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Open Access
Book part
Publication date: 6 May 2019

Michael Rigby, Grit Kühne and Shalmali Deshpande

Information and communication technologies can transform how services can be and are delivered as has already happened in other arenas, such as civil aviation, financial services…

Abstract

Information and communication technologies can transform how services can be and are delivered as has already happened in other arenas, such as civil aviation, financial services and retailing. Most modern health care is heavily dependent on e-health, including record keeping, targeted information sharing and digital diagnostic and imaging techniques. However, there remains little scientific knowledge base for optimal system content and function in primary health care, particularly for children. Models of Child Health Appraised (MOCHA) aimed to establish the current e-health situation in children’s primary care services. Electronic health records (EHRs) are in regular use in much of northern and western Europe and in some newer European Union Member States, but other countries lag behind. MOCHA investigated the use of unique identifiers, the use of case-based public health EHRs and the capability of record linkage, linkage of information with school health data and monitoring of social media influences, such as health websites and health apps. A widespread lack of standards underlined a lack of research enquiry into this issue in terms of children’s health data and health knowledge. Health websites and apps are a growing area of healthcare delivery, but there is a worrying lack of safeguards in place. The challenge for policy-makers and practitioners is to be aware and to lead on the innovative harnessing of new technologies, while protecting child users against new harms.

Details

Issues and Opportunities in Primary Health Care for Children in Europe
Type: Book
ISBN: 978-1-78973-354-9

Keywords

Open Access
Article
Publication date: 19 February 2021

Isto Huvila, Åsa Cajander, Jonas Moll, Heidi Enwald, Kristina Eriksson-Backa and Hanife Rexhepi

Data from a national patient survey (N = 1,155) of the Swedish PAEHR “Journalen” users were analysed, and an extended version of the theory of technological frames was developed…

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Abstract

Purpose

Data from a national patient survey (N = 1,155) of the Swedish PAEHR “Journalen” users were analysed, and an extended version of the theory of technological frames was developed to explain the variation in the technological and informational framing of information technologies found in the data.

Design/methodology/approach

Patient Accessible Electronic Health Records (PAEHRs) are implemented globally to address challenges with an ageing population. However, firstly, little is known about age-related variation in PAEHR use, and secondly, user perceptions of the PAEHR technology and the health record information and how the technology and information–related perceptions are linked to each other. The purpose of this study is to investigate these two under-studied aspects of PAEHRs and propose a framework based on the theory of technological frames to support studying the second aspect, i.e. the interplay of information and technology–related perceptions.

Findings

The results suggest that younger respondents were more likely to be interested in PAEHR contents for general interest. However, they did not value online access to the information as high as older ones. Older respondents were instead inclined to use medical records information to understand their health condition, prepare for visits, become involved in their own healthcare and think that technology has a much potential. Moreover, the oldest respondents were more likely to consider the information in PAEHRs useful and aimed for them but to experience the technology as inherently difficult to use.

Research limitations/implications

The sample excludes non-users and is not a representative sample of the population of Sweden. However, although the data contain an unknown bias, there are no specific reasons to believe that it would differently affect the survey's age groups.

Practical implications

Age should be taken into account as a key factor that influences perceptions of the usefulness of PAEHRs. It is also crucial to consider separately patients' views of PAEHRs as a technology and of the information contained in the EHR when developing and evaluating existing and future systems and information provision for patients.

Social implications

This study contributes to bridging the gap between information behaviour and systems design research by showing how the theory of technological frames complemented with parallel informational frames to provide a potentially powerful framework for elucidating distinct conceptualisations of (information) technologies and the information they mediate. The empirical findings show how information and information technology needs relating to PAEHRs vary according to age. In contrast to the assumptions in much of the earlier work, they need to be addressed separately.

Originality/value

Few earlier studies focus on (1) age-related variation in PAEHR use and (2) user perceptions of the PAEHR technology and the health record information and how the technology and information–related perceptions are linked to each other.

Details

Information Technology & People, vol. 35 no. 8
Type: Research Article
ISSN: 0959-3845

Keywords

Open Access
Article
Publication date: 7 April 2022

Vandoir Welchen, Juliana Matte, Cintia Paese Giacomello, Franciele Dalle Molle and Maria Emilia Camargo

The purpose of this paper is to validate and measure the overall evaluation of electronic health record (EHR) and identify the factors that influence the health information…

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Abstract

Purpose

The purpose of this paper is to validate and measure the overall evaluation of electronic health record (EHR) and identify the factors that influence the health information systems (HIS) assessment in Brazil.

Design/methodology/approach

From February to May 2020, this study surveyed 262 doctors and nurses who work in hospitals and use the EHR in their workplace. This study validated the National Usability-focused HIS Scale (NuHISS) to measure usability in the Brazilian context.

Findings

The results showed adequate validity and reliability, validating the NuHISS in the Brazilian context. The survey showed that 38.9% of users rated the system as high quality. Technical quality, ease of use and benefits explained 43.5% of the user’s overall system evaluation.

