Big is Beautiful: Electronic Patient Records in Large Norwegian Hospitals 1980s – 2001

2003 ◽  
Vol 42 (04) ◽  
pp. 366-370 ◽  
Author(s):  
G. Ellingsen ◽  
E. Monteiro
Keyword(s):  
Information Systems ◽  
Electronic Patient Record ◽  
Public Institutions ◽  
Small Scale ◽  
General Tendency ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Crucial Aspect ◽  
Technological Complexity ◽  
Interpretative Approach

Summary Objectives: This paper aims to describe and analyze the prolonged efforts – spanning close to two decades – of developing and using electronic patient records in the large, university-based hospitals in Norway. Methods: This study belongs to an interpretative approach to the development and use of information systems. Results: The increase in organizational, institutional, political and technological complexity has been seriously underestimated. This paper describes and analyses the prolonged efforts – spanning close to two decades – of developing and using EPRs in the large, university-based hospitals in Norway. The investments involved were considerable, implying that a crucial aspect of these efforts has been the way alliances have been forged with public institutions and agendas. Conclusions: The conditions for small-scale, bottom-up and evolutionary approaches never succeeded in constructing themselves as a viable alternative to the larger, more sweeping electronic patient record initiative, reiterating a more general tendency to privilege the more comprehensive and daring projects.

scholarly journals The Electronic Patient Record as an Organizational Artifact

2011 ◽  
pp. 78-89 ◽  
Author(s):  
Pieter Toussaint ◽  
Marc Berg
Keyword(s):  
Electronic Patient Record ◽  
Healthcare Professionals ◽  
Research Effort ◽  
Patient Record ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Specific Research ◽  
Technological Bias

The research effort on Electronic Patient Records (EPRs) has rapidly increased in the last decade. Much of this research focussed on standardisation and technical realizations. We will describe such a research effort in this chapter and evaluate its success. Our main finding is that the lack of success of this specific research effort is mainly due to its technological bias. Although standards (both conceptual and technical) are important prerequisites for the realisation of an EPR, organisational issues are decisive for success. The role played by these organisational issues will be illustrated by analysing the findings of the case study presented in the chapter. We will argue that research on EPRs should be more focussed on the role of an EPR as an organisational artefact that coordinates the work of healthcare professionals, in order to lead to successful implementations.

scholarly journals Section 2: Patient Records: Electronic Patient Records and their Benefit for Patient Care

2006 ◽  
Vol 15 (01) ◽  
pp. 40-42
Author(s):  
P. Knaup ◽  
Keyword(s):  
Patient Care ◽  
Electronic Patient Record ◽  
Patient Record ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Quality Patient Care ◽  
Access To Health ◽  
Excellent Research ◽  
Therapy Attitudes ◽  
Ward Rounds

SummaryTo summarize current excellent research in the field of patient records.Synopsis of the articles selected for the IMIA Yearbook 2006.Current research in the field of patient records analyses users’ needs and attitudes as well as the potential and limitations of electronic patient record systems. Particular topics are the questions physicians have when assessing patients during ward rounds, the timeliness of results when ordered electronically, the quality of documenting haemophilia home therapy, attitudes towards patient access to health records and adequate strategies for record linkage in dependence on the intended purpose.The best paper selection of articles on patient records shows examples of excellent research on methods used for the management of patient records and for processing their content as well as assessing the potential, limitations of and user attitudes towards electronic patient record systems. Computerized patient records are mature, so that they can contribute to high quality patient care and efficient patient management.

Political Attitudes on the Dutch Electronic Patient Record

2016 ◽  
pp. 1207-1221
Author(s):  
Evert Mouw
Keyword(s):  
The Netherlands ◽  
Electronic Patient Record ◽  
Political Attitudes ◽  
Patient Record ◽  
The Political ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Political Debate ◽  
Opt Out ◽  
The Law

In the Netherlands, the introduction of a nationwide electronic patient record (EPR) infrastructure was rejected in 2011 after a heated political debate. Such debate is influenced by the political attitudes of politicians and voters, such as their trust in governments. The objective is to explore the relation between political attitudes of individuals and the priority they give to health privacy. The method is from a new survey that was developed; the Health Privacy and Political Attitudes Survey. The survey is as compatible as possible with a few well-known surveys. With 218 respondents enough data was collected for a first explorative study. Little correlations were found between political attitudes and the individual's priorisation of health privacy or their trust in a nationwide EPR. In general, most respondents valued their health privacy highly and trust in a nationwide EPR was low, irrespective of their political affiliation or their political attitudes. One exception were respondents with authoritarian attitudes. Such individuals had, on average, more trust in (government regulated) electronic records. More trust in the law correlates with less fear for problems with the EPR. Interestingly, higher educated and older respondents have, on average, the same level of trust in the EPR as others but are more apt to act when they distrust the system (opt-out). In general, political attitudes and one's trust in electronic patient records (EPRs) are not strongly related, but individuals who score high on authoritarian attitudes and trust in the law are more likely to also trust EPRs. Still, nearly everybody places a high value on health privacy, so EPR providers should be careful in this regard.

scholarly journals On the security enhancement of integrated electronic patient records information systems

2015 ◽  
Vol 12 (2) ◽  
pp. 857-872 ◽  
Author(s):  
Muhammad Khan ◽  
Ankita Chaturvedi ◽  
Dheerendra Mishra ◽  
Saru Kumari
Keyword(s):  
Information Systems ◽  
Medical Information ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Security Risk ◽  
Authentication Protocols ◽  
Privacy And Security ◽  
Public Network ◽  
Authentication Mechanism ◽  
Medical Institutions

Electronic patient records (EPR) information systems maintain the patients? medical information on the web servers, and remain available to the medical institutions, practitioners, and the academia. The transmission of data is being done over the public network, which increases the privacy and security risk. However, authentication mechanism tries to ensure secure and authorized communication over insecure public network. In recent years, several authentication protocols have been proposed, but most of them fail to satisfy desirable security attributes. In this paper, we discuss the failure of two authentication protocols for EPR information systems. To overcome the flows, we present improved scheme for the integrated EPR information systems. The correctness of proposed protocol is proved using BAN logic. Moreover, the protocol performs is comparable and security is efficient than the existing schemes.

PP20 A retrospective service evaluation of the presentation of anaphylaxis to a UK ambulance service

2019 ◽  
Vol 36 (10) ◽  
pp. e9.2-e9
Author(s):  
Nicholas Groom ◽  
Sarah Taylor ◽  
Ed England ◽  
Helen Pocock ◽  
Charles D Deakin
Keyword(s):  
Service Evaluation ◽  
Ambulance Service ◽  
Small Scale ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Self Administration ◽  
Patient Demographics ◽  
The Mean ◽  
The Impact ◽  
To Receive

BackgroundThere is a lack of data relating to frequency and presentation of anaphylaxis to the ambulance service in England. Little research exists relating to the patients’ self-treatment of anaphylaxis and there is an absence of evidence to evaluate the impact of self-administered adrenaline, there is a need to describe this patient group to evaluate any potential to develop their care.MethodsRetrospective data were collected from the electronic patient records of a single NHS ambulance service serving a population of approximately four million. Records between 1stApril 2017 and 31st March 2018 were included where a diagnosis of anaphylaxis was recorded. Gender, age, incident location, allergy history, were summarised to identify any trends in presentation. The frequency of patient self-administration, as well as ambulance administration, of adrenaline was also included for analysis to determine any correlation.Results326 records were included in the analysis. The mean, median and modal patient ages were 34, 29 and 20 respectively. Patient ages ranged from six months to 95 years. Patients were 65% female, 35% male and 59% of incidents occurred at home. 76% of patients reported having a known allergy with food being the most common allergen (44%). Peak times for calling 999 were midday and 6pm. 35% of patients had self-administered adrenaline. 52% received ambulance-administered adrenaline. The doses of self-administered adrenaline ranged from 0–3 doses and ambulance administered adrenaline ranged from 0–8 doses. Patients who self-administered adrenaline were less likely to receive further adrenaline from the ambulance service. No correlation was found between the number of self-administered doses and ambulance administered doses.ConclusionPatient demographics such as age, gender and allergies were consistent with two previous small-scale studies. This study suggests that early self-administration of adrenaline is beneficial. Opportunities for improvements in data recording as well as patient education were identified.

Medical Narratives and Patient Analogs: The Ethical Implications of Electronic Patient Records

1999 ◽  
Vol 38 (04/05) ◽  
pp. 253-259 ◽  
Author(s):  
E.-H. W. Kluge
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Electronic Patient Record ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Specific Patient ◽  
Patient Profile ◽  
Ethical Implications ◽  
Data Space ◽  
Medical Narratives

AbstractAn electronic patient record consists of electronically stored data about a specific patient. It therefore constitutes a data-space. The data may be combined into a patient profile which is relative to a particular speciality as well as phenomenologically unique to the specific professional who constructs the profile. Further, a diagnosis may be interpreted as a path taken by a health care professional with a certain specialty through the data-space relative to the patient profile constructed by that professional. This way of looking at electronic patient records entails certain ethical implications about privacy and accessibility. However, it also permits the construction of artificial intelligence and competence algorithms for health care professionals relative to their specialties.

scholarly journals Electronic Patient Records: Some Answers to the Data Representation and Reuse Challenges

2007 ◽  
Vol 16 (01) ◽  
pp. 47-48
Author(s):  
S. Meystre ◽  
Keyword(s):  
Language Processing ◽  
Electronic Patient Record ◽  
Data Entry ◽  
Data Representation ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Clinical Text ◽  
Part Of Speech ◽  
Excellent Research ◽  
Speech Information

SummaryTo summarize current excellent research in the field of patient records.Synopsis of the papers selected for the IMIA Yearbook 2007.The Electronic Patient Record encompasses a broad field of research and development. Some current research topics were selected for this IMIA Yearbook: EHR representation and communication standards, and secondary uses of clinical data for research and decision support. Four excellent papers representing the research in those fields were selected for the Patient Records section.The best papers selected for this section focus on the analysis and comparison of two important clinical documents representation standards, on direct structured data entry, on the use of Natural Language Processing to detect adverse events, and on the development and evaluation of a clinical text corpus annotated for part-of-speech information.

Electronic Patient Records in Medical Practice: A Multidisciplinary Endeavor

1999 ◽  
Vol 38 (04/05) ◽  
pp. 287-288 ◽  
Author(s):  
J. van der Lei ◽  
P. W. Moorman ◽  
M. A. Musen
Keyword(s):  
Medical Practice ◽  
Patient Records ◽  
Electronic Patient Records
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