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https://www.readbyqxmd.com/read/28430572/lessons-about-so-called-difficult-patients-from-the-uk-controversy-over-patient-access-to-electronic-health-records
#1
Federica Lucivero
Increasing numbers of patients have direct access to their electronic health records (EHRs). Proponents of direct access argue that it empowers patients by making them more informed and offering them more control over their health and care. According to some proponents of patients' access to EHRs, clinicians' concerns about potential negative implications are grounded in a form of paternalism that protects clinicians' authority. This paper draws upon narratives from patients in the United Kingdom (UK) who have access to their EHRs and suggests strategies for moving beyond these controversies between proponents and critics of the system...
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28428097/care-coordination-and-comprehensive-electronic-health-records-are-associated-with-increased-transition-planning-activities
#2
Niraj Sharma, Kitty O'Hare, Karen G O'Connor, Umbereen Nehal, Megumi J Okumura
OBJECTIVE: Youth with Special Health Care Needs (YSHCN) require assistance from their pediatricians to transition to adult care. There is little data on what transition resources pediatricians have. This paper studies if care coordination and/or comprehensive electronic health record (CEHR) implementation are associated with improved transition processes. METHODS: Using AAP Periodic Survey #79, we report whether practices generated written transition plans, assisted in finding adult providers, and discussed confidentiality issues...
April 18, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28427407/constructive-ehealth-evaluation-lessons-from-evaluation-of-ehr-development-in-4-danish-hospitals
#3
Anna Marie Balling Høstgaard, Pernille Bertelsen, Christian Nøhr
BACKGROUND: Information and communication sources in the healthcare sector are replaced with new eHealth technologies. This has led to problems arising from the lack of awareness of the importance of end-user involvement in eHealth development and of the difficulties caused by using traditional summative evaluation methods. The Constructive eHealth evaluation method (CeHEM) provides a solution to these problems by offering an evaluation framework for supporting and facilitating end-user involvement during all phases of eHealth development...
April 20, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28426643/incidence-and-trends-of-infections-with-pathogens-transmitted-commonly-through-food-and-the-effect-of-increasing-use-of-culture-independent-diagnostic-tests-on-surveillance-foodborne-diseases-active-surveillance-network-10-u-s-sites-2013-2016
#4
Ellyn P Marder, Paul R Cieslak, Alicia B Cronquist, John Dunn, Sarah Lathrop, Therese Rabatsky-Ehr, Patricia Ryan, Kirk Smith, Melissa Tobin-D'Angelo, Duc J Vugia, Shelley Zansky, Kristin G Holt, Beverly J Wolpert, Michael Lynch, Robert Tauxe, Aimee L Geissler
Foodborne diseases represent a substantial public health concern in the United States. CDC's Foodborne Diseases Active Surveillance Network (FoodNet) monitors cases reported from 10 U.S. sites* of laboratory-diagnosed infections caused by nine enteric pathogens commonly transmitted through food. This report describes preliminary surveillance data for 2016 on the nine pathogens and changes in incidences compared with 2013-2015. In 2016, FoodNet identified 24,029 infections, 5,512 hospitalizations, and 98 deaths caused by these pathogens...
April 21, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28426302/innovations-in-population-health-surveillance-using-electronic-health-records-for-chronic-disease-surveillance
#5
Sharon E Perlman, Katharine H McVeigh, Lorna E Thorpe, Laura Jacobson, Carolyn M Greene, R Charon Gwynn
With 87% of providers using electronic health records (EHRs) in the United States, EHRs have the potential to contribute to population health surveillance efforts. However, little is known about using EHR data outside syndromic surveillance and quality improvement. We created an EHR-based population health surveillance system called the New York City (NYC) Macroscope and assessed the validity of diabetes, hyperlipidemia, hypertension, smoking, obesity, depression, and influenza vaccination indicators. The NYC Macroscope uses aggregate data from a network of outpatient practices...
April 20, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28423855/ehr-improvement-using-incident-reports
#6
Tesfay Teame, Tor Stålhane, Øystein Nytrø
This paper discusses reactive improvement of clinical software using methods for incident analysis. We used the "Five Whys" method because we had only descriptive data and depended on a domain expert for the analysis. The analysis showed that there are two major root causes for EHR software failure, and that they are related to human and organizational errors. A main identified improvement is allocating more resources to system maintenance and user training.
