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 Ethical and Legal Analysis of a Patient Case

2004 ◽  
Author(s):  
Rolando Lazaro
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Professionals ◽  
Legal Analysis ◽  
Patient Case ◽  
Specific Patient ◽  
Ethical Implications ◽  
Systematic Process

As health care professionals encounter increasingly complex issues surrounding patient care, it is important to develop an effective approach in investigating the legal and ethical consequences of such scenarios. This paper presents a systematic process to analyze and solve the legal and ethical implications of a specific patient case. This procedure may be used by other practitioners as a template for analyzing practice issues involving their respective professions.

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.

scholarly journals Exploring the Unmet Needs of the Patients in the Outpatient Respiratory Medical Clinic: Patients versus Clinicians Perspectives

2015 ◽  
Vol 2015 ◽  
pp. 1-13
Author(s):  
Lone Birgitte Skov Jensen ◽  
Ulf Brinkjær ◽  
Kristian Larsen ◽  
Hanne Konradsen
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Unmet Needs ◽  
Lifestyle Changes ◽  
Medical Clinic ◽  
Ethical Implications ◽  
Emotional Suffering ◽  
Medical Clinics ◽  
Guidance Program ◽  
Fitting In

Aim. Developing a theoretical framework explaining patients’ behaviour and actions related to unmet needs during interactions with health care professionals in hospital-based outpatient respiratory medical clinics.Background. The outpatient respiratory medical clinic plays a prominent role in many patients’ lives regarding treatment and counselling increasing the need for a better understanding of patients’ perspective to the counselling of the health care professionals.Design. The study is exploratory and based on Charmaz’s interpretation of grounded theory.Methods. The study included 65 field observations with a sample of 43 patients, 11 doctors, and 11 nurses, as well as 30 interviews with patients, conducted through theoretical sampling from three outpatient respiratory medical clinics in Denmