A Global Socio-economic-medico-legal Model for the Sustainability of Longitudinal Electronic Health Records

2006 ◽  
Vol 45 (03) ◽  
pp. 240-245 ◽  
Author(s):  
A. Shabo
Keyword(s):  
Electronic Health Records ◽  
Healthcare Providers ◽  
Financial Assets ◽  
Healthcare Organizations ◽  
Health Records ◽  
Record Keeping ◽  
Proposed Model ◽  
Legal Model ◽  
Electronic Health

Summary Objectives: This paper pursues the challenge of sustaining lifetime electronic health records (EHRs) based on a comprehensive socio-economic-medico-legal model. The notion of a lifetime EHR extends the emerging concept of a longitudinal and cross-institutional EHR and is invaluable information for increasing patient safety and quality of care. Methods: The challenge is how to compile and sustain a coherent EHR across the lifetime of an individual. Several existing and hypothetical models are described, analyzed and compared in an attempt to suggest a preferred approach. Results: The vision is that lifetime EHRs should be sustained by new players in the healthcare arena, who will function as independent health record banks (IHRBs). Multiple competing IHRBs would be established and regulated following preemptive legislation. They should be neither owned by healthcare providers nor by health insurer/payers or government agencies. The new legislation should also stipulate that the records located in these banks be considered the medico-legal copies of an individual’s records, and that healthcare providers no longer serve as the legal record keepers. Conclusions: The proposed model is not centered on any of the current players in the field; instead, it is focussed on the objective service of sustaining individual EHRs, much like financial banks maintain and manage financial assets. This revolutionary structure provides two main benefits: 1) Healthcare organizations will be able to cut the costs of long-term record keeping, and 2) healthcare providers will be able to provide better care based on the availability of a lifelong EHR of their new patients.

A Global Socio-economic-medico-legal Model for the Sustainability of Longitudinal Electronic Health Records

2006 ◽  
Vol 45 (05) ◽  
pp. 498-505 ◽  
Author(s):  
A. Shabo
Keyword(s):  
Electronic Health Records ◽  
Healthcare Providers ◽  
Financial Assets ◽  
Healthcare Organizations ◽  
Health Records ◽  
Record Keeping ◽  
Proposed Model ◽  
Legal Model ◽  
Electronic Health

Summary Objectives: This paper pursues the challenge of sustaining lifetime electronic health records (EHRs) based on a comprehensive socio-economic-medico-legal model. The notion of a lifetime EHR extends the emerging concept of a longitudinal and cross-institutional EHR and is invaluable information for increasing patient safety and quality of care. Methods: The challenge is how to compile and sustain a coherent EHR across the lifetime of an individual. Several existing and hypothetical models are described, analyzed and compared in an attempt to suggest a preferred approach. Results: The vision is that lifetime EHRs should be sustained by new players in the healthcare arena, who will function as independent health record banks (IHRBs). Multiple competing IHRBs would be established and regulated following preemptive legislation. They should be neither owned by healthcare providers nor by health insurer/payers or government agencies. The new legislation should also stipulate that the records located in these banks be considered the medico-legal copies of an individual’s records, and that healthcare providers no longer serve as the legal record keepers. Conclusions: The proposed model is not centered on any of the current players in the field; instead, it is focussed on the objective service of sustaining individual EHRs, much like financial banks maintain and manage financial assets. This revolutionary structure provides two main benefits: 1) Healthcare organizations will be able to cut the costs of long-term record keeping, and 2) healthcare providers will be able to provide better care based on the availability of a lifelong EHR of their new patients.

Electronic Health Records Implementation in Jordan: Perceptions of Healthcare Providers and Determinant Factors (Preprint)

2020 ◽  
Author(s):  
Tamadur Shudayfat ◽  
Çağdaş Akyürek ◽  
Noha Al-Shdayfat ◽  
Hatem Alsaqqa
Keyword(s):  
Electronic Health Records ◽  
Electronic Health Record ◽  
Technology Acceptance ◽  
Technology Acceptance Model ◽  
Healthcare Providers ◽  
Health Record ◽  
Health Records ◽  
Context Factors ◽  
Electronic Health ◽  
Acceptance Model

BACKGROUND Acceptance of Electronic Health Record systems is considered an essential factor for an effective implementation among the Healthcare providers. In an attempt to understand the healthcare providers’ perceptions on the Electronic Health Record systems implementation and evaluate the factors influencing healthcare providers’ acceptance of Electronic Health Records, the current research examines the effects of individual (user) context factors, and organizational context factors, using Technology Acceptance Model. OBJECTIVE The current research examines the effects of individual (user) context factors, and organizational context factors, using Technology Acceptance Model. METHODS A quantitative cross-sectional survey design was used, in which 319 healthcare providers from five public hospital participated in the present study. Data was collected using a self-administered questionnaire, which was based on the Technology Acceptance Model. RESULTS Jordanian healthcare providers demonstrated positive perceptions of the usefulness and ease of use of Electronic Health Record systems, and subsequently, they accepted the technology. The results indicated that they had a significant effect on the perceived usefulness and perceived ease of use of Electronic Health Record, which in turn was related to positive attitudes towards Electronic Health Record systems as well as the intention to use them. CONCLUSIONS User attributes, organizational competency, management support and training and education are essential variables in predicting healthcare provider’s acceptance toward Electronic Health records. These findings should be considered by healthcare organizations administration to introduce effective system to other healthcare organizations.

