scholarly journals Designing electronic health records versus total digital health systems: A systemic analysis

2009 ◽  
Vol 26 (1) ◽  
pp. 63-79 ◽  
Author(s):  
Wullianallur Raghupathi ◽  
Someswar Kesh
Keyword(s):  
Electronic Health Records ◽  
Health Systems ◽  
Digital Health ◽  
Health Records ◽  
Systemic Analysis ◽  
Electronic Health

scholarly journals Digital Health and the State of Interoperable Electronic Health Records (Preprint)

2018 ◽  
Author(s):  
Jessica Germaine Shull
Keyword(s):  
Health Care ◽  
Best Practices ◽  
Electronic Health Records ◽  
Health Systems ◽  
Health Care Services ◽  
Care Delivery ◽  
Digital Health ◽  
Health Records ◽  
Number Of Patients ◽  
Electronic Health

UNSTRUCTURED Digital health systems and innovative care delivery within these systems have great potential to improve national health care and positively impact the health outcomes of patients. However, currently, very few countries have systems that can implement digital interventions at scale. This is partly because of the lack of interoperable electronic health records (EHRs). It is difficult to make decisions for an individual or population when the data on that person or population are dispersed over multiple incompatible systems. This viewpoint paper has highlighted some key obstacles of current EHRs and some promising successes, with the goal of promoting EHR evolution and advocating for frameworks that develop digital health systems that serve populations—a critical goal as we move further into this data-rich century with an ever-increasing number of patients who live longer and depend on health care services where resources may already be strained. This paper aimed to analyze the evolution, obstacles, and current landscape of EHRs and identify fundamental areas of hindrance for interoperability. It also aimed to highlight countries where advances have been made and extract best practices from these examples. The obstacles to EHR interoperability are not easily solved, but improving the current situation in countries where a national policy is not in place will require a focused inquiry into solutions from various sources in the public and private sector. Effort must be made on a national scale to seek solutions for optimally interoperable EHRs beyond status quo solutions. A list of considerations for best practices is suggested.

scholarly journals Digital Health and the State of Interoperable Electronic Health Records

10.2196/12712 ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. e12712 ◽  
Author(s):  
Jessica Germaine Shull
Keyword(s):  
Health Care ◽  
Best Practices ◽  
Electronic Health Records ◽  
Health Systems ◽  
Health Care Services ◽  
Care Delivery ◽  
Digital Health ◽  
Health Records ◽  
Number Of Patients ◽  
Electronic Health

Digital health systems and innovative care delivery within these systems have great potential to improve national health care and positively impact the health outcomes of patients. However, currently, very few countries have systems that can implement digital interventions at scale. This is partly because of the lack of interoperable electronic health records (EHRs). It is difficult to make decisions for an individual or population when the data on that person or population are dispersed over multiple incompatible systems. This viewpoint paper has highlighted some key obstacles of current EHRs and some promising successes, with the goal of promoting EHR evolution and advocating for frameworks that develop digital health systems that serve populations—a critical goal as we move further into this data-rich century with an ever-increasing number of patients who live longer and depend on health care services where resources may already be strained. This paper aimed to analyze the evolution, obstacles, and current landscape of EHRs and identify fundamental areas of hindrance for interoperability. It also aimed to highlight countries where advances have been made and extract best practices from these examples. The obstacles to EHR interoperability are not easily solved, but improving the current situation in countries where a national policy is not in place will require a focused inquiry into solutions from various sources in the public and private sector. Effort must be made on a national scale to seek solutions for optimally interoperable EHRs beyond status quo solutions. A list of considerations for best practices is suggested.

Innovating through integration with electronic health records: The UCSF Digital Diagnostics and Therapeutics Committee (Preprint)

2019 ◽  
Author(s):  
Andrew Auerbach ◽  
Russell Cucina ◽  
Kelsey Sobomehein ◽  
Priyanka Agarwal ◽  
Aaron Neinstein ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Health Systems ◽  
Digital Health ◽  
Software Tools ◽  
Lessons Learned ◽  
Health Records ◽  
Review Team ◽  
Wide Availability ◽  
Electronic Health ◽  
Therapeutics Committee

UNSTRUCTURED Despite the wide availability of Digital Health Software Tools (DHSTs) and increasing technical ease with which they can be added to Electronic Health Records (EHRs), many hospitals and health systems struggle with how to select, screen, and then implement them in actual practice. Developing a multidisciplinary review team – one we call the ‘Digital Diagnostics and Therapeutics’ Committee at UCSF – represents a key solution to ensuring innovations are vetted and adopted effectively, and allows health systems and providers to evaluate DHST in practice. In this paper, we describe the rationale, early work, and lessons learned from our team’s efforts.

scholarly journals Designing Decentralized Ledger Technology for Electronic Health Records

2018 ◽  
Vol 1 (2) ◽  
Author(s):  
Vikram Dhillon
Keyword(s):  
Electronic Health Records ◽  
Open Source ◽  
Digital Health ◽  
Health Records ◽  
Distributed Ledger ◽  
Distributed Ledger Technology ◽  
Electronic Health

No abstract available. Editor’s note: A proposal to implement distributed ledger technology for electronic health records is outlined here. The rationale for integration of distributed ledgers in the healthcare domain is introduced, followed by a discussion of the features enabled by the use of a blockchain. An open source implementation of a distributed ledger is then presented. The article concludes with an examination of opportunities and challenges ahead in deploying blockchains for digital health.

