and `thumb through' all cases similar to a particular study, and for research with over a billion medical items that can be searched and analyzed on-line within context and with continuity. The same software can also run in a desktop microcomputer managing a private practice physician's office.

  11. Developing a point-of-care electronic medical record system for TB/HIV co-infected patients: experiences from Lighthouse Trust, Lilongwe, Malawi.

    PubMed

    Tweya, Hannock; Feldacker, Caryl; Gadabu, Oliver Jintha; Ng'ambi, Wingston; Mumba, Soyapi L; Phiri, Dave; Kamvazina, Luke; Mwakilama, Shawo; Kanyerere, Henry; Keiser, Olivia; Mwafilaso, Johnbosco; Kamba, Chancy; Egger, Matthias; Jahn, Andreas; Simwaka, Bertha; Phiri, Sam

    2016-03-05

    Implementation of user-friendly, real-time, electronic medical records for patient management may lead to improved adherence to clinical guidelines and improved quality of patient care. We detail the systematic, iterative process that implementation partners, Lighthouse clinic and Baobab Health Trust, employed to develop and implement a point-of-care electronic medical records system in an integrated, public clinic in Malawi that serves HIV-infected and tuberculosis (TB) patients. Baobab Health Trust, the system developers, conducted a series of technical and clinical meetings with Lighthouse and Ministry of Health to determine specifications. Multiple pre-testing sessions assessed patient flow, question clarity, information sequencing, and verified compliance to national guidelines. Final components of the TB/HIV electronic medical records system include: patient demographics; anthropometric measurements; laboratory samples and results; HIV testing; WHO clinical staging; TB diagnosis; family planning; clinical review; and drug dispensing. Our experience suggests that an electronic medical records system can improve patient management, enhance integration of TB/HIV services, and improve provider decision-making. However, despite sufficient funding and motivation, several challenges delayed system launch including: expansion of system components to include of HIV testing and counseling services; changes in the national antiretroviral treatment guidelines that required system revision; and low confidence to use the system among new healthcare workers. To ensure a more robust and agile system that met all stakeholder and user needs, our electronic medical records launch was delayed more than a year. Open communication with stakeholders, careful consideration of ongoing provider input, and a well-functioning, backup, paper-based TB registry helped ensure successful implementation and sustainability of the system. Additional, on-site, technical support provided

  12. 78 FR 17778 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-22

    ... ``Patient Medical Record--VA'' (24VA19) as set forth in the Federal Register at 74 FR 60040. That notice... of records entitled ``Patient Medical Records-- VA'' (24VA19), which revised the System Number (the... AFFAIRS Privacy Act of 1974; System of Records AGENCY: Department of Veterans Affairs. ACTION: Notice...

  13. HARVEST, a longitudinal patient record summarizer

    PubMed Central

    Hirsch, Jamie S; Tanenbaum, Jessica S; Lipsky Gorman, Sharon; Liu, Connie; Schmitz, Eric; Hashorva, Dritan; Ervits, Artem; Vawdrey, David; Sturm, Marc; Elhadad, Noémie

    2015-01-01

    Objective To describe HARVEST, a novel point-of-care patient summarization and visualization tool, and to conduct a formative evaluation study to assess its effectiveness and gather feedback for iterative improvements. Materials and methods HARVEST is a problem-based, interactive, temporal visualization of longitudinal patient records. Using scalable, distributed natural language processing and problem salience computation, the system extracts content from the patient notes and aggregates and presents information from multiple care settings. Clinical usability was assessed with physician participants using a timed, task-based chart review and questionnaire, with performance differences recorded between conditions (standard data review system and HARVEST). Results HARVEST displays patient information longitudinally using a timeline, a problem cloud as extracted from notes, and focused access to clinical documentation. Despite lack of familiarity with HARVEST, when using a task-based evaluation, performance and time-to-task completion was maintained in patient review scenarios using HARVEST alone or the standard clinical information system at our institution. Subjects reported very high satisfaction with HARVEST and interest in using the system in their daily practice. Discussion HARVEST is available for wide deployment at our institution. Evaluation provided informative feedback and directions for future improvements. Conclusions HARVEST was designed to address the unmet need for clinicians at the point of care, facilitating review of essential patient information. The deployment of HARVEST in our institution allows us to study patient record summarization as an informatics intervention in a real-world setting. It also provides an opportunity to learn how clinicians use the summarizer, enabling informed interface and content iteration and optimization to improve patient care. PMID:25352564

  14. A Standards-Based Architecture Proposal for Integrating Patient mHealth Apps to Electronic Health Record Systems

    PubMed Central

    Fontelo, P.; Rossi, E.; Ackerman, MJ

    2015-01-01

    Summary Background Mobile health Applications (mHealth Apps) are opening the way to patients’ responsible and active involvement with their own healthcare management. However, apart from Apps allowing patient’s access to their electronic health records (EHRs), mHealth Apps are currently developed as dedicated “island systems”. Objective Although much work has been done on patient’s access to EHRs, transfer of information from mHealth Apps to EHR systems is still low. This study proposes a standards-based architecture that can be adopted by mHealth Apps to exchange information with EHRs to support better quality of care. Methods Following the definition of requirements for the EHR/mHealth App information exchange recently proposed, and after reviewing current standards, we designed the architecture for EHR/mHealth App integration. Then, as a case study, we modeled a system based on the proposed architecture aimed to support home monitoring for congestive heart failure patients. We simulated such process using, on the EHR side, OpenMRS, an open source longitudinal EHR and, on the mHealth App side, the iOS platform. Results The integration architecture was based on the bi-directional exchange of standard documents (clinical document architecture rel2 – CDA2). In the process, the clinician “prescribes” the home monitoring procedures by creating a CDA2 prescription in the EHR that is sent, encrypted and de-identified, to the mHealth App to create the monitoring calendar. At the scheduled time, the App alerts the patient to start the monitoring. After the measurements are done, the App generates a structured CDA2-compliant monitoring report and sends it to the EHR, thus avoiding local storage. Conclusions The proposed architecture, even if validated only in a simulation environment, represents a step forward in the integration of personal mHealth Apps into the larger health-IT ecosystem, allowing the bi-directional data exchange between patients and

  15. Evolution of a legacy system to a Web patient record server: leveraging investment while opening the system.

    PubMed Central

    Flanagan, J. R.; Chun, J.; Wagner, J. R.

    1996-01-01

    A layered system is under development to enhance our legacy system as a backend in a WEB-enabled system. Each layer of the system has defined functionality, leverages the investment in the layer below, and follows the strategy of reducing support requirements for workstations. The mainframe system provides administrative integration of sub-systems, security, and the central data repository for most information. The second layer is a graphical user interface (GUI) to the system for Windows platforms. Support needs are limited by relying chiefly on X-terminals and application servers. The "Intranet" layer is a WEB Server building upon the second layer gateways to provide platform-independent access to selected information and images. The fourth layer, under evaluation, will extend access to the central data repository for Internet users of web browsers that support private-key/public-key encryption. PMID:8947740

  16. Evolution of a legacy system to a Web patient record server: leveraging investment while opening the system.

    PubMed

    Flanagan, J R; Chun, J; Wagner, J R

    1996-01-01

    A layered system is under development to enhance our legacy system as a backend in a WEB-enabled system. Each layer of the system has defined functionality, leverages the investment in the layer below, and follows the strategy of reducing support requirements for workstations. The mainframe system provides administrative integration of sub-systems, security, and the central data repository for most information. The second layer is a graphical user interface (GUI) to the system for Windows platforms. Support needs are limited by relying chiefly on X-terminals and application servers. The "Intranet" layer is a WEB Server building upon the second layer gateways to provide platform-independent access to selected information and images. The fourth layer, under evaluation, will extend access to the central data repository for Internet users of web browsers that support private-key/public-key encryption.

  17. [Development of an magnetic resonance imaging safety management system for metallic biomedical products using an magnetic resonance compatibility database and inquiry-based patient records].

    PubMed

    Fujiwara, Yasuhiro; Kata, Tomomi; Fujimoto, Shinichi; Yachida, Takuya; Kanamoto, Masayuki; Nanbu, Yousuke; Seki, Kouichirou; Kosaka, Nobuyuki; Kimura, Hirohiko; Adachi, Toshiki

    2014-12-01

    Several incidents involving magnetic resonance imaging (MRI) examinations of patients with unchecked MR-unsafe metallic products have been reported. To improve patient safety, we developed a new MRI safety management system for metallic biomedical products and evaluated its efficiency in clinical practice. Our system was integrated into the picture archiving and communication system (PACS) and comprised an MR compatibility database and inquiry-based patient records of internal metallic biomedical products, enabling hospital staff to check MR compatibility by product name. A total of 6,637 biomedical implants and devices were listed in this system, including product names and their MR compatibilities. Furthermore, MRI histories for each patient at our hospital were also recorded. Using this system, it was possible to confirm the MR compatibility of the patients' metallic biomedical products effectively and to reduce the number of unchecked internal products through systematic patient inquiry. In conclusion, our new system enhanced metallic biomedical product checking procedures, and improved patient safety during clinical MRI examinations.

  18. Electronic medical records in humanitarian emergencies – the development of an Ebola clinical information and patient management system

    PubMed Central

    Jobanputra, Kiran; Greig, Jane; Shankar, Ganesh; Perakslis, Eric; Kremer, Ronald; Achar, Jay; Gayton, Ivan

    2017-01-01

    By November 2015, the West Africa Ebola epidemic had caused 28598 infections and 11299 deaths in the three countries most affected. The outbreak required rapid innovation and adaptation. Médecins sans Frontières (MSF) scaled up its usual 20-30 bed Ebola management centres (EMCs) to 100-300 beds with over 300 workers in some settings. This brought challenges in patient and clinical data management resulting from the difficulties of working safely with high numbers of Ebola patients. We describe a project MSF established with software developers and the Google Social Impact Team to develop context-adapted tools to address the challenges of recording Ebola clinical information. We share the outcomes and key lessons learned in innovating rapidly under pressure in difficult environmental conditions. Information on adoption, maintenance, and data quality was gathered through review of project documentation, discussions with field staff and key project stakeholders, and analysis of tablet data. In March 2015, a full prototype was deployed in Magburaka EMC, Sierra Leone. Inpatient data were captured on 204 clinical interactions with 34 patients from 5 March until 10 April 2015. Data continued to also be recorded on paper charts, creating theoretically identical record “pairs” on paper and tablet. 83 record pairs for 33 patients with 22 data items (temperature and symptoms) per pair were analysed. The overall Kappa coefficient for agreement between sources was 0.62, but reduced to 0.59 when rare bleeding symptoms were excluded, indicating moderate to good agreement. The time taken to deliver the product was more than that anticipated by MSF (7 months versus 6 weeks). Deployment of the tablet coincided with a dramatic drop in patient numbers and thus had little impact on patient care. We have identified lessons specific to humanitarian-technology collaborative projects and propose a framework for emergency humanitarian innovation. Time and effort is required to bridge

  19. Electronic medical records in humanitarian emergencies - the development of an Ebola clinical information and patient management system.

    PubMed

    Jobanputra, Kiran; Greig, Jane; Shankar, Ganesh; Perakslis, Eric; Kremer, Ronald; Achar, Jay; Gayton, Ivan

    2016-01-01

    By November 2015, the West Africa Ebola epidemic had caused 28598 infections and 11299 deaths in the three countries most affected. The outbreak required rapid innovation and adaptation. Médecins sans Frontières (MSF) scaled up its usual 20-30 bed Ebola management centres (EMCs) to 100-300 beds with over 300 workers in some settings. This brought challenges in patient and clinical data management resulting from the difficulties of working safely with high numbers of Ebola patients. We describe a project MSF established with software developers and the Google Social Impact Team to develop context-adapted tools to address the challenges of recording Ebola clinical information. We share the outcomes and key lessons learned in innovating rapidly under pressure in difficult environmental conditions. Information on adoption, maintenance, and data quality was gathered through review of project documentation, discussions with field staff and key project stakeholders, and analysis of tablet data. In March 2015, a full prototype was deployed in Magburaka EMC, Sierra Leone. Inpatient data were captured on 204 clinical interactions with 34 patients from 5 March until 10 April 2015. Data continued to also be recorded on paper charts, creating theoretically identical record "pairs" on paper and tablet. 83 record pairs for 33 patients with 22 data items (temperature and symptoms) per pair were analysed. The overall Kappa coefficient for agreement between sources was 0.62, but reduced to 0.59 when rare bleeding symptoms were excluded, indicating moderate to good agreement. The time taken to deliver the product was more than that anticipated by MSF (7 months versus 6 weeks). Deployment of the tablet coincided with a dramatic drop in patient numbers and thus had little impact on patient care. We have identified lessons specific to humanitarian-technology collaborative projects and propose a framework for emergency humanitarian innovation. Time and effort is required to bridge

  20. Implementing security in computer based patient records clinical experiences.

    PubMed

    Iversen, K R; Heimly, V; Lundgren, T I

    1995-01-01

    In Norway, organizational changes in hospitals and a stronger focus on patient safety have changed the way of organizing and managing paper based patient records. Hospital-wide patient records tend to replace department based records. Since not only clinicians, but also other non-medical staff have access to the paper records, they also have easy access to all the information which is available on a specific patient; such a system has obvious 'side effects' on privacy and security. Computer based patient records (CPRs) can provide the solution to this apparent paradox if the complex aspects of security, privacy, effectiveness, and user friendliness are focused on jointly from the outset in designing such systems. Clinical experiences in Norway show that it is possible to design patient record systems that provide a very useful tool for clinicians and other health care personnel (HCP) while fully complying with comprehensive security and privacy requirements.

  1. The Scottish Emergency Care Summary--an evaluation of a national shared record system aiming to improve patient care: technology report.

    PubMed

    Morris, Libby M M; Brown, Colin; Williamson, Marysia; Wyatt, Jeremy C

    2012-01-01

    In Scotland, out-of-hours calls are all triaged by the National Health Service emergency service (NHS24) but the clinicians receiving calls have no direct access to patient records. To improve the safety of patient care in unscheduled consultations when the usual primary care record is not available. The Emergency Care Summary (ECS) is a record system offering controlled access to medication and adverse reactions details for nearly every person registered with a general practice in Scotland. It holds a secure central copy of these parts of the general practitioner (GP) practice record and is updated automatically twice daily. It is accessible under specified unplanned clinical circumstances by clinicians working in out-of-hours organisations, NHS24 and accident and emergency departments if they have consent from the patient and a current legitimate relationship for that patient's care. We describe the design of the security model, management of data quality, deployment, costs and clinical benefits of the ECS over four years nationwide in Scotland, to inform the debate on the safe and effective sharing of health data in other nations. Forms were emailed to 300 NHS24 clinicians and 81% of the 113 respondents said that the ECS was helpful or very helpful and felt that it changed their clinical management in 20% of cases. The ECS is acceptable to patients and helpful for clinicians and is used routinely for unscheduled care when normal medical records are unavailable. Benefits include more efficient assessment and reduced drug interaction, adverse reaction and duplicate prescribing.

  2. Recording performance and system integration of perpendicular magnetic recording

    NASA Astrophysics Data System (ADS)

    Tanaka, Yoichiro

    2005-02-01

    Perpendicular recording has been actively developed for future high-density recording system. We studied the integration of the perpendicular recording system to the hard disk drive (HDD). Double layer perpendicular media and single-pole type perpendicular head with GMR reader were employed in 2.5″ HDD. As a result of the integration test, it was confirmed that perpendicular recording 2.5″ test HDDs functioned well at the capacity of 50 GB/platter. Through the drive integration, the features of the perpendicular recording were thoroughly studied. The complementary features between perpendicular recording and longitudinal recording are also discussed.

  3. Comparison of the patient-activated event recording system vs. traditional 24 h Holter electrocardiography in individuals with paroxysmal palpitations or dizziness.

    PubMed

    de Asmundis, Carlo; Conte, Giulio; Sieira, Juan; Chierchia, Gian-Battista; Rodriguez-Manero, Moises; Di Giovanni, Giacomo; Ciconte, Giuseppe; Levinstein, Moises; Baltogiannis, Giannis; Saitoh, Yukio; Casado-Arroyo, Rubén; Brugada, Pedro

    2014-08-01

    Electrocardiographic documentation of symptomatic episodes of palpitations by means of traditional methods such as 24 h Holter monitoring (HM) or loop recorders is challenging. Patient-activated electrocardiography (ECG) recorders have been proved to be a useful tool in the diagnosis of arrhythmias in these patients. However, no comparison studies between the two techniques have been conducted. The aim of this study was to compare the diagnostic value of Holter ECG and a patient-activated event recorder (OMRON portable HeartScan ECG Monitor(®)) (HeartScan) in the detection of arrhythmias in patients with paroxysmal palpitations or dizziness suggestive of cardiac arrhythmias. Patients with paroxysmal palpitations or dizziness were eligible for this study. All patients underwent an HM for 24 h and a 15-day HeartScan after the HM. Six hundred and twenty-five patients (48% male, mean age: 37 ± 11 years) were included in the study. All patients present with normal heart structure, normal baseline 12-lead ECG, and normal echocardiogram. Indications for ECG monitoring were palpitations in 577 patients (92.3%) and dizziness in 48 (7.7%). Holter monitoring offered a clinical diagnosis in 11 patients (1.8%). Conversely, HeartScan diagnosed the clinical arrhythmia in 558 individuals (89%). Detection of symptoms-related arrhythmias by means of HeartScan was significantly higher when compared with HM (P < 0.01). The studied system proved to be an efficient event recorder providing the diagnosis of the clinical arrhythmia in 89% of patients with paroxysmal palpitations or dizziness. Further studies are needed to confirm our results. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

  4. Cockpit Ocular Recording System (CORS)

    NASA Technical Reports Server (NTRS)

    Rothenheber, Edward; Stokes, James; Lagrossa, Charles; Arnold, William; Dick, A. O.

    1990-01-01

    The overall goal was the development of a Cockpit Ocular Recording System (CORS). Four tasks were used: (1) the development of the system; (2) the experimentation and improvement of the system; (3) demonstrations of the working system; and (4) system documentation. Overall, the prototype represents a workable and flexibly designed CORS system. For the most part, the hardware use for the prototype system is off-the-shelf. All of the following software was developed specifically: (1) setup software that the user specifies the cockpit configuration and identifies possible areas in which the pilot will look; (2) sensing software which integrates the 60 Hz data from the oculometer and heat orientation sensing unit; (3) processing software which applies a spatiotemporal filter to the lookpoint data to determine fixation/dwell positions; (4) data recording output routines; and (5) playback software which allows the user to retrieve and analyze the data. Several experiments were performed to verify the system accuracy and quantify system deficiencies. These tests resulted in recommendations for any future system that might be constructed.

  5. Patient health record on a smart card.

    PubMed

    Naszlady, A; Naszlady, J

    1998-02-01

    A validated health questionnaire has been used for the documentation of a patient's history (826 items) and of the findings from physical examination (591 items) in our clinical ward for 25 years. This computerized patient record has been completed in EUCLIDES code (CEN TC/251) for laboratory tests and an ATC and EAN code listing for the names of the drugs permanently required by the patient. In addition, emergency data were also included on an EEPROM chipcard with a 24 kb capacity. The program is written in FOX-PRO language. A group of 5000 chronically ill in-patients received these cards which contain their health data. For security reasons the contents of the smart card is only accessible by a doctor's PIN coded key card. The personalization of each card was carried out in our health center and the depersonalized alphanumeric data were collected for further statistical evaluation. This information served as a basis for a real need assessment of health care and for the calculation of its cost. Code-combined with an optical card, a completely paperless electronic patient record system has been developed containing all three information carriers in medicine: Texts, Curves and Pictures.

  6. Linking medical records to an expert system

    NASA Technical Reports Server (NTRS)

    Naeymi-Rad, Frank; Trace, David; Desouzaalmeida, Fabio

    1991-01-01

    This presentation will be done using the IMR-Entry (Intelligent Medical Record Entry) system. IMR-Entry is a software program developed as a front-end to our diagnostic consultant software MEDAS (Medical Emergency Decision Assistance System). MEDAS (the Medical Emergency Diagnostic Assistance System) is a diagnostic consultant system using a multimembership Bayesian design for its inference engine and relational database technology for its knowledge base maintenance. Research on MEDAS began at the University of Southern California and the Institute of Critical Care in the mid 1970's with support from NASA and NSF. The MEDAS project moved to Chicago in 1982; its current progress is due to collaboration between Illinois Institute of Technology, The Chicago Medical School, Lake Forest College and NASA at KSC. Since the purpose of an expert system is to derive a hypothesis, its communication vocabulary is limited to features used by its knowledge base. The development of a comprehensive problem based medical record entry system which could handshake with an expert system while creating an electronic medical record at the same time was studied. IMR-E is a computer based patient record that serves as a front end to the expert system MEDAS. IMR-E is a graphically oriented comprehensive medical record. The programs major components are demonstrated.

  7. A computer-based medical record system and personal digital assistants to assess and follow patients with respiratory tract infections visiting a rural Kenyan health centre

    PubMed Central

    Diero, Lameck; Rotich, Joseph K; Bii, John; Mamlin, Burke W; Einterz, Robert M; Kalamai, Irene Z; Tierney, William M

    2006-01-01

    Background Clinical research can be facilitated by the use of informatics tools. We used an existing electronic medical record (EMR) system and personal data assistants (PDAs) to assess the characteristics and outcomes of patients with acute respiratory illnesses (ARIs) visiting a Kenyan rural health center. Methods We modified the existing EMR to include details on patients with ARIs. The EMR database was then used to identify patients with ARIs who were prospectively followed up by a research assistant who rode a bicycle to patients' homes and entered data into a PDA. Results A total of 2986 clinic visits for 2009 adult patients with respiratory infections were registered in the database between August 2002 and January 2005; 433 patients were selected for outcome assessments. These patients were followed up in the villages and assessed at 7 and 30 days later. Complete follow-up data were obtained on 381 patients (88%) and merged with data from the enrollment visit's electronic medical records and subsequent health center visits to assess duration of illness and complications. Symptoms improved at 7 and 30 days, but a substantial minority of patients had persistent symptoms. Eleven percent of patients sought additional care for their respiratory infection. Conclusion EMRs and PDA are useful tools for performing prospective clinical research in resource constrained developing countries. PMID:16606466

  8. [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.

  9. Electronic Health Records and the Disappearing Patient.

    PubMed

    Hunt, Linda M; Bell, Hannah S; Baker, Allison M; Howard, Heather A

    2017-09-01

    With rapid consolidation of American medicine into large-scale corporations, corporate strategies are coming to the forefront in health care delivery, requiring a dramatic increase in the amount and detail of documentation, implemented through use of electronic health records (EHRs). EHRs are structured to prioritize the interests of a myriad of political and corporate stakeholders, resulting in a complex, multi-layered, and cumbersome health records system, largely not directly relevant to clinical care. Drawing on observations conducted in outpatient specialty clinics, we consider how EHRs prioritize institutional needs manifested as a long list of requisites that must be documented with each consultation. We argue that the EHR enforces the centrality of market principles in clinical medicine, redefining the clinician's role to be less of a medical expert and more of an administrative bureaucrat, and transforming the patient into a digital entity with standardized conditions, treatments, and goals, without a personal narrative. © 2017 by the American Anthropological Association.

  10. [Patients' access to their medical records].

    PubMed

    Laranjo, Liliana; Neves, Ana Luisa; Villanueva, Tiago; Cruz, Jorge; Brito de Sá, Armando; Sakellarides, Constantitno

    2013-01-01

    Until recently, the medical record was seen exclusively as being the property of health institutions and doctors. Its great technical and scientific components, as well as the personal characteristics attributed by each doctor, have been the reasons appointed for that control. However, nowadays throughout the world that paradigm has been changing. In Portugal, since 2007 patients are allowed full and direct access to their medical records. Nevertheless, the Deontological Code of the Portuguese Medical Association (2009) explicitly states that patients' access to their medical records should have a doctor as intermediary and that the records are each physician's intellectual property. Furthermore, several doctors and health institutions, receiving requests from patients to access their medical records, end up requesting the legal opinion of the Commission for access to administrative documents. Each and every time, that opinion goes in line with the notion of full and direct patient access. Sharing medical records with patients seems crucial and inevitable in the current patient-centred care model, having the potential to improve patient empowerment, health literacy, autonomy, self-efficacy and satisfaction with care. With the recent technological developments and the fast dissemination of Personal Health Records, it is foreseeable that a growing number of patients will want to access their medical records. Therefore, promoting awareness on this topic is essential, in order to allow an informed debate between all the stakeholders.

  11. 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

  12. Recent perspectives of electronic medical record systems.

    PubMed

    Zhang, Xiao-Ying; Zhang, Peiying

    2016-06-01

    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.

  13. The electronic patient records of the Hannover Medical School.

    PubMed

    Porth, A J; Niehoff, C; Matthies, H K

    1999-01-01

    In this paper, the successful introduction of a commercially available electronic patient record archiving system at the Hannover Medical School is described. Since 1996, more than 11 million document sheets of 130,000 patient records have been stored electronically. Currently, 100,000 sheets are stored each week.

  14. American Health Information Management Association. Position statement. Issue: healthcare reform--information systems and the need for computer-based patient records.

    PubMed

    1994-01-01

    Timely, reliable information is a critical part of healthcare reform. The Clinton Administration's current proposal would streamline health information through the use of standard forms and data definitions and establish a nationwide electronic highway to link health records and exchange needed information. Information would be captured, retained, and transmitted as a routine byproduct of patient care. These goals can be achieved only through broad implementation of the computer-based patient record (CPR). The CPR will contribute to more effective and cost-efficient care through (1) ready access to longitudinal (lifetime) health information; (2) support for continuous quality improvement; (3) easy access to clinical knowledge bases; and (4) patient participation in health documentation and disease prevention. The technology exists to implement the CPR, but further work is needed to develop the necessary standards and security mechanisms. The American Health Information Management Association is committed to working with applicable state and federal agencies, professional associations, accrediting agencies, voluntary standards organizations, and the Computer-Based Patient Record Institute (CPRI) to achieve the information management objectives of the current health care reform plan. With their expertise in health information systems and strong commitment to patient privacy, health information management professionals can make significant contributions to the development, implementation, and ongoing security of national and state health information networks.

  15. Patient records: from single events to elements for health planning.

    PubMed

    Pisanelli, D M; Ricci, F L

    1994-12-01

    Data collected in patient records are not only the kernel of a ward information system, but also the groundwork for planning and evaluating services in health care. The aim of this study was to analyze the problem of aggregate data generation starting from separate items in patient records. After describing the different uses of patient record data, we outline the process which generates aggregates data starting from individual records. This process leads to the definition of the "view on aggregation" as an intermediate step between patient records and aggregate data. A simplified schema is presented based on the Entity-Relationship model representing a conceptual model of the integration of aggregate data and patient record items. Finally, the role is discussed of automation in this process and the perspectives for its implementation.

  16. Aerial Photography Summary Record System

    USGS Publications Warehouse

    ,

    1998-01-01

    The Aerial Photography Summary Record System (APSRS) describes aerial photography projects that meet specified criteria over a given geographic area of the United States and its territories. Aerial photographs are an important tool in cartography and a number of other professions. Land use planners, real estate developers, lawyers, environmental specialists, and many other professionals rely on detailed and timely aerial photographs. Until 1975, there was no systematic approach to locate an aerial photograph, or series of photographs, quickly and easily. In that year, the U.S. Geological Survey (USGS) inaugurated the APSRS, which has become a standard reference for users of aerial photographs.

  17. Toward an integrated computerized patient record.

    PubMed

    Dole, T R; Luberti, A A

    2000-04-01

    Developing a comprehensive electronic medical record system to serve ambulatory care providers in a large health care enterprise requires significant time and resources. One approach to achieving this system is to devise a series of short-term, workable solutions until a complete system is designed and implemented. The initial solution introduced a basic (mini) medical record system that provided an automated problem/summary sheet and decentralization of ambulatory-based medical records. The next step was to partner with an information system vendor committed to continued development of the long-term system capable of supporting the health care organization well into the future.

  18. 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…

  19. 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…

  20. Records Systems of the Naval Research Laboratory: Central Records and Directives System Records.

    DTIC Science & Technology

    1981-02-24

    20 2.2.3.6 Special Collections ................. 20 3. DIRECTIVES SYSTEM RECORDS ................. . 21 3.1 The Management Information Division...the Photographic Branch, the Supply Division, the Fi- nancial Management Division, the Public Works Division, and the Person- nel Division. In...Records and Correspondence Management Branch. Beginning in 1959, NRL, like the rest of the Navy, switched to a strict numerical filing system . This was a

  1. An electronic patient record implementation using clinical document architecture.

    PubMed

    Poulymenopoulou, M; Vassilacopoulos, G

    2004-01-01

    Electronic patient records (EPRs) provide the means for integrated access to patient information that may be scattered across dispersed healthcare organizations that, in general, use heterogeneous systems in order to support their internal functions. XML language and Clinical Document Architecture (CDA) provides a mechanism for defining, structuring, manipulating and visualizing patient medical data using the same semantics through web. In this paper, a prototype implementation of a web-based electronic patient record (EPR) system using XML for data format and CDA for defining and structuring patient clinical documents is presented.

  2. 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.

  3. Continuous Holter telemetry of atrial electrograms and marker annotations using a common Holter recording system: impact on Holter electrocardiogram interpretation in patients with dual chamber pacemakers.

    PubMed

    Wiegand, Uwe K H; Bonnemeier, Hendrik; Bode, Frank; Eberhardt, Frank; Chun, Julian K R; Katus, Hugo A; Peters, Werner

    2002-12-01

    The impact of continuous telemetry of atrial electrogram and marker annotations on Holter ECG interpretation was assessed in 98 patients with bipolar dual chamber pacemakers (VDD pacemakers n = 29, DDD(R) systems n = 69). Atrial electrogram and marker annotations were continuously sampled by a telemetry coil that was externally positioned on the pacemaker pocket, amplified, and transduced to a three-channel Holter ECG recorder in addition to an ECG recording. Holter tapes were analyzed by two experienced investigators for quality of P wave recognition and episodes suspicious of pacemaker dysfunction. Initially, only the ECG channel was analyzed. Thereafter, results were compared to those achieved on the basis of the complete recording including atrial electrogram and marker annotations. Recognition of atrial rhythm was markedly improved by Holter telemetry. During 99.3% of recording time telemetry showed a satisfying quality, whereas ECG alone allowed a reliable P wave recognition only during 84.4% of recording time (P < 0.001). One hundred twenty-nine episodes suspicious of pacemaker malfunction occurred in 17 of 98 patients. By analysis of ECG, only 78.3% of episodes were concordantly classified by the investigators. However, 98.4% of all episodes were properly identified when atrial electrogram and marker annotations were added to the analysis (P < 0.001). In particular, discrimination between atrial undersensing, sinus bradycardia, and atrial sensed events within the refractory periods was facilitated. Holter telemetry of atrial electrogram and marker annotations facilitates the analysis of Holter ECGs in pacemaker recipients and improves the detection of pacemaker dysfunctions.

  4. Portable EGG recording system based on a digital voice recorder.

    PubMed

    Jang, J-K; Shieh, M-J; Kuo, T-S; Jaw, F-S

    2009-01-01

    Cutaneous electrogastrogram (EGG) recording offers the benefit of non-invasive gastrointestinal diagnosis. With long-term ambulatory recording of signals, researchers and clinicians could have more opportunities to investigate and analyse paroxysmal or acute symptoms. A portable EGG system based on a digital voice recorder (DVR) is designed for long-term recording of cutaneous EGG signals. The system consists of electrodes, an EGG amplifier, a modulator, and a DVR. Online monitoring and off-line acquisition of EGG are handled by software. A special design employing an integrated timer circuit is used to modulate the EGG frequency to meet the input requirements of the DVR. This approach involves low supply voltage and low power consumption. Software demodulation is used to simplify the complexity of the system, and is helpful in reducing the size of the portable device. By using surface-mount devices (SMD) and a low-power design, the system is robust, compact, and suitable for long-term portable recording. As a result, researchers can record an ambulatory EGG signal by means of the proposed circuits in conjunction with an up-to-date voice-recording device.

  5. Access control for electronic patient records.

    PubMed

    Glagola, M J

    1998-01-01

    The transition from hardcopy records to electronic records is in the forefront for healthcare today. For healthcare facilities, a major issue is determining who can access patients' medical information and how access to this information can be controlled. There are three components to access control: identification, authentication and authorization. Checking proof of identity is a means of authenticating someone--through a driver's license, passport or their fingerprints. Similar processes are needed in a computer environment, through the use of passwords, one-time passwords or smartcards, encryption and kerberos, and call-back procedures. New in the area of access control are biometric devices, which are hardware/software combinations that digitize a physical characteristic and compare the sample with previously stored samples. Fingerprints, voiceprints and facial features are examples. Their cost is currently prohibitive, but in time, they may become more common. Digital certificates and certification authorities are other means used to authenticate identify. When a system challenges a user's identity at log on, the user provides a certification that tells the system to go to the issuing certification authority and find proof the user's claim is valid. Low-level certifications offer little value for sensitive data, but high-level certification is now being introduced. It requires more specific, detailed information on the applicant. Authorization, the final component of access control, establishes what a specific user can and cannot access. To have effective access control, transaction logging and system monitoring are needed to ensure the various techniques are being used and performing properly.

  6. 20 CFR 345.208 - System records.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 1 2013-04-01 2012-04-01 true System records. 345.208 Section 345.208... EMPLOYERS' CONTRIBUTIONS AND CONTRIBUTION REPORTS Individual Employer Records § 345.208 System records... charges, pooled credits, and unallocated charges for the experience rating system and will publish a...

  7. 20 CFR 345.208 - System records.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 1 2011-04-01 2011-04-01 false System records. 345.208 Section 345.208... EMPLOYERS' CONTRIBUTIONS AND CONTRIBUTION REPORTS Individual Employer Records § 345.208 System records... charges, pooled credits, and unallocated charges for the experience rating system and will publish a...

  8. 20 CFR 345.208 - System records.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false System records. 345.208 Section 345.208... EMPLOYERS' CONTRIBUTIONS AND CONTRIBUTION REPORTS Individual Employer Records § 345.208 System records... charges, pooled credits, and unallocated charges for the experience rating system and will publish a...

  9. 20 CFR 345.208 - System records.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 1 2012-04-01 2012-04-01 false System records. 345.208 Section 345.208... EMPLOYERS' CONTRIBUTIONS AND CONTRIBUTION REPORTS Individual Employer Records § 345.208 System records... charges, pooled credits, and unallocated charges for the experience rating system and will publish a...

  10. Joint development of evidence-based medical record by doctors and patients through integrated Chinese and Western medicine on digestive system diseases.

    PubMed

    Li, Bo; Gao, Hong-yang; Gao, Rui; Zhao, Ying-pan; Li, Qing-na; Zhao, Yang; Tang, Xu-dong; Shang, Hong-cai

    2016-02-01

    Building the clinical therapeutic evaluation system by combing the evaluation given by doctors and patients can form a more comprehensive and objective evaluation system. A literature search on the practice of evidence-based evaluation was conducted in key biomedical databases, i.e. PubMed, Excerpt Medica Database, China Biology Medicine disc and China National Knowledge Infrastructure. However, no relevant study on the subjects of interest was identified. Therefore, drawing on the principles of narrative medicine and expert opinion from systems of Chinese medicine and Western medicine, we propose to develop and pilot-test a novel evidence-based medical record format that captures the perspectives of both patients and doctors in a clinical trial. Further, we seek to evaluate a strategic therapeutic approach that integrates the wisdom of Chinese medicine with the scientific basis of Western medicine in the treatment of digestive system disorders. Evaluation of therapeutic efficacy of remedies under the system of Chinese medicine is an imperative ongoing research. The present study intends to identify a novel approach to assess the synergistic benefits achievable from an integrated therapeutic approach combining Chinese and Western system of medicine to treat digestive system disorders.

  11. Information integrity and privacy for computerized medical patient records

    SciTech Connect

    Gallegos, J.; Hamilton, V.; Gaylor, T.; McCurley, K.; Meeks, T.

    1996-09-01

    Sandia National Laboratories and Oceania, Inc. entered into a Cooperative Research and Development Agreement (CRADA) in November 1993 to provide ``Information Integrity and Privacy for Computerized Medical Patient Records`` (CRADA No. SC93/01183). The main objective of the project was to develop information protection methods that are appropriate for databases of patient records in health information systems. This document describes the findings and alternative solutions that resulted from this CRADA.

  12. A health record integrated clinical decision support system to support prescriptions of pharmaceutical drugs in patients with reduced renal function: design, development and proof of concept.

    PubMed

    Shemeikka, Tero; Bastholm-Rahmner, Pia; Elinder, Carl-Gustaf; Vég, Anikó; Törnqvist, Elisabeth; Cornelius, Birgitta; Korkmaz, Seher

    2015-06-01

    To develop and verify proof of concept for a clinical decision support system (CDSS) to support prescriptions of pharmaceutical drugs in patients with reduced renal function, integrated in an electronic health record system (EHR) used in both hospitals and primary care. A pilot study in one geriatric clinic, one internal medicine admission ward and two outpatient healthcare centers was evaluated with a questionnaire focusing on the usefulness of the CDSS. The usage of the system was followed in a log. The CDSS is considered to increase the attention on patients with impaired renal function, provides a better understanding of dosing and is time saving. The calculated glomerular filtration rate (eGFR) and the dosing recommendation classification were perceived useful while the recommendation texts and background had been used to a lesser extent. Few previous systems are used in primary care and cover this number of drugs. The global assessment of the CDSS scored high but some elements were used to a limited extent possibly due to accessibility or that texts were considered difficult to absorb. Choosing a formula for the calculation of eGFR in a CDSS may be problematic. A real-time CDSS to support kidney-related drug prescribing in both hospital and outpatient settings is valuable to the physicians. It has the potential to improve quality of drug prescribing by increasing the attention on patients with renal insufficiency and the knowledge of their drug dosing. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. Electronic medical record systems are associated with appropriate placement of HIV patients on antiretroviral therapy in rural health facilities in Kenya: a retrospective pre-post study

    PubMed Central

    Oluoch, Tom; Katana, Abraham; Ssempijja, Victor; Kwaro, Daniel; Langat, Patrick; Kimanga, Davies; Okeyo, Nicky; Abu-Hanna, Ameen; de Keizer, Nicolette

    2014-01-01

    Background and objective There is little evidence that electronic medical record (EMR) use is associated with better compliance with clinical guidelines on initiation of antiretroviral therapy (ART) among ART-eligible HIV patients. We assessed the effect of transitioning from paper-based to an EMR-based system on appropriate placement on ART among eligible patients. Methods We conducted a retrospective, pre-post EMR study among patients enrolled in HIV care and eligible for ART at 17 rural Kenyan clinics and compared the: (1) proportion of patients eligible for ART based on CD4 count or WHO staging who initiate therapy; (2) time from eligibility for ART to ART initiation; (3) time from ART initiation to first CD4 test. Results 7298 patients were eligible for ART; 54.8% (n=3998) were enrolled in HIV care using a paper-based system while 45.2% (n=3300) were enrolled after the implementation of the EMR. EMR was independently associated with a 22% increase in the odds of initiating ART among eligible patients (adjusted OR (aOR) 1.22, 95% CI 1.12 to 1.33). The proportion of ART-eligible patients not receiving ART was 20.3% and 15.1% for paper and EMR, respectively (χ2=33.5, p<0.01). Median time from ART eligibility to ART initiation was 29.1 days (IQR: 14.1–62.1) for paper compared to 27 days (IQR: 12.9–50.1) for EMR. Conclusions EMRs can improve quality of HIV care through appropriate placement of ART-eligible patients on treatment in resource limited settings. However, other non-EMR factors influence timely initiation of ART. PMID:24914014

  14. Shallow medication extraction from hospital patient records.

    PubMed

    Boytcheva, Svetla

    2011-01-01

    This paper presents methods for shallow Information Extraction (IE) from the free text zones of hospital Patient Records (PRs) in Bulgarian language in the Patient Safety through Intelligent Procedures in medication (PSIP) project. We extract automatically information about drug names, dosage, modes and frequency and assign the corresponding ATC code to each medication event. Using various modules for rule-based text analysis, our IE components in PSIP perform a significant amount of symbolic computations. We try to address negative statements, elliptical constructions, typical conjunctive phrases, and simple inferences concerning temporal constraints and finally aim at the assignment of the drug ACT code to the extracted medication events, which additionally complicates the extraction algorithm. The prototype of the system was used for experiments with a training corpus containing 1,300 PRs and the evaluation results are obtained using a test corpus containing 6,200 PRs. The extraction accuracy (f-score) for drug names is 98.42% and for dose 93.85%.

  15. [Electronic medical record--interface specifications with medical informatics systems].

    PubMed

    Mocanu, Carmen; Mocanu, Mihai

    2007-01-01

    The paper presents the initial efforts of description and implementation for a new scheme of electronic patients recording, based on distributed database for chronic ophthalmologic diseases. Structural specifications derived from principal system's goals are the implementation of an efficient and flexible way of patients' data administration, using actual Web technologies, permitting future extensions, without reducing in performances and without exponential cost increasing. A very important aspect, that must be take into consideration is their interfacing with other medical programs and systems, as the systems for recording clinical data, monitoring systems (Patient Administrations Systems - PAS) for demographical data, systems for monitoring of treatment (Hippocrates program), web systems, including wireless.

  16. 75 FR 72873 - Privacy Act Of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-26

    ... records 121VA19, ``National Patient Databases--VA'', and 136VA19E, ``Library Network (VALNET)--VA'' to... additional databases. DATES: Comments on the amendment of these systems of records must be received no later... 121VA19, ``National Patient Databases--VA,'' as set forth in the Federal Register, 73 FR 16103, and...

  17. Privacy Act System of Records: Federal Lead-Based Paint Program System of Records, EPA-54

    EPA Pesticide Factsheets

    Learn about the Federal Lead-Based Paint Program System of Records (FLPPSOR), including the security classification, individuals covered by the system, categories of records, routine uses of the records, and other security procedures.

  18. Development of a knowledge-based electronic patient record.

    PubMed

    Safran, C; Rind, D M; Sands, D Z; Davis, R B; Wald, J; Slack, W V

    1996-01-01

    To help clinicians care for patients with HIV infection, we developed an interactive knowledge-based electronic patient record that integrates rule-based decision support and full-text information retrieval with an online patient record. This highly interactive clinical workstation now allows the clinicians at a large primary care practice (30,000 ambulatory visits per year) to use online information resources and fully electronic patient records during all patient encounters. The resulting practice database is continually updated with outcome data on a cohort of 700 patients with HIV infection. As a byproduct of this integrated system, we have developed improved statistical methods to measure the effects of electronic alerts and reminders.

  19. Towards a Web-Based System for Family Health Record

    PubMed Central

    Marceglia, Sara; Bonacina, Stefano; Braidotti, Andrea; Nardelli, Marco; Pinciroli, Francesco

    2006-01-01

    Electronic health records are a fundamental support needed not only by healthcare providers, but also for individual patients. We considered the health management in the familiar environment and we developed a web-based system for family health record. The system permits an easy compilation and provides an effective visualization of the clinical data concerning family members also for friendly printing tasks. PMID:17238642

  20. Towards a web-based system for family health record.

    PubMed

    Marceglia, Sara; Bonacina, Stefano; Braidotti, Andrea; Nardelli, Marco; Pinciroli, Francesco

    2006-01-01

    Electronic health records are a fundamental support needed not only by healthcare providers, but also for individual patients. We considered the health management in the familiar environment and we developed a web-based system for family health record. The system permits an easy compilation and provides an effective visualization of the clinical data concerning family members also for friendly printing tasks.

  1. SU-E-T-502: Biometrically Accepted Patient Records

    SciTech Connect

    Basavatia, A; Kalnicki, S; Garg, M; Lukaj, A; Hong, L; Fret, J; Yaparpalvi, R; Tome, W

    2014-06-01

    Purpose: To implement a clinically useful palm vein pattern recognition biometric system to treat the correct treatment plan to the correct patient each and every time and to check-in the patient into the department to access the correct medical record. Methods: A commercially available hand vein scanning system was paired to Aria and utilized an ADT interface from the hospital electronic health system. Integration at two points in Aria, version 11 MR2, first at the appointment tracker screen for the front desk medical record access and second at the queue screen on the 4D treatment console took place for patient daily time-out. A test patient was utilized to check accuracy of identification as well as to check that no unintended interactions take place between the 4D treatment console and the hand vein scanning system. This system has been in clinical use since December 2013. Results: Since implementation, 445 patients have been enrolled into our biometric system. 95% of patients learn the correct methodology of hand placement on the scanner in the first try. We have had two instances of patient not found because of a bad initial scan. We simply erased the scanned metric and the patient enrolled again in those cases. The accuracy of the match is 100% for each patient, we have not had one patient misidentified. We can state this because we still use patient photo and date of birth as identifiers. A QA test patient is run monthly to check the integrity of the system. Conclusion: By utilizing palm vein scans along with the date of birth and patient photo, another means of patient identification now exits. This work indicates the successful implementation of technology in the area of patient safety by closing the gap of treating the wrong plan to a patient in radiation oncology. FOJP Service Corporation covered some of the costs of the hardware and software of the palm vein pattern recognition biometric system.

  2. Giving Patients Access to Their Medical Records via the Internet

    PubMed Central

    Masys, Daniel; Baker, Dixie; Butros, Amy; Cowles, Kevin E.

    2002-01-01

    Objective: The Patient-Centered Access to Secure Systems Online (pcasso) project is designed to apply state-of-the-art-security to the communication of clinical information over the Internet. Design: The authors report the legal and regulatory issues associated with deploying the system, and results of its use by providers and patients. Human subject protection concerns raised by the Institutional Review Board focused on three areas—unauthorized access to information by persons other than the patient; the effect of startling or poorly understood information; and the effect of patient access to records on the record-keeping behavior of providers. Measurements: Objective and subjective measures of security and usability were obtained. Results: During its initial deployment phase, the project enrolled 216 physicians and 41 patients; of these, 68 physicians and 26 patients used the system one or more times. The system performed as designed, with no unauthorized information access or intrusions detected. Providers rated the usability of the system low because of the complexity of the secure login and other security features and restrictions limiting their access to those patients with whom they had a professional relationship. In contrast, patients rated the usability and functionality of the system favorably. Conclusion: High-assurance systems that serve both patients and providers will need to address differing expectations regarding security and ease of use. PMID:11861633

  3. Medical record search engines, using pseudonymised patient identity: an alternative to centralised medical records.

    PubMed

    Quantin, Catherine; Jaquet-Chiffelle, David-Olivier; Coatrieux, Gouenou; Benzenine, Eric; Allaert, François-André

    2011-02-01

    The purpose of our multidisciplinary study was to define a pragmatic and secure alternative to the creation of a national centralised medical record which could gather together the different parts of the medical record of a patient scattered in the different hospitals where he was hospitalised without any risk of breaching confidentiality. We first analyse the reasons for the failure and the dangers of centralisation (i.e. difficulty to define a European patients' identifier, to reach a common standard for the contents of the medical record, for data protection) and then propose an alternative that uses the existing available data on the basis that setting up a safe though imperfect system could be better than continuing a quest for a mythical perfect information system that we have still not found after a search that has lasted two decades. We describe the functioning of Medical Record Search Engines (MRSEs), using pseudonymisation of patients' identity. The MRSE will be able to retrieve and to provide upon an MD's request all the available information concerning a patient who has been hospitalised in different hospitals without ever having access to the patient's identity. The drawback of this system is that the medical practitioner then has to read all of the information and to create his own synthesis and eventually to reject extra data. Faced with the difficulties and the risks of setting up a centralised medical record system, a system that gathers all of the available information concerning a patient could be of great interest. This low-cost pragmatic alternative which could be developed quickly should be taken into consideration by health authorities. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  4. Patient-Reported Safety Events in Chronic Kidney Disease Recorded With an Interactive Voice-Inquiry Dial-Response System: Monthly Report Analysis

    PubMed Central

    Doerfler, Rebecca M; Yoffe, Marni R; Diamantidis, Clarissa J; Blumenthal, Jacob B; Siddiqui, Tariq; Gardner, James F; Snitker, Soren; Zhan, Min

    2016-01-01

    Background Monitoring patient-reported outcomes (PROs) may improve safety of chronic kidney disease (CKD) patients. Objective Evaluate the performance of an interactive voice-inquiry dial-response system (IVRDS) in detecting CKD-pertinent adverse safety events outside of the clinical environment and compare the incidence of events using the IVDRS to that detected by paper diary. Methods This was a 6-month study of Stage III-V CKD patients in the Safe Kidney Care (SKC) study. Participants crossed over from a paper diary to the IVDRS for recording patient-reported safety events defined as symptoms or events attributable to medications or care. The IVDRS was adapted from the SKC paper diary to record event frequency and remediation. Participants were auto-called weekly and permitted to self-initiate calls. Monthly reports were reviewed by two physician adjudicators for their clinical significance. Results 52 participants were followed over a total of 1384 weeks. 28 out of 52 participants (54%) reported events using the IVDRS versus 8 out of 52 (15%) with the paper diary; hypoglycemia was the most common event for both methods. All IVDRS menu options were selected at least once except for confusion and rash. Events were reported on 121 calls, with 8 calls reporting event remediation by ambulance or emergency room (ER) visit. The event rate with the IVDRS and paper diary, with and without hypoglycemia, was 26.7 versus 4.7 and 18.3 versus 0.8 per 100 person weeks, respectively (P=.002 and P<.001). The frequent users (ie, >10 events) largely differed by method, and event rates excluding the most frequent user of each were 16.9 versus 2.5 per 100 person weeks, respectively (P<.001). Adjudicators found approximately half the 80 reports clinically significant, with about a quarter judged as actionable. Hypoglycemia was often associated with additional reports of fatigue and falling. Participants expressed favorable satisfaction with the IVDRS. Conclusions Use of the IVDRS

  5. Voice-Recognition System Records Inspection Data

    NASA Technical Reports Server (NTRS)

    Rochester, Larry L.

    1993-01-01

    Main Injector Voice Activated Record (MIVAR) system acts on vocal commands and processes spoken inspection data into electronic and printed inspection reports. Devised to improve acquisition and recording of data from borescope inspections of interiors of liquid-oxygen-injecting tubes on main engine of Space Shuttle. With modifications, system used in other situations to relieve inspectors of manual recording of data. Enhances flow of work and quality of data acquired by enabling inspector to remain visually focused on workpiece.

  6. Voice-Recognition System Records Inspection Data

    NASA Technical Reports Server (NTRS)

    Rochester, Larry L.

    1993-01-01

    Main Injector Voice Activated Record (MIVAR) system acts on vocal commands and processes spoken inspection data into electronic and printed inspection reports. Devised to improve acquisition and recording of data from borescope inspections of interiors of liquid-oxygen-injecting tubes on main engine of Space Shuttle. With modifications, system used in other situations to relieve inspectors of manual recording of data. Enhances flow of work and quality of data acquired by enabling inspector to remain visually focused on workpiece.

  7. User's Satisfaction of Multiple Accounting Record System.

    PubMed

    Chen, M C; Yu, H C

    2016-01-01

    The study hospital had developed a multiple account recording system that generates the accounting information of the consumed materials based on daily nursing records. A questionnaire survey was delivered to further investigate the impact of the system. Four concepts of the system were investigated. (1) Supportive and time saving; (2) impact on workflows and job satisfactions; (3) ease of use; and (4) overall satisfactions. The system scored 4.03 out of 5 as the highest for helpfulness for daily practices, 3.98 for decrease the time for recording material consumptions, 3.98 for actually changed the way they work. Users mostly expressed positive attitude towards the system.

  8. An imaging informatics-based ePR (electronic patient record) system for providing decision support in evaluating dose optimization in stroke rehabilitation

    NASA Astrophysics Data System (ADS)

    Liu, Brent J.; Winstein, Carolee; Wang, Ximing; Konersman, Matt; Martinez, Clarisa; Schweighofer, Nicolas

    2012-02-01

    Stroke is one of the major causes of death and disability in America. After stroke, about 65% of survivors still suffer from severe paresis, while rehabilitation treatment strategy after stroke plays an essential role in recovery. Currently, there is a clinical trial (NIH award #HD065438) to determine the optimal dose of rehabilitation for persistent recovery of arm and hand paresis. For DOSE (Dose Optimization Stroke Evaluation), laboratory-based measurements, such as the Wolf Motor Function test, behavioral questionnaires (e.g. Motor Activity Log-MAL), and MR, DTI, and Transcranial Magnetic Stimulation (TMS) imaging studies are planned. Current data collection processes are tedious and reside in various standalone systems including hardcopy forms. In order to improve the efficiency of this clinical trial and facilitate decision support, a web-based imaging informatics system has been implemented together with utilizing mobile devices (eg, iPAD, tablet PC's, laptops) for collecting input data and integrating all multi-media data into a single system. The system aims to provide clinical imaging informatics management and a platform to develop tools to predict the treatment effect based on the imaging studies and the treatment dosage with mathematical models. Since there is a large amount of information to be recorded within the DOSE project, the system provides clinical data entry through mobile device applications thus allowing users to collect data at the point of patient interaction without typing into a desktop computer, which is inconvenient. Imaging analysis tools will also be developed for structural MRI, DTI, and TMS imaging studies that will be integrated within the system and correlated with the clinical and behavioral data. This system provides a research platform for future development of mathematical models to evaluate the differences between prediction and reality and thus improve and refine the models rapidly and efficiently.

  9. 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

  10. Digital optical recorder-reproducer system

    NASA Technical Reports Server (NTRS)

    Reddersen, Brad R. (Inventor); Zech, Richard G. (Inventor); Roberts, Howard N. (Inventor)

    1980-01-01

    A mass archival optical recording and reproduction system includes a recording light source such as a laser beam focussed and directed upon an acousto-optic linear modulator array (or page composer) that receives parallel blocks of data converted from a serial stream of digital data to be stored. The page composer imparts to the laser beam modulation representative of a plurality of parallel channels of data and through focussing optics downstream of the page composer parallel arrays of optical spots are recorded upon a suitable recording medium such as a photographic film floppy disc. The recording medium may be substantially frictionlessly and stably positioned for recording at a record/read station by an air-bearing platen arrangement which is preferably thermodynamically non-throttling so that the recording film may be positioned in the path of the information-carrying light beam in a static or dynamic mode. During readout, the page composer is bypassed and a readout light beam is focussed directly upon the recording medium containing an array of previously recorded digital spots, a sync bit, data positioning bits, and a tracking band. The readout beam which has been directed through the recording medium is then imaged upon a photodetector array, the output of which may be coupled to suitable electronic processing circuitry, such as a digital multiplexer, whereby the parallel spot array is converted back into the original serial data stream.

  11. The electronic medical record system: health care marvel or morass?

    PubMed

    Silverman, D C

    1998-01-01

    The author considers the potential advantages and disadvantages, as well as possible unintended consequences, of introducing electronic medical record systems in health care organizations. Special consideration is given to the issues such information systems raise concerning privacy, confidentiality, and quality of care from both patient and provider perspectives. The potential gains from computerizing medical records include the benefit of instantaneous availability of patients' medical history, treatment regimes, and current health status in routine and emergency clinical situations. Ease of access to this information should reduce adverse outcomes. The added value of a complete and up-to-date medical record immediately available to medical caregivers seems undeniable. The potential disadvantages include issues around patient confidentiality and unauthorized access to records, the enormous capital investment for computer hardware, and system maintenance.

  12. An object oriented computer-based patient record reference model.

    PubMed Central

    Doré, L.; Lavril, M.; Jean, F. C.; Degoulet, P.

    1995-01-01

    In the context of health care information systems based on client/server architecture, we address the problem of a common Computer-based Patient Record (CPR). We define it as a collection of faithful observations about patients care, with respect to the free expression of physicians. This CPR model supports several views of the medical data, in order to provide applications with a comprehensive and standardized access to distributed patient data. Finally, we validated our CPR approach as a primary data model server for an application for hypertensive patient management. PMID:8563306

  13. Patient experiences with electronic medical records: Lessons learned

    PubMed Central

    Rose, Dale; Richter, Louiseann T; Kapustin, Jane

    2014-01-01

    Purpose To describe the lived experience of patients communicating with their nurse practitioners and physicians while using paper health records (PHRs) and electronic health records (EHRs) in the examination rooms. The significance of the study lies in the salience of communication between the patient and provider in promoting optimal clinical outcomes and the highest level of patient satisfaction. Data sources The study used a qualitative, phenomenological design. Audio-taped focus group interviews were conducted with 21 patients from a diabetes clinic in Baltimore, Maryland. Patients had visits with the provider before and after implementation of EHRs in the clinic. Conclusions The four themes that emerged from the three focus groups included communication issues, patient preferences for electronic records, safety and security concerns, and transition problems with implementation of EHRs. Implications for practice Potential benefits for nurse practitioners implementing the recommendations in this study include enhanced communication between patients and providers while using EHRs, increased patient satisfaction, higher levels of nurse practitioner and physician satisfaction, and avoidance of communication issues during implementation of EHR systems. PMID:25234112

  14. UK Age-Related Macular Degeneration Electronic Medical Record System (AMD EMR) Users Group Report IV: Incidence of Blindness and Sight Impairment in Ranibizumab-Treated Patients.

    PubMed

    Johnston, Robert L; Lee, Aaron Y; Buckle, Miranda; Antcliff, Richard; Bailey, Clare; McKibbin, Martin; Chakravarthy, Usha; Tufail, Adnan

    2016-11-01

    To study the incidence of blindness and sight impairment in treatment-naive patients receiving ranibizumab (Lucentis) for neovascular age-related macular degeneration (nAMD) in the United Kingdom (UK) National Health Service. Multicenter nAMD database study. A total of 11 135 patients who collectively received 92 976 treatment episodes to 12 951 eyes. Data were extracted from 14 UK centers using the same electronic medical record system (EMR). The EMR-mandated collection of a data set (defined before first data entry) including: age, Early Treatment Diabetic Retinopathy Study visual acuity letter score (VA) for both eyes at all visits, and injection episodes. Participating centers used overwhelmingly a pro re nata re-treatment posology at intended monthly follow-up visits following a loading phase of 3 monthly injections. Incidence of blindness and sight impairment (VA in the better-seeing eye <38 letters [≤20/200 Snellen, approximately], and <68 letters [≤20/50 Snellen, approximately] at 2 consecutive visits, or 1 visit if no further follow-up data) in each year after initiating treatment. Information from >300 000 clinic visits (2.8 million data points) collected over 5 years was collated from 14 centers. Mean age at first treatment was 79.7 years (standard deviation = 9.19 years), with a female preponderance (63%). The mean (median) VA at baseline in the better-seeing eye was 67.2 (72.0) letters, 20/40- (20/40+) approximate Snellen conversion. The cumulative incidence of new blindness and sight impairment in patients with treated nAMD in at least 1 eye at years 1 to 4 after first injection were 5.1%, 8.6%, 12% and 15.6% for new blindness and 29.6%, 41.0%, 48.7%, and 53.7% for new sight impairment, but with significant reductions in the rates between year cohorts initiating treatment (blindness [P = 4.72 × 10(-08)], sight impaired [P = 3.27 × 10(-06)]). To the best of our knowledge, this is the first multicenter real-world study on the

  15. How Patients Can Improve the Accuracy of their Medical Records

    PubMed Central

    Dullabh, Prashila M.; Sondheimer, Norman K.; Katsh, Ethan; Evans, Michael A.

