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Ireland’s physicians have a legal and an ethical duty to protect confidential patient information. Most healthcare records in Ireland remain paper based, so the purpose of this paper is to: assess the protection afforded to paper records; log highest risk records; note the variations that occurred during the working week; and observe the varying protection that occurred when staff, students and public members were present.

A customised audit tool was created using Sphinx software. Data were collected for three months. All wards included in the study were visited once during four discrete time periods across the working week. The medical records trolley’s location was noted and total unattended medical records, total unattended nursing records, total unattended patient lists and when nursing personnel, medical students, public and a ward secretary were visibly present were recorded.

During 84 occasions when the authors visited wards, unattended medical records were identified on 33 per cent of occasions, 49 per cent were found during weekend visiting hours and just 4 per cent were found during morning rounds. The unattended medical records belonged to patients admitted to a medical specialty in 73 per cent of cases and a surgical specialty in 27 per cent. Medical records were found unattended in the nurses’ station with much greater frequency when the ward secretary was off duty. Unattended nursing records were identified on 67 per cent of occasions the authors visited the ward and were most commonly found unattended in groups of six or more.

This study is a timely reminder that confidential patient information is at risk from inappropriate disclosure in the hospital. There are few context-specific standards for data protection to guide healthcare professionals, particularly paper records. Nursing records are left unattended with twice the frequency of medical records and are found unattended in greater numbers than medical records. Protection is strongest when ward secretaries are on duty. Over-reliance on vigilant ward secretaries could represent a threat to confidential patient information.

While other studies identified data protection as an issue, this study assesses how data security varies inside and outside conventional working hours. It provides a rationale and an impetus for specific changes across the whole working week. By identifying the on-duty ward secretary’s favourable effect on medical record security, it highlights the need for alternative arrangements when the ward secretary is off duty. Data were collected prospectively in real time, giving a more accurate healthcare record security snapshot in each data collection point.

This paper examines existing research on the topic of personal health records (PHRs). Areas covered include PHR/patient portal, recordkeeping, preservation planning, access and provider needs for future reuse of health information. Patient and physician PHR use and functionality, as well as adoption facilitators and barriers, are also reviewed.

The paper engages in a review of relevant literature from a variety of subject domains, including personal information management, medical informatics, medical literature and archives and records management literature.

The review finds that PHRs are extensions of electronic records. In addition, it finds a lack of literature within archives and records management that may lead to a less preservation-centric examination of the new PHR technologies that are desirable for controlling the lifecycle of these important new records-type.

Although the issues presented by PHRs are issues that can best be solved with the use of techniques from records management, there is no current literature related to PHRs in the records management literature, and that offered in the medical informatics literature treats the stewardship aspects of PHRs as insurmountable. This paper offers an introduction to the aspects of PHRs that could fruitfully be examined in archives and records management.

Big Data is one of the most promising area where it can be applied to make a change is health care. Healthcare analytics have the potential to reduce the treatment costs, forecast outbreaks of epidemics, avoid preventable diseases, and improve the quality of life. In general, the lifetime of human is increasing along world population, which poses new experiments to today’s treatment delivery methods. Health professionals are skillful of gathering enormous volumes of data and look for best approaches to use these numbers. Big data analytics has helped the healthcare area by providing personalized medicine and prescriptive analytics, medical risk interference and predictive analytics, computerized external and internal reporting of patient data, homogeneous medical terms and patient registries, and fragmented point solutions. The data generated level within healthcare systems is significant. This includes electronic health record data, imaging data, patient-generated data, etc. While widespread information in health care is now mostly electronic and fits under the big data as most is unstructured and difficult to use. The use of big data in health care has raised substantial ethical challenges ranging from risks for specific rights, privacy and autonomy, to transparency and trust.

Tremendous measure of data lakes with the exponential mounting rate is produced by the present healthcare sector. The information from differing sources like electronic wellbeing record, clinical information, streaming information from sensors, biomedical image data, biomedical signal information, lab data, and so on brand it substantial as well as mind-boggling as far as changing information positions, which have stressed the abilities of prevailing regular database frameworks in terms of scalability, storage of unstructured data, concurrency, and cost. Big data solutions step in the picture by harnessing these colossal, assorted, and multipart data indexes to accomplish progressively important and learned patterns. The reconciliation of multimodal information seeking after removing the relationship among the unstructured information types is a hotly debated issue these days. Big data energizes in triumphing the bits of knowledge from these immense expanses of information. Big data is a term which is required to take care of the issues of volume, velocity, and variety generally seated in the medicinal services data. This work plans to exhibit a survey of the writing of big data arrangements in the medicinal services part, the potential changes, challenges, and accessible stages and philosophies to execute enormous information investigation in the healthcare sector. The work categories the big healthcare data (BHD) applications in five broad categories, followed by a prolific review of each sphere, and also offers some practical available real-life applications of BHD solutions.