scholarly journals Electronic Health Records, Interoperability and Patient Safety in Health Systems of High-income Countries: A Systematic Review Protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e044941
Author(s):  
Edmond Li ◽  
Jonathan Clarke ◽  
Ana Luisa Neves ◽  
Hutan Ashrafian ◽  
Ara Darzi
Keyword(s):  
Systematic Review ◽  
Patient Safety ◽  
Electronic Health Records ◽  
Health Systems ◽  
Risk Of Bias ◽  
High Income ◽  
The Body ◽  
Health Records ◽  
Electronic Health ◽  
The Impact

IntroductionThe availability and routine use of electronic health records (EHRs) have become commonplace in healthcare systems of many high-income countries. While there is an ever-growing body of literature pertaining to their use, evidence surrounding the importance of EHR interoperability and its impact on patient safety remains less clear. There is, therefore, a need and opportunity to evaluate the evidence available regarding this relationship so as to better inform health informatics development and policies in the years to come. This systematic review aims to evaluate the impact of EHR interoperability on patient safety in health systems of high-income countries.Methods and analysisA systematic literature review will be conducted via a computerised search through four databases: PubMed, Embase, Health Management Information Consortium and PsycInfo for relevant articles published between 2010 and 2020. Outcomes of interest will include impact on patient safety and the broader effects on health systems. Quality of the randomised quantitative studies will be assessed using Cochrane Risk of Bias Tool. Non-randomised papers will be evaluated with the Risk of Bias In Non-Randomised Studies—of Interventions tool. Drummond’s Checklist will be used for publications pertaining to economic evaluation. The National Institute for Health and Care Excellence quality appraisal checklist will be used to assess qualitative studies. A narrative synthesis will be conducted for included studies, and the body of evidence will be summarised in a summary of findings table.Ethics and disseminationThis review will summarise published studies with non-identifiable data and, thus, does not require ethical approval. Findings will be disseminated through preprints, open access peer-reviewed publications, and conference presentations.PROSPERO registration numberCRD42020209285.

scholarly journals Diabetes and hypertension among South Asians in New York and Atlanta leveraging hospital electronic health records

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Jeannette M. Beasley ◽  
Joyce C. Ho ◽  
Sarah Conderino ◽  
Lorna E. Thorpe ◽  
Megha Shah ◽  
...  
Keyword(s):  
New York ◽  
Electronic Health Records ◽  
Health Systems ◽  
South Asian ◽  
South Asians ◽  
New York University ◽  
Health Records ◽  
Asian Patients ◽  
The Us ◽  
Electronic Health

Abstract Background Diabetes and hypertension disparities are pronounced among South Asians. There is regional variation in the prevalence of diabetes and hypertension in the US, but it is unknown whether there is variation among South Asians living in the US. The objective of this study was to compare the burden of diabetes and hypertension between South Asian patients receiving care in the health systems of two US cities. Methods Cross-sectional analyses were performed using electronic health records (EHR) for 90,137 South Asians receiving care at New York University Langone in New York City (NYC) and 28,868 South Asians receiving care at Emory University (Atlanta). Diabetes was defined as having 2 + encounters with a diagnosis of diabetes, having a diabetes medication prescribed (excluding Acarbose/Metformin), or having 2 + abnormal A1C levels (≥ 6.5%) and 1 + encounter with a diagnosis of diabetes. Hypertension was defined as having 3 + BP readings of systolic BP ≥ 130 mmHg or diastolic BP ≥ 80 mmHg, 2 + encounters with a diagnosis of hypertension, or having an anti-hypertensive medication prescribed. Results Among South Asian patients at these two large, private health systems, age-adjusted diabetes burden was 10.7% in NYC compared to 6.7% in Atlanta. Age-adjusted hypertension burden was 20.9% in NYC compared to 24.7% in Atlanta. In Atlanta, 75.6% of those with diabetes had comorbid hypertension compared to 46.2% in NYC. Conclusions These findings suggest differences by region and sex in diabetes and hypertension risk. Additionally, these results call for better characterization of race/ethnicity in EHRs to identify ethnic subgroup variation, as well as intervention studies to reduce lifestyle exposures that underlie the elevated risk for type 2 diabetes and hypertension development in South Asians.

scholarly journals A Mechanism for Verifying the Integrity and Immutability of Tuberculosis Data Using IOTA Distributed Ledger Technology

2021 ◽  
Author(s):  
Vinícius Lima ◽  
Filipe Bernardi ◽  
Rui Rijo ◽  
Jó Ueyama ◽  
Domingos Alves
Keyword(s):  
Electronic Health Records ◽  
Digital Health ◽  
Health Records ◽  
Related Information ◽  
Research And Innovation ◽  
Distributed Ledger ◽  
Collective Process ◽  
Supporting Tool ◽  
Electronic Health ◽  
Digital Transactions

Background: Intensified research and innovation and rapid uptake of new tools, interventions, and strategies are crucial to fight Tuberculosis, the world’s deadliest infectious disease. The sharing of health data remains a significant challenge. Data consumers must be able to verify the consistency and integrity of data. Solutions based on distributed ledger technologies may be adequate, where each member in a network holds a unique credential and stores an identical copy of the ledger and contributes to the collective process of validating and certifying digital transactions. Objectives: This work proposes a mechanism and presents a use case in Digital Health to allow the verification of integrity and immutability of TB electronic health records. Methods: IOTA was selected as a supporting tool due to its data immutability, traceability and tamper-proof characteristics. Results: A mechanism to verify the integrity of data through hash functions and the IOTA network is proposed. Then, a set of TB related information systems was integrated with the network. Conclusion: IOTA technology offers performance and flexibility to enable a reliable environment for electronic health records.

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