    2014-01-01

    Objectives: Assess (1) if patients can improve their medical records’ accuracy if effectively engaged using a networked Personal Health Record; (2) workflow efficiency and reliability for receiving and processing patient feedback; and (3) patient feedback’s impact on medical record accuracy. Background: Improving medical record’ accuracy and associated challenges have been documented extensively. Providing patients with useful access to their records through information technology gives them new opportunities to improve their records’ accuracy and completeness. A new approach supporting online contributions to their medication lists by patients of Geisinger Health Systems, an online patient-engagement advocate, revealed this can be done successfully. In late 2011, Geisinger launched an online process for patients to provide electronic feedback on their medication lists’ accuracy before a doctor visit. Patient feedback was routed to a Geisinger pharmacist, who reviewed it and followed up with the patient before changing the medication list shared by the patient and the clinicians. Methods: The evaluation employed mixed methods and consisted of patient focus groups (users, nonusers, and partial users of the feedback form), semi structured interviews with providers and pharmacists, user observations with patients, and quantitative analysis of patient feedback data and pharmacists’ medication reconciliation logs. Findings/Discussion: (1) Patients were eager to provide feedback on their medications and saw numerous advantages. Thirty percent of patient feedback forms (457 of 1,500) were completed and submitted to Geisinger. Patients requested changes to the shared medication lists in 89 percent of cases (369 of 414 forms). These included frequency—or dosage changes to existing prescriptions and requests for new medications (prescriptions and over-the counter). (2) Patients provided useful and accurate online feedback. In a subsample of 107 forms

  16. A computer-based patient record: Emory's approach.

    PubMed

    Bennett, J J; Alligood, R; Beck, K L; Dardeen, K; Payne, L

    1993-05-01

    The replacement of the paper medical record at Emory will be gradual over the next several years. We foresee milestone events after which portions of the patient record are no longer retained in paper form. As these milestones are identified, the HIM professionals at the three institutions will begin the formidable task of managing the transition to a paperless system. Evaluation of business processes and the skill sets needed by staff members can be accomplished and a plan for each phase of transition developed.

  17. Five-day recorder seismic system

    USGS Publications Warehouse

    Criley, Ed; Eaton, Jerry P.; Ellis, Jim

    1978-01-01

    The 10-day recorder seismic system used by the USGS since 1965 has been modified substantially to improve its dynamic range and frequency response, to decrease its power consumption and physical complexity, and to make its recordings more compatible with other NCER systems to facilitate data processing. The principal changes include: 1. increasing tape speed from 15/160 ips to 15/80 ips (reducing running time from 10 days to 5 days with a 14' reel of 1 mil tape), 2. increasing the FM center frequency by a factor of 4, from 84.4 Hz to 337.6 Hz, 3. replacing the original amplifiers and FM modulators with new low-power units, 4. replacing the chronometer with a higher quality time code generator (with IRIG-C) to permit automation of data retrieval, 5. eliminating the amplifier/WWVB radio field case by incorporating these elements, along with the new TCG, in the weatherproof tape-recorder box, 6. reducing the power consumption of the motor-drive circuit by removal of a redundant component. In the new system, the tape-recorder case houses all components except the seismometers, the WWVB antenna, the 70-amp-hour 12-VDC battery (which powers the system for 5 days), and the cables to connect these external elements to the recorder box. The objectives of this report are: 1. to describe the new 5-day-recorder seismic system in terms of its constituent parts and their functions, 2. to describe modifications to parts of the original system that were retained and to document new or replacement components with appropriate circuit diagrams and constructional details, 3. to provide detailed instructions for the correct adjustment or alignment of the system in the laboratory, and 4. to provide detailed instructions for installing and operating the system in the field.

  18. 76 FR 79660 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-22

    ... deleting one system of records notices in its existing inventory of record systems subject to the Privacy... proposes to delete a system of records notice from its inventory of record systems subject to the Privacy... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Information Systems...

  19. 11 CFR 1.3 - Procedures for requests pertaining to individual records in a record system.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... individual records in a record system. 1.3 Section 1.3 Federal Elections FEDERAL ELECTION COMMISSION PRIVACY... location and to the person specified in the notice describing that record system. (b) An individual who... record system contains those records, may request assistance by mail or in person from the Chief...

  20. 11 CFR 1.3 - Procedures for requests pertaining to individual records in a record system.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... individual records in a record system. 1.3 Section 1.3 Federal Elections FEDERAL ELECTION COMMISSION PRIVACY... location and to the person specified in the notice describing that record system. (b) An individual who... record system contains those records, may request assistance by mail or in person from the Chief...

  1. Timing Recovery Strategies in Magnetic Recording Systems

    NASA Astrophysics Data System (ADS)

    Kovintavewat, Piya

    At some point in a digital communications receiver, the received analog signal must be sampled. Good performance requires that these samples be taken at the right times. The process of synchronizing the sampler with the received analog waveform is known as timing recovery. Conventional timing recovery techniques perform well only when operating at high signal-to-noise ratio (SNR). Nonetheless, iterative error-control codes allow reliable communication at very low SNR, where conventional techniques fail. This paper provides a detailed review on the timing recovery strategies based on per-survivor processing (PSP) that are capable of working at low SNR. We also investigate their performance in magnetic recording systems because magnetic recording is a primary method of storage for a variety of applications, including desktop, mobile, and server systems. Results indicate that the timing recovery strategies based on PSP perform better than the conventional ones and are thus worth being employed in magnetic recording systems.

  2. Paleomagnetic recording fidelity of nonideal magnetic systems.

    PubMed

    Muxworthy, Adrian R; Krása, David; Williams, Wyn; Almeida, Trevor P

    2014-06-01

    A suite of near-identical magnetite nanodot samples produced by electron-beam lithography have been used to test the thermomagnetic recording fidelity of particles in the 74-333 nm size range; the grain size range most commonly found in rocks. In addition to controlled grain size, the samples had identical particle spacings, meaning that intergrain magnetostatic interactions could be controlled. Their magnetic hysteresis parameters were indicative of particles thought not to be ideal magnetic recorders; however, the samples were found to be excellent thermomagnetic recorders of the magnetic field direction. They were also found to be relatively good recorders of the field intensity in a standard paleointensity experiment. The samples' intensities were all within ∼15% of the expected answer and the mean of the samples within 3% of the actual field. These nonideal magnetic systems have been shown to be reliable records of the geomagnetic field in terms of both direction and intensity even though their magnetic hysteresis characteristics indicate less than ideal magnetic grains. Nonideal magnetic systems accurately record field directionWeak-field remanences more stable than strong-field remanences.

  3. Crash Survivable Flight Data Recording System Study.

    DTIC Science & Technology

    1981-06-30

    on the design of adding parameters associated with structural integrity, turbine engine health , and flight control Ij monitoring. 81-17693 AIRES.ARCH...recording, each wi iii different objective. There are programs concerned with engine health and performance, with the objective to improve system support...it is recommended that any CITSE requirement would be met with a separate system. Many other engine health monitoring systems with various degrees of

  4. 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.

  5. 77 FR 58816 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-24

    ... Agency is deleting five systems of records notices from its existing inventory of record systems subject... proposes to delete five systems of records from its inventory of record systems subject to the Privacy Act... Accounting Service system of records notice, T-7340d, Defense Military Pay Office Input and Reporting...

  6. 76 FR 1409 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-10

    ... system of records notice from its existing inventory of record systems subject to the Privacy Act of 1974... delete one system of records notice from its inventory of record systems subject to the Privacy Act of... system are also covered by Defense Finance and Accounting Service records notice T7332, Defense...

  7. 75 FR 78211 - Privacy Act System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-15

    ... System of Records notice entitled COMMERCE/CENSUS-8, Statistical Administrative Records System. DATES... Privacy Act System of Records AGENCY: U.S. Census Bureau, Department of Commerce. ACTION: Notice of amended Privacy Act System of Records: COMMERCE/ CENSUS-8, Statistical Administrative Records System...

  8. Nursing record systems: effects on nursing practice and healthcare outcomes.

    PubMed

    Urquhart, Christine; Currell, Rosemary; Grant, Maria J; Hardiker, Nicholas R

    2009-01-21

    A nursing record system is the record of care that was planned or given to individual patients and clients by qualified nurses or other caregivers under the direction of a qualified nurse. Nursing record systems may be an effective way of influencing nurse practice. To assess the effects of nursing record systems on nursing practice and patient outcomes. For the original version of this review in 2000, and updates in 2003 and 2008, we searched: the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register; MEDLINE, EMBASE, CINAHL, BNI, ISI Web of Knowledge, and ASLIB Index of Theses. We also handsearched: Computers, Informatics, Nursing (Computers in Nursing); Information Technology in Nursing; and the Journal of Nursing Administration. For this update, searches can be considered complete until the end of 2007. We checked reference lists of retrieved articles and other related reviews. Randomised controlled trials (RCTs), controlled before and after studies, and interrupted time series comparing one kind of nursing record system with another in hospital, community or primary care settings. The participants were qualified nurses, students or healthcare assistants working under the direction of a qualified nurse, and patients receiving care recorded or planned using nursing record systems. Two review authors (in two pairs) independently assessed trial quality and extracted data. We included nine trials (eight RCTs, one controlled before and after study) involving 1846 people. The studies that evaluated nursing record systems focusing on relatively discrete and focused problems, for example effective pain management in children, empowering pregnant women and parents, reducing loss of notes, reducing time spent on data entry of test results, reducing transcription errors, and reducing the number of pieces of paper in a record, all demonstrated some degree of success in achieving the desired results. Studies of nursing care planning systems

  9. System Synchronizes Recordings from Separated Video Cameras

    NASA Technical Reports Server (NTRS)

    Nail, William; Nail, William L.; Nail, Jasper M.; Le, Doung T.

    2009-01-01

    A system of electronic hardware and software for synchronizing recordings from multiple, physically separated video cameras is being developed, primarily for use in multiple-look-angle video production. The system, the time code used in the system, and the underlying method of synchronization upon which the design of the system is based are denoted generally by the term "Geo-TimeCode(TradeMark)." The system is embodied mostly in compact, lightweight, portable units (see figure) denoted video time-code units (VTUs) - one VTU for each video camera. The system is scalable in that any number of camera recordings can be synchronized. The estimated retail price per unit would be about $350 (in 2006 dollars). The need for this or another synchronization system external to video cameras arises because most video cameras do not include internal means for maintaining synchronization with other video cameras. Unlike prior video-camera-synchronization systems, this system does not depend on continuous cable or radio links between cameras (however, it does depend on occasional cable links lasting a few seconds). Also, whereas the time codes used in prior video-camera-synchronization systems typically repeat after 24 hours, the time code used in this system does not repeat for slightly more than 136 years; hence, this system is much better suited for long-term deployment of multiple cameras.

  10. Contextualization in automatic extraction of drugs from hospital patient records.

    PubMed

    Boytcheva, Svetla; Tcharaktchiev, Dimitar; Angelova, Galia

    2011-01-01

    Information Extraction (IE) from medical texts aims at the automatic recognition of entities and relations of interests. IE is based on shallow analysis and considers only sentences containing important words. Thus IE of drugs from discharge letters can identify as 'current' some past or future medication events. This article presents heuristic observations enabling to filter drugs that are taken by the patients during the hospitalization. These heuristics are based on the default PR structure and linguistic expressions signaling temporal and conditional markers. They are integrated in a system for drug extraction from hospital Patient Records (PRs) in Bulgarian language. Present evaluation results are summarized as well.

  11. 36 CFR 903.11 - Routine uses of records maintained in the system of records.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Routine uses of records... AVENUE DEVELOPMENT CORPORATION PRIVACY ACT § 903.11 Routine uses of records maintained in the system of records. (a) It shall be a routine use of the records in this system of records to disclose them to the...

  12. 36 CFR 903.11 - Routine uses of records maintained in the system of records.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false Routine uses of records... AVENUE DEVELOPMENT CORPORATION PRIVACY ACT § 903.11 Routine uses of records maintained in the system of records. (a) It shall be a routine use of the records in this system of records to disclose them to the...

  13. 36 CFR 903.11 - Routine uses of records maintained in the system of records.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 3 2014-07-01 2014-07-01 false Routine uses of records... AVENUE DEVELOPMENT CORPORATION PRIVACY ACT § 903.11 Routine uses of records maintained in the system of records. (a) It shall be a routine use of the records in this system of records to disclose them to the...

  14. 36 CFR § 903.11 - Routine uses of records maintained in the system of records.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 3 2013-07-01 2012-07-01 true Routine uses of records... PENNSYLVANIA AVENUE DEVELOPMENT CORPORATION PRIVACY ACT § 903.11 Routine uses of records maintained in the system of records. (a) It shall be a routine use of the records in this system of records to disclose...

  15. 36 CFR 903.11 - Routine uses of records maintained in the system of records.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false Routine uses of records... AVENUE DEVELOPMENT CORPORATION PRIVACY ACT § 903.11 Routine uses of records maintained in the system of records. (a) It shall be a routine use of the records in this system of records to disclose them to the...

  16. Instrumentation Development of an Airborne Recording System.

    DTIC Science & Technology

    1978-01-01

    calculator and suitable peripheral equipment. Accelerometer time histories from an analog recorder are digitized and processed on the programmable calculator system...spectral data in support of materiel air transportability and air delivery testing missions. The new data processing is based on a programmable

  17. Patient-Reported Use of Personalized Video Recordings to Improve Neurosurgical Patient-Provider Communication

    PubMed Central

    Porter, Randall

    2015-01-01

    Background: Providing patients with a video recording of their visit with a medical professional is a common-sense method for improving patient-provider communication. Objective: To describe the patient and provider experiences to video recording clinical medical encounters and providing the patient with a copy of the video for informational purposes. Methods: Since 2009, over 2,800 patients of eight different neurosurgeons chose to be video recorded during their encounter with the doctor and were provided access to the recording to watch over again as a way to recall what the doctor had said. The video system was set up as a handheld video camera, and video files were downloaded and made accessible to patients via a secure Internet patient portal. Between 2012 and 2014, patients who participated were surveyed regarding their use of the video and what was recorded on the video. The experience of the providers from a clinical and medico-legal standpoint was also reviewed. Results: Three hundred and thirty-three responses to the survey were received (39.2% response rate). More than half of patients (N=333; 56.2%) watched their video more than once, and over two-thirds (N=333; 68.6%) shared their video with a family member, friend, or another physician. Patients self-reported improved memory after watching their videos (N=299; 73.6% could remember more) and 50.2% responded that having the video made them feel more “at ease” with their medical problem (N=299). Overall, 88.0% of respondents indicated that their video had been helpful to them, and 98.5% would recommend having future visits video recorded. No patient made a comment that the video was intrusive or had prevented them from being open with their doctor. Finally, in the high-risk specialty of neurosurgery, none of the 2,807 patients who have been recorded since 2009 have used a video in a medico-legal action. Conclusions: Patient responses to the recording system and having a copy of their video

  18. Attitudes toward inter-hospital electronic patient record exchange: discrepancies among physicians, medical record staff, and patients.

    PubMed

    Wang, Jong-Yi; Ho, Hsiao-Yun; Chen, Jen-De; Chai, Sinkuo; Tai, Chih-Jaan; Chen, Yung-Fu

    2015-07-12

    In this era of ubiquitous information, patient record exchange among hospitals still has technological and individual barriers including resistance to information sharing. Most research on user attitudes has been limited to one type of user or aspect. Because few analyses of attitudes toward electronic patient records (EPRs) have been conducted, understanding the attitudes among different users in multiple aspects is crucial to user acceptance. This proof-of-concept study investigated the attitudes of users toward the inter-hospital EPR exchange system implemented nationwide and focused on discrepant behavioral intentions among three user groups. The system was designed by combining a Health Level 7-based protocol, object-relational mapping, and other medical informatics techniques to ensure interoperability in realizing patient-centered practices. After implementation, three user-specific questionnaires for physicians, medical record staff, and patients were administered, with a 70 % response rate. The instrument showed favorable convergent construct validity and internal consistency reliability. Two dependent variables were applied: the attitudes toward privacy and support. Independent variables comprised personal characteristics, work characteristics, human aspects, and technology aspects. Major statistical methods included exploratory factor analysis and general linear model. The results from 379 respondents indicated that the patients highly agreed with privacy protection by their consent and support for EPRs, whereas the physicians remained conservative toward both. Medical record staff was ranked in the middle among the three groups. The three user groups demonstrated discrepant intentions toward privacy protection and support. Experience of computer use, level of concerns, usefulness of functions, and specifically, reason to use electronic medical records and number of outpatient visits were significantly associated with the perceptions. Overall, four

  19. Nurses' perceptions of usefulness of nursing information system: module of electronic medical record for patient care in two university hospitals of iran.

    PubMed

    Kahouei, Mehdi; Baba Mohammadi, Hassan; Askari Majdabadi, Hesamedin; Solhi, Mahnaz; Parsania, Zeinab; Said Roghani, Panoe; Firozeh, Mehri

    2014-02-01

    For almost fifteen years, the application of computer in hospitals increasingly has become popular. Nurses' beliefs and attitudes towards computer is one of the most important indicators of the application of nursing information system. The purpose of this study was to investigate the perceptions of nurses on the usefulness of nursing information system for patient care. Here, a descriptive study was carried out. Sample was consisted of 316 nurses working in teaching hospitals in an urban area of Iran. This study was conducted during 2011 to 2012. A reliable and valid questionnaire was developed as a data collection tool. The collected data was analyzed using descriptive and inferential statistics. It was not believed that nursing information system was useful for patient care. However, it was mentioned that nursing information system is useful in some aspects of patient care such as expediting care, making early diagnosis and formulating diet plan. A significant association was found between the demographic background of sample and their perceptions of the usefulness of nursing information system (P<0.05). Totally, it can be concluded that nursing information system has a potential for improving patient care in hospital settings. Therefore, policy makers should consider implementing nursing information system in teaching hospitals.

  20. Nurses’ Perceptions of Usefulness of Nursing Information System: Module of Electronic Medical Record for Patient Care in Two University Hospitals of Iran

    PubMed Central

    Kahouei, Mehdi; Baba Mohammadi, Hassan; Askari Majdabadi, Hesamedin; Solhi, Mahnaz; Parsania, Zeinab; Said Roghani, Panoe; Firozeh, Mehri

    2014-01-01

    Introduction: For almost fifteen years, the application of computer in hospitals increasingly has become popular. Nurses’ beliefs and attitudes towards computer is one of the most important indicators of the application of nursing information system. The purpose of this study was to investigate the perceptions of nurses on the usefulness of nursing information system for patient care. Methods: Here, a descriptive study was carried out. Sample was consisted of 316 nurses working in teaching hospitals in an urban area of Iran. This study was conducted during 2011 to 2012. A reliable and valid questionnaire was developed as a data collection tool. The collected data was analyzed using descriptive and inferential statistics. Results: It was not believed that nursing information system was useful for patient care. However, it was mentioned that nursing information system is useful in some aspects of patient care such as expediting care, making early diagnosis and formulating diet plan. A significant association was found between the demographic background of sample and their perceptions of the usefulness of nursing information system (P<0.05). Conclusion: Totally, it can be concluded that nursing information system has a potential for improving patient care in hospital settings. Therefore, policy makers should consider implementing nursing information system in teaching hospitals. PMID:24757398

  1. Global positioning system recorder and method

    DOEpatents

    Hayes, D.W.; Hofstetter, K.J.; Eakle, R.F. Jr.; Reeves, G.E.

    1998-12-22

    A global positioning system recorder (GPSR) is disclosed in which operational parameters and recorded positional data are stored on a transferable memory element. Through this transferrable memory element, the user of the GPSR need have no knowledge of GPSR devices other than that the memory element needs to be inserted into the memory element slot and the GPSR must be activated. The use of the data element also allows for minimal downtime of the GPSR and the ability to reprogram the GPSR and download data therefrom, without having to physically attach it to another computer. 4 figs.

  2. 78 FR 45454 - Patient Access to Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-29

    ... records if VA determines that such release could have an adverse effect on the physical or mental health... ``would not be injurious to the physical or mental health of the claimant.'' VA developed a special...(d), in those cases where records contain information that may be injurious to the physical or...

  3. Personal Health Records for Patients with Chronic Disease

    PubMed Central

    Rozenblum, R.; Park, A.; Dunn, M.; Bates, D.W.

    2014-01-01

    Summary Background Personal health records (PHRs) connected to a physician’s electronic health record system hold substantial promise for supporting and engaging patients with chronic disease. Objectives: To explore how U.S. health care organizations are currently utilizing PHRs for chronic disease populations. Methods A mixed methods study including semi-structured interviews and a questionnaire was conducted. A purposive sample was developed of health care organizations which were recognized as exemplars for PHRs and were high performers in national patient satisfaction surveys (H-CAHPS or CAHPS). Within each organization, participants were health IT leaders or those managing high-risk or chronic disease populations. Results Interviews were conducted with 30 informants and completed questionnaires were received from 16 organizations (84% response rate). Most PHRs allowed patients to access health records and educational material, message their provider, renew prescriptions and request appointments. Patient generated data was increasingly being sought and combined with messaging, resulted in greater understanding of patient health and functioning outside of the clinic visit. However for chronic disease populations, there was little targeted involvement in PHR design and few tools to help interpret and manage their conditions beyond those offered for all. The PHR was largely uncoupled from high risk population management interventions and no clear framework for future PHR development emerged. Conclusion This technology is currently underutilized and represents a major opportunity given the potential benefits of patient engagement and shared decision making. A coherent patient-centric PHR design and evaluation strategy is required to realize its potential and maximize this natural hub for multidisciplinary care co-ordination. PMID:25024758

  4. 32 CFR 318.6 - Procedures for requests pertaining to individual records in a record system.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... individual seeking notification of whether a system of records, maintained by the Defense Threat Reduction... request in writing. Requesters are encourage to review the systems of records notices published by the... records in a record system. 318.6 Section 318.6 National Defense Department of Defense (Continued)...

  5. 32 CFR 318.6 - Procedures for requests pertaining to individual records in a record system.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... individual seeking notification of whether a system of records, maintained by the Defense Threat Reduction... request in writing. Requesters are encourage to review the systems of records notices published by the... records in a record system. 318.6 Section 318.6 National Defense Department of Defense (Continued)...

  6. 32 CFR 318.6 - Procedures for requests pertaining to individual records in a record system.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... individual seeking notification of whether a system of records, maintained by the Defense Threat Reduction... request in writing. Requesters are encourage to review the systems of records notices published by the... records in a record system. 318.6 Section 318.6 National Defense Department of Defense (Continued)...

  7. 32 CFR 318.6 - Procedures for requests pertaining to individual records in a record system.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... individual seeking notification of whether a system of records, maintained by the Defense Threat Reduction... request in writing. Requesters are encourage to review the systems of records notices published by the... records in a record system. 318.6 Section 318.6 National Defense Department of Defense (Continued)...

  8. 21 CFR 21.71 - Disclosure of records in Privacy Act Record Systems; accounting required.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Systems; accounting required. 21.71 Section 21.71 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT... Record Systems to Persons Other Than the Subject Individual § 21.71 Disclosure of records in Privacy Act Record Systems; accounting required. (a) Except as provided in § 21.70, a record about an individual...

  9. Giving patients a copy of their computer medical record.

    PubMed

    Sheldon, M G

    1982-02-01

    Medical summaries were prepared by a general practitioner for inclusion in a computer system. Both the medical records and a patient-filled questionnaire were used. A representative sample of the practice population were then sent their summaries. In creating the summaries the general practitioner felt the need to exclude 11 diagnoses whenever they appeared (5 per cent of the patients), and to suppress one or more diagnoses in a further 14 per cent of patients. In 2 per cent of summaries the general practitioner felt unable to give a copy to the patient because he was afraid of an adverse reaction by the patient or immediate relatives.The patients' views of the usefulness of the summaries, and of their accuracy and completeness, were sought by a questionnaire. Replies were received from 71 per cent; of these, 91 per cent reported that they thought the summary useful. However, in 18 per cent of cases, the patients requested additions, corrections or deletions. Only 1 per cent of patients replied that they definitely did not like the idea of a computer containing their medical information.Some of the benefits and difficulties both of using a computer to store medical information, and of giving the patient a copy of the medical summary, are discussed.

  10. 49 CFR 802.5 - Procedures for requests pertaining to individual records in a record system.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ..., provided the record under the control of the NTSB is maintained in a system of records from which... solely as a statistical research or reporting record and that it is to be transferred in a form...

  11. Privacy Act System of Records: Employee Counseling and Assistance Program Records, EPA-27

    EPA Pesticide Factsheets

    Learn about the Employee Counseling and Assistance Program Records System, including who is covered in the system, the purpose of data collection, routine uses for the system's records, and other security procedures.

  12. Privacy Act System of Records: Libby Asbestos Exposure Assessment Records, EPA-48

    EPA Pesticide Factsheets

    Learn about the Libby Asbestos Exposure Assessment Records System, including who is covered in the system, the purpose of data collection, routine uses for the system's records, and other security procedure.

  13. Privacy Act System of Records: Medical and Research Study Records of Human Volunteers, EPA-34

    EPA Pesticide Factsheets

    Learn about the Medical and Research Study Records of Human Volunteers System, including who is covered in the system, the purpose of data collection, routine uses for the system's records, and other security procedures.

  14. Privacy Act System of Records: EPA Telecommunications Detail Records, EPA-32

    EPA Pesticide Factsheets

    Learn more about the EPA Telecommunications Detail Records System, including who is covered in the system, the purpose of data collection, routine uses for the system's records, and other security procedures.

  15. 75 FR 21253 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-23

    ... of systems of records notices. Education Management Information System (EDMIS): Education Centers at..., and in some instances their dependents. Education Management Information System (EDMIS): Civilian... records notices also apply to this system. Education Management Information System (EDMIS): Information......

  16. A hypermedia-based medical records management system.

    PubMed

    Laforest, F; Frénot, S; Flory, A

    1998-01-01

    This article presents a new way to manage computerized medical records, based on a totally-hypermedia system. As a matter of fact, the classical use of a database limits the necessary variability of the medical record, in function of both the patient profile and the care practitioner habits. The system we propose is based on a hospital Intranet, and on the XML language. This language allows the definition of semantic tags in hyperdocuments, and thus information retrieval is ensured through semantic tags indexation.

  17. Patient access to complex chronic disease records on the Internet

    PubMed Central

    2012-01-01

    Background Access to medical records on the Internet has been reported to be acceptable and popular with patients, although most published evaluations have been of primary care or office-based practice. We tested the feasibility and acceptability of making unscreened results and data from a complex chronic disease pathway (renal medicine) available to patients over the Internet in a project involving more than half of renal units in the UK. Methods Content and presentation of the Renal PatientView (RPV) system was developed with patient groups. It was designed to receive information from multiple local information systems and to require minimal extra work in units. After piloting in 4 centres in 2005 it was made available more widely. Opinions were sought from both patients who enrolled and from those who did not in a paper survey, and from staff in an electronic survey. Anonymous data on enrolments and usage were extracted from the webserver. Results By mid 2011 over 17,000 patients from 47 of the 75 renal units in the UK had registered. Users had a wide age range (<10 to >90 yrs) but were younger and had more years of education than non-users. They were enthusiastic about the concept, found it easy to use, and 80% felt it gave them a better understanding of their disease. The most common reason for not enrolling was being unaware of the system. A minority of patients had security concerns, and these were reduced after enrolling. Staff responses were also strongly positive. They reported that it aided patient concordance and disease management, and increased the quality of consultations with a neutral effect on consultation length. Neither patient nor staff responses suggested that RPV led to an overall increase in patient anxiety or to an increased burden on renal units beyond the time required to enrol each patient. Conclusions Patient Internet access to secondary care records concerning a complex chronic disease is feasible and popular, providing an increased

  18. 76 FR 61132 - Privacy Act; System of Records: State-77, Country Clearance Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-03

    ... paper records. RETRIEVABILITY: Records are retrieved by the individual's name or itinerary number... escort. All paper records containing personal information are maintained in secured file cabinets in... Act; System of Records: State-77, Country Clearance Records SUMMARY: Notice is hereby given that the...

  19. [Introduction of a simple audio recording system to the operating room--experience at a small local hospital].

    PubMed

    Taniguchi, Ayano; Nakamura, Eriko; Yaegashi, Kazuhiro

    2012-10-01

    We developed a simple audio recording system using a small personal computer and free audio recording software that makes voice recordings for use in emergencies, particularly for emergency caesarean sections. The system makes a continuous audio recording while the patient receives medical treatment. The recording provides an accurate record of the anesthesia used during treatment. This audio recording system is useful as an auxiliary means of record keeping during medical emergencies.