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423843/an-approach-for-the-support-of-semantic-workflows-in-electronic-health-records
#7
Marco Schweitzer, Alexander Hoerbst
With the unprecedented increase of healthcare data, technologies need to be both, highly efficient for the meaningful utilization of accessible data and flexible to adapt to future challenges and individual preferences. The OntoHealth system makes use of semantic technologies to enable flexible and individual interaction with Electronic Health Records (EHR) for physicians. This is achieved by the execution of formally modelled clinical workflows and the composition of Semantic Web Services (SWS). Several seamless components provide a service-oriented structure defined by individual designed EHR-workflows...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423833/hl7-fhir-ontological-reinterpretation-of-medication-resources
#8
Catalina Martinez-Costa, Stefan Schulz
"A solid ontology-based analysis with a rigorous formal mapping for correctness" is one of the ten reasons why the HL7 standard Fast Healthcare Interoperability Resources (FHIR) is advertised to be better than other standards for EHR interoperability. In this paper, we aim at contributing to this formal analysis by proposing an RDF representation of a subset of FHIR resources based on a highly constrained top-level ontology and guided by the use of a set of Content Ontology Design Patterns (Content ODPs) for representing clinical information...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423825/hemic-project-design-of-a-clinical-information-modelling-tool-based-on-iso13972-technical-specification
#9
Alberto Moreno-Conde, Francisco Sanchez-Laguna, Bidatzi Marin-Bastida, Antonio Romero-Tabares, Eva Martin-Sánchez, Dipak Kalra, Carlos Luis Parra-Calderón
The Andalusian Health Service is the public healthcare provider for 8.302.923 inhabitants in the South Spain. This organization coordinates primary and specialized care with an IT infrastructure composed by multiple Electronic Health Record Systems. According to the large volume of healthcare professionals involved, there is a need for providing a consistent management of information through multiple locations and systems. The HEMIC project aims to address this need developing and validating a methodology based on a software tool for standardizing information contained within EHR systems...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423824/querying-archetype-based-electronic-health-records-using-hadoop-and-dewey-encoding-of-openehr-models
#10
Erik Sundvall, Fang Wei-Kleiner, Sergio M Freire, Patrick Lambrix
Archetype-based Electronic Health Record (EHR) systems using generic reference models from e.g. openEHR, ISO 13606 or CIMI should be easy to update and reconfigure with new types (or versions) of data models or entries, ideally with very limited programming or manual database tweaking. Exploratory research (e.g. epidemiology) leading to ad-hoc querying on a population-wide scale can be a challenge in such environments. This publication describes implementation and test of an archetype-aware Dewey encoding optimization that can be used to produce such systems in environments supporting relational operations, e...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423815/mobile-medical-apps-and-mhealth-devices-a-framework-to-build-medical-apps-and-mhealth-devices-in-an-ethical-manner-to-promote-safer-use-a-literature-review
#11
Mary Sharp, Declan O'Sullivan
This paper presents a preliminary literature review in the area of ethics in the development of Mobile Medical Apps and mHealth. The review included both direct health apps and also apps marketed under the area of well-being in addition to mHealth devices. The following words and combinations of them were used to carry out the search for publications, mHealth, Apps, Ethics. The search engines used were Google Scholar, and PubMed. The paper is restricted to publications since 2012. The total number of papers found was 1,920 of which 84 were reviewed...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423809/use-of-a-nationwide-personally-controlled-electronic-health-record-by-healthcare-professionals-and-patients-a-case-study-with-the-french-dmp
#12
Brigitte Seroussi, Jacques Bouaud
If the wide adoption of electronic health records (EHRs) is necessary to address health information sharing and care coordination issues, it is not sufficient. In order to address health information sharing, some countries, among which, France, have implemented a centralized framework with "new" nationwide care records. The French DMP is a centralized, nationally shared, electronic medical record, created according to the opt-in model. More than five years after the launching of the DMP project, DMPs have been created for 1...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423803/business-rules-to-improve-secondary-data-use-of-electronic-healthcare-systems
#13
Jonathan Blaisure, Werner Ceusters
The 'fit for purpose' paradigm used for data quality assessment in electronic healthcare record (EHR) systems is not so fit when assessed in the light of secondary data use. An analysis of the difficulties encountered in trying to use existing EHR data for cohort identification for prospective clinical trials and retrograde data analytics, revealed the root causes to fall in three categories: (1) issues in workflow and data registration, (2) preventable inadequacies in software configuration and personalization and (3) software development issues on the side of the vendor...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423792/acronym-disambiguation-in-spanish-electronic-health-narratives-using-machine-learning-techniques