Research limitations/implications

This study validated the items that measure usability of health-care systems and identified that not all usability items impact the overall evaluation of the EHR.

Practical implications

NuHISS can be a valuable tool to measure HIS usability for doctors and nurses and monitor health systems’ long-term usability among health professionals. The results suggest dissatisfaction with the usability of HIS systems, specifically the EHR in hospital units. For this reason, those responsible for health systems must observe usability. This tool enables usability monitoring to highlight information system deficiencies for public managers. Furthermore, the government can create and develop actions to improve the existing tools to support health professionals.

Social implications

From the scale validation, public managers could monitor and develop actions to foster the system’s usability, especially the system’s technical qualities – the factor that impacted the overall system evaluation.

Originality/value

To the best of the authors’ knowledge, this study is the first to validate the usability scale of EHR systems in Brazil. The results showed dissatisfaction with HIS and identified the factors that most influence the system evaluation.

Open Access
Article
Publication date: 9 May 2022

Kevin Wang and Peter Alexander Muennig

The study explores how Taiwan’s electronic health data systems can be used to build algorithms that reduce or eliminate medical errors and to advance precision medicine.

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Abstract

Purpose

The study explores how Taiwan’s electronic health data systems can be used to build algorithms that reduce or eliminate medical errors and to advance precision medicine.

Design/methodology/approach

This study is a narrative review of the literature.

Findings

The body of medical knowledge has grown far too large for human clinicians to parse. In theory, electronic health records could augment clinical decision-making with electronic clinical decision support systems (CDSSs). However, computer scientists and clinicians have made remarkably little progress in building CDSSs, because health data tend to be siloed across many different systems that are not interoperable and cannot be linked using common identifiers. As a result, medicine in the USA is often practiced inconsistently with poor adherence to the best preventive and clinical practices. Poor information technology infrastructure contributes to medical errors and waste, resulting in suboptimal care and tens of thousands of premature deaths every year. Taiwan’s national health system, in contrast, is underpinned by a coordinated system of electronic data systems but remains underutilized. In this paper, the authors present a theoretical path toward developing artificial intelligence (AI)-driven CDSS systems using Taiwan’s National Health Insurance Research Database. Such a system could in theory not only optimize care and prevent clinical errors but also empower patients to track their progress in achieving their personal health goals.

Originality/value

While research teams have previously built AI systems with limited applications, this study provides a framework for building global AI-based CDSS systems using one of the world’s few unified electronic health data systems.

Details

Applied Computing and Informatics, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2634-1964

Keywords

Content available
Article
Publication date: 28 October 2014

Silvia Gherardi, Carsten Østerlund and Finn Kensing

420

Abstract

Details

Information Technology & People, vol. 27 no. 4
Type: Research Article
ISSN: 0959-3845

Open Access
Article
Publication date: 11 April 2016

Denise L. Anthony and Timothy Stablein

The purpose of this paper is to explore different health care professionals’ discourse about privacy – its definition and importance in health care, and its role in their…

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Abstract

Purpose

The purpose of this paper is to explore different health care professionals’ discourse about privacy – its definition and importance in health care, and its role in their day-to-day work. Professionals’ discourse about privacy reveals how new technologies and laws challenge existing practices of information control within and between professional groups in health care, with implications not only for patient privacy, but also for the role of information control in professions more generally.

Design/methodology/approach

The authors conducted in-depth, semi-structured interviews with n=83 doctors, nurses, and health information professionals in two academic medical centers and one veteran’s administration hospital/clinic in the Northeastern USA. Interview responses were qualitatively coded for themes and patterns across groups were identified.

Findings

The health care providers and the authors studied actively sought to uphold the protection (and control) of patient information through professional ethics and practices, as well as through the use of technologies and compliance with legal regulations. They used discourses of professionalism, as well as of law and technology, to sometimes accept and sometimes resist changes to practice required in the changing technological and legal context of health care. The authors found differences across professional groups; for some, protection of patient information is part of core professional ethics, while for others it is simply part of their occupational work, aligned with organizational interests.

Research limitations/implications

This qualitative study of physicians, nurses, and health information professionals revealed some differences in views and practices for protecting patient information in the changing technological and legal context of health care that suggest some professional groups (doctors) may be more likely to resist such changes and others (health information professionals) will actively adopt them.

Practical implications

New technologies and regulations are changing how information is used in health care delivery, challenging professional practices for the control of patient information that may change the value or meaning of medical records for different professional groups.

Originality/value

Qualitative findings suggest that professional groups in health care vary in the extent of information control they have, as well in how they view such control. Some groups may be more likely to (be able to) resist changes in the professional control of information that stem from new technologies or regulatory policies. Some professionals recognize that new IT systems and regulations challenge existing social control of information in health care, with the potential to undermine (or possibly bolster) professional self-control for some but not necessarily all occupational groups.

Details

Journal of Health Organization and Management, vol. 30 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

Open Access
Book part
Publication date: 4 May 2018

Syahril Efendi, Baihaqi Siregar and Heru Pranoto

Innovation in a decentralized blockchain infrastructure can be used by medicine as a prerequisite for the exchange of patient data. Developments in the medical device industry…

Abstract

Innovation in a decentralized blockchain infrastructure can be used by medicine as a prerequisite for the exchange of patient data. Developments in the medical device industry that support the technology of the internet of things and wireless sensor networks also facilitate the examination of patient medical records that no longer require visits to the practice of doctors or hospitals which in some cases takes in a considerable time. Not to mention the consideration of traffic congestion and busy routine in the work. Patients can check their healthcare concerns using only sensors such as e-Health Sensor Shield Platform which then sends recording results through the transmission line to the data lakes. However, this patient’s medical record data is very confidential and may only be accessed by certain parties only. This required the design of the concept of security in the transmission of data so that the data does not leak to parties who are not eligible. This paper attempts to provide an overview of the concept of using encryption with an asymmetric key for securing data from sensors to data lakes before forwarding to a decentralized, interconnected blockchain infrastructure.

Open Access
Article
Publication date: 19 September 2022

Tyler Aird, Ceara Holditch, Sarah Culgin, Margareta Vanderheyden, Greg Rutledge, Carlo Encinareal, Dan Perri, Fraser Edward and Hugh Boyd

The purpose of the article is to assess the effectiveness, compliance, adoption and lessons learnt from the pilot implementation of a data integration solution between an acute…

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Abstract

Purpose

The purpose of the article is to assess the effectiveness, compliance, adoption and lessons learnt from the pilot implementation of a data integration solution between an acute care hospital information system (HIS) and a long-term care (LTC) home electronic medical record through a case report.

Design/methodology/approach

Utilization statistics of the data integration solution were captured at one-month post implementation and again one year later for both the emergency department (ED) and LTC home. Clinician feedback from surveys and structured interviews was obtained from ED physicians and a multidisciplinary LTC group.

Findings

The authors successfully exchanged health information between a HIS and the electronic medical record (EMR) of an LTC facility in Canada. Perceived time savings were acknowledged by ED physicians, and actual time savings as high as 45 min were reported by LTC staff when completing medication reconciliation. Barriers to adoption included awareness, training efficacy and delivery models, workflow integration within existing practice and the limited number of facilities participating in the pilot. Future direction includes broader staff involvement, expanding the number of sites and re-evaluating impacts.

Practical implications

A data integration solution to exchange clinical information can make patient transfers more efficient, reduce data transcription errors, and improve the visibility of essential patient information across the continuum of care.

Originality/value

Although there has been a large effort to integrate health data across care levels in the United States and internationally, the groundwork for such integrations between interoperable systems has only just begun in Canada. The implementation of the integration between an enterprise LTC electronic medical record system and an HIS described herein is the first of its kind in Canada. Benefits and lessons learnt from this pilot will be useful for further hospital-to-LTC home interoperability work.

Details

Journal of Integrated Care, vol. 30 no. 4
Type: Research Article
ISSN: 1476-9018

Keywords

Open Access
Book part
Publication date: 6 May 2019

Abstract

Details

Issues and Opportunities in Primary Health Care for Children in Europe
Type: Book
ISBN: 978-1-78973-354-9

Open Access
Article
Publication date: 20 May 2021

Ricardo Luz, Clarissa Carneiro Mussi, Ademar Dutra and Leonardo Correa Chaves

The study aims to analyze the previous literature on government initiatives to implement health information systems (HISs).

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Abstract

Purpose

The study aims to analyze the previous literature on government initiatives to implement health information systems (HISs).

Design/methodology/approach

Proknow-C (Knowledge Development Process-Constructivist) was used in the selection of the literature and in the bibliometric and systematic analysis.

Findings

The research identified a portfolio composed of 33 articles aligned with the research theme and with scientific recognition, as well as periodicals, authors, papers and keywords that stood out the most. Amongst the government initiatives in the 24 identified countries, England has been the most studied nation, and there is a certain prominence of research arising from developed countries. Electronic health records (EHRs) have been the most explored technology. Efficiency and safety of health care delivery, integration of information and among health organizations, cost reduction and economicity are the most expected benefits from government programs. The difficulties found are related to the broader context in which the system is inserted, to the management of the program, to technology itself and to individuals. The most emphasized difficulties identified in most countries were previous context marked by a lack of standardization/interoperability, acceptance of providers and users and project financing. The findings of the present article provide a theoretical framework for future studies, in addition to yielding a replicable process for future use.

Originality/value

This research may be considered original as it analyzes – through a constructivism-structured process (Proknow-C) – the phenomenon under investigation by gathering bibliometric and systematic review data concomitantly. The countries and technologies reported emerge from the process itself.

Details

Revista de Gestão, vol. 28 no. 2
Type: Research Article
ISSN: 1809-2276

Keywords

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