Electronic medical record systems: decision support examination framework for individual, security and privacy concerns using multi-perspective analysis

2018 ◽  
Vol 10 (3) ◽  
pp. 795-822 ◽  
Author(s):  
Odai Enaizan ◽  
A. A. Zaidan ◽  
N. H. M Alwi ◽  
B. B. Zaidan ◽  
M. A. Alsalem ◽  
...  
Keyword(s):  
Decision Support ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Security And Privacy ◽  
Privacy Concerns ◽  
Electronic Medical Record Systems ◽  
Individual Security ◽  
Perspective Analysis

scholarly journals Security issues and framework of electronic medical record: A review

2020 ◽  
Vol 9 (2) ◽  
Author(s):  
Jibril Adamu ◽  
Raseeda Hamzah ◽  
Marshima Mohd Rosli
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Security And Privacy ◽  
Security Threats ◽  
Security Vulnerabilities ◽  
Sql Injection ◽  
Security Issues ◽  
Electronic Medical Record Systems ◽  
Cross Site ◽  
Common Security

The electronic medical record has been more widely accepted due to its unarguable benefits when compared to a paper-based system. As electronic medical record becomes more popular, this raises many security threats against the systems. Common security vulnerabilities, such as weak authentication, cross-site scripting, SQL injection, and cross-site request forgery had been identified in the electronic medical record systems. To achieve the goals of using EMR, attaining security and privacy is extremely important. This study aims to propose a web framework with inbuilt security features that will prevent the common security vulnerabilities in the electronic medical record. The security features of the three most popular and powerful PHP frameworks Laravel, CodeIgniter, and Symfony were reviewed and compared. Based on the results, Laravel is equipped with the security features that electronic medical record currently required. This paper provides descriptions of the proposed conceptual framework that can be adapted to implement secure EMR systems.

Virtuelle Medizin in der Behandlung von Sucht in den USA, Kanada und darüber hinaus

Suchttherapie ◽  
2020 ◽  
Vol 21 (04) ◽  
pp. 189-193
Author(s):  
R. Michael Krausz ◽  
Farhud Shams ◽  
Maurice Cabanis
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Electronic Medical Record Systems

ZusammenfassungInsbesondere während der aktuellen Corona-Pandemie hat der Gebrauch virtueller Lösungen in der Medizin international stark zugenommen. Es gibt eine zunehmende Akzeptanz gerade auch in dem Bereich der hausärztlichen Versorgung, der Behandlung psychischer Störungen und der Abhängigkeitserkrankungen.Die Entwicklung ist international unterschiedlich, v. a, wenn man die USA und Kanada auf der einen Seite und Europa, insbesondere Deutschland, andererseits vergleicht. In Nordamerika hat bei dem Einsatz von moderner Technologie die Einführung von „Electronic Medical Record Systems“ eine dominierende Rolle gespielt. Diese ist insbesondere auf Abrechnung und Dokumentation zu Versicherungszwecken fokussiert. Daneben gibt es zunehmend Apps, die spezifische therapeutische Ansätze zu implementieren helfen. Die Anwendung virtueller Ansätze im Suchtbereich ist begrenzt, aber in Teilen sehr innovativ und auf deutsche Verhältnisse anwendbar. Wie in Europa gibt es auch in Nordamerika nur sehr begrenzte Forschungskapazitäten und prinzipiell Widerstand bei den medizinischen Berufsgruppen bezüglich der Anwendungsmöglichkeiten und der Rolle im Behandlungsprozess. Mehr Kooperation würde international zu einer Beschleunigung der Entwicklung und der Etablierung gemeinsamer Standards beitragen sowie die Behandlungssysteme bedeutend verbessern.

scholarly journals Supporting deprescribing in hospitalised patients: formative usability testing of a computerised decision support tool

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Melissa T. Baysari ◽  
Mai H. Duong ◽  
Patrick Hooper ◽  
Michaela Stockey-Bridge ◽  
Selvana Awad ◽  
...  
Keyword(s):  
Decision Support ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Adverse Drug Events ◽  
Digital Health ◽  
Usability Testing ◽  
Routine Care ◽  
Assessment Tools ◽  
Support Tool ◽  
Hospitalised Patients