Informatics and Health Services

2017 ◽  
pp. 215-241
Author(s):  
Nelson Ravka
Keyword(s):  
Health Care ◽  
Electronic Health Records ◽  
Health Care Providers ◽  
Health Care Services ◽  
Electronic Record ◽  
Inappropriate Drug ◽  
Health Records ◽  
Record Keeping ◽  
Care Services ◽  
Electronic Health

Personal electronic health records are seen as a key component to improved health care for patients, empowering motivated patients by giving them access to their own records resulting in increased self-care, shared decision making, and better clinical outcomes. Benefits through electronic record keeping would also accrue to health care providers through the availability and retrievability of data, reduced duplication of medical tests, more effective physician diagnosis and treatment, reduced incidence of prescription errors, and flagging inappropriate drug combinations. Utilizing information technology could also moderate the cost of health care services. Electronic health records would also improve clinical research through access to a large database of patient electronic records for research and determining best practices. Although potential benefits are considerable, many challenges to implementation must be addressed and resolved before this potential of improved health care provision and cost efficiency can be realized.

Hierarchy Similarity Analyser-An Approach to Securely Share Electronic Health Records

2020 ◽  
pp. 1485-1501
Author(s):  
Shalini Bhartiya ◽  
Deepti Mehrotra ◽  
Anup Girdhar
Keyword(s):  
Access Control ◽  
Electronic Health Records ◽  
Control Policy ◽  
Healthcare Organizations ◽  
Health Records ◽  
Role Hierarchy ◽  
Access Control Policies ◽  
Electronic Health ◽  
Policy Testing ◽  
Organizational Rules

Health professionals need an access to various dimensions of Electronic Health Records (EHR). Depending on technical constraints, each organization defines its own access control schema exhibiting heterogeneity in organizational rules and policies. Achieving interoperability between such schemas often result in contradictory rules thereby exposing data to undue disclosures. Permitting interoperable sharing of EHRs and simultaneously restricting unauthorized access is the major objective of this paper. An Extensible Access Control Markup Language (XACML)-based framework, Hierarchy Similarity Analyser (HSA), is proposed which fine-grains access control policies of disparate healthcare organizations to achieve interoperable and secured sharing of EHR under set authorizations. The proposed framework is implemented and verified using automated Access Control Policy Testing (ACPT) tool developed by NIST. Experimental results identify the users receive secured and restricted access as per their authorizations and role hierarchy in the organization.

scholarly journals Secure Exchange of Medical Data Using a Novel Real-Time Biometric-Based Protection and Recognition Method

Electronics ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. 2013
Author(s):  
Shams Ud Din ◽  
Zahoor Jan ◽  
Muhammad Sajjad ◽  
Maqbool Hussain ◽  
Rahman Ali ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Real Time ◽  
Signal To Noise Ratio ◽  
Security And Privacy ◽  
The Internet ◽  
Healthcare Organizations ◽  
Health Records ◽  
Clinical Notes ◽  
Electronic Health ◽  
Value Decomposition

Security and privacy are essential requirements, and their fulfillment is considered one of the most challenging tasks for healthcare organizations to manage patient data using electronic health records. Electronic health records (clinical notes, images, and documents) become more vulnerable to breaching patients’ privacy when shared with an external organization in the current arena of the internet of medical things (IoMT). Various watermarking techniques were introduced in the medical field to secure patients’ data. Most of the existing techniques focus on an image or document’s imperceptibility without considering the watermark(logo). In this research, a novel technique of watermarking is introduced, which supersedes the shortcomings of existing approaches. It guarantees the imperceptibility of the image/document and takes care of watermark(biometric), which is further passed through a process of recognition for claiming ownership. It extracts suitable frequencies from the transform domain using specialized filters to increase the robustness level. The extracted frequencies are modified by adding the biomedical information while considering the strength factor according to the human visual system. The watermarked frequencies are further decomposed through a singular value decomposition technique to increase payload capacity up to (256 × 256). Experimental results over a variety of medical and official images demonstrate the average peak signal-to-noise ratio (PSNR 54.43), and the normal correlation (N.C.) value is 1. PSNR and N.C. of the watermark were calculated after attacks. The proposed technique is working in real-time for embedding, extraction, and recognition of biometrics over the internet, and its uses can be realized in various platforms of IoMT technologies.

scholarly journals Recordkeeping Metadata Standardization for Electronic Health Records System Integration: a Preliminary Study