#14
Ignacio Rubio-López, Roberto Costumero, Héctor Ambit, Consuelo Gonzalo-Martín, Ernestina Menasalvas, Alejandro Rodríguez González
Electronic Health Records (EHRs) are now being massively used in hospitals what has motivated current developments of new methods to process clinical narratives (unstructured data) making it possible to perform context-based searches. Current approaches to process the unstructured texts in EHRs are based in applying text mining or natural language processing (NLP) techniques over the data. In particular Named Entity Recognition (NER) is of paramount importance to retrieve specific biomedical concepts from the text providing the semantic type of the concept retrieved...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423789/using-electronic-health-records-to-assess-depression-and-cancer-comorbidities
#15
Miguel A Mayer, Alba Gutierrez-Sacristan, Angela Leis, Santiago De La Peña, Ferran Sanz, Laura I Furlong
Comorbid diseases are an important concern in oncology since they can affect the choice and effectiveness of treatment. What is particularly relevant is the fact that the diagnosis of depression in cancer patients has an important impact on the quality of life of these patients. Although there is no consensus about a specific relationship of depression with certain cancer types, some authors have proposed that depression constitutes a risk factor for cancer. The objective of this study is to identify the presence of comorbidities in a massive EHR system, between depression and the 10 most common cancers in women and men and to determine if there is a preferred temporal ordering in the co-occurrence of these diseases...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423780/development-and-evaluation-of-a-case-based-retrieval-service
#16
Emilie Pasche, Marcello Chinali, Julien Gobeill, Patrick Ruch
Identifying similar patients might greatly facilitate the treatment of a given patient, enabling to observe the response and outcome to a particular treatment. Case-based retrieval services dealing with natural language processing are of major importance to deal with the significant amount of unstructured clinical data. In this paper, we present the development and evaluation of a case-based retrieval (CBR) service tested on a collection of Italian pediatric cardiology cases. Cases are indexed and a search engine is proposed...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423779/fast-and-efficient-feature-engineering-for-multi-cohort-analysis-of-ehr-data
#17
Michal Ozery-Flato, Chen Yanover, Assaf Gottlieb, Omer Weissbrod, Naama Parush Shear-Yashuv, Yaara Goldschmidt
We present a framework for feature engineering, tailored for longitudinal structured data, such as electronic health records (EHRs). To fast-track feature engineering and extraction, the framework combines general-use plug-in extractors, a multi-cohort management mechanism, and modular memoization. Using this framework, we rapidly extracted thousands of features from diverse and large healthcare data sources in multiple projects.
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423773/introducing-a-method-for-transformation-of-paper-based-research-data-into-concept-based-representation-with-openehr
#18
Birgit Saalfeld, Erik Tute, Klaus-Hendrik Wolf, Michael Marschollek
Combining research data and clinical routine data is a chance for medical research. We present our method for the transformation of paper-based research data into a concept-based representation. With this representation the study data from research projects can be combined with data from clinical tools with less integration effort. We applied and verified our method using data from a current research study. In this paper we also show our main challenges and lessons learned. Clinical assessment data and study diaries from a long term study (n=24, 3 months observation time each, 17 different clinical assessments) stored on paper were used as the data set...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423769/linked-data-applications-through-ontology-based-data-access-in-clinical-research
#19
Ann-Kristin Kock-Schoppenhauer, Christian Kamann, Hannes Ulrich, Petra Duhm-Harbeck, Josef Ingenerf
Clinical care and research data are widely dispersed in isolated systems based on heterogeneous data models. Biomedicine predominantly makes use of connected datasets based on the Semantic Web paradigm. Initiatives like Bio2RDF created Resource Description Framework (RDF) versions of Omics resources, enabling sophisticated Linked Data applications. In contrast, electronic healthcare records (EHR) data are generated and processed in diverse clinical subsystems within hospital information systems (HIS). Usually, each of them utilizes a relational database system with a different proprietary schema...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423767/querying-ehrs-with-a-semantic-and-entity-oriented-query-language
#20
Romain Lelong, Lina Soualmia, Badisse Dahamna, Nicolas Griffon, Stéfan J Darmoni
While the digitization of medical documents has greatly expanded during the past decade, health information retrieval has become a great challenge to address many issues in medical research. Information retrieval in electronic health records (EHR) should also reduce the difficult tasks of manual information retrieval from records in paper format or computer. The aim of this article was to present the features of a semantic search engine implemented in EHRs. A flexible, scalable and entity-oriented query language tool is proposed...
2017: Studies in Health Technology and Informatics
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