Abstract Background Despite growing evidence that deprescribing can improve clinical outcomes, quality of life and reduce the likelihood of adverse drug events, the practice is not widespread, particularly in hospital settings. Clinical risk assessment tools, like the Drug Burden Index (DBI), can help prioritise patients for medication review and prioritise medications to deprescribe, but are not integrated within routine care. The aim of this study was to conduct formative usability testing of a computerised decision support (CDS) tool, based on DBI, to identify modifications required to the tool prior to trialling in practice. Methods Our CDS tool comprised a DBI MPage in the electronic medical record (clinical workspace) that facilitated review of a patient’s DBI and medication list, access to deprescribing resources, and the ability to deprescribe. Two rounds of scenario-based formative usability testing with think-aloud protocol were used. Seventeen end-users participated in the testing, including junior and senior doctors, and pharmacists. Results Participants expressed positive views about the DBI CDS tool but testing revealed a number of clear areas for improvement. These primarily related to terminology used (i.e. what is a DBI and how is it calculated?), and consistency of functionality and display. A key finding was that users wanted the CDS tool to look and function in a similar way to other decision support tools in the electronic medical record. Modifications were made to the CDS tool in response to user feedback. Conclusion Usability testing proved extremely useful for identifying components of our CDS tool that were confusing, difficult to locate or to understand. We recommend usability testing be adopted prior to implementation of any digital health intervention. We hope our revised CDS tool equips clinicians with the knowledge and confidence to consider discontinuation of inappropriate medications in routine care of hospitalised patients. In the next phase of our project, we plan to pilot test the tool in practice to evaluate its uptake and effectiveness in supporting deprescribing in routine hospital care.

scholarly journals Association of Lowering Default Pill Counts in Electronic Medical Record Systems With Postoperative Opioid Prescribing

JAMA Surgery ◽  
2018 ◽  
Vol 153 (11) ◽  
pp. 1012 ◽  
Author(s):  
Alexander S. Chiu ◽  
Raymond A. Jean ◽  
Jessica R. Hoag ◽  
Mollie Freedman-Weiss ◽  
James M. Healy ◽  
...  
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Opioid Prescribing ◽  
Pill Counts ◽  
Electronic Medical Record Systems

scholarly journals Interdisciplinary Plans of Care, Electronic Medical Record Systems, and Inpatient Mortality

ACI Open ◽  
2018 ◽  
Vol 02 (01) ◽  
pp. e21-e29
Author(s):  
Joseph Bonner ◽  
Brandon Stange ◽  
Mindy Kjar ◽  
Margaret Reynolds ◽  
Eric Hartz ◽  
...  
Keyword(s):  
Observational Study ◽  
Medical Record ◽  
Electronic Medical Record ◽  
Patient Outcomes ◽  
Odds Ratio ◽  
Experimental Setting ◽  
Inpatient Mortality ◽  
Quasi Experimental ◽  
Electronic Medical Record Systems ◽  
Guide Care

Background Interdisciplinary plans of care (IPOCs) guide care standardization and satisfy accreditation requirements. Yet patient outcomes associated with IPOC usage through an electronic medical record (EMR) are not present in the literature. EMR systems facilitate the documentation of IPOC use and produce data to evaluate patient outcomes. Objectives This article aimed to evaluate whether IPOC-guided care as documented in an EMR is associated with inpatient mortality. Methods We contrasted whether IPOC-guided care was associated with a patient being discharged alive. We further tested whether the association differed across strata of acuity levels and overall frequency of IPOC usage within a hospital. Results Our sample included 165,334 adult medical/surgical discharges for a 12-month period for 17 hospitals. All hospitals had 1 full year of EMR use antedating the study period. IPOCs guided care in 85% (140,187/165,334) of discharges. When IPOCs guided care, 2.1% (3,009/140,187) of admissions ended with the patient dying while in the hospital. Without IPOC-guided care, 4.3% (1,087/25,147) of admissions ended with the patient dying in the hospital. The relative likelihood of dying while in the hospital was lower when IPOCs guided care (odds ratio: 0.45; 99% confidence interval: 0.41–0.50). Conclusion In this observational study within a quasi-experimental setting of 17 community hospitals and voluntary usage, IPOC-guided care is associated with a decreased likelihood of patients dying while in the hospital.

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