2018 ◽  
Vol 7 (3.7) ◽  
pp. 266
Author(s):  
Seri Intan Idayu Binti Shahrul Asari ◽  
Nurussobah Binti Hussin ◽  
Ahmad Zam Hariro Bin Samsudin ◽  
Mohd Nizam Bin Yunus
Keyword(s):  
Electronic Health Records ◽  
System Integration ◽  
Health Records ◽  
Metadata Standard ◽  
Information Technology Managers ◽  
Record Keeping ◽  
Recordkeeping System ◽  
Face To Face ◽  
Electronic Health ◽  
Technology Managers

Electronic Health Records (EHRs) are beneficial in improving patient care, promoting safe practice, as well as enhancing patients and multiple providers’ communication and risk error reduction. However, it seems that the adoption of EHR system is happening very slowly to become fully integrated in both primary care and within hospital settings. In Malaysia, the implemented system still has limited integration and interoperability for supporting clinical operations among other Ministry of Health Malaysia (MOHM) hospitals, health centres, and clinics. Therefore, the objective of this paper is to discuss about this scenario and strain the need for solution through the consideration towards metadata standard establishment in health records system integration. Method used in this study is literature review analysis and face-to-face interview. The paper begins with discussions from various literatures highlighting the need of metadata standard for recordkeeping system integration. Subsequently, the face-to-face interview is done to explore the real situation in Malaysia to encounter the scenario discuss in the literatures. The finding of this study reveals that there is significant need for further research on record keeping metadata standard development for realization of electronic health records system integration. This study is significant for records managers, information technology managers, system developers and record keeping audit.   

Hierarchy Similarity Analyser-An Approach to Securely Share Electronic Health Records

2016 ◽  
Vol 7 (2) ◽  
pp. 14-29 ◽  
Author(s):  
Shalini Bhartiya ◽  
Deepti Mehrotra ◽  
Anup Girdhar
Keyword(s):  
Access Control ◽  
Electronic Health Records ◽  
Control Policy ◽  
Healthcare Organizations ◽  
Health Records ◽  
Role Hierarchy ◽  
Access Control Policies ◽  
Electronic Health ◽  
Policy Testing ◽  
Organizational Rules

Health professionals need an access to various dimensions of Electronic Health Records (EHR). Depending on technical constraints, each organization defines its own access control schema exhibiting heterogeneity in organizational rules and policies. Achieving interoperability between such schemas often result in contradictory rules thereby exposing data to undue disclosures. Permitting interoperable sharing of EHRs and simultaneously restricting unauthorized access is the major objective of this paper. An Extensible Access Control Markup Language (XACML)-based framework, Hierarchy Similarity Analyser (HSA), is proposed which fine-grains access control policies of disparate healthcare organizations to achieve interoperable and secured sharing of EHR under set authorizations. The proposed framework is implemented and verified using automated Access Control Policy Testing (ACPT) tool developed by NIST. Experimental results identify the users receive secured and restricted access as per their authorizations and role hierarchy in the organization.

scholarly journals Identification of Master Patient Index Record Challenges from Healthcare Professionals’ Perspectives

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Lintz
Keyword(s):  
Electronic Health Records ◽  
Electronic Health Record ◽  
Patient Information ◽  
Healthcare Professionals ◽  
Health Record ◽  
Healthcare Organizations ◽  
Health Records ◽  
Electronic Health ◽  
Revenue Cycle ◽  
Master Patient Index

Abstract Background A Master Patient Index (MPI) system is essentially a database that is built into an Electronic Health Record (EHR) system to maintain a unique identifier for each patient seen at the organizational or enterprise level. The current study is to identify the gaps between the revenue cycle and patient information functionalities used in Electronic Health Records (EHRs) in collecting and reporting patient information. Additional focus was on perceptions of healthcare professionals who are familiar with MPI systems on the impact of these gaps of ensuring maximum reimbursements and adequacy of services provided. The study also sought to glean their perceptions vis-a-vis key challenges in the EHRs that affect organizational workflow. Methods A semi-structured questionnaire was used to collect information from healthcare professionals responsible for the MPI. The population studied is healthcare organizations using EPIC as the Electronic Health Records (EHRs). Results This study confirmed systems gaps between EPIC and other downstream systems used by the healthcare organizations to process patient information, as well as the extent of patient matching challenges that healthcare professionals have encountered in the MPI. These challenges include varying methods of matching patient data; lack of data standardization; absence of policies and procedures; frequently changing demographic data; multiple required data points needed for record matching; and default and null values in key-identifying fields. Conclusions The study offered evidence found in the literature that implies that duplicate records continue to plague healthcare organizations. Widespread technological interoperability insufficiency among healthcare facilities points to future challenges for federal policy makers as they seek to promote interoperability programs to demonstrate meaningful use of certified electronic health record technology (CEHRT). Key messages The study confirmed that despite a low level of duplication in the MPI, the organizations have lost revenue during the last 6 months. Duplicate records in the EHR systems has led to downstream problems in the revenue cycle, including denials and insurance takebacks that impact hospital revenue cycle efficiency.

Sign in / Sign up

Export Citation Format

Share Document