  20. Customer-oriented medical records can promote patient satisfaction.

    PubMed

    MacStravic, R S

    1988-04-01

    The customer-oriented medical record helps promote patient satisfaction by providing a mechanism to monitor and document quality of care from the patient's perspective. Information that should be contained in the record includes the following: Personal and family information. Reasons for selecting the provider. Reasons for patient visit. Patient requests and responses thereto. Provider and staff observations. Patient feedback. Summaries of previous visits. Record of progress made. In addition to promoting patient satisfaction, the customer-oriented medical record provides a data base for analyzing the current market that can be used in designing marketing communications to attract new patients. It also contributes to provider success by reminding care givers of their commitment to patient satisfaction, motivating them to be sensitive to patients' needs and expectations, and helping them to personalize the care experience.

  1. Integrated Electronic Health Record Database Management System: A Proposal.

    PubMed

    Schiza, Eirini C; Panos, George; David, Christiana; Petkov, Nicolai; Schizas, Christos N

    2015-01-01

    eHealth has attained significant importance as a new mechanism for health management and medical practice. However, the technological growth of eHealth is still limited by technical expertise needed to develop appropriate products. Researchers are constantly in a process of developing and testing new software for building and handling Clinical Medical Records, being renamed to Electronic Health Record (EHR) systems; EHRs take full advantage of the technological developments and at the same time provide increased diagnostic and treatment capabilities to doctors. A step to be considered for facilitating this aim is to involve more actively the doctor in building the fundamental steps for creating the EHR system and database. A global clinical patient record database management system can be electronically created by simulating real life medical practice health record taking and utilizing, analyzing the recorded parameters. This proposed approach demonstrates the effective implementation of a universal classic medical record in electronic form, a procedure by which, clinicians are led to utilize algorithms and intelligent systems for their differential diagnosis, final diagnosis and treatment strategies.

  2. 77 FR 65939 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-31

    ... currently entitled ``Veterans Health Information Systems and Technology Architecture (VistA) Records-VA... Architecture (VistA) Records-VA ROUTINE USES OF RECORDS MAINTAINED IN THE SYSTEM, INCLUDING CATEGORIES OF USERS...

  3. PAMFOnline: integrating EHealth with an electronic medical record system.

    PubMed

    Tang, Paul C; Black, William; Buchanan, Jenny; Young, Charles Y; Hooper, David; Lane, Steven R; Love, Barbara; Mitchell, Charlotte; Smith, Nancy; Turnbull, Jenifer R

    2003-01-01

    The Institute of Medicine stressed the need for continuous healing relationships, yet the delivery of health care has traditionally been confined to the physician office or hospital. We implemented an eHealth application tightly integrated with our electronic medical record system that provides patients with a convenient, continuously available communication channel to their physician's office. Patients can view summary data from their medical record, including the results of diagnostic tests, and request medical advice, prescription renewals, appointments, or updates to their demographic information. We have found that patients embrace this new communication channel and are using the service appropriately. Patients especially value electronic messaging with their physicians and timely access to their test results. While initially concerned about an increase in work, physicians have found that use of electronic messaging can be an efficient method for handling non-urgent communication with their patients. Online tools for patients, when integrated with an electronic medical record, can provide patients with better access to health information, improve patient satisfaction, and improve operational efficiency.

  4. 36 CFR 1121.3 - Procedures for requests pertaining to individuals' records in a records system.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... pertaining to individuals' records in a records system. 1121.3 Section 1121.3 Parks, Forests, and Public Property ARCHITECTURAL AND TRANSPORTATION BARRIERS COMPLIANCE BOARD PRIVACY ACT IMPLEMENTATION § 1121.3 Procedures for requests pertaining to individuals' records in a records system. An individual or authorized...

  5. 12 CFR 792.54 - Procedures for requests pertaining to individual records in a system of records.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... approximate dates covered by the record; and, the systems of record in which records are thought to be... individual records in a system of records. 792.54 Section 792.54 Banks and Banking NATIONAL CREDIT UNION... system of records. (a) Individuals desiring to know if a system of records contains records pertaining to...

  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. Security architecture for multi-site patient records research.

    PubMed Central

    Behlen, F. M.; Johnson, S. B.

    1999-01-01

    A security system was developed as part of a patient records research database project intended for both local and multi-site studies. A comprehensive review of ethical foundations and legal environment was undertaken, and a security system comprising both administrative policies and computer tools was developed. For multi-site studies, Institutional Review Board (IRB) approval is required for each study, at each participating site. A sponsoring Principal Investigator (PI) is required at each site, and each PI needs automated enforcement tools. Systems fitting this model were implemented at two academic medical centers. Security features of commercial database systems were found to be adequate for basic enforcement of approved research protocols. PMID:10566404

  8. 42 CFR 137.178 - May Self-Governance Tribes store patient records at the Federal Records Centers?

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false May Self-Governance Tribes store patient records at... SELF-GOVERNANCE Operational Provisions Records § 137.178 May Self-Governance Tribes store patient records at the Federal Records Centers? Yes, at the option of a Self-Governance Tribe, patient records...

  9. 76 FR 39392 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-06

    ... disposing of records in the system: Storage: Paper records in file folders and electronic storage media... Department of the Army Privacy Act of 1974; System of Records AGENCY: Department of the Army, DoD. ACTION: Notice to Amend a System of Records. SUMMARY: The Department of the Army is proposing to amend a system...

  10. 78 FR 44102 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-23

    ... Department of the Navy Privacy Act of 1974; System of Records AGENCY: Department of the Navy, DoD. ACTION: Notice to alter a system of records. SUMMARY: The Department of the Navy proposes to alter a system of records in its inventory of record systems subject to the Privacy Act of 1974 (5 U.S.C. 552a), as...

  11. 77 FR 59251 - Privacy Act of 1974; Systems of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-26

    ...The Pension Benefit Guaranty Corporation is proposing four new routine uses applicable to all of its existing systems of records maintained pursuant to the Privacy Act of 1974, as amended (5 U.S.C. 552a), three new systems of records, adding new routine uses to existing systems of record, and is amending eight systems of records to make technical and clarifying changes.

  12. 21 CFR 820.186 - Quality system record.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Quality system record. 820.186 Section 820.186...) MEDICAL DEVICES QUALITY SYSTEM REGULATION Records § 820.186 Quality system record. Each manufacturer shall maintain a quality system record (QSR). The QSR shall include, or refer to the location of, procedures...

  13. 21 CFR 820.186 - Quality system record.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Quality system record. 820.186 Section 820.186...) MEDICAL DEVICES QUALITY SYSTEM REGULATION Records § 820.186 Quality system record. Each manufacturer shall maintain a quality system record (QSR). The QSR shall include, or refer to the location of, procedures...

  14. 21 CFR 820.186 - Quality system record.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Quality system record. 820.186 Section 820.186...) MEDICAL DEVICES QUALITY SYSTEM REGULATION Records § 820.186 Quality system record. Each manufacturer shall maintain a quality system record (QSR). The QSR shall include, or refer to the location of, procedures...

  15. 21 CFR 820.186 - Quality system record.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Quality system record. 820.186 Section 820.186...) MEDICAL DEVICES QUALITY SYSTEM REGULATION Records § 820.186 Quality system record. Each manufacturer shall maintain a quality system record (QSR). The QSR shall include, or refer to the location of, procedures...

  16. 77 FR 75621 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-21

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Contract Audit Agency, DoD. ACTION: Notice to amend a System of Records. SUMMARY: The Defense Contract Audit Agency is amending a system of records notice in its existing inventory of record systems subject to the Privacy Act of 1974...

  17. 75 FR 43498 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-26

    ... Department of the Army Privacy Act of 1974; System of Records AGENCY: Department of the Army, DoD. ACTION: Notice to add a system of records. SUMMARY: The Department of the Army proposes to add a system of records to its inventory of record systems subject to the Privacy Act of 1974 (5 U.S.C. 552a), as amended...

  18. 76 FR 67561 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-01

    ... AFFAIRS Privacy Act of 1974; System of Records AGENCY: Department of Veterans Affairs (VA). ACTION: Notice of establishment of new system of records. SUMMARY: The Privacy Act of 1974 (5 U.S.C. 552(e)(4... systems of records. Notice is hereby given that VA is establishing a new system of records...

  19. 77 FR 65370 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-26

    ... Office of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Finance and Accounting Service, DoD. ACTION: Notice to delete a Systems of Records. SUMMARY: The Defense Finance and Accounting Service is deleting a system of records notice in its existing inventory of record systems subject to the...

  20. 78 FR 6078 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-29

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Finance and Accounting Service, DoD. ACTION: Notice to delete a system of records. SUMMARY: The Defense Finance and Accounting Service is deleting a system of records notice in its existing inventory of record systems subject to the...

  1. 78 FR 27195 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-09

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Finance and Accounting Service, DoD. ACTION: Notice to delete two Systems of Records. SUMMARY: The Defense Finance and Accounting Service is deleting two systems of records notices in its existing inventory of record systems subject to...

  2. Patients' positive identification systems.

    PubMed

    Pagliaro, Pasqualepaolo; Turdo, Rosalia; Capuzzo, Enrico

    2009-10-01

    Blood safety must be maintained throughout the whole transfusion chain to prevent the transfusion of incorrect blood components. The estimated risk of an incorrect transfusion is in the order of 1 per 10,000 units of blood. Although several kinds of errors contribute to "wrong blood" events, 70% of errors occur in clinical areas with the most common being due to failure of the pre-transfusion bedside checking procedure. Several methods are available to reduce such errors. The I-TRAC Plus system by Immucor consists of an identification bracelet which is a bar-coded wristband and a handheld portable computer that identifies patients and blood bags by a scanner and prints the information through a portable printer. The labels attached on the blood order forms and on the sample tubes are read and recorded in the blood bank's informatics system (EmoNet INSIEL). Labels showing the bar-code of the assigned number, which includes the ID number of the patient, the ID number of the unit and a code identifying the kind of product and use (allogeneic or autologous), are generated and applied to the blood components. The transfusions are administered after checking the unit and the patient's wristband using the scanner of a portable PC. In 5 years a total of 71,400 units of blood components were transfused to 15,430 patients using the I-TRAC Plus system. The system prevented 12 cases of mis-identification of patients (5 in 2003, 0 in 2004, 1 in 2005, 1 in 2006 and 5 in 2007). In 2003 we introduced the use of a bar-code matching system between a patient's wristband and the blood bag to avoid mistakes at the bedside. In 5 years the system provided benefits by avoiding errors in the identification of patients, thus preventing "wrong blood" transfusions.

  3. 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

  4. 75 FR 71090 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-22

    ... records in the system: Storage: Electronic storage media and paper records. Retrievability: Name, Social... paper records for one year after cut off, then transfer to a Federal Records Center where they will be... Department of the Air Force Privacy Act of 1974; System of Records AGENCY: Department of the Air Force, DoD...

  5. On the usage of health records for the design of virtual patients: a systematic review

    PubMed Central

    2013-01-01

    Background The process of creating and designing Virtual Patients for teaching students of medicine is an expensive and time-consuming task. In order to explore potential methods of mitigating these costs, our group began exploring the possibility of creating Virtual Patients based on electronic health records. This review assesses the usage of electronic health records in the creation of interactive Virtual Patients for teaching clinical decision-making. Methods The PubMed database was accessed programmatically to find papers relating to Virtual Patients. The returned citations were classified and the relevant full text articles were reviewed to find Virtual Patient systems that used electronic health records to create learning modalities. Results A total of n = 362 citations were found on PubMed and subsequently classified, of which n = 28 full-text articles were reviewed. Few articles used unformatted electronic health records other than patient CT or MRI scans. The use of patient data, extracted from electronic health records or otherwise, is widespread. The use of unformatted electronic health records in their raw form is less frequent. Patient data use is broad and spans several areas, such as teaching, training, 3D visualisation, and assessment. Conclusions Virtual Patients that are based on real patient data are widespread, yet the use of unformatted electronic health records, abundant in hospital information systems, is reported less often. The majority of teaching systems use reformatted patient data gathered from electronic health records, and do not use these electronic health records directly. Furthermore, many systems were found that used patient data in the form of CT or MRI scans. Much potential research exists regarding the use of unformatted electronic health records for the creation of Virtual Patients. PMID:24011027

  6. A multimedia electronic patient record (ePR) system to improve decision support in pre- and rehabilitation through clinical and movement analysis

    NASA Astrophysics Data System (ADS)

    Liu, Brent; Documet, Jorge; McNitt-Gray, Sarah; Requejo, Phil; McNitt-Gray, Jill

    2011-03-01

    Clinical decisions for improving motor function in patients both with disability as well as improving an athlete's performance are made through clinical and movement analysis. Currently, this analysis facilitates identifying abnormalities in a patient's motor function for a large amount of neuro-musculoskeletal pathologies. However definitively identifying the underlying cause or long-term consequences of a specific abnormality in the patient's movement pattern is difficult since this requires information from multiple sources and formats across different times and currently relies on the experience and intuition of the expert clinician. In addition, this data must be persistent for longitudinal outcomes studies. Therefore a multimedia ePR system integrating imaging informatics data could have a significant impact on decision support within this clinical workflow. We present the design and architecture of such an ePR system as well as the data types that need integration in order to develop relevant decision support tools. Specifically, we will present two data model examples: 1) A performance improvement project involving volleyball athletes and 2) Wheelchair propulsion evaluation of patients with disabilities. The end result is a new frontier area of imaging informatics research within rehabilitation engineering and biomechanics.

  7. An information retrieval system for computerized patient records in the context of a daily hospital practice: the example of the Léon Bérard Cancer Center (France).

    PubMed

    Biron, P; Metzger, M H; Pezet, C; Sebban, C; Barthuet, E; Durand, T

    2014-01-01

    A full-text search tool was introduced into the daily practice of Léon Bérard Center (France), a health care facility devoted to treatment of cancer. This tool was integrated into the hospital information system by the IT department having been granted full autonomy to improve the system. To describe the development and various uses of a tool for full-text search of computerized patient records. The technology is based on Solr, an open-source search engine. It is a web-based application that processes HTTP requests and returns HTTP responses. A data processing pipeline that retrieves data from different repositories, normalizes, cleans and publishes it to Solr, was integrated in the information system of the Leon Bérard center. The IT department developed also user interfaces to allow users to access the search engine within the computerized medical record of the patient. From January to May 2013, 500 queries were launched per month by an average of 140 different users. Several usages of the tool were described, as follows: medical management of patients, medical research, and improving the traceability of medical care in medical records. The sensitivity of the tool for detecting the medical records of patients diagnosed with both breast cancer and diabetes was 83.0%, and its positive predictive value was 48.7% (gold standard: manual screening by a clinical research assistant). The project demonstrates that the introduction of full-text-search tools allowed practitioners to use unstructured medical information for various purposes.

  8. Solving incompatibilities between electronic records for orthodontic patients.

    PubMed

    Magni, Antonio; de Oliveira Albuquerque, Robson; de Sousa, Rafael Timóteo; Hans, Mark G; Magni, Franco G

    2007-07-01

    Today, orthodontists should not need to burden their work load with tasks such as figuring out how to send patient information to colleagues or how to share the same patient record across different software programs. In a long-term attempt to lighten these tasks, we are developing a standard for electronic orthodontic patient records to enable a seamless interchange of data between software programs. This article describes a practical proposal that integrates 2 existing standards, HL7 and DICOM, to create a standard for electronic orthodontic patient records.

  9. 21 CFR 21.71 - Disclosure of records in Privacy Act Record Systems; accounting required.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Systems; accounting required. 21.71 Section 21.71 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT... Record Systems; accounting required. (a) Except as provided in § 21.70, a record about an individual that... of the disclosure. The accounting shall not be considered a Privacy Act Record System. (2) Retain the...

  10. 75 FR 64711 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-20

    ...: Delete entry and replace with ``Paper records in file folders and electronic storage media..., and Disposing of Records in the System: Storage: Paper records in file folders and electronic storage... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Information Systems Agency...

  11. 32 CFR 327.5 - Systems of records.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) Supervisor/Manager paper records maintained by DeCA personnel will be treated as ‘For Official Use Only... 32 National Defense 2 2010-07-01 2010-07-01 false Systems of records. 327.5 Section 327.5 National... DEFENSE COMMISSARY AGENCY PRIVACY ACT PROGRAM § 327.5 Systems of records. (a) System of records. To be...

  12. 75 FR 19946 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-16

    ... from the system, paper records are destroyed by shredding, burning or pulping.'' * * * * * Notification... for storing, retrieving, accessing, retaining, and disposing of records in the system: Storage: Paper... longer with the agency. Electronic records are deleted from the system, paper records are destroyed by...

  13. 77 FR 4798 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-31

    ... Department of the Army Privacy Act of 1974; System of Records AGENCY: Department of the Army, DoD. ACTION: Notice to Delete a System of Records. SUMMARY: The Department of the Army is deleting a system of records.... Leroy Jones, Department of the Army, Privacy Office, U.S. Army Records Management and...

  14. 78 FR 38017 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-25

    ... Department of the Army Privacy Act of 1974; System of Records AGENCY: Department of the Army, DoD. ACTION: Notice to amend a System of Records. SUMMARY: The Department of the Army is amending a system of records... Army, Privacy Office, U.S. Army Records Management and Declassification Agency, 7701 Telegraph...

  15. 28 CFR 16.51 - Security of systems of records.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Security of systems of records. 16.51... Security of systems of records. (a) Each component shall establish administrative and physical controls to prevent unauthorized access to its systems of records, to prevent unauthorized disclosure of records,...

  16. 28 CFR 16.51 - Security of systems of records.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Security of systems of records. 16.51... Security of systems of records. (a) Each component shall establish administrative and physical controls to prevent unauthorized access to its systems of records, to prevent unauthorized disclosure of records,...

  17. 22 CFR 308.12 - Contents of records systems.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Contents of records systems. 308.12 Section 308.12 Foreign Relations PEACE CORPS IMPLEMENTATION OF THE PRIVACY ACT OF 1974 § 308.12 Contents of records systems. (a) The agency shall maintain in any records contained in any records system hereunder...

  18. 22 CFR 308.12 - Contents of records systems.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 22 Foreign Relations 2 2012-04-01 2009-04-01 true Contents of records systems. 308.12 Section 308.12 Foreign Relations PEACE CORPS IMPLEMENTATION OF THE PRIVACY ACT OF 1974 § 308.12 Contents of records systems. (a) The agency shall maintain in any records contained in any records system...

  19. 22 CFR 308.12 - Contents of records systems.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Contents of records systems. 308.12 Section 308.12 Foreign Relations PEACE CORPS IMPLEMENTATION OF THE PRIVACY ACT OF 1974 § 308.12 Contents of records systems. (a) The agency shall maintain in any records contained in any records system...

  20. Multicenter patient records research: security policies and tools.

    PubMed

    Behlen, F M; Johnson, S B

    1999-01-01

    The expanding health information infrastructure offers the promise of new medical knowledge drawn from patient records. Such promise will never be fulfilled, however, unless researchers first address policy issues regarding the rights and interests of both the patients and the institutions who hold their records. In this article, the authors analyze the interests of patients and institutions in light of public policy and institutional needs. They conclude that the multicenter study, with Institutional Review Board approval of each study at each site, protects the interests of both. "Anonymity" is no panacea, since patient records are so rich in information that they can never be truly anonymous. Researchers must earn and respect the trust of the public, as responsible stewards of facts about patients' lives. The authors find that computer security tools are needed to administer multicenter patient records studies and describe simple approaches that can be implemented using commercial database products.

  1. The standard data model approach to patient record transfer.

    PubMed

    Canfield, K; Silva, M; Petrucci, K

    1994-01-01

    This paper develops an approach to electronic data exchange of patient records from Ambulatory Encounter Systems (AESs). This approach assumes that the AES is based upon a standard data model. The data modeling standard used here is IDEFIX for Entity/Relationship (E/R) modeling. Each site that uses a relational database implementation of this standard data model (or a subset of it) can exchange very detailed patient data with other such sites using industry standard tools and without excessive programming efforts. This design is detailed below for a demonstration project between the research-oriented geriatric clinic at the Baltimore Veterans Affairs Medical Center (BVAMC) and the Laboratory for Healthcare Informatics (LHI) at the University of Maryland.

  2. 76 FR 5351 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-31

    ... records in file folders and electronic storage media. Retrievability: By individual's name and Social....'' Categories of records in the system: Delete entry and replace with ``Identification data: name, rank, Social..., promotion data, qualification record. Dependent education information: academic and diagnostic...

  3. Clinical experience with a computerized record and verify system.

    PubMed

    Podmaniczky, K C; Mohan, R; Kutcher, G J; Kestler, C; Vikram, B

    1985-08-01

    To improve the quality of patient care by detecting and preventing many types of treatment mistakes, we have implemented a computerized system for recording and verifying external beam radiation treatments on our therapy machines. It inhibits the radiation beam if treatment machine settings do not agree with prescribed values to within maximum permissible deviations (tolerances). The tolerances are determined from experience and adjusted when necessary to make the system more effective and less susceptible to "false alarms." The system uses a common data base for all treatment machines. As a result, it permits statistical analysis and generation of reports based on data encompassing the entire patient population as well as verification of treatments of patients transferred from one machine to another. Reports of verification failures reveal patterns of mistakes. Knowing these, attempts can be made to reduce the frequency of verification failures. "Significant" mistakes that were prevented are extracted by treatment planning personnel from these reports. Analysis of data indicates a rate of approximately 150 "significant" mistakes detected and prevented per machine per year, representing 1.0% of all fields treated. We present and discuss our experiences with the system and with the frequency, patterns, and significance of verification failures. We selected a few of the patients for whose treatments significant set-up mistakes were made, and were detected and prevented by the Record and Verify System. We include discussions of the overall effect these mistakes would have had on dose distribution had they not been prevented.

  4. 78 FR 14276 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-05

    ... Marine Corps Manpower Management Information System Records, and M01070-6, Marine Corps Official Military... system; M01040-3 Marine Corps Manpower Management Information System Records, and M01070-6, Marine Corps... systems; M01040-3, Marine Corps Manpower Management Information System Records, NM01560-2 Department......

  5. 78 FR 73514 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-06

    ... Department of the Navy Privacy Act of 1974; System of Records AGENCY: Department of the Navy, DoD. ACTION: Notice to alter a System of Records. SUMMARY: The Department of the Navy proposes to alter the system of... of record systems subject to the Privacy Act of 1974, as amended. This system will be used to...

  6. 78 FR 70543 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-26

    ...The Defense Information Systems Agency proposes to add a new system of records, KWHC 08, entitled ``DefenseReady'', to its inventory of record systems subject to the Privacy Act of 1974, as amended. This system will manage personnel and security records for the purpose of validation, analysis, and appraisal throughout the lifecycle. This system is used to track travel, security, sensitive......

  7. A web-based electronic patient record (ePR) system for data integration in movement analysis research on wheel-chair users to minimize shoulder pain

    NASA Astrophysics Data System (ADS)

    Deshpande, Ruchi R.; Requejo, Philip; Sutisna, Erry; Wang, Ximing; Liu, Margaret; McNitt-Gray, Sarah; Ruparel, Puja; Liu, Brent J.

    2012-02-01

    Patients confined to manual wheel-chairs are at an added risk of shoulder injury. There is a need for developing optimal bio-mechanical techniques for wheel-chair propulsion through movement analysis. Data collected is diverse and in need of normalization and integration. Current databases are ad-hoc and do not provide flexibility, extensibility and ease of access. The need for an efficient means to retrieve specific trial data, display it and compare data from multiple trials is unmet through lack of data association and synchronicity. We propose the development of a robust web-based ePR system that will enhance workflow and facilitate efficient data management.

  8. Embedded-structure template for electronic records affects patient note quality and management for emergency head injury patients

    PubMed Central

    Sonoo, Tomohiro; Iwai, Satoshi; Inokuchi, Ryota; Gunshin, Masataka; Kitsuta, Yoichi; Nakajima, Susumu

    2016-01-01

    Abstract Along with article-based checklists, structured template recording systems have been reported as useful to create more accurate clinical recording, but their contributions to the improvement of the quality of patient care have been controversial. An emergency department (ED) must manage many patients in a short time. Therefore, such a template might be especially useful, but few ED-based studies have examined such systems. A structured template produced according to widely used head injury guidelines was used by ED residents for head injury patients. The study was conducted by comparing each 6-month period before and after launching the system. The quality of the patient notes and factors recorded in the patient notes to support the head computed tomography (CT) performance were evaluated by medical students blinded to patient information. The subject patients were 188 and 177 in respective periods. The numbers of patient notes categorized as “CT indication cannot be determined” were significantly lower in the postintervention term (18% → 9.0%), which represents the patient note quality improvement. No difference was found in the rates of CT performance or CT skip without clearly recorded CT indication in the patient notes. The structured template functioned as a checklist to support residents in writing more appropriately recorded patient notes in the ED head injury patients. Such a template customized to each clinical condition can facilitate standardized patient management and can improve patient safety in the ED. PMID:27749590

  9. Electronic Health Record Innovations for Healthier Patients and Happier Doctors

    PubMed Central

    Krist, Alex H.

    2015-01-01

    This special issue explores a range of health information technology (HIT) issues that can help primary care practices and patients. Findings address the design of HIT systems, primarily electronic health records (EHRs), the utility of various functionalities, and implementation strategies that ensure the greatest value. The articles also remind us that, while HIT can support the delivery of care, it is not a panacea. To be effective, functionality needs to be relevant and timely for both the clinician and patient. Prompts and better documentation can improve care, and “prompt fatigue” is not inevitable. Information presented within EHRs needs to be actionable. There is an ongoing tension between information overload and the right—and helpful—information. Even the order of presentation of information can make a difference in the outcome. Whether supported by HIT or not, basic tenants of care, such as including the whole care team in trainings, communicating with other providers, and engaging patients, remain essential. The studies in this issue will prove useful for informatics developers, practices and health systems making HIT decisions, and care teams refining HIT to support the needs of their patients. PMID:25957359

  10. 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

  11. Consumers' perceptions of patient-accessible electronic medical records.

    PubMed

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

    2013-08-26

    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. 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. This qualitative study used 4 focus groups with 28 low education level, English-speaking consumers in June and July 2010, in New York City. 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. 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 engaging, and have user-friendly navigation.

  12. 75 FR 58368 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-24

    ..., accessing, retaining, and disposing of records in the system: Storage: Paper file folders and electronic... files and databases are password protected with access restricted to authorized users. Paper records are... supervision of agency records managers upon supersession of the record. Paper records are shredded using a...

  13. 76 FR 65535 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-21

    ... environment. Older records may be maintained in paper form. Paper records are stored in file folders within... properly authorized to assist in the conduct of an agency function related to these records. Paper records... Privacy Act of 1974; System of Records AGENCY: Federal Bureau of Investigation, Department of Justice...

  14. Patient access to medical records on a psychiatric inpatient unit.

    PubMed

    Stein, E J; Furedy, R L; Simonton, M J; Neuffer, C H

    1979-03-01

    The authors studied the effects of patient access to medical records during hospitalization in a psychiatric unit of a community general hospital. Questionnaires were completed by about 20 staff and 88 patients, and records were compared with those from an earlier period to note any changes in the written record. Patients reported feeling better informed and more involved in their treatment, and staff said that they became more thoughtful about their notes in the chart. The availability of staff seems crucial to this process and facilitates the working alliance.

  15. Patient Access to Their Health Record Using Open Source EHR.

    PubMed

    Chelsom, John; Dogar, Naveed

    2015-01-01

    In both Europe and North America, patients are beginning to gain access to their health records in electronic form. Using the open source cityEHR as an example, we have focussed on the needs of clinical users to gather requirements for patient access and have implemented these requirements in a new application called cityEHR-PA. The development of a separate application for patient access was necessary to address requirements for security and ease of use. The use of open standards throughout the design of the EHR allows the possibility of third parties to develop applications for patient access, consuming the individual patient record extracted from the full EHR.

  16. Effect of introduction of a new electronic anesthesia record (Epic) system on the safety and efficiency of patient care in a gastrointestinal endoscopy suite-comparison with historical cohort

    PubMed Central

    Goudra, B; Singh, PM; Borle, A; Gouda, G

    2016-01-01

    Background: Use of electronic medical record systems has increased in the recent years. Epic is one such system gaining popularity in the USA. Epic is a private company, which invented the electronic documentation system adopted in our hospital. In spite of many presumed advantages, its use is not critically analyzed. Some of the perceived advantages are increased efficiency and protection against litigation as a result of accurate documentation. Materials and Methods: In this study, retrospective data of 305 patients who underwent endoscopic retrograde cholangiopancreatography (wherein electronic charting was used - “Epic group”) were compared with 288 patients who underwent the same procedure with documentation saved on a paper chart (“paper group”). Time of various events involved in the procedure such as anesthesia start, endoscope insertion, endoscope removal, and transfer to the postanesthesia care unit were routinely documented. From this data, the various time durations were calculated. Results: Both “anesthesia start to scope insertion” times and “scope removal to transfer” times were significantly less in the Epic group compared to the paper group. Use of Epic system led to a saving of 4 min of procedure time per patient. However, the mean oxygen saturation was significantly less in the Epic group. Conclusion: In spite of perceived advantages of Epic documentation system, significant hurdles remain with its use. Although the system allows seamless flow of patients, failure to remove all artifacts can lead to errors and become a source of potential litigation hazard. PMID:27051360

  17. 75 FR 70342 - Privacy Act; System of Records: Equal Employment Opportunity Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-17

    ... Opportunity Records. SECURITY CLASSIFICATION: Unclassified. SYSTEM LOCATION: Department of State, 2201 C.... RETRIEVABILITY: By individual name. SAFEGUARDS: All users are given cyber security awareness training which... Act; System of Records: Equal Employment Opportunity Records SUMMARY: Notice is hereby given that the...

  18. 75 FR 42722 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-22

    ... 31793) Changes: * * * * * System location: Delete entry and replace with ``Intercontinental Ballistic... System name: Cable Affairs Personnel/Agency Records System location: Intercontinental Ballistic Missile...

  19. 77 FR 56628 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-13

    ..., retaining, and disposing of records in the system: Storage: Paper in file folders and electronic storage... disposal: Records are retained for 10 years and then destroyed. Paper records are destroyed by pulping...-0106] Privacy Act of 1974; System of Records AGENCY: National Security Agency/Central Security Service...

  20. 75 FR 38792 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-06

    ... storing, retrieving, accessing, retaining, and disposing of records in the system: Storage: Paper records... disposal: The paper records produced by this system will be reviewed to determine alert notification and acknowledgement times. The paper records produced will be shredded immediately after use and will not be retained...

  1. 8 CFR 103.34 - Security of records systems.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Security of records systems. 103.34 Section 103.34 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS POWERS AND DUTIES; AVAILABILITY OF RECORDS § 103.34 Security of records systems. The security of records...

  2. 8 CFR 103.34 - Security of records systems.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 8 Aliens and Nationality 1 2011-01-01 2011-01-01 false Security of records systems. 103.34 Section 103.34 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS POWERS AND DUTIES; AVAILABILITY OF RECORDS § 103.34 Security of records systems. The security of records...

  3. Patient-initiated electronic health record amendment requests

    PubMed Central

    Hanauer, David A; Preib, Rebecca; Zheng, Kai; Choi, Sung W

    2014-01-01

    Background and objective Providing patients access to their medical records offers many potential benefits including identification and correction of errors. The process by which patients ask for changes to be made to their records is called an ‘amendment request’. Little is known about the nature of such amendment requests and whether they result in modifications to the chart. Methods We conducted a qualitative content analysis of all patient-initiated amendment requests that our institution received over a 7-year period. Recurring themes were identified along three analytic dimensions: (1) clinical/documentation area, (2) patient motivation for making the request, and (3) outcome of the request. Results The dataset consisted of 818 distinct requests submitted by 181 patients. The majority of these requests (n=636, 77.8%) were made to rectify incorrect information and 49.7% of all requests were ultimately approved. In 6.6% of the requests, patients wanted valid information removed from their record, 27.8% of which were approved. Among all of the patients requesting a copy of their chart, only a very small percentage (approximately 0.2%) submitted an amendment request. Conclusions The low number of amendment requests may be due to inadequate awareness by patients about how to make changes to their records. To make this approach effective, it will be important to inform patients of their right to view and amend records and about the process for doing so. Increasing patient access to medical records could encourage patient participation in improving the accuracy of medical records; however, caution should be used. PMID:24863430

  4. 76 FR 81950 - Privacy Act; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-29

    ... HUMAN SERVICES Office of Inspector General Privacy Act; System of Records AGENCY: Office of Inspector General, HHS. ACTION: Notice of amendment to system of existing records. SUMMARY: In accordance with the... its Privacy Act system of records entitled ``Consolidated Data Repository'' (09-90-1000). This system...

  5. 78 FR 14297 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-05

    ... ``Paper records and electronic storage media.'' * * * * * System manager(s) and address: Delete entry and... Department of the Navy Privacy Act of 1974; System of Records AGENCY: Department of the Navy, DoD. ACTION: Notice to alter a System of Records. SUMMARY: The Department of the Navy proposes to alter a system of...

  6. 78 FR 5787 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-28

    ... Secretary of Defense established a new Privacy Act System of Records entitled ``Public Affairs Management Information System.'' This notice responds to comments received on the Privacy Act Systems of Records Notice...) 372-0461. SUPPLEMENTARY INFORMATION: The Privacy Act Systems of Records Notice was published...

  7. 77 FR 13573 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-07

    ...: Notice to delete thirteen systems of records. SUMMARY: The Department of the Army is deleting thirteen... Department of the Army proposes to delete thirteen systems of records notices from its inventory of record.../Division Personnel System (SIDPERS) (December 11, 2006, 71 FR 71537). Reason: The system at Army...

  8. 32 CFR 505.3 - Privacy Act systems of records.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 3 2011-07-01 2009-07-01 true Privacy Act systems of records. 505.3 Section 505... AND PUBLIC RELATIONS ARMY PRIVACY ACT PROGRAM § 505.3 Privacy Act systems of records. (a) Systems of... assigned to an individual. (2) Privacy Act systems of records must be— (i) Authorized by Federal statute...

  9. 32 CFR 505.3 - Privacy Act systems of records.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 3 2013-07-01 2013-07-01 false Privacy Act systems of records. 505.3 Section... AUTHORITIES AND PUBLIC RELATIONS ARMY PRIVACY ACT PROGRAM § 505.3 Privacy Act systems of records. (a) Systems... assigned to an individual. (2) Privacy Act systems of records must be— (i) Authorized by Federal statute...

  10. 78 FR 74122 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-10

    ... Department of the Air Force Privacy Act of 1974; System of Records AGENCY: Department of the Air Force, DoD... inventory of records systems subject to the Privacy Act of 1974, as amended. This system will be used to... notices for systems of records subject to the Privacy Act of 1974 (5 U.S.C. 552a(r)), as amended,...

  11. 75 FR 6000 - Privacy Act of 1974; Systems of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-05

    ... (NSA) is proposing to alter a system of records notice in its inventory of record systems subject to.... GNSA 15 SYSTEM NAME: NSA/CSS Computer Users Control System (February 22, 1993; 58 FR 10531). CHANGES... and access of NSA/CSS networks, computers, software, and databases. The records may also be used to...

  12. 78 FR 23810 - Privacy Act System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-22

    ... ADMINISTRATION Privacy Act System of Records AGENCY: Small Business Administration. ACTION: Notice of new Privacy... amending its Privacy Act Systems of Records to add a new System of Records to maintain the protected... Small Business Technology Transfer (STTR) Programs. DATES: Written comments on the system of...

  13. 75 FR 81247 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-27

    ... by government-wide system notice OPM/GOVT-1, General Personnel Records. DWHS B45 DoD Salary Offset... DoD Salary Offset Suspense Control Records system of records is also covered by the Defense Finance and Accounting System T7330a, Salary Offset Reporting System (November 14, 2007, 72 FR 64055)...

  14. 75 FR 81249 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-27

    ..., state and local agencies; educational institutions; and automated system interfaces. Exemptions claimed... Department of the Navy Privacy Act of 1974; System of Records AGENCY: U.S. Marine Corps, DoD. ACTION: Notice to Add a System of Records. SUMMARY: The U.S. Marine Corps proposes to add a system of records to...

  15. 75 FR 33792 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-06-15

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Intelligence Agency, DoD. ACTION: Notice to add a system of records. SUMMARY: The Defense Intelligence proposes to add a system of...) 231-1193. SUPPLEMENTARY INFORMATION: The Defense Intelligence Agency systems of records notices...

  16. 32 CFR 505.3 - Privacy Act systems of records.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... AND PUBLIC RELATIONS ARMY PRIVACY ACT PROGRAM § 505.3 Privacy Act systems of records. (a) Systems of... Register in a system of records notice, which will provide the public an opportunity to comment before DA... Register on new, amended, altered, or deleted systems of records to inform the public of the Privacy...

  17. 77 FR 56630 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-13

    ...-0108] Privacy Act of 1974; System of Records AGENCY: Defense Information Systems Agency, DoD. ACTION... system of records in its existing inventory of record systems subject to the Privacy Act of 1974 (5 U.S.C... Privacy Officer, Chief Information Office, 6916 Cooper Avenue, Fort Meade, MD 20755-7901, or by phone...

  18. 32 CFR 505.3 - Privacy Act systems of records.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 3 2014-07-01 2014-07-01 false Privacy Act systems of records. 505.3 Section... AUTHORITIES AND PUBLIC RELATIONS ARMY PRIVACY ACT PROGRAM § 505.3 Privacy Act systems of records. (a) Systems... assigned to an individual. (2) Privacy Act systems of records must be— (i) Authorized by Federal statute...

  19. 29 CFR 1611.3 - Procedures for requests pertaining to individual records in a record system.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Appeals), OPM/GOVT-10 (Employee Medical File System Records) and DOL/ESA-13 (Office of Workers... Financial Disclosure Reports and Other Ethics Program Records), OGE/GOVT-2 (Confidential Statements of...

  20. 29 CFR 1611.3 - Procedures for requests pertaining to individual records in a record system.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Appeals), OPM/GOVT-10 (Employee Medical File System Records) and DOL/ESA-13 (Office of Workers... Financial Disclosure Reports and Other Ethics Program Records), OGE/GOVT-2 (Confidential Statements of...

  1. 29 CFR 1611.3 - Procedures for requests pertaining to individual records in a record system.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Appeals), OPM/GOVT-10 (Employee Medical File System Records) and DOL/ESA-13 (Office of Workers... Financial Disclosure Reports and Other Ethics Program Records), OGE/GOVT-2 (Confidential Statements of...

  2. 29 CFR 1611.3 - Procedures for requests pertaining to individual records in a record system.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Appeals), OPM/GOVT-10 (Employee Medical File System Records) and DOL/ESA-13 (Office of Workers... Financial Disclosure Reports and Other Ethics Program Records), OGE/GOVT-2 (Confidential Statements of...

  3. 29 CFR 1611.3 - Procedures for requests pertaining to individual records in a record system.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Appeals), OPM/GOVT-10 (Employee Medical File System Records) and DOL/ESA-13 (Office of Workers... Financial Disclosure Reports and Other Ethics Program Records), OGE/GOVT-2 (Confidential Statements of...

  4. 11 CFR 9410.3 - Procedures for requests pertaining to individual records in a record system.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... IMPLEMENTATION OF THE PRIVACY ACT OF 1974 § 9410.3 Procedures for requests pertaining to individual records in a... in person or in writing at the location of the record system and to the person specified in...

  5. Keeping record of the postoperative nursing care of patients.

    PubMed

    Roets, L; Aucamp, M C; de Beer, H; Niemand, M

    2002-11-01

    The aim of this research project was to evaluate the record-keeping of postoperative nursing care. A total of 186 randomly selected patient records were evaluated in terms of a checklist that included the most important parameters for postoperative nursing care. All the patients underwent operations under general anaesthetic in one month in a Level 3 hospital and were transferred to general wards after the operations. The data collected was analysed by means of frequencies. One finding was that the neurological status of most patients was assessed but that little attention was paid in the patient records to emotional status and physical comfort. The respiratory and circulatory status of the patients and their fluid balance were inadequately recorded. The patients were well monitored for signs of external haemorrhage, but in most cases haemorrhage was checked only once, on return from the theatre. Although the patients' pain experience were well-monitored, follow-up actions after the administration of pharmacological agents was poor. The surgical intervention was fully described and, generally speaking, the records were complete and legible, but the signatures and ranks of the nurses were illegible. Allergies were indicated in the most important records. The researchers recommend that a comprehensive and easily usable documentation form be used in postoperative nursing care. Such a form would serve as a checklist and could ensure to a large degree that attention is given to the most important postoperative parameters. Errors and negligence could also be reduced by this means.

  6. [Video Instruction for Synchronous Video Recording of Mimic Movement of Patients with Facial Palsy].

    PubMed

    Schaede, Rebecca Anna; Volk, Gerd Fabian; Modersohn, Luise; Barth, Jodi Maron; Denzler, Joachim; Guntinas-Lichius, Orlando

    2017-05-03

    Photografy and video are necessary to record the severity of a facial palsy or to allow offline grading with a grading system. There is no international standard for the video recording urgently needed to allow a standardized comparison of different patient cohorts. A video instruction was developed. The instruction was shown to the patient and presents several mimic movements. At the same time the patient is recorded while repeating the presented movement using commercial hardware. Facial movements were selected in such a way that it was afterwards possible to evaluate the recordings with standard grading systems (House-Brackmann, Sunnybrook, Stennert, Yanagihara) or even with (semi)automatic software. For quality control, the patients evaluated the instruction using a questionnaire. The video instruction takes 11 min and 05 and is divided in 3 parts: 1) Explanation of the procedure; 2) Foreplay and recreating of the facial movements; 3) Repeating of sentences to analyze the communication skills. So far 13 healthy subjects and 10 patients with acute or chronic facial palsy were recorded. All recordings could be assessed by the above mentioned grading systems. The instruction was rated as well explaining and easy to follow by healthy persons and patients. There is now a video instruction available for standardized recording of facial movement. This instruction is recommended for use in clinical routine and in clinical trials. This will allow a standardized comparison of patients within Germany and international patient cohorts. © Georg Thieme Verlag KG Stuttgart · New York.

  7. The Health of the Computer-Based Patient Record.

    ERIC Educational Resources Information Center

    Frisse, Mark E.

    1992-01-01

    The newly incorporated Computer-Based Patient Record Institute (CPRI) is discussed in the context of the history of medical records, the need for change (mainly because of health care reimbursement and regulation), and the need for involvement by all medical professionals in the development of standards of data collection which reflect public…

  8. The Health of the Computer-Based Patient Record.

    ERIC Educational Resources Information Center

    Frisse, Mark E.

    1992-01-01

    The newly incorporated Computer-Based Patient Record Institute (CPRI) is discussed in the context of the history of medical records, the need for change (mainly because of health care reimbursement and regulation), and the need for involvement by all medical professionals in the development of standards of data collection which reflect public…

  9. Hazard Ranking System (HRS) documentation record training

    SciTech Connect

    Not Available

    1994-01-01

    Documentation Record Training Course Agenda: Introduction; Review and organization of site information; Writing the documentation record; Overview of the NPL listing process; Quality assurance and public comment review; and Conclusion.

  10. Patient ECG recording control for an automatic implantable defibrillator

    NASA Technical Reports Server (NTRS)

    Fountain, Glen H. (Inventor); Lee, Jr., David G. (Inventor); Kitchin, David A. (Inventor)

    1986-01-01

    An implantable automatic defibrillator includes sensors which are placed on or near the patient's heart to detect electrical signals indicative of the physiology of the heart. The signals are digitally converted and stored into a FIFO region of a RAM by operation of a direct memory access (DMA) controller. The DMA controller operates transparently with respect to the microprocessor which is part of the defibrillator. The implantable defibrillator includes a telemetry communications circuit for sending data outbound from the defibrillator to an external device (either a patient controller or a physician's console or other) and a receiver for sensing at least an externally generated patient ECG recording command signal. The patient recording command signal is generated by the hand held patient controller. Upon detection of the patient ECG recording command, DMA copies the contents of the FIFO into a specific region of the RAM.

  11. Audio-visual recording in the surgery: do patients mind?

    PubMed Central

    Campbell, I. K.

    1982-01-01

    The results of questionnaires completed by 145 patients following audio-visual recording of their consultations are analysed. It is concluded that the technique is well accepted and non-intrusive. ImagesFigure 1.Figure 2. PMID:7143315

  12. 77 FR 29619 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-18

    ... system: Name, Social Security Number (SSN), gender, race/ethnicity, birth date, place of birth, home..., address, phone number, email address), medical information, military records, and education information..., accessing, retaining, and disposing of records in the system: Storage: Electronic storage...

  13. Challenges and methodology for indexing the computerized patient record.

    PubMed

    Ehrler, Frédéric; Ruch, Patrick; Geissbuhler, Antoine; Lovis, Christian

    2007-01-01

    Patient records contain most crucial documents for managing the treatments and healthcare of patients in the hospital. Retrieving information from these records in an easy, quick and safe way helps care providers to save time and find important facts about their patient's health. This paper presents the scalability issues induced by the indexing and the retrieval of the information contained in the patient records. For this study, EasyIR, an information retrieval tool performing full text queries and retrieving the related documents has been used. An evaluation of the performance reveals that the indexing process suffers from overhead consequence of the particular structure of the patient records. Most IR tools are designed to manage very large numbers of documents in a single index whereas in our hypothesis, one index per record, which usually implies few documents, has been imposed. As the number of modifications and creations of patient records are significant in a day, using a specialized and efficient indexation tool is required.

  14. Shared Electronic Health Record Systems: Key Legal and Security Challenges.

    PubMed

    Christiansen, Ellen K; Skipenes, Eva; Hausken, Marie F; Skeie, Svein; Østbye, Truls; Iversen, Marjolein M

    2017-05-01

    Use of shared electronic health records opens a whole range of new possibilities for flexible and fruitful cooperation among health personnel in different health institutions, to the benefit of the patients. There are, however, unsolved legal and security challenges. The overall aim of this article is to highlight legal and security challenges that should be considered before using shared electronic cooperation platforms and health record systems to avoid legal and security "surprises" subsequent to the implementation. Practical lessons learned from the use of a web-based ulcer record system involving patients, community nurses, GPs, and hospital nurses and doctors in specialist health care are used to illustrate challenges we faced. Discussion of possible legal and security challenges is critical for successful implementation of shared electronic collaboration systems. Key challenges include (1) allocation of responsibility, (2) documentation routines, (3) and integrated or federated access control. We discuss and suggest how challenges of legal and security aspects can be handled. This discussion may be useful for both current and future users, as well as policy makers.

  15. The Regenstrief Medical Record System: a quarter century experience.

    PubMed

    McDonald, C J; Overhage, J M; Tierney, W M; Dexter, P R; Martin, D K; Suico, J G; Zafar, A; Schadow, G; Blevins, L; Glazener, T; Meeks-Johnson, J; Lemmon, L; Warvel, J; Porterfield, B; Warvel, J; Cassidy, P; Lindbergh, D; Belsito, A; Tucker, M; Williams, B; Wodniak, C

    1999-06-01

    Entrusted with the records for more than 1.5 million patients, the Regenstrief Medical Record System (RMRS) has evolved into a fast and comprehensive data repository used extensively at three hospitals on the Indiana University Medical Center campus and more than 30 Indianapolis clinics. The RMRS routinely captures laboratory results, narrative reports, orders, medications, radiology reports, registration information, nursing assessments, vital signs, EKGs and other clinical data. In this paper, we describe the RMRS data model, file structures and architecture, as well as recent necessary changes to these as we coordinate a collaborative effort among all major Indianapolis hospital systems, improving patient care by capturing city-wide laboratory and encounter data. We believe that our success represents persistent efforts to build interfaces directly to multiple independent instruments and other data collection systems, using medical standards such as HL7, LOINC, and DICOM. Inpatient and outpatient order entry systems, instruments for visit notes and on-line questionnaires that replace hardcopy forms, and intelligent use of coded data entry supplement the RMRS. Physicians happily enter orders, problems, allergies, visit notes, and discharge summaries into our locally developed Gopher order entry system, as we provide them with convenient output forms, choice lists, defaults, templates, reminders, drug interaction information, charge information, and on-line articles and textbooks. To prepare for the future, we have begun wrapping our system in Web browser technology, testing voice dictation and understanding, and employing wireless technology.

  16. Engaging primary care patients to use a patient-centered personal health record.

    PubMed

    Krist, Alex H; Woolf, Steven H; Bello, Ghalib A; Sabo, Roy T; Longo, Daniel R; Kashiri, Paulette; Etz, Rebecca S; Loomis, John; Rothemich, Stephen F; Peele, J Eric; Cohn, Jeffrey

    2014-01-01

    Health care leaders encourage clinicians to offer portals that enable patients to access personal health records, but implementation has been a challenge. Although large integrated health systems have promoted use through costly advertising campaigns, other implementation methods are needed for small to medium-sized practices where most patients receive their care. We conducted a mixed methods assessment of a proactive implementation strategy for a patient portal (an interactive preventive health record [IPHR]) offered by 8 primary care practices. The practices implemented a series of learning collaboratives with practice champions and redesigned workflow to integrate portal use into care. Practice implementation strategies, portal use, and factors influencing use were assessed prospectively. A proactive and customized implementation strategy designed by practices resulted in 25.6% of patients using the IPHR, with the rate increasing 1.0% per month over 31 months. Fully 23.5% of IPHR users signed up within 1 day of their office visit. Older patients and patients with comorbidities were more likely to use the IPHR, but blacks and Hispanics were less likely. Older age diminished as a factor after adjusting for comorbidities. Implementation by practice varied considerably (from 22.1% to 27.9%, P <.001) based on clinician characteristics and workflow innovations adopted by practices to enhance uptake. By directly engaging patients to use a portal and supporting practices to integrate use into care, primary care practices can match or potentially surpass the usage rates achieved by large health systems. © 2014 Annals of Family Medicine, Inc.

  17. Engaging Primary Care Patients to Use a Patient-Centered Personal Health Record

    PubMed Central

    Krist, Alex H.; Woolf, Steven H.; Bello, Ghalib A.; Sabo, Roy T.; Longo, Daniel R.; Kashiri, Paulette; Etz, Rebecca S.; Loomis, John; Rothemich, Stephen F.; Peele, J. Eric; Cohn, Jeffrey

    2014-01-01

    PURPOSE Health care leaders encourage clinicians to offer portals that enable patients to access personal health records, but implementation has been a challenge. Although large integrated health systems have promoted use through costly advertising campaigns, other implementation methods are needed for small to medium-sized practices where most patients receive their care. METHODS We conducted a mixed methods assessment of a proactive implementation strategy for a patient portal (an interactive preventive health record [IPHR]) offered by 8 primary care practices. The practices implemented a series of learning collaboratives with practice champions and redesigned workflow to integrate portal use into care. Practice implementation strategies, portal use, and factors influencing use were assessed prospectively. RESULTS A proactive and customized implementation strategy designed by practices resulted in 25.6% of patients using the IPHR, with the rate increasing 1.0% per month over 31 months. Fully 23.5% of IPHR users signed up within 1 day of their office visit. Older patients and patients with comorbidities were more likely to use the IPHR, but blacks and Hispanics were less likely. Older age diminished as a factor after adjusting for comorbidities. Implementation by practice varied considerably (from 22.1% to 27.9%, P <.001) based on clinician characteristics and workflow innovations adopted by practices to enhance uptake. CONCLUSIONS By directly engaging patients to use a portal and supporting practices to integrate use into care, primary care practices can match or potentially surpass the usage rates achieved by large health systems. PMID:25354405

  18. 77 FR 18205 - Privacy Act System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-27

    ... amended Privacy Act System of Records: COMMERCE/ CENSUS-4, Economic Survey Collection. SUMMARY: In order... effective date of a Privacy Act System of Records notice titled, ``COMMERCE/CENSUS-4, Economic Survey..., Economic Survey Collection.'' The amendment serves to generally update the system of records by updating...

  19. 77 FR 11534 - Privacy Act of 1974; Systems of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-27

    ... INVESTMENT BOARD Privacy Act of 1974; Systems of Records AGENCY: Federal Retirement Thrift Investment Board. ACTION: Notice of revision to existing systems of records. SUMMARY: The Federal Retirement Thrift Investment Board (Agency) is proposing to revise its Privacy Act Systems of Records to reflect the...

  20. 75 FR 10476 - Privacy Act of 1974; Systems of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-08

    ... of the Secretary Privacy Act of 1974; Systems of Records AGENCY: Defense Logistics Agency, DoD. ACTION: Notice to delete a system of records. SUMMARY: The Defense Logistics Agency proposes to delete a... Sinkler at (703) 767-5045. SUPPLEMENTARY INFORMATION: The Defense Logistics Agency systems of records...

  1. 75 FR 47797 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-09

    ... Defense Logistics Agency Privacy Act of 1974; System of Records AGENCY: Defense Logistics Agency, DoD. ACTION: Notice to delete a system of records. ] SUMMARY: The Defense Logistics Agency proposes to delete... Defense Logistics Agency systems of records notices subject to the Privacy Act of 1974, (5 U.S.C. 552a...

  2. 75 FR 17910 - Privacy Act of 1974; Systems of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-08

    ... of the Secretary Privacy Act of 1974; Systems of Records AGENCY: Defense Logistics Agency, DoD. ACTION: Notice to delete a system of records. SUMMARY: The Defense Logistics Agency proposes to delete a... Logistics Agency systems of records notices subject to the Privacy Act of 1974, (5 U.S.C. 552a), as amended...

  3. 76 FR 43278 - Privacy Act; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-20

    .... The Board has created a new system, DNFSB-9, Occupational Beryllium Exposure Records, but the creation... OF THE ACT: None. DNFSB-9 SYSTEM NAME: Occupational Beryllium Exposure Records. SECURITY... and contractors. CATEGORIES OF RECORDS IN THE SYSTEM: Occupational beryllium exposure information...

  4. 22 CFR 1507.7 - Contents of records systems.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...) Publish a notice in the Federal Register of any new or revised use of the information in the system or... 22 Foreign Relations 2 2013-04-01 2009-04-01 true Contents of records systems. 1507.7 Section 1507... Contents of records systems. (a) The Foundation will maintain in its records only such information about an...

  5. 22 CFR 1507.7 - Contents of records systems.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...) Publish a notice in the Federal Register of any new or revised use of the information in the system or... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Contents of records systems. 1507.7 Section....7 Contents of records systems. (a) The Foundation will maintain in its records only such information...

  6. 75 FR 78688 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-16

    ..., Millington, TN 38054-5045 for records of all active duty and reserve members. Primary locations: Personnel... 456, Millington, TN 38054-5045 for records of all active duty and reserve members. Primary locations... Records System, Enlisted Master File Automated System, Officer Master File Automated System, Reserve...

  7. 77 FR 74282 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-13

    ... existing system of records ``Loan Guaranty Home, Condominium and Manufactured Home Loan Applicants Records... to amend its system of records entitled ``Loan Guaranty Home, Condominium and Manufactured Home Loan... revised to add a new Routine Use Number 35 as follows: 55VA26 System name: Loan Guaranty Home,...

  8. 77 FR 15038 - Amendment to Privacy Act System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-14

    ...- 2697, on January 19, 2012. DATES: The system of records becomes effective on March 14, 2012... Amendment to Privacy Act System of Records AGENCY: Office of Inspector General (OIG), Department of Commerce. ACTION: Notice; COMMERCE/DEPT-12, OIG Investigative Records. SUMMARY: In order to update the system of...

  9. 75 FR 27294 - Privacy Act System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-14

    ... (Commerce) publishes this notice to announce the effective date of a Privacy Act System of Records notice entitled COMMERCE/CENSUS-5, Decennial Census Program. DATES: The system of records becomes effective on May... Privacy Act System of Records AGENCY: U.S. Census Bureau, Department of Commerce. ACTION: Notice of...

  10. 78 FR 40447 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-05

    ..., DoD. ACTION: Notice to amend a System of Records. SUMMARY: The Office of the Inspector General is amending a system of records notice in its existing inventory of record systems subject to the Privacy Act... unless comments are received which result in a contrary determination. Comments will be accepted on or...

  11. 5 CFR 2606.103 - Systems of records.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Senate confirmation, candidates for a position, and former employees. (b) OGE Internal systems of records. The Office of Government Ethics internal systems of records are under OGE's physical custody and... matters relating to the internal management of the Office. These systems of records consist of the...

  12. 13 CFR 102.33 - Security of systems of records.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Security of systems of records....33 Security of systems of records. (a) Each Program/Support Office Head or designee shall establish administrative and physical controls to prevent unauthorized access to its systems of records, to...

  13. 13 CFR 102.33 - Security of systems of records.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Security of systems of records....33 Security of systems of records. (a) Each Program/Support Office Head or designee shall establish administrative and physical controls to prevent unauthorized access to its systems of records, to...

  14. 76 FR 114 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-03

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Contract Audit Agency, DoD. ACTION: Notice to amend a system of records. SUMMARY: The Defense Contract Audit Agency is proposing to..., VA 22060-6219. SUPPLEMENTARY INFORMATION: The Defense Contract Audit Agency systems of records...

  15. 76 FR 115 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-03

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Contract Audit Agency, DoD. ACTION: Notice to amend a system of records. SUMMARY: The Defense Contract Audit Agency is proposing to..., VA 22060-6219. SUPPLEMENTARY INFORMATION: The Defense Contract Audit Agency systems of records...

  16. 21 CFR 820.186 - Quality system record.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Quality system record. 820.186 Section 820.186 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES QUALITY SYSTEM REGULATION Records § 820.186 Quality system record. Each manufacturer...

  17. 77 FR 37885 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-25

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Threat Reduction Agency, DoD. ACTION: Notice to Delete a System of Records. SUMMARY: The Defense Threat Reduction Agency is deleting a...) 767-1771. SUPPLEMENTARY INFORMATION: The Defense Threat Reduction Agency systems of records...

  18. 77 FR 69443 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-19

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Threat Reduction Agency, DoD... two systems of records notices in its existing inventory of record systems subject to the Privacy Act... available for public viewing on the Internet at http://www.regulations.gov as they are received without...

  19. 75 FR 65456 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-25

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Department of Defense (DoD). ACTION... a system of records notice from its existing inventory of record systems subject to the Privacy Act... of the public is to make these submissions available for public viewing on the Internet at http://www...

  20. 76 FR 10008 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-23

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Office of the Secretary, DoD. ACTION... system of records notice from its existing inventory of record systems subject to the Privacy Act of 1974... submissions available for public viewing on the Internet at http://www.regulations.gov as they are ] received...

  1. 78 FR 60265 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-01

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Office of the Secretary, DoD. ACTION... systems of record notice from its existing inventory of record systems subject to the Privacy Act of 1974... members of the public is to make these submissions available for public viewing on the Internet at http...

  2. 77 FR 77048 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-31

    ... Office of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Contract Audit Agency, DoD... system of records notice in its existing inventory of record systems subject to the Privacy Act of 1974... on the Internet at http://www.regulations.gov as they are received without change, including any...

  3. 75 FR 78683 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-16

    ... of the Secretary Privacy Act of 1974; System of Records Agency: Office of the Secretary, DoD. Action... systems of record notice from its existing inventory of record systems subject to the Privacy Act of 1974... available for public viewing on the Internet at http://www.regulations.gov as they are received without...

  4. 77 FR 26261 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-03

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Office of the Defense Logistics... to alter a system of records in its inventory of record systems subject to the Privacy Act of 1974 (5... public is to make these submissions available for public viewing on the Internet at http://www...

  5. 77 FR 37004 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-20

    ...] Privacy Act of 1974; System of Records AGENCY: National Geospatial-Intelligence Agency, DoD. ACTION... establishing a new system of records in its inventory of record systems subject to the Privacy Act of 1974 (5 U... submissions available for public viewing on the Internet at http://www.regulations.gov as they are received...

  6. 76 FR 10010 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-23

    ... Office of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Intelligence Agency, DoD. ACTION: Notice to Delete a System of Records. SUMMARY: The Defense Intelligence Agency proposes to delete..., DC 20340. SUPPLEMENTARY INFORMATION: The Defense Intelligence Agency systems of records...

  7. 75 FR 81247 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-27

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Intelligence Agency, DoD. ACTION: Notice to delete a system of records. SUMMARY: The Defense Intelligence Agency proposes to delete...-1193. SUPPLEMENTARY INFORMATION: The Defense Intelligence Agency systems of records notices subject to...

  8. 75 FR 43497 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-26

    ... Office of the Secretary Privacy Act of 1974; System of Records AGENCY: National Geospatial-Intelligence...-Intelligence Agency (NGA) proposes to add a system of records to its inventory of record systems subject to the...: Mr. John Eller at 703-453-3808. SUPPLEMENTARY INFORMATION: The National Geospatial-Intelligence...

  9. 77 FR 15086 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-14

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Intelligence Agency, DoD. ] ACTION: Notice to Delete a System of Records. SUMMARY: The Defense Intelligence Agency is deleting a... Defense Intelligence Agency systems of records notices subject to the Privacy Act of 1974 (5 U.S.C. 552a...

  10. 75 FR 65060 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-21

    ... AFFAIRS Privacy Act of 1974; System of Records AGENCY: Department of Veterans Affairs (VA). ACTION: Notice of Establishment of New System of Records. SUMMARY: The Privacy Act of 1974 (5 U.S.C. 552(e) (4... systems of records. Notice is hereby given that the Department of Veterans Affairs (VA) is establishing...

  11. 75 FR 26851 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-12

    ...] [FR Doc No: 2010-11349] DEPARTMENT OF VETERANS AFFAIRS Privacy Act of 1974; System of Records AGENCY: Department of Veterans Affairs (VA). ACTION: Notice of amendment to System of Records. SUMMARY: As required... Affairs (VA) is amending the system of records currently entitled ``Veterans Canteen Service (VCS)...

  12. 77 FR 39346 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-02

    ... records in this system of records in legal proceedings before a court or administrative body after... Children and Families, Department of Health and Human Services Federal Parent Locator System (FPLS) for the... AFFAIRS Privacy Act of 1974; System of Records AGENCY: Department of Veterans Affairs. ACTION: Notice...

  13. 78 FR 27194 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-09

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Finance and Accounting Service, DoD. ACTION: Notice to delete two Systems of Records. SUMMARY: The Defense Finance and Accounting...--Accounting (DTRS-A) Records (October 1, 2008, 73 FR 57070) Reason: System was retired and replaced by T7225a...

  14. 78 FR 14280 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-05

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Office of the Secretary of Defense, DoD. ACTION: Notice to alter a System of Records. SUMMARY: The Defense Finance and Accounting Service.... SUPPLEMENTARY INFORMATION: The Defense Finance and Accounting Service notices for systems of records subject to...

  15. 78 FR 47309 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-05

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Finance and Accounting Service, DoD. ACTION: Notice to amend a System of Records. SUMMARY: The Defense Finance and Accounting...-4591. SUPPLEMENTARY INFORMATION: The Defense Finance and Accounting Service systems of records notices...

  16. 78 FR 14283 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-05

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Office of the Secretary of Defense, DoD. ] ACTION: Notice to alter a system of records. SUMMARY: The Defense Finance and Accounting.... SUPPLEMENTARY INFORMATION: The Defense Finance and Accounting Service notices for systems of records subject to...

  17. 78 FR 14286 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-05

    ..., DoD. ACTION: Notice to amend a System of Records. SUMMARY: The Defense Finance and Accounting Service... INFORMATION: The Defense Finance and Accounting Service notices for systems of records subject to the Privacy... themselves contained in this record system should address written inquiries to Defense Finance and Accounting...

  18. 75 FR 61450 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-05

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Finance and Accounting Service; DoD. ACTION: Notice to add a system of records. SUMMARY: The Defense Finance and Accounting.... SUPPLEMENTARY INFORMATION: The Defense Finance and Accounting Service notices for systems of records subject to...

  19. 78 FR 69392 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-19

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Finance and Accounting Service, DoD. ACTION: Notice to delete a system of records. SUMMARY: The Defense Finance and Accounting.... SUPPLEMENTARY INFORMATION: The Defense Finance and Accounting Service systems of records notices subject to the...

  20. 76 FR 79216 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-21

    ... Privacy Act of 1974; System of Records AGENCY: Federal Bureau of Prisons, Department of Justice. ACTION: Notice of Modification of a System of Records. SUMMARY: Pursuant to the Privacy Act of 1974 (5 U.S.C... Bureau clarifies that the records contained in this system may be located at any authorized location,...

  1. 78 FR 14292 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-05

    ... Department of the Air Force Privacy Act of 1974; System of Records AGENCY: Department of the Air Force, DoD... system of records notice in its existing inventory of records systems subject to the Privacy Act of 1974..., Department of the Air Force Privacy Office, Air Force Privacy Act Office, Office of Warfighting...

  2. 75 FR 21264 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-23

    ... Management Information System Records System location: Software Engineering Center, Functional Processing... Management Information System will be used to automate the Army's Food Service Program. The system... should address written inquiries to Army Food Management Information System, Supervisor, 401 First...

  3. Patient experiences at primary care practices using electronic health records.

    PubMed

    De Leon, Samantha F; Silfen, Sheryl L; Wang, Jason J; Kamara, Taafoi S; Wu, Winfred Y; Shih, Sarah C

    2012-01-01

    We assessed patient experiences before and one year after electronic health record (EHR) implementation among primary care practices in New York City. These practices represented an ethnically diverse population in lower-income, urban communities. Surveys, available in English, Spanish, and Chinese languages, were administered at 10 sites. Generally, patients reported positive responses during both periods. After EHR implementation, patients were more likely to want e-mail communication with their doctors' office. The 70% of patients with Internet access were generally more satisfied with their experience and more likely to recognize benefits of EHRs. However, older patients and those with lower education levels or chronic diseases were significantly less likely than their counterparts to use the Internet. Therefore, disparities in Internet access could potentially lead to unequal access and use of healthcare if not addressed. Practices should routinely record patient communication preferences within the EHR, to tailor communications and improve patient experiences.

  4. From medical record to patient record through electronic data interchange (EDI).

    PubMed

    Kinkhorst, O M; Lalleman, A W; Hasman, A

    1996-07-01

    In this contribution the role of Electronic Data Interchange (EDI) for patient records is discussed. It is our opinion that unlimited access to patient records of different care provides is not a wise thing to do and may even not be acceptable legally. The exchange of EDI messages may be a solution in that the relevant information is exchanged on a need to know basis under the responsibility of the care provider that generated the information. The state of the art with respect to the availability of EDI messages in Europe is presented.

  5. 75 FR 76432 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-08

    ... and replace with ``Paper records are maintained in security containers with access only to officials..., ACCESSING, RETAINING, AND DISPOSING OF RECORDS IN THE SYSTEM: STORAGE: Paper records in file folders and..., and Freedom of Information Act request case number. SAFEGUARDS: Paper records are maintained in...

  6. 77 FR 74878 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-18

    ...: Paper records maintained in file folders at the Commission's office and electronic records located on... identification of a claim by claimants' name. SAFEGUARDS: Paper records are under security safeguards at the... Foreign Claims Settlement Commission of the United States Privacy Act of 1974; System of Records AGENCY...

  7. Confidentiality of Substance Use Disorder Patient Records. Final rule.

    PubMed

    2017-01-18

    The Department of Health and Human Services (HHS) is issuing this final rule to update and modernize the Confidentiality of Alcohol and Drug Abuse Patient Records regulations and facilitate information exchange within new health care models while addressing the legitimate privacy concerns of patients seeking treatment for a substance use disorder. These modifications also help clarify the regulations and reduce unnecessary burden.

  8. 75 FR 4632 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-28

    ... records entitled ``Veterans and ] Dependents (Living and Deceased) National Cemetery System Correspondence... the National Cemetery Administration's (NCA) Memorial Programs. VA no longer maintains the System...

  9. 77 FR 74176 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-13

    ... cabinets. Those in computer storage devices are protected by computer system software.'' Retention and..., macerating, or burning. Computer records are destroyed by erasing, deleting or overwriting.'' System...

  10. 44 CFR 6.6 - Safeguarding systems of records.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... systems of records. (a) Systems managers shall ensure that appropriate administrative, technical, and..., training, special qualification, and skills, performance appraisals, and conduct, shall be stored in a...

  11. The Accuracy of Recording Patient Problems in Family Practice

    ERIC Educational Resources Information Center

    Bentsen, Bent Gutterm

    1976-01-01

    Reports studies of the validity of medical data recorded and computerized at University of Western Ontario family medical centers. In the 59 encounters observed residents recorded an average of 1.51 problems and observers 2.45. Implications for medical education, audit, research, computer systems, and quality of care are discussed. (JT)

  12. 76 FR 13994 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-15

    ... Source Corporate Management Information System (OS-CMIS), which is covered by OPM/GOVT-1 General... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Information Systems Agency, DoD. ACTION: Notice to delete a system of records. SUMMARY: The Defense Information Systems Agency...

  13. 78 FR 43866 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-22

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Information Systems Agency, DoD. ACTION: Notice to delete a System of Records notice. SUMMARY: The Defense Information Systems... the instructions for submitting comments. * Mail: Federal Docket Management System Office, 4800...

  14. 77 FR 56821 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-14

    ... replace with ``None.'' N07250-1 System name: Navy Cash Financial System (June 29, 2012, 77 FR 38782... Department of the Navy Privacy Act of 1974; System of Records AGENCY: Department of the Navy, DoD. ACTION: Notice to amend two Systems of Records. SUMMARY: The Department of the Navy is amending two systems of...

  15. 78 FR 79412 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-30

    ... alter a System of Records. SUMMARY: The Defense Finance and Accounting Service proposes to alter a system of records, T7205, General Accounting and Finance System--Report Database for Financial Statements.... T7205 System name: General Accounting and Finance System, Report Database for Financial Statements (June...

  16. Patient-held records for undocumented immigrants: a blind spot. A systematic review of patient-held records.

    PubMed

    Schoevers, M A; van den Muijsenbergh, M E T C; Lagro-Janssen, A L M

    2009-10-01

    As a result of inadequate medical record information, the medical care for undocumented immigrants in general practice is time consuming and often unsatisfactory. The availability of medical record information might improve the medical care for undocumented immigrants. Therefore, we executed a systematic review of literature to investigate the potential benefits of a patient-held record (PHR) for undocumented immigrants. We searched MEDLINE, EMBASE, PSYCH info and the Cochrane database of systematic reviews. Search terms were: patient-held medical records, client-held medical records, PHRs, client-held records, home-based medical record, medical passport and/or illegal immigrants, and undocumented immigrants. Inclusion criteria were: information on patient and/or doctors compliance of PHRs OR information about views of patient and/or doctors on PHRs and age over 18 years. Two independent reviewers assessed the methodological quality of the selected articles. No studies were found about undocumented immigrants and PHRs. Therefore, we decided to eliminate the search terms illegal immigrants, and undocumented immigrants, and perform a broader search about the use of PHRs in general. This search yielded 61 articles; 42 articles were excluded. Sixteen articles were screened for methodological quality: seven articles met the criteria, six quantitative studies and one qualitative study. In these studies the use and appreciation of PHRs by patients is satisfactory. The use and appreciation of the PHRs by physicians in the studies is lower than the use by patients. The most important obstacle for physicians is the time investment required. A PHR for undocumented immigrants seems to be appropriate because in most cases there is no other record available. However, the uncertainty of our findings is considerable. Therefore, we recommend a pilot evaluation of the use of PHRs for undocumented immigrants. In addition, a qualitative approach might be useful to solicit the views of

  17. Cognitive Analysis of the Summarization of Longitudinal Patient Records

    PubMed Central

    Reichert, Daniel; Kaufman, David; Bloxham, Benjamin; Chase, Herbert; Elhadad, Noémie

    2010-01-01

    Electronic health records contain an abundance of valuable information that can be used to guide patient care. However, the large volume of information embodied in these records also renders access to relevant information a time-consuming and inefficient process. Our ultimate objective is to develop an automated summarizer that succinctly captures all relevant information in the patient record. In this paper, we present a cognitive study of 8 clinicians who were asked to create summaries based on data contained in the patients’ electronic health record. The study characterized the primary sources of information that were prioritized by clinicians, the temporal strategies used to develop a summary and the cognitive operations used to guide the summarization process. Although we would not expect the automated summarizer to emulate human performance, we anticipate that this study will inform its development in instrumental ways. PMID:21347062

  18. 76 FR 72391 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-23

    ... authorized web access to DMDC computer systems and databases.'' Categories of records in the system: Delete... financial data as required for security background investigations. Criminal history information on... records provided by OPM for approved computer matching. Non-appropriated fund employment/personnel records...

  19. 76 FR 54743 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-02

    ... Department of the Army Privacy Act of 1974; System of Records AGENCY: Department of the Army, Department of Defense (DoD). ACTION: Notice to Add a System of Records. SUMMARY: The Department of the Army proposes to.... Leroy Jones, Department of the Army, Privacy Office, U.S. Army Records Management and...

  20. 76 FR 66916 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-28

    ... the system: Storage: Paper records in file folders and electronic storage media. Retrievability... agency, or any combination of fields. Safeguards: Paper records are maintained in Defense Security vault... Office of the Secretary Privacy Act of 1974; System of Records AGENCY: Office of the Secretary...

  1. 78 FR 5791 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-28

    ....'' * * * * * Retention and disposal: Delete entry and replace with ``The paper records produced by this system will be reviewed to determine alert notification and acknowledgement times. The paper records produced will be... Department of the Air Force Privacy Act of 1974; System of Records AGENCY: Department of the Air Force, DoD...

  2. 75 FR 38494 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-02

    ... system: Storage: Paper and electronic records. Retrievability: By last name and Social Security Number... years and then destroyed. Paper records are authorized for destruction in accordance with agency... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Intelligence Agency, DoD...

  3. 77 FR 15360 - Privacy Act of 1974; Systems of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-15

    ...: Delete entry and replace with ``Paper records in file folders and electronic storage media... of the Secretary Privacy Act of 1974; Systems of Records AGENCY: National Security Agency/Central Security Service, DoD. ACTION: Notice to Amend a System of Records. SUMMARY: The National Security Agency...

  4. 78 FR 14287 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-05

    ... 58106). Paper records previously maintained by AFPC were destroyed by tearing into pieces, shredding... Department of the Air Force Privacy Act of 1974; System of Records AGENCY: Department of the Air Force, DoD. ACTION: Notice to delete a System of Records. SUMMARY: The Department of the Air Force is deleting a...

  5. 77 FR 18205 - Privacy Act System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-27

    ..., Individual and Household Statistical Surveys and Special Studies Records.'' The notice of proposed amendment... amended Privacy Act System of Records: COMMERCE/ CENSUS-3, Special Censuses, Surveys, and Other Studies... the Privacy Act System of Records titled, ``COMMERCE/CENSUS-3, Individual and Household...

  6. 6 CFR 5.31 - Security of systems of records.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 6 Domestic Security 1 2011-01-01 2011-01-01 false Security of systems of records. 5.31 Section 5.31 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY DISCLOSURE OF RECORDS AND INFORMATION Privacy Act § 5.31 Security of systems of records. (a) In general. Each...

  7. 6 CFR 5.31 - Security of systems of records.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 6 Domestic Security 1 2010-01-01 2010-01-01 false Security of systems of records. 5.31 Section 5.31 Domestic Security DEPARTMENT OF HOMELAND SECURITY, OFFICE OF THE SECRETARY DISCLOSURE OF RECORDS AND INFORMATION Privacy Act § 5.31 Security of systems of records. (a) In general. Each...

  8. 28 CFR 700.24 - Security of systems of records.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Security of systems of records. 700.24... Records Under the Privacy Act of 1974 § 700.24 Security of systems of records. (a) The Office Administrator or Security Officer shall be responsible for issuing regulations governing the security of...

  9. 28 CFR 700.24 - Security of systems of records.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Security of systems of records. 700.24... Records Under the Privacy Act of 1974 § 700.24 Security of systems of records. (a) The Office Administrator or Security Officer shall be responsible for issuing regulations governing the security of...

  10. 1 CFR 304.29 - Security of systems of records.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 1 General Provisions 1 2012-01-01 2012-01-01 false Security of systems of records. 304.29 Section 304.29 General Provisions ADMINISTRATIVE CONFERENCE OF THE UNITED STATES DISCLOSURE OF RECORDS OR... Security of systems of records. (a) Administrative and physical controls. The agency will...

  11. 77 FR 51949 - Privacy Act, Exempt Record System

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-28

    ... Research Misconduct Proceedings, HHS/FDA/OC.'' HHS/FDA proposes to exempt this system of records from certain requirements of the Privacy Act to protect the integrity of FDA's scientific misconduct inquiries... a new system of records called the ``FDA Records Related to Research Misconduct Proceedings.''...

  12. 75 FR 29818 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-27

    .... VA may disclose information from this system of records to the Department of Justice (DoJ), either on... components in legal proceedings before a court or each case, the agency also determines prior to disclosure... records in this system of records in legal proceedings before a court or administrative body...

  13. 77 FR 26260 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-03

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Logistics Agency, DoD. ACTION... records in its inventory of record systems subject to the Privacy Act of 1974 (5 U.S.C. 552a), as amended... available for public viewing on the Internet at http://www.regulations.gov as they are received without...

  14. 77 FR 21755 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-11

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Logistics Agency, DoD. ACTION... of records in its inventory of record systems subject to the Privacy Act of 1974 (5 U.S.C. 552a), as... available for public viewing on the Internet at http://www.regulations.gov as they are received without...

  15. 78 FR 22854 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-17

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Logistics Agency, DoD. ACTION... records in its inventory of record systems subject to the Privacy Act of 1974 (5 U.S.C. 552a), as amended... members of the public is to make these submissions available for public viewing on the Internet at http...

  16. 22 CFR 1507.7 - Contents of records systems.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Contents of records systems. 1507.7 Section 1507.7 Foreign Relations AFRICAN DEVELOPMENT FOUNDATION RULES SAFEGUARDING PERSONAL INFORMATION § 1507.7 Contents of records systems. (a) The Foundation will maintain in its records only such information about an...

  17. 76 FR 39389 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-06

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Logistics Agency, DoD. ACTION... of records notice in its existing inventory of record systems subject to the Privacy Act of 1974 (5 U.... Jody Sinkler, Privacy Act Officer, Headquarters Defense Logistics Agency, ATTN: DGA, 8725 John...

  18. 78 FR 14283 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-05

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Logistics Agency, DoD. ACTION... of records in its inventory of record systems subject to the Privacy Act of 1974 (5 U.S.C. 552a), as... information. FOR FURTHER INFORMATION CONTACT: Ms. Jody Sinkler, DLA FOIA/Privacy Act Office,...

  19. 75 FR 19624 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-15

    ...] Privacy Act of 1974; System of Records AGENCY: Defense Logistics Agency, DoD. ACTION: Notice to amend a... in its existing inventory of record systems subject to the Privacy Act of 1974 (5 U.S.C. 552a), as... record notices subject to the Privacy Act of 1974 (5 U.S.C. 552a), as amended, have been published in...

  20. Redundancy-aware topic modeling for patient record notes.

    PubMed

    Cohen, Raphael; Aviram, Iddo; Elhadad, Michael; Elhadad, Noémie

    2014-01-01

    The clinical notes in a given patient record contain much redundancy, in large part due to clinicians' documentation habit of copying from previous notes in the record and pasting into a new note. Previous work has shown that this redundancy has a negative impact on the quality of text mining and topic modeling in particular. In this paper we describe a novel variant of Latent Dirichlet Allocation (LDA) topic modeling, Red-LDA, which takes into account the inherent redundancy of patient records when modeling content of clinical notes. To assess the value of Red-LDA, we experiment with three baselines and our novel redundancy-aware topic modeling method: given a large collection of patient records, (i) apply vanilla LDA to all documents in all input records; (ii) identify and remove all redundancy by chosing a single representative document for each record as input to LDA; (iii) identify and remove all redundant paragraphs in each record, leaving partial, non-redundant documents as input to LDA; and (iv) apply Red-LDA to all documents in all input records. Both quantitative evaluation carried out through log-likelihood on held-out data and topic coherence of produced topics and qualitative assessment of topics carried out by physicians show that Red-LDA produces superior models to all three baseline strategies. This research contributes to the emerging field of understanding the characteristics of the electronic health record and how to account for them in the framework of data mining. The code for the two redundancy-elimination baselines and Red-LDA is made publicly available to the community.

  1. Redundancy-Aware Topic Modeling for Patient Record Notes

    PubMed Central

    Cohen, Raphael; Aviram, Iddo; Elhadad, Michael; Elhadad, Noémie

    2014-01-01

    The clinical notes in a given patient record contain much redundancy, in large part due to clinicians’ documentation habit of copying from previous notes in the record and pasting into a new note. Previous work has shown that this redundancy has a negative impact on the quality of text mining and topic modeling in particular. In this paper we describe a novel variant of Latent Dirichlet Allocation (LDA) topic modeling, Red-LDA, which takes into account the inherent redundancy of patient records when modeling content of clinical notes. To assess the value of Red-LDA, we experiment with three baselines and our novel redundancy-aware topic modeling method: given a large collection of patient records, (i) apply vanilla LDA to all documents in all input records; (ii) identify and remove all redundancy by chosing a single representative document for each record as input to LDA; (iii) identify and remove all redundant paragraphs in each record, leaving partial, non-redundant documents as input to LDA; and (iv) apply Red-LDA to all documents in all input records. Both quantitative evaluation carried out through log-likelihood on held-out data and topic coherence of produced topics and qualitative assessement of topics carried out by physicians show that Red-LDA produces superior models to all three baseline strategies. This research contributes to the emerging field of understanding the characteristics of the electronic health record and how to account for them in the framework of data mining. The code for the two redundancy-elimination baselines and Red-LDA is made publicly available to the community. PMID:24551060

  2. 78 FR 45185 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-26

    ... alter a system of records, CIG-16, Defense Case Activity Tracking System (D-CATS), in its inventory of...: Delete entry and replace with ``Defense Case Activity Tracking System (D-CATS).'' System location:...

  3. Patient experiences with full electronic access to health records and clinical notes through the My HealtheVet Personal Health Record Pilot: qualitative study.

    PubMed

    Woods, Susan S; Schwartz, Erin; Tuepker, Anais; Press, Nancy A; Nazi, Kim M; Turvey, Carolyn L; Nichol, W Paul

    2013-03-27

    Full sharing of the electronic health record with patients has been identified as an important opportunity to engage patients in their health and health care. The My HealtheVet Pilot, the initial personal health record of the US Department of Veterans Affairs, allowed patients and their delegates to view and download content in their electronic health record, including clinical notes, laboratory tests, and imaging reports. A qualitative study with purposeful sampling sought to examine patients' views and experiences with reading their health records, including their clinical notes, online. Five focus group sessions were conducted with patients and family members who enrolled in the My HealtheVet Pilot at the Portland Veterans Administration Medical Center, Oregon. A total of 30 patients enrolled in the My HealtheVet Pilot, and 6 family members who had accessed and viewed their electronic health records participated in the sessions. Four themes characterized patient experiences with reading the full complement of their health information. Patients felt that seeing their records positively affected communication with providers and the health system, enhanced knowledge of their health and improved self-care, and allowed for greater participation in the quality of their care such as follow-up of abnormal test results or decision-making on when to seek care. While some patients felt that seeing previously undisclosed information, derogatory language, or inconsistencies in their notes caused challenges, they overwhelmingly felt that having more, rather than less, of their health record information provided benefits. Patients and their delegates had predominantly positive experiences with health record transparency and the open sharing of notes and test results. Viewing their records appears to empower patients and enhance their contributions to care, calling into question common provider concerns about the effect of full record access on patient well-being. While shared

  4. 75 FR 3899 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-25

    ... media. Retrievability: Records are retrieved in the system by name, Social Security Number (SSN), NGA..., Social Security Number (SSN), current address, telephone number, personnel records, partial medical... Equal Employment Opportunity (EEO) data; education; health and life insurance; thrift savings plan...

  5. 76 FR 33286 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-08

    ... Executive Branch Public Financial Disclosure Reports and Other Ethics Program Records; OGE/GOVT-2...) Claims and Complaints; OPM/GOVT-10 Employee Medical File System Records; and OSC/GOVT-1 OSC Complaint...

  6. A one-appointment impression and centric relation record technique for compromised complete denture patients.

    PubMed

    Ansari, I H

    1997-09-01

    This article describes a two-in-one modified custom tray and record block system that is recommended for compromised elderly patients. Custom trays, which are made on primary casts and formed from a patient's functionally corrected old dentures, are used to make final impressions and centric jaw relation records in one clinical appointment. The clinical visits are reduced without compromising the quality of denture construction.

  7. Considering Governance for Patient Access to E-Medical Records.

    PubMed

    Day, Karen; Wells, Susan

    2015-01-01

    People having access to their medical records could have a transformative improvement effect on healthcare delivery and use. Our research aimed to explore the concerns and attitudes of giving people electronic access to their medical records through patient portals. We conducted 28 semi-structured interviews with 30 people, asking questions about portal design, organisational implications and governance. We report the findings of the governance considerations raised during the interviews. These revealed that (1) there is uncertainty about the possible design and extent of giving people access to their medical records to view/use, (2) existing policies about patient authentication, proxy, and privacy require modification, and (3) existing governance structures and functions require further examination and adjustment. Future research should include more input from patients and health informaticians.

  8. 77 FR 65245 - Privacy Act; System of Records: Visa Records, State-39

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-25

    ... undergone a thorough background security investigation. All Department users are given cyber security... to the following sections: Security Classification, System Location, Categories of Individuals... NAME: Visa Records. SECURITY CLASSIFICATION: Classified and Unclassified. SYSTEM LOCATION: Visa Office...

  9. 28 CFR 25.6 - Accessing records in the system.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Accessing records in the system. 25.6 Section 25.6 Judicial Administration DEPARTMENT OF JUSTICE DEPARTMENT OF JUSTICE INFORMATION SYSTEMS The National Instant Criminal Background Check System § 25.6 Accessing records in the system. (a) FFLs...

  10. 28 CFR 25.6 - Accessing records in the system.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 1 2012-07-01 2012-07-01 false Accessing records in the system. 25.6 Section 25.6 Judicial Administration DEPARTMENT OF JUSTICE DEPARTMENT OF JUSTICE INFORMATION SYSTEMS The National Instant Criminal Background Check System § 25.6 Accessing records in the system. (a) FFLs...

  11. 28 CFR 25.6 - Accessing records in the system.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Accessing records in the system. 25.6 Section 25.6 Judicial Administration DEPARTMENT OF JUSTICE DEPARTMENT OF JUSTICE INFORMATION SYSTEMS The National Instant Criminal Background Check System § 25.6 Accessing records in the system. (a) FFLs...

  12. 28 CFR 25.7 - Querying records in the system.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Querying records in the system. 25.7 Section 25.7 Judicial Administration DEPARTMENT OF JUSTICE DEPARTMENT OF JUSTICE INFORMATION SYSTEMS The National Instant Criminal Background Check System § 25.7 Querying records in the system. (a) The...

  13. 28 CFR 25.7 - Querying records in the system.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 1 2012-07-01 2012-07-01 false Querying records in the system. 25.7 Section 25.7 Judicial Administration DEPARTMENT OF JUSTICE DEPARTMENT OF JUSTICE INFORMATION SYSTEMS The National Instant Criminal Background Check System § 25.7 Querying records in the system. (a) The...

  14. 28 CFR 25.7 - Querying records in the system.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Querying records in the system. 25.7 Section 25.7 Judicial Administration DEPARTMENT OF JUSTICE DEPARTMENT OF JUSTICE INFORMATION SYSTEMS The National Instant Criminal Background Check System § 25.7 Querying records in the system. (a) The...

  15. 28 CFR 25.7 - Querying records in the system.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Querying records in the system. 25.7 Section 25.7 Judicial Administration DEPARTMENT OF JUSTICE DEPARTMENT OF JUSTICE INFORMATION SYSTEMS The National Instant Criminal Background Check System § 25.7 Querying records in the system. (a) The...

  16. 28 CFR 25.7 - Querying records in the system.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Querying records in the system. 25.7 Section 25.7 Judicial Administration DEPARTMENT OF JUSTICE DEPARTMENT OF JUSTICE INFORMATION SYSTEMS The National Instant Criminal Background Check System § 25.7 Querying records in the system. (a) The...

  17. 75 FR 5579 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-03

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Logistics Agency, DoD. ACTION: Notice to amend a system of records. SUMMARY: The Defense Logistics Agency is proposing to amend a system...: Ms. Jody Sinkler at (703) 767-5045. SUPPLEMENTARY INFORMATION: The Defense Logistics Agency's system...

  18. 75 FR 52515 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-26

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Logistics Agency, DoD. ACTION: Notice to alter a system of records. SUMMARY: The Defense Logistics Agency proposes to alter a system of...: Ms. Jody Sinkler at (703) 767-5045. SUPPLEMENTARY INFORMATION: The Defense Logistics Agency systems...

  19. 78 FR 69076 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-18

    ... Third Party Collection System. DHA 16 DoD EDHA 16 DoD...... Special Needs Program Management Information System (SNPMIS) Records. ] DHA 17 DoD EDHA 17 DoD...... Defense Nutrition Management Information System...: Notice to amend nineteen Record Systems. SUMMARY: The TRICARE Management Activity (TMA) transitioned...

  20. 77 FR 16569 - Privacy Act of 1974: Systems of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-21

    ... ``Administrative Audit System (SEC-14)'' last published in the Federal Register Volume 63, Number 47 on Wednesday... INFORMATION: The Commission proposes to revise two existing systems of records, ``Administrative Audit System... the last published notice, the Administrative Audit System (SEC-14) records are used to ensure...

  1. 78 FR 21599 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-11

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Information Systems Agency, DoD. ACTION: Notice to delete three Systems of Records Notices. SUMMARY: The Defense Information....gov . Follow the instructions for submitting comments. * Mail: Federal Docket Management System...

  2. 75 FR 27051 - Privacy Act of 1974: System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-13

    ... records under the Privacy Act of 1974. The system is FMCSA's National Consumer Complaint Database (NCCDB... categories of records; (6) clarity to the purpose of the system. This system would not duplicate any other.../FMCSA 004 SYSTEM NAME: National Consumer Complaint Database (NCCDB). SECURITY CLASSIFICATION:...

  3. 77 FR 60400 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-03

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Finance and Accounting Service. ACTION: Notice to delete two systems of records. SUMMARY: The Defense Finance and Accounting...: T7320a System name: Centralized Finance & Accounting Support Systems (CFASS) (August 13, 2007, 72 FR...

  4. 78 FR 5784 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-28

    ..., DoD. ACTION: Notice to alter a system of records. SUMMARY: The Defense Finance and Accounting Service.... SUPPLEMENTARY INFORMATION: The Defense Finance and Accounting Service notices for systems of records subject to... Accounting System (August 13, 2007, 72 FR 45231). * * * * * Changes: System Identifier: Delete entry and...

  5. Predefined headings in a multiprofessional electronic health record system

    PubMed Central

    Lindstedt, Helena; Sonnander, Karin

    2012-01-01

    Background Applying multiprofessional electronic health records (EHRs) is expected to improve the quality of patient care and patient safety. Both EHR systems and system users depend on semantic interoperability to function efficiently. A shared clinical terminology comprising unambiguous terms is required for semantic interoperability. Empirical studies of clinical terminology, such as predefined headings, in EHR systems are scarce and limited to one profession or one clinical specialty. Objective To study predefined headings applied by users in a Swedish multiprofessional EHR system. Materials and methods This was a descriptive study of predefined headings (n=3596) applied by 5509 users in a Swedish multiprofessional EHR system. The predefined headings were classified into four term and word categories. Results Less than half of the predefined headings were shared by two or more professional groups. All eight professionals groups shared 1.7% of the predefined headings. The distribution of predefined headings across categories yielded two-thirds “terms for special purposes” and “specialist terms” and one-third “common words” and “unclassified headings”. Discussion The indicated presence of profession-specific predefined headings and the conflict between ambiguity and comprehension of terms and words used as headings are discussed. Conclusions The predefined headings in the multiprofessional EHR system studied did not constitute a joint language for specific purposes. The improvement of the quality and usability of multiprofessional EHR systems requires attention. PMID:22744962

  6. Barriers to Retrieving Patient Information from Electronic Health Record Data: Failure Analysis from the TREC Medical Records Track

    PubMed Central

    Edinger, Tracy; Cohen, Aaron M.; Bedrick, Steven; Ambert, Kyle; Hersh, William

    2012-01-01

    Objective: Secondary use of electronic health record (EHR) data relies on the ability to retrieve accurate and complete information about desired patient populations. The Text Retrieval Conference (TREC) 2011 Medical Records Track was a challenge evaluation allowing comparison of systems and algorithms to retrieve patients eligible for clinical studies from a corpus of de-identified medical records, grouped by patient visit. Participants retrieved cohorts of patients relevant to 35 different clinical topics, and visits were judged for relevance to each topic. This study identified the most common barriers to identifying specific clinic populations in the test collection. Methods: Using the runs from track participants and judged visits, we analyzed the five non-relevant visits most often retrieved and the five relevant visits most often overlooked. Categories were developed iteratively to group the reasons for incorrect retrieval for each of the 35 topics. Results: Reasons fell into nine categories for non-relevant visits and five categories for relevant visits. Non-relevant visits were most often retrieved because they contained a non-relevant reference to the topic terms. Relevant visits were most often infrequently retrieved because they used a synonym for a topic term. Conclusions: This failure analysis provides insight into areas for future improvement in EHR-based retrieval with techniques such as more widespread and complete use of standardized terminology in retrieval and data entry systems. PMID:23304287

  7. Barriers to retrieving patient information from electronic health record data: failure analysis from the TREC Medical Records Track.

    PubMed

    Edinger, Tracy; Cohen, Aaron M; Bedrick, Steven; Ambert, Kyle; Hersh, William

    2012-01-01

    Secondary use of electronic health record (EHR) data relies on the ability to retrieve accurate and complete information about desired patient populations. The Text Retrieval Conference (TREC) 2011 Medical Records Track was a challenge evaluation allowing comparison of systems and algorithms to retrieve patients eligible for clinical studies from a corpus of de-identified medical records, grouped by patient visit. Participants retrieved cohorts of patients relevant to 35 different clinical topics, and visits were judged for relevance to each topic. This study identified the most common barriers to identifying specific clinic populations in the test collection. Using the runs from track participants and judged visits, we analyzed the five non-relevant visits most often retrieved and the five relevant visits most often overlooked. Categories were developed iteratively to group the reasons for incorrect retrieval for each of the 35 topics. Reasons fell into nine categories for non-relevant visits and five categories for relevant visits. Non-relevant visits were most often retrieved because they contained a non-relevant reference to the topic terms. Relevant visits were most often infrequently retrieved because they used a synonym for a topic term. This failure analysis provides insight into areas for future improvement in EHR-based retrieval with techniques such as more widespread and complete use of standardized terminology in retrieval and data entry systems.

  8. Recommendations for responsible monitoring and regulation of clinical software systems. American Medical Informatics Association, Computer-based Patient Record Institute, Medical Library Association, Association of Academic Health Science Libraries, American Health Information Management Association, American Nurses Association.

    PubMed

    Miller, R A; Gardner, R M

    1997-01-01

    In mid-1996, the FDA called for discussions on regulation of clinical software programs as medical devices. In response, a consortium of organizations dedicated to improving health care through information technology has developed recommendations for the responsible regulation and monitoring of clinical software systems by users, vendors, and regulatory agencies. Organizations assisting in development of recommendations, or endorsing the consortium position include the American Medical Informatics Association, the Computer-based Patient Record Institute, the Medical Library Association, the Association of Academic Health Sciences Libraries, the American Health Information Management Association, the American Nurses Association, the Center for Healthcare Information Management, and the American College of Physicians. The consortium proposes four categories of clinical system risks and four classes of measured monitoring and regulatory actions that can be applied strategically based on the level of risk in a given setting. The consortium recommends local oversight of clinical software systems, and adoption by healthcare information system developers of a code of good business practices. Budgetary and other constraints limit the type and number of systems that the FDA can regulate effectively. FDA regulation should exempt most clinical software systems and focus on those systems posing highest clinical risk, with limited opportunities for competent human intervention.

  9. 44 CFR 6.72 - Effective date of new system of records or alteration of an existing system of records.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Effective date of new system of records or alteration of an existing system of records. 6.72 Section 6.72 Emergency Management and... PRIVACY ACT OF 1974 Report on New Systems and Alterations of Existing Systems § 6.72 Effective date of new...

  10. 44 CFR 6.72 - Effective date of new system of records or alteration of an existing system of records.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Effective date of new system of records or alteration of an existing system of records. 6.72 Section 6.72 Emergency Management and... PRIVACY ACT OF 1974 Report on New Systems and Alterations of Existing Systems § 6.72 Effective date of new...

  11. 44 CFR 6.72 - Effective date of new system of records or alteration of an existing system of records.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 44 Emergency Management and Assistance 1 2012-10-01 2011-10-01 true Effective date of new system of records or alteration of an existing system of records. 6.72 Section 6.72 Emergency Management and... PRIVACY ACT OF 1974 Report on New Systems and Alterations of Existing Systems § 6.72 Effective date of new...

  12. 44 CFR 6.72 - Effective date of new system of records or alteration of an existing system of records.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Effective date of new system of records or alteration of an existing system of records. 6.72 Section 6.72 Emergency Management and... PRIVACY ACT OF 1974 Report on New Systems and Alterations of Existing Systems § 6.72 Effective date of new...

  13. 44 CFR 6.72 - Effective date of new system of records or alteration of an existing system of records.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Effective date of new system of records or alteration of an existing system of records. 6.72 Section 6.72 Emergency Management and... PRIVACY ACT OF 1974 Report on New Systems and Alterations of Existing Systems § 6.72 Effective date of new...

  14. From planning to realisation of an electronic patient record.

    PubMed

    Krämer, T; Rapp, R; Krämer, K-L

    1999-03-01

    The high complex requirements on information and information flow in todays hospitals can only be accomplished by the use of modern Information Systems (IS). In order to achieve this, the Stiftung Orthopädische Universitätsklinik has carried out first the Project "Strategic Informations System Planning" in 1993. Then realizing the neccessary infrastructure (network; client-server) from 1993 to 1997, and finally started the introduction of modern IS (SAP R/3 and IXOS-Archive) in the clinical area. One of the approved goal was the replacement of the paper medical record by an up-to-date electronical medical record. In this article the following three topics will be discussed: the difference between the up-to-date electronical medical record and the electronically archived finished cases, steps performed by our clinic to realize the up-to-date electronical medical record and the problems occured during this process.

  15. What do patients with glaucoma think about personal health records?

    PubMed

    Somner, John E A; Sii, Freda; Bourne, Rupert; Cross, Vinette; Shah, Peter

    2013-11-01

    Putting patients in control of their records is one way of promoting patient centred care and patients with chronic health problems may benefit most from personal health records (PHRs). Glaucoma management is often complicated by incomplete understanding and poor adherence to treatment, two areas which a PHR may help to address. This study aimed to discover what patients with glaucoma think about PHRs and what type of information a glaucoma PHR should contain. A consultation exercise using a focus group approach involving 71 participants was undertaken to discuss if a PHR would be useful and what it would be like. Narrative data were collected through written notes and an online forum in addition to transcripts of the focus group feedback session and individual interviews. Recordings were transcribed and analysed with simple thematic analysis facilitated by NVivo software (www.qsrinternational.com). The consultation exercise indicated enthusiasm for PHRs. Views varied on the best format, some participants strongly favoured electronic records and others preferred a low-tech, paper based format. A comprehensive dataset of 24 items was developed which highlighted areas which are not covered by existing guidance to developers. A model for how PHRs may be useful as an education tool in clinical practice was devised. Asking patients what they thought about a glaucoma PHR raised challenging questions and adds perspective to predominantly clinician led development. Listening and responding to such viewpoints is fundamental to developing more patient centred PHRs which may act both as health record and self-care educational tool to promote more holistic, efficient glaucoma care. © 2013 The Authors Ophthalmic & Physiological Optics © 2013 The College of Optometrists.

  16. Access to records by persons other than the patient.

    PubMed

    Dimond, Bridgit

    This article explores what rights persons, other than the patient, have to access health records which come under Data Protection Act and other statutory provisions. These other persons could include the relatives of a patient, the parents of a child or those concerned with the estate of a deceased person. In addition, there are other rights of disclosure recognized by the common law and these will be considered in a later article.

  17. 77 FR 13571 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-07

    ... NARA retention schedule; therefore, the system of records notice can be deleted. A0600-8-22j AHRC Cold War Recognition System (January 6, 2004, 69 FR 790). Reason: The system at Army Human Resource...

  18. 12 CFR 310.3 - Procedures for requests pertaining to individual records in a system of records.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... individual records in a system of records. 310.3 Section 310.3 Banks and Banking FEDERAL DEPOSIT INSURANCE... to individual records in a system of records. (a) Any present or former employee of the Corporation... government-wide records systems maintained by the Corporation, the procedures prescribed in the respective...

  19. 12 CFR 310.3 - Procedures for requests pertaining to individual records in a system of records.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... government-wide records systems maintained by the Corporation, the procedures prescribed in the respective... individual records in a system of records. 310.3 Section 310.3 Banks and Banking FEDERAL DEPOSIT INSURANCE... to individual records in a system of records. (a) Any present or former employee of the...

  20. 42 CFR 491.10 - Patient health records.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Patient health records. 491.10 Section 491.10 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CERTIFICATION OF CERTAIN HEALTH FACILITIES Rural Health...

  1. 42 CFR 491.10 - Patient health records.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 5 2011-10-01 2011-10-01 false Patient health records. 491.10 Section 491.10 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CERTIFICATION OF CERTAIN HEALTH FACILITIES Rural Health...

  2. 42 CFR 491.10 - Patient health records.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 5 2014-10-01 2014-10-01 false Patient health records. 491.10 Section 491.10 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CERTIFICATION OF CERTAIN HEALTH FACILITIES Rural Health...

  3. 42 CFR 491.10 - Patient health records.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Patient health records. 491.10 Section 491.10 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CERTIFICATION OF CERTAIN HEALTH FACILITIES Rural Health...

  4. 42 CFR 491.10 - Patient health records.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 5 2012-10-01 2012-10-01 false Patient health records. 491.10 Section 491.10 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STANDARDS AND CERTIFICATION CERTIFICATION OF CERTAIN HEALTH FACILITIES Rural Health...

  5. Confidentiality of Alcohol and Drug Abuse Patient Records. Participant Manual.

    ERIC Educational Resources Information Center

    Coggins, Patrick C.; And Others

    This participant manual is designed to provide an overview of federal laws and regulations pertaining to the confidentiality of alcohol and drug abuse patient records. The relationship of federal laws to state laws and regulations is also discussed. The materials, useful for persons involved in the fields of substance abuse treatment or…

  6. 76 FR 16739 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-25

    ...: Electronic storage media and paper records. Retrievability: Retrieved by individual's name and Social...-know. Retention and disposal: Paper records are retained at the local command for a minimum of five... Department of the Navy Privacy Act of 1974; System of Records AGENCY: Department of the Navy, DoD. ACTION...

  7. 78 FR 5788 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-28

    ... Privacy Program.'' * * * * * Storage: Delete entry and replace with ``Paper records and electronic storage media.'' * * * * * Safeguards: Delete entry and replace with ``Paper records are maintained in security... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Security Service, DoD. ACTION...

  8. 77 FR 60411 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-03

    ... Information (January 18, 2002, 67 FR 2642). Reason: Unit Personnel Records are no longer maintained in paper by each Installation Military Personnel Section (MPS). As of June 2008, paper records were converted... Department of the Air Force Privacy Act of 1974; System of Records AGENCY: Department of the Air Force, DoD...

  9. 76 FR 53421 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-26

    ...: Paper records and electronic storage media. Retrievability: By individual's name. Safeguards: Paper and..., deleting, or overwriting. When paper records are no longer needed, they are destroyed by shredding... Department of the Air Force Privacy Act of 1974; System of Records AGENCY: Department of the Air Force, DoD...

  10. 78 FR 73508 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-06

    ..., retrieving, accessing, retaining, and disposing of records in the system: Storage: Paper and electronic... key card and is accessible only to authorized personnel. Paper records are stored in locked file... volunteer relationship has terminated. Paper records are destroyed by cross-cut shredding. Electronic media...

  11. 78 FR 6077 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-29

    ... names used, date and place of birth, and Social Security Number.'' Record access procedures: Delete... only former names used, date and place of birth, and Social Security Number.'' Contesting record... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Security Service, DoD....

  12. 77 FR 16019 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-19

    ..., National Guard, National Guard retired personnel, Reserve personnel, Non-US citizens including military and civilian personnel, and individuals who are the subject of records in the system. Categories of Records in...: Personnel: Records concerning military and DoD civilian personnel as they relate to general personnel data...

  13. 77 FR 27740 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-11

    ....'' Categories of records in the system: Delete ``Social Security Numbers'' from the ``Waiting List Applicant Records'' paragraph and ``Social Security Number (SSN)'' from the ``Employee Records'' paragraph..., replace ``CDP'' with ``Child Development and Youth Program (CDYP)'' the first time; thereafter replace...

  14. 75 FR 43494 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-26

    .../CSS Access, Authority and Release of Information File (February 22, 1993; 58 FR 10531). Reason: The records contained in this system of records are covered by GNSA 11, NSA/CSS Key Accountability Records, GNSA 10, NSA/CSS Personnel Security File and DPR 39 DoD, DoD Personnel Accountability &...

  15. 78 FR 21600 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-11

    ... Internet at http://www.regulations.gov as they are received without change, including any personal... System name: DLA Drug-Free Workplace Program Records (May 20, 2010; 75 FR 28242) Reason: Records are... ] Register on June 21, 2010, at 75 FR 35099. Therefore, S380.50, DLA Drug-Free Workplace Program Records can...

  16. 76 FR 49455 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-10

    ..., educational and medical institutions; and open source information, such as property tax records.'' Exemptions... medical institutions; and open source information, such as property tax records. Exemptions claimed for... Program''; or may be obtained from the system manager.'' Record source categories: Delete entry and...

  17. 78 FR 25414 - Privacy Act of 1974, System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-01

    ...; ] AGENCY FOR INTERNATIONAL DEVELOPMENT Privacy Act of 1974, System of Records AGENCY: United States Agency... of records maintained in accordance with the Privacy Act of 1974, (5 U.S.C. 552a), as amended... of record for a non-significant change, to reflect the address change for the location of the...

  18. 75 FR 5997 - Privacy Act of 1974; Systems of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-05

    ... of the Secretary Privacy Act of 1974; Systems of Records AGENCY: Defense Logistics Agency, DoD. ACTION: Notice to alter a system of records. SUMMARY: The Defense Logistics Agency proposes to alter a...: Ms. Jody Sinkler at (703) 767-5045. SUPPLEMENTARY INFORMATION: The Defense Logistics Agency systems...

  19. 75 FR 6000 - Privacy Act of 1974; Systems of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-02-05

    ... of the Secretary Privacy Act of 1974; Systems of Records AGENCY: Defense Logistics Agency, DoD. ACTION: Notice to delete a system of records. SUMMARY: The Defense Logistics Agency proposes to delete a...: Jody Sinkler at (703) 767-5045. SUPPLEMENTARY INFORMATION: The Defense Logistics Agency systems of...

  20. 75 FR 10473 - Privacy Act of 1974; Systems of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-08

    ... of the Secretary Privacy Act of 1974; Systems of Records AGENCY: Defense Logistics Agency, DoD. ACTION: Notice to amend a system of records. SUMMARY: The Defense Logistics Agency proposes to amend a...: Ms. Jody Sinkler at (703) 767-5045. SUPPLEMENTARY INFORMATION: The Defense Logistics Agency systems...

  1. 78 FR 17386 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-21

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Logistics Agency, DoD. ACTION: Notice to alter a System of Records. SUMMARY: The Defense Logistics Agency proposes to alter a system of..., Defense Logistics Agency, ATTN: DGA, 8725 John J. Kingman Road, Suite 1644, Fort Belvoir, VA 22060-6221...

  2. 75 FR 17906 - Privacy Act of 1974; Systems of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-08

    ... of the Secretary Privacy Act of 1974; Systems of Records AGENCY: Defense Logistics Agency, DoD. ACTION: Notice to amend a system of records. SUMMARY: The Defense Logistics Agency proposes to amend a...: Ms. Jody Sinkler at (703) 767-5045. SUPPLEMENTARY INFORMATION: The Defense Logistics Agency systems...

  3. 5 CFR 2606.103 - Systems of records.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 3 2014-01-01 2014-01-01 false Systems of records. 2606.103 Section 2606.103 Administrative Personnel OFFICE OF GOVERNMENT ETHICS ORGANIZATION AND PROCEDURES PRIVACY ACT RULES... system, comprised of Computer Systems Activity and Access Records; and the OGE/INTERNAL-5...

  4. 5 CFR 2606.103 - Systems of records.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Systems of records. 2606.103 Section 2606.103 Administrative Personnel OFFICE OF GOVERNMENT ETHICS ORGANIZATION AND PROCEDURES PRIVACY ACT RULES... system, comprised of Computer Systems Activity and Access Records; and the OGE/INTERNAL-5...

  5. 75 FR 55576 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-13

    ... Record Notices from the services: Army A0680 31a AHRC, Officer Personnel Management Information System (OPMIS); Army A0680 31b AHRC, Enlisted Personnel Management Information System (EPMIS); Air Force F036...; Marines M01040-3, Marine Corps Manpower Management Information System Records. BILLING CODE 5001-06-P...

  6. 77 FR 38782 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-29

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF DEFENSE Department of the Navy Privacy Act of 1974; System of Records AGENCY: Department of the Navy, DoD. ACTION: Notice to add a system of records. SUMMARY: The Department of the Navy proposes to add a system of...

  7. 75 FR 42720 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-22

    ... Department of the Air Force Privacy Act of 1974; System of Records AGENCY: Department of the Air Force, DoD. ACTION: Notice to alter a system of records. SUMMARY: The Department of the Air Force is proposing to.... Charles J. Shedrick, 703-696-6488. SUPPLEMENTARY INFORMATION: The Department of the Air Force systems...

  8. 78 FR 42038 - Privacy Act New System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-15

    ... date of a Privacy Act system of records entitled COMMERCE/DEPT-23, Information Collected Electronically in Connection with Department of Commerce Activities, Events, and Programs. DATES: The system of... Privacy Act New System of Records AGENCY: Department of Commerce. ACTION: Notice; COMMERCE/DEPT-23...

  9. 77 FR 77047 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-31

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Contract Audit Agency, DoD. ACTION: Notice to delete a Systems of Records. SUMMARY: The Defense Contract Audit Agency (DCAA) is... instructions for submitting comments. * Mail: Federal Docket Management System Office, 4800 Mark Center...

  10. 76 FR 40343 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-08

    ... Department of the Army Privacy Act of 1974; System of Records AGENCY: Department of the Army, DoD. ACTION: Notice to amend a system of records. SUMMARY: The Department of the Army is proposing to amend a system... contact information. FOR FURTHER INFORMATION CONTACT: Mr. Leroy Jones, Department of the Army,...

  11. 12 CFR 792.67 - Security of systems of records.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Security of systems of records. 792.67 Section... AND PRIVACY ACT, AND BY SUBPOENA; SECURITY PROCEDURES FOR CLASSIFIED INFORMATION The Privacy Act § 792.67 Security of systems of records. (a) Each system manager, with the approval of the head of...

  12. 12 CFR 792.67 - Security of systems of records.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Security of systems of records. 792.67 Section... AND PRIVACY ACT, AND BY SUBPOENA; SECURITY PROCEDURES FOR CLASSIFIED INFORMATION The Privacy Act § 792.67 Security of systems of records. (a) Each system manager, with the approval of the head of...

  13. 78 FR 14284 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-05

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Contract Audit Agency, DoD. ACTION: Notice to alter a System of Records. SUMMARY: The Defense Contract Audit Agency proposes to alter..., telephone (703) 767-1022. SUPPLEMENTARY INFORMATION: The Defense Contract Audit Agency notices for systems...

  14. 77 FR 4798 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-31

    ...; home and work addresses; home and work email addresses; phone numbers (home, office, cell, and fax... Department of the Navy Privacy Act of 1974; System of Records AGENCY: Department of the Navy, DoD. ACTION: Notice to Add a System of Records. SUMMARY: The Department of the Navy proposes to add a system of...

  15. 77 FR 38342 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-27

    ... ADDRESS: Vice President, Engineering Systems, United States Postal Service, 8403 Lee Highway, Merrifield... of 1974; System of Records AGENCY: Postal Service \\TM\\. ACTION: Notice of modification to existing systems of records. SUMMARY: The United States Postal Service is proposing to modify fifteen of its...

  16. 76 FR 12076 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-04

    ...) and computer screens automatically lock after a preset period of inactivity with re-entry controlled... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Logistics Agency, DoD. ACTION: Notice to amend a system of records. SUMMARY: The Defense Logistics Agency is proposing to amend a system...

  17. 78 FR 14273 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-05

    .... * Mail: Federal Docket Management System Office, 4800 Mark Center Drive, East Tower, 2nd Floor, Suite..., duplicates existing DoD-wide and OPM/Government-wide Privacy Act systems of records which cover Training and... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Logistics Agency, DoD....

  18. 77 FR 40863 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-11

    ... . Follow the instructions for submitting comments. Mail: Federal Docket Management System Office, 4800 Mark... Office of the Secretary Privacy Act of 1974; System of Records AGENCY: National Reconnaissance Office, DoD. ACTION: Notice to Add a New System of Records. SUMMARY: The National Reconnaissance...

  19. 77 FR 40861 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-11

    ... . Follow the instructions for submitting comments. Mail: Federal Docket Management System Office, 4800 Mark... of the Secretary Privacy Act of 1974; System of Records AGENCY: Office of the Secretary, DoD. ACTION: Notice to add a new system of records. SUMMARY: The Office of the Secretary of Defense proposes to add...

  20. 77 FR 43815 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-26

    ..., computer system software, and Common Access Card (CAC) access, passwords, and encryption... Department of the Air Force Privacy Act of 1974; System of Records AGENCY: Department of the Air Force, DoD. ACTION: Notice to alter a system of records. SUMMARY: The Department of the Air Force proposes to alter a...

  1. 75 FR 13094 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-18

    ... interfaces. Exemptions claimed for the system: None. BILLING CODE 5001-06-P ... Department of the Air Force Privacy Act of 1974; System of Records AGENCY: Department of the Air Force, DoD. ACTION: Notice to add a system of records. SUMMARY: The Department of the Air Force proposes to add...

  2. 77 FR 70136 - Privacy Act of 1974, System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-23

    ...; ] AGENCY FOR INTERNATIONAL DEVELOPMENT Privacy Act of 1974, System of Records AGENCY: United States Agency for International Development. ACTION: Altered system of records. SUMMARY: The United States Agency for International Development (USAID) is issuing public notice of its intent to alter a system of...

  3. 77 FR 26260 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-03

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Intelligence Agency, DoD. ACTION: Notice to Delete a System of Records. SUMMARY: The Defense Intelligence Agency proposes to delete... number (202) 231-1193. SUPPLEMENTARY INFORMATION: The Defense Intelligence Agency systems of...

  4. 75 FR 17904 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-08

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Intelligence Agency, DoD. ACTION: Notice to alter a system of records. Summary: The Defense Intelligence Agency is proposing to.... Theresa Lowery at (202) 231-1193. SUPPLEMENTARY INFORMATION: The Defense Intelligence Agency system of...

  5. 78 FR 52518 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-23

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Finance and Accounting Service, DoD. ACTION: Notice to amend a System of Records. SUMMARY: The Defense Finance and Accounting... amended. This system will integrate resource, accounting, financial and other business functions into a...

  6. 78 FR 14285 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-05

    ..., DoD. ACTION: Notice to alter a System of Records. SUMMARY: The Defense Finance and Accounting Service... INFORMATION: The Defense Finance and Accounting Service notices for systems of records subject to the Privacy... replace with ``Defense Finance & Accounting Service-Indianapolis, ATAAPS System Manager, 8899 East 56th...

  7. 78 FR 14281 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-05

    ..., DoD. ACTION: Notice to amend a System of Records. SUMMARY: The Defense Finance and Accounting Service... INFORMATION: The Defense Finance and Accounting Service notices for systems of records subject to the Privacy...''. * * * * * System location: Delete entry and replace with ``Defense Finance and Accounting Service--Indianapolis...

  8. 78 FR 41918 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-12

    ...: Notice to alter a System of Records. SUMMARY: The Defense Finance and Accounting Service proposes to... INFORMATION: The Defense Finance and Accounting Service notices for systems of records subject to the Privacy... replace with ``Defense Finance and Accounting Service-Indianapolis, Accounting Systems Division, 8899 East...

  9. 78 FR 27194 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-09

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Finance and Accounting Service, DoD. ACTION: Notice to delete a System of Records. SUMMARY: The Defense Finance and Accounting... Outlaw, (317)510-4591. SUPPLEMENTARY INFORMATION: The Defense Finance and Accounting Service systems of...

  10. 78 FR 78946 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-12-27

    ... of the Secretary Privacy Act of 1974; System of Records AGENCY: Office of the Inspector General, DoD... inventory of record systems subject to the Privacy Act of 1974 (5 U.S.C. 552a), as amended. This system...: Mark Dorgan, DoD IG FOIA/Privacy Office, Department of Defense, Inspector General, 4800 Mark...

  11. 77 FR 15143 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-14

    ... TRANSPARENCY BOARD Privacy Act of 1974; System of Records AGENCY: Recovery Accountability and Transparency... Accountability and Transparency Board (Board) is issuing public notice of its intent to amend a system of records... LOCATION: The principal location of the system is the Recovery Accountability and Transparency Board, 1717...

  12. Finding Trapped Miners by Using a Prototype Seismic Recording System Made from Music-Recording Hardware

    USGS Publications Warehouse

    Pratt, Thomas L.

    2009-01-01

    The goal of this project was to use off-the-shelf music recording equipment to build and test a prototype seismic system to listen for people trapped in underground chambers (mines, caves, collapsed buildings). Previous workers found that an array of geophones is effective in locating trapped miners; displaying the data graphically, as well as playing it back into an audio device (headphones) at high speeds, was found to be effective for locating underground tapping. The desired system should record the data digitally to allow for further analysis, be capable of displaying the data graphically, allow for rudimentary analysis (bandpass filter, deconvolution), and allow the user to listen to the data at varying speeds. Although existing seismic reflection systems are adequate to record, display and analyze the data, they are relatively expensive and difficult to use and do not have an audio playback option. This makes it difficult for individual mines to have a system waiting on the shelf for an emergency. In contrast, music recording systems, like the one I used to construct the prototype system, can be purchased for about 20 percent of the cost of a seismic reflection system and are designed to be much easier to use. The prototype system makes use of an ~$3,000, 16-channel music recording system made by Presonus, Inc., of Baton Rouge, Louisiana. Other manufacturers make competitive systems that would serve equally well. Connecting the geophones to the recording system required the only custom part of this system - a connector that takes the output from the geophone cable and breaks it into 16 microphone inputs to be connected to the music recording system. The connector took about 1 day of technician time to build, using about $300 in off-the-shelf parts. Comparisons of the music recording system and a standard seismic reflection system (A 24-channel 'Geode' system manufactured by Geometrics, Inc., of San Jose, California) were carried out at two locations. Initial

  13. 78 FR 52517 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-23

    ... Counseling Record (July 6, 2011, 76 FR 39389). Changes: * * * * * ] System name: Delete entry and replace with ``Chaplain Counseling Care Files.'' * * * * * Retention and disposal: Delete entry and replace...

  14. Healthcare utilization in older patients using personal emergency response systems: an analysis of electronic health records and medical alert data : Brief Description: A Longitudinal Retrospective Analyses of healthcare utilization rates in older patients using Personal Emergency Response Systems from 2011 to 2015.

    PubMed

    Agboola, Stephen; Golas, Sara; Fischer, Nils; Nikolova-Simons, Mariana; Op den Buijs, Jorn; Schertzer, Linda; Kvedar, Joseph; Jethwani, Kamal

    2017-04-18

    Personal Emergency Response Systems (PERS) are traditionally used as fall alert systems for older adults, a population that contributes an overwhelming proportion of healthcare costs in the United States. Previous studies focused mainly on qualitative evaluations of PERS without a longitudinal quantitative evaluation of healthcare utilization in users. To address this gap and better understand the needs of older patients on PERS, we analyzed longitudinal healthcare utilization trends in patients using PERS through the home care management service of a large healthcare organization. Retrospective, longitudinal analyses of healthcare and PERS utilization records of older patients over a 5-years period from 2011-2015. The primary outcome was to characterize the healthcare utilization of PERS patients. This outcome was assessed by 30-, 90-, and 180-day readmission rates, frequency of principal admitting diagnoses, and prevalence of conditions leading to potentially avoidable admissions based on Centers for Medicare and Medicaid Services classification criteria. The overall 30-day readmission rate was 14.2%, 90-days readmission rate was 34.4%, and 180-days readmission rate was 42.2%. While 30-day readmission rates did not increase significantly (p = 0.16) over the study period, 90-days (p = 0.03) and 180-days (p = 0.04) readmission rates did increase significantly. The top 5 most frequent principal diagnoses for inpatient admissions included congestive heart failure (5.7%), chronic obstructive pulmonary disease (4.6%), dysrhythmias (4.3%), septicemia (4.1%), and pneumonia (4.1%). Additionally, 21% of all admissions were due to conditions leading to potentially avoidable admissions in either institutional or non-institutional settings (16% in institutional settings only). Chronic medical conditions account for the majority of healthcare utilization in older patients using PERS. Results suggest that PERS data combined with electronic medical records data can

  15. 18 CFR 1301.13 - Procedures for requests pertaining to individual records in a record system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Procedures for requests pertaining to individual records in a record system. 1301.13 Section 1301.13 Conservation of Power and Water Resources TENNESSEE VALLEY AUTHORITY PROCEDURES Privacy Act § 1301.13 Procedures for requests pertaining...

  16. 18 CFR 1301.13 - Procedures for requests pertaining to individual records in a record system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 18 Conservation of Power and Water Resources 2 2011-04-01 2011-04-01 false Procedures for requests pertaining to individual records in a record system. 1301.13 Section 1301.13 Conservation of Power and Water Resources TENNESSEE VALLEY AUTHORITY PROCEDURES Privacy Act § 1301.13 Procedures for requests pertaining...

  17. 21 CFR 21.71 - Disclosure of records in Privacy Act Record Systems; accounting required.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Disclosure of records in Privacy Act Record Systems; accounting required. 21.71 Section 21.71 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT... sufficient historical or other value to warrant its continued preservation by the U.S. Government, or to...

  18. 21 CFR 21.71 - Disclosure of records in Privacy Act Record Systems; accounting required.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 1 2014-04-01 2014-04-01 false Disclosure of records in Privacy Act Record Systems; accounting required. 21.71 Section 21.71 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT... sufficient historical or other value to warrant its continued preservation by the U.S. Government, or to...

  19. 21 CFR 21.71 - Disclosure of records in Privacy Act Record Systems; accounting required.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 1 2013-04-01 2013-04-01 false Disclosure of records in Privacy Act Record Systems; accounting required. 21.71 Section 21.71 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT... sufficient historical or other value to warrant its continued preservation by the U.S. Government, or to...

  20. Retrospective record review in proactive patient safety work – identification of no-harm incidents

    PubMed Central

    2013-01-01

    Background In contrast to other safety critical industries, well-developed systems to monitor safety within the healthcare system remain limited. Retrospective record review is one way of identifying adverse events in healthcare. In proactive patient safety work, retrospective record review could be used to identify, analyze and gain information and knowledge about no-harm incidents and deficiencies in healthcare processes. The aim of the study was to evaluate retrospective record review for the detection and characterization of no-harm incidents, and compare findings with conventional incident-reporting systems. Methods A two-stage structured retrospective record review of no-harm incidents was performed on a random sample of 350 admissions at a Swedish orthopedic department. Results were compared with those found in one local, and four national incident-reporting systems. Results We identified 118 no-harm incidents in 91 (26.0%) of the 350 records by retrospective record review. Ninety-four (79.7%) no-harm incidents were classified as preventable. The five incident-reporting systems identified 16 no-harm incidents, of which ten were also found by retrospective record review. The most common no-harm incidents were related to drug therapy (n = 66), of which 87.9% were regarded as preventable. Conclusions No-harm incidents are common and often preventable. Retrospective record review seems to be a valuable tool for identifying and characterizing no-harm incidents. Both harm and no-harm incidents can be identified in parallel during the same record review. By adding a retrospective record review of randomly selected records to conventional incident-reporting, health care providers can gain a clearer and broader picture of commonly occurring, no-harm incidents in order to improve patient safety. PMID:23876023

  1. Are low income patients receiving the benefits of electronic health records? A statewide survey.

    PubMed

    Butler, Matthew J; Harootunian, Gevork; Johnson, William G

    2013-06-01

    There are concerns that physicians serving low-income, Medicaid patients, in the United States are less likely to adopt electronic health records and, if so, that Medicaid patients will be denied the benefits from electronic health record use. This study seeks to determine whether physicians treating Medicaid patients were less likely to have adopted electronic health records. Physician surveys completed during physicians' license renewal process in Arizona were merged with the physician licensing data and Medicaid administrative claims data. Survey responses were received from 50.7 percent (6,780 out of 13,380) of all physicians practicing in Arizona. Physician survey responses were used to identify whether the physician used electronic health records and the degree to which the physician exchanged electronic health records with other health-care providers. Medicaid claims data were used to identify which physicians provided health care to Medicaid beneficiaries. The primary outcome of interest was whether Medicaid providers were more or less likely to have adopted electronic health records. Logistic regression analysis was used to estimate average marginal effects. In multivariate analysis, physicians with 20 or more Medicaid patients during the survey cycle were 4.1 percent more likely to use an electronic health record and 5.2 percent more likely to be able to transmit electronic health records to at least one health-care provider outside of their practice. These effects increase in magnitude when the analysis is restricted to solo practice physicians This is the first study to find a pro-Medicaid gap in electronic health record adoption suggesting that the low income patients served by Arizona's Health Care Cost Containment System are not at a disadvantage with regard to electronic health record access and that Arizona's model of promoting electronic health record adoption merits further study.

  2. Can Patient Record Summarization Support Quality Metric Abstraction?

    PubMed Central

    Pivovarov, Rimma; Coppleson, Yael Judith; Gorman, Sharon Lipsky; Vawdrey, David K.; Elhadad, Noémie

    2016-01-01

    We present a pre/post intervention study, where HARVEST, a general-purpose patient record summarization tool, was introduced to ten data abstraction specialists. The specialists are responsible for reviewing hundreds of patient charts each month and reporting disease-specific quality metrics to a variety of online registries and databases. We qualitatively and quantitatively investigated whether HARVEST improved the process of quality metric abstraction. Study instruments included pre/post questionnaires and log analyses of the specialists’ actions in the electronic health record (EHR). The specialists reported favorable impressions of HARVEST and suggested that it was most useful when abstracting metrics from patients with long hospitalizations and for metrics that were not consistently captured in a structured manner in the EHR. A statistically significant reduction in time spent per chart before and after use of HARVEST was observed for 50% of the specialists and 90% of the specialists continue to use HARVEST after the study period. PMID:28269899

  3. Transforming patient and family access to medical information: utilisation patterns of a patient-accessible electronic health record.

    PubMed

    Burke, Redmond P; Rossi, Anthony F; Wilner, Bryan R; Hannan, Robert L; Zabinsky, Jennifer A; White, Jeffrey A

    2010-10-01

    The purpose of this study was to evaluate the utilisation of a web-based multimedia patient-accessible electronic health record, for patients with congenital cardiac disease. This was a prospective analysis of patients undergoing congenital cardiac surgery at a single institution from 1 September, 2006 to 1 February, 2009. After meetings with hospital administration, physicians, nurses, and patients, we configured a subset of the cardiac program's web-based clinical electronic health record for patient and family access. The Electronic Health Record continuously measured frequency and time of logins, logins during and between hospitalisations, and page views by type (imaging versus textual data). Of the first 270 patients offered access to the system, 252 became users (93% adoption rate). System uptime was 99.9%, and no security breaches were reported. Users accessed the system more often while the patients were in hospital (67% of total logins) than after discharge (33% of total logins). The maximum number of logins by a family was 440, and the minimum was 1. The average number of logins per family was 25. Imaging data were viewed significantly more frequently than textual data (p 0.001). A total of 12 patients died during the study period and 11 members of their families continued to access their Electronic Health Records after the date of death. A web-based Patient Accessible Electronic Health Record was designed for patients with congenital cardiac disease. The adoption rate was high, and utilisation patterns suggest that the Electronic Health Record could become a useful tool for health information exchange.

  4. The influence of the type and design of the anesthesia record on ASA physical status scores in surgical patients: paper records vs. electronic anesthesia records.

    PubMed

    Marian, Anil A; Bayman, Emine O; Gillett, Anita; Hadder, Brent; Todd, Michael M

    2016-03-02

    The American Society of Anesthesiologists Physical Status classification (ASA PS) of surgical patients is a standard element of the preoperative assessment. In early 2013, the Department of Anesthesia was notified that the distribution of ASA PS scores for sampled patients at the University of Iowa had recently begun to deviate from national comparison data. This change appeared to coincide with the transition from paper records to a new electronic Anesthesia Information Management System (AIMS). We hypothesized that the design of the AIMS was unintentionally influencing how providers assigned ASA PS values. Primary analyses were based on 12-month blocks of data from paper records and AIMS. For the purpose of analysis, ASA PS was dichotomized to ASA PS 1 and 2 vs. ASA PS >2. To ensure that changes in ASA PS were not due to "real" changes in our patient mix, we examined other relevant covariates (e.g. age, weight, case distribution across surgical services, emergency vs. elective surgeries etc.). There was a 6.1 % (95 % CI: 5.1-7.1 %) absolute increase in the fraction of ASA PS 1&2 classifications after the transition from paper (54.9 %) to AIMS (61.0 %); p < 0.001. The AIMS was then modified to make ASA PS entry clearer (e.g. clearly highlighting ASA PS on the main anesthesia record). Following the modifications, the AS PS 1&2 fraction decreased by 7.7 % (95 % CI: 6.78-8.76 %) compared to the initial AIMS records (from 61.0 to 53.3 %); p < 0.001. There were no significant or meaningful differences in basic patient characteristics and case distribution during this time. The transition from paper to electronic AIMS resulted in an unintended but significant shift in recorded ASA PS scores. Subsequent design changes within the AIMS resulted in resetting of the ASA PS distributions to previous values. These observations highlight the importance of how user interface and cognitive demands introduced by a computational system can impact the recording of

  5. Electromagnetic recording of the auditory system.

    PubMed

    Poeppel, David; Hickok, Gregory

    2015-01-01

    Auditory processing is remarkably fast and sensitive to the precise temporal structure of acoustic signals over a range of scales, from submillisecond phenomena such as localization to the construction of elementary auditory attributes at tens of milliseconds to basic properties of speech and music at hundreds of milliseconds. In light of the rapid (and often transitory) nature of auditory phenomena, in order to investigate the neurocomputational basis of auditory perception and cognition, a technique with high temporal resolution is appropriate. Here we briefly outline the utility of magnetoencephalography (MEG) for the study of the neural basis of audition. The basics of MEG are outlined in brief, and some of the most-used neural responses are described. We discuss the classic transient evoked fields (e.g., M100), responses elicited by change in a stimulus (e.g., pitch-onset response), the auditory steady-state response, and neural oscillations (e.g., theta-phase tracking). Because of the high temporal resolution and the good spatial resolution of MEG, paired with the convenient location of human auditory cortex for MEG-based recording, electromagnetic recording of this type is well suited to investigate various aspects from audition, from crafted laboratory experiments on pitch perception or scene analysis to naturalistic speech and music tasks. © 2015 Elsevier B.V. All rights reserved.

  6. Deep Patient: An Unsupervised Representation to Predict the Future of Patients from the Electronic Health Records.

    PubMed

    Miotto, Riccardo; Li, Li; Kidd, Brian A; Dudley, Joel T

    2016-05-17

    Secondary use of electronic health records (EHRs) promises to advance clinical research and better inform clinical decision making. Challenges in summarizing and representing patient data prevent widespread practice of predictive modeling using EHRs. Here we present a novel unsupervised deep feature learning method to derive a general-purpose patient representation from EHR data that facilitates clinical predictive modeling. In particular, a three-layer stack of denoising autoencoders was used to capture hierarchical regularities and dependencies in the aggregated EHRs of about 700,000 patients from the Mount Sinai data warehouse. The result is a representation we name "deep patient". We evaluated this representation as broadly predictive of health states by assessing the probability of patients to develop various diseases. We performed evaluation using 76,214 test patients comprising 78 diseases from diverse clinical domains and temporal windows. Our results significantly outperformed those achieved using representations based on raw EHR data and alternative feature learning strategies. Prediction performance for severe diabetes, schizophrenia, and various cancers were among the top performing. These findings indicate that deep learning applied to EHRs can derive patient representations that offer improved clinical predictions, and could provide a machine learning framework for augmenting clinical decision systems.

  7. Maternity patients' access to their electronic medical records: use and perspectives of a patient portal.

    PubMed

    Megan Forster, Megan; Dennison, Kerrie; Callen, Joanne; Andrew, Andrew; Westbrook, Johanna I

    2015-01-01

    Patients have been able to access clinical information from their paper-based health records for a number of years. With the advent of Electronic Medical Records (EMRs) access to this information can now be achieved online using a secure electronic patient portal. The purpose of this study was to investigate maternity patients' use and perceptions of a patient portal developed at the Mater Mothers' Hospital in Brisbane, Australia. A web-based patient portal, one of the first developed and deployed in Australia, was introduced on 26 June 2012. The portal was designed for maternity patients booked at Mater Mothers' Hospital, as an alternative to the paper-based Pregnancy Health Record. Through the portal, maternity patients are able to complete their hospital registration form online and obtain current health information about their pregnancy (via their EMR), as well as access a variety of support tools to use during their pregnancy such as tailored public health advice. A retrospective cross-sectional study design was employed. Usage statistics were extracted from the system for a one year period (1 July 2012 to 30 June 2013). Patients' perceptions of the portal were obtained using an online survey, accessible by maternity patients for two weeks in February 2013 (n=80). Descriptive statistics were employed to analyse the data. Between July 2012 and June 2013, 10,892 maternity patients were offered a patient portal account and access to their EMR. Of those 6,518 created one (60%; 6,518/10,892) and 3,104 went on to request access to their EMR (48%; 3,104/6,518). Of these, 1,751 had their access application granted by 30 June 2013. The majority of maternity patients submitted registration forms online via the patient portal (56.7%). Patients could view their EMR multiple times: there were 671 views of the EMR, 2,781 views of appointment schedules and 135 birth preferences submitted via the EMR. Eighty survey responses were received from EMR account holders, (response

  8. 18 CFR 1301.13 - Procedures for requests pertaining to individual records in a record system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Resources TENNESSEE VALLEY AUTHORITY PROCEDURES Privacy Act § 1301.13 Procedures for requests pertaining to.... Certain TVA system notices designate officials at field locations of TVA systems. With respect to such TVA systems, an individual who believes his record is located at the field location may present a request...

  9. 18 CFR 1301.13 - Procedures for requests pertaining to individual records in a record system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Resources TENNESSEE VALLEY AUTHORITY PROCEDURES Privacy Act § 1301.13 Procedures for requests pertaining to.... Certain TVA system notices designate officials at field locations of TVA systems. With respect to such TVA systems, an individual who believes his record is located at the field location may present a request...

  10. 18 CFR 1301.13 - Procedures for requests pertaining to individual records in a record system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... Resources TENNESSEE VALLEY AUTHORITY PROCEDURES Privacy Act § 1301.13 Procedures for requests pertaining to.... Certain TVA system notices designate officials at field locations of TVA systems. With respect to such TVA systems, an individual who believes his record is located at the field location may present a request...

  11. The development and evaluation of a new coding system for medical records.

    PubMed

    Papazissis, Elias

    2014-01-01

    The present study aims to develop a simple, reliable and easy tool enabling clinicians to codify the major part of individualized medical details (patient history and findings of physical examination) quickly and easily in routine medical practice, by entering data to a purpose-built software application, using structure data elements and detailed medical illustrations. We studied medical records of 9,320 patients and we extracted individualized medical details. We recorded the majority of symptoms and the majority of findings of physical examination into the system, which was named IMPACT® (Intelligent Medical Patient Record and Coding Tool). Subsequently the system was evaluated by clinicians, based on the examination of 1206 patients. The evaluation results showed that IMPACT® is an efficient tool, easy to use even under time-pressing conditions. IMPACT® seems to be a promising tool for illustration-guided, structured data entry of medical narrative, in electronic patient records.

  12. 76 FR 18195 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-01

    ... with ``Electronic storage media.'' Retrievability: Delete entry and replace with ``By Social Security... records in the system: Delete entry and replace with ``Full name; other names used; Social Security Number... contact; education information; and system- generated, record specific identification number via...

  13. 78 FR 47308 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-05

    ... data for managing the student population at the National Intelligence University and for historical... of the Secretary Privacy Act of 1974; System of Records AGENCY: Defense Intelligence Agency, DoD. ACTION: Notice to alter a System of Records. SUMMARY: The Defense Intelligence Agency is proposing to...

  14. Digital Data Recording System (DDRS) operating and maintenance manual

    NASA Technical Reports Server (NTRS)

    Griffin, C. R.; Jones, J. I.

    1980-01-01

    The digital data recording system (DDRS) was designed, fabricated, tested, and delivered. This unit is the interface between the synthetic aperture radar (SAR) and the recording system. The SAR data are formatted in the DDRS for data processing on the ground.

  15. 76 FR 12078 - Privacy Act of 1974; Systems of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-04

    ... Affairs, and the Office of Management and Budget (OMB) pursuant to paragraph 4c of Appendix I to OMB....'' * * * * * Categories of records in the system: Delete entry and replace with ``Records contain name, grade, Social..., and military training documents.'' Authority for maintenance of the system: Delete entry and replace...

  16. 7 CFR 1520.3 - Indexes/Record systems.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 7 Agriculture 10 2012-01-01 2012-01-01 false Indexes/Record systems. 1520.3 Section 1520.3... OF AGRICULTURE AVAILABILITY OF INFORMATION TO THE PUBLIC § 1520.3 Indexes/Record systems. 5 U.S.C. 552(a)(2) required that each agency publish or otherwise make available a current index of all...

  17. 7 CFR 1520.3 - Indexes/Record systems.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Indexes/Record systems. 1520.3 Section 1520.3... OF AGRICULTURE AVAILABILITY OF INFORMATION TO THE PUBLIC § 1520.3 Indexes/Record systems. 5 U.S.C. 552(a)(2) required that each agency publish or otherwise make available a current index of all...

  18. 7 CFR 1520.3 - Indexes/Record systems.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 7 Agriculture 10 2014-01-01 2014-01-01 false Indexes/Record systems. 1520.3 Section 1520.3... OF AGRICULTURE AVAILABILITY OF INFORMATION TO THE PUBLIC § 1520.3 Indexes/Record systems. 5 U.S.C. 552(a)(2) required that each agency publish or otherwise make available a current index of all...

  19. 7 CFR 1520.3 - Indexes/Record systems.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 7 Agriculture 10 2013-01-01 2013-01-01 false Indexes/Record systems. 1520.3 Section 1520.3... OF AGRICULTURE AVAILABILITY OF INFORMATION TO THE PUBLIC § 1520.3 Indexes/Record systems. 5 U.S.C. 552(a)(2) required that each agency publish or otherwise make available a current index of all...

  20. 7 CFR 1520.3 - Indexes/Record systems.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 7 Agriculture 10 2011-01-01 2011-01-01 false Indexes/Record systems. 1520.3 Section 1520.3... OF AGRICULTURE AVAILABILITY OF INFORMATION TO THE PUBLIC § 1520.3 Indexes/Record systems. 5 U.S.C. 552(a)(2) required that each agency publish or otherwise make available a current index of all...

  1. 76 FR 20339 - Privacy Act of 1974; Systems of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-12

    ... of the Secretary Privacy Act of 1974; Systems of Records AGENCY: Defense Logistics Agency, DoD. ACTION: Notice to Alter a System of Records. SUMMARY: The Defense Logistics Agency proposes to alter a...: Ms. Jody Sinkler at (703) 767-5045, or Privacy Act Officer, Headquarters, Defense Logistics Agency...

  2. 76 FR 37082 - Privacy Act of 1974; Systems of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-24

    ... of the Secretary Privacy Act of 1974; Systems of Records AGENCY: Defense Logistics Agency, DoD. ACTION: Notice To Amend a System of Records. SUMMARY: The Defense Logistics Agency proposes to amend a..., Privacy Act Officer, Headquarters, Defense Logistics Agency, ATTN: DGA, 8725 John J. Kingman Road, Stop...

  3. 76 FR 20341 - Privacy Act of 1974; Systems of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-12

    ... of the Secretary Privacy Act of 1974; Systems of Records AGENCY: Defense Logistics Agency, DoD. ACTION: Notice to alter a system of records. SUMMARY: The Defense Logistics Agency proposes to alter a...: Ms. Jody Sinkler at (703) 767-5045, or Privacy Act Officer, Headquarters, Defense Logistics Agency...

  4. 76 FR 28002 - Privacy Act of 1974; Systems of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-13

    ... of the Secretary Privacy Act of 1974; Systems of Records AGENCY: Defense Logistics Agency, DoD. ACTION: Notice to delete three systems of records. SUMMARY: The Defense Logistics Agency proposes to... Sinkler at (703) 767-5045, or Chief Privacy and FOIA Officer, Headquarters Defense Logistics Agency, ATTN...

  5. 10 CFR 1705.03 - Systems of records notification.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 false Systems of records notification. 1705.03 Section 1705.03 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD PRIVACY ACT § 1705.03 Systems of records notification. (a... writing. Written requests should be directed to: Privacy Act Officer, Defense Nuclear Facilities...

  6. 10 CFR 1705.03 - Systems of records notification.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 4 2012-01-01 2012-01-01 false Systems of records notification. 1705.03 Section 1705.03 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD PRIVACY ACT § 1705.03 Systems of records notification. (a... writing. Written requests should be directed to: Privacy Act Officer, Defense Nuclear Facilities...

  7. 10 CFR 1705.03 - Systems of records notification.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 4 2011-01-01 2011-01-01 false Systems of records notification. 1705.03 Section 1705.03 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD PRIVACY ACT § 1705.03 Systems of records notification. (a... writing. Written requests should be directed to: Privacy Act Officer, Defense Nuclear Facilities...

  8. 10 CFR 1705.03 - Systems of records notification.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Systems of records notification. 1705.03 Section 1705.03 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD PRIVACY ACT § 1705.03 Systems of records notification. (a... writing. Written requests should be directed to: Privacy Act Officer, Defense Nuclear Facilities...

  9. 77 FR 4002 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-26

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE RIN 0605-XA37 Privacy Act of 1974; System of Records AGENCY: U.S. Census Bureau, Department of Commerce. ACTION: Notice of Amendment, Privacy Act System of Records; COMMERCE/ CENSUS-3, Individual and...

  10. 76 FR 22682 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-22

    ...: Washington Headquarters Services no longer provides human resource services for the Defense Advanced Research... of the Secretary Privacy Act of 1974; System of Records AGENCY: Office of the Secretary, DoD. ACTION: Notice to Delete a System of Records. SUMMARY: The Office of the Secretary of Defense is deleting...

  11. 78 FR 12423 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-22

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Privacy Act of 1974; System of Records AGENCY: Department of Veterans Affairs. ACTION: Notice of... records. Notice is hereby given that the Department of Veterans Affairs (VA) is establishing a new system...

  12. 78 FR 18565 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-27

    ...: Department of Defense military personnel (Active/reserve duty) and their spouses; U.S. Coast Guard personnel...: Applicants for appointment in the U.S. Army or U.S. Army Reserves. Categories of records in the system... Management Program Appeal File. System location: Active Duty Army and Active Army Reserve records are located...

  13. 78 FR 19462 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-01

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF COMMERCE... Trademark Office, Commerce. ACTION: Notice of amendment of Privacy Act system of records. SUMMARY: In... Trademark Office (USPTO) is amending the system of records currently listed under ``COMMERCE/...

  14. 22 CFR 505.15 - Exempt systems of records used.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Exempt systems of records used. 505.15 Section 505.15 Foreign Relations BROADCASTING BOARD OF GOVERNORS PRIVACY ACT REGULATION § 505.15 Exempt systems of records used. The BBG is authorized to use exemptions (k)(1), (k)(2), (k)(4), (k)(5) and (k)(6)....

  15. 10 CFR 1705.03 - Systems of records notification.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 4 2014-01-01 2014-01-01 false Systems of records notification. 1705.03 Section 1705.03 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD PRIVACY ACT § 1705.03 Systems of records notification. (a... writing. Written requests should be directed to: Privacy Act Officer, Defense Nuclear Facilities Safety...

  16. 77 FR 61582 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-10

    ..., Air Force Privacy Act Office, Office of Warfighting Integration and Chief Information Officer, ATTN... Department of the Air Force Privacy Act of 1974; System of Records AGENCY: Department of the Air Force, DoD. ACTION: Notice To Alter a System of Records. SUMMARY: The Department of the Air Force proposes to alter...

  17. 77 FR 17035 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-23

    ..., Air Force Privacy Act Office, Office of Warfighting Integration and Chief Information Officer, ATTN... Department of the Air Force Privacy Act of 1974; System of Records AGENCY: Department of the Air Force, DoD. ] ACTION: Notice to delete a system of records. SUMMARY: The Department of the Air Force is deleting...

  18. 77 FR 13570 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-07

    ..., Air Force Privacy Act Office, Office of Warfighting Integration and Chief Information officer, ATTN... Department of the Air Force Privacy Act of 1974; System of Records AGENCY: Department of the Air Force, DoD. ACTION: Notice to Delete a System of Records. ] SUMMARY: The Department of the Air Force is deleting...

  19. 76 FR 14119 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-15

    ... of Amendment of Systems of Records Notice ``Supervised Fiduciary/Beneficiary and General... inventory entitled ``Supervised Fiduciary/Beneficiary and General Investigative Records--VA'' (37VA27). VA.... Gingrich, Chief of Staff, Department of Veterans Affairs. 37VA27 SYSTEM NAME: ``VA Supervised Fiduciary...

  20. 77 FR 25993 - Privacy Act of 1974; System of Records

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-02

    ...). Categories of records in the system: Name, Social Security Number (SSN), date of birth, home address, place... certifications or licenses; awards information and merit promotion information; separation and retirement data..., accessing, retaining, and disposing of records in the system: Storage: Electronic storage media...