Information systems play a significant role in the improving of health and healthcare, as well as in the planning and financing of health services. Fund’s Information System is an essential component of the information infrastructure that allows assessment of the impact of changes in health insurance and healthcare for the population. The purpose of this paper is to give a brief overview of the affection of e-services and electronic data exchange (between Fund’s information systems and other IT systems) at the quality of service for insured people and savings funds.

The authors opted for an exploratory study using the e-services implemented in Health Insurance Fund (HIF) of Macedonia and data which were complemented by documentary analysis, including brand documents and descriptions of internal processes. In this paper is presented an analysis of the financial aspects of some e-services in HIF of Macedonia by using computer-based information systems and calculating the financial implications on insured people, companies and healthcare providers.

The analysis conducted in this paper shows that the HIF’s e-services would have a positive impact for the insured people, healthcare providers and companies when fulfilling their administrative obligations and exercising their rights.

The analysis presented in this paper can serve as a valuable input for the healthcare authorities in making decisions related to introducing e-services in healthcare. These enhanced e-services will improve the quality service of the HIF.

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.

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.

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.

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.

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.

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.

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.

The purpose of this paper is to analyze two case studies with a trust matrix tool, to identify trust issues related to electronic health records.

A qualitative research approach is applied using two case studies. The data analysis of these studies generated a problem list, which was mapped to a trust matrix.

Results demonstrate flaws in current practices and point to achieving balance between organizational, person and technology trust perspectives. The analysis revealed three challenge areas, to: achieve higher trust in patient-focussed healthcare; improve communication between patients and healthcare professionals; and establish clear terminology. By taking trust into account, a more holistic perspective on healthcare can be achieved, where trust can be obtained and optimized.

A trust matrix is tested and shown to identify trust problems on different levels and relating to trusting beliefs. Future research should elaborate and more fully address issues within three identified challenge areas.

The trust matrix’s usefulness as a tool for organizations to analyze trust problems and issues is demonstrated.

Healthcare trust issues are captured to a greater extent and from previously unchartered perspectives.

Recently, blockchain technology (BT) has resolved healthcare data management challenges. It helps healthcare providers automate medical records and mining to aid in data sharing and making more accurate diagnoses. This paper attempts to identify the critical success factors (CSFs) for successfully implementing BT in healthcare.

The paper is methodologically structured in four phases. The first phase leads to identifying success factors by reviewing the extant literature. In the second phase, expert opinions were solicited to authenticate the critical success factors required to implement BT in the healthcare sector. Decision Making Trial and Evaluation Laboratory (DEMATEL) method was employed to find the cause-and-effect relationship among the third phase’s critical success factors. In phase 4, the authors resort to validating the final results and findings.

Based on the analysis, 21 CSFs were identified and grouped under six dimensions. After applying the DEMATEL technique, nine factors belong to the causal group, and the remaining 12 factors fall under the effect group. The top three influencing factors of blockchain technology implementation in the healthcare ecosystem are data transparency, track and traceability and government support, whereas; implementation cost was the least influential.

This study provides a roadmap and may facilitate healthcare professionals to overcome contemporary challenges with the help of BT.

The purpose of this paper is to describe the application of soft systems methodology (SSM) to address the problematic situation of low opt-in rates for Precision Health-Care (PHC).

The design logic is that when trust is enhanced and compliance is better assured, participants such as patients and their doctors would be more likely to share their medical data and diagnosis for the purpose of precision modeling.

The authors present the findings of an empirical study that confronts the design challenge of increasing participant opt-in to a PHC repository of Electronic Medical Records and genetic sequencing. Guided by SSM, the authors formulate design rules for the establishment of a trust-less platform for PHC which incorporates key principles of transparency, traceability and immutability.

The SSM approach has been criticized for its lack of “rigour” and “replicability”. This is a fallacy in understanding its purpose – theory exploration rather than theory confirmation. Moreover, it is unlikely that quantitative modeling yields any clearer an understanding of complex, socio-technical systems.

The application of Blockchain, a platform for distributed ledgers, and associated technologies present a feasible approach for resolving the problematic situation of low opt-in rates.

A consequence of low participation is the weak recall and precision of descriptive, predictive and prescriptive analytic models. Factors such as cyber-crime, data violation and the potential for misuse of genetic and medical records have led to a lack of trust from key stakeholders – accessors, participants, miners and regulators – to varying degrees.

The application of Blockchain as a trust-enabling platform in the domain of an emerging eco-system such as precision health is novel and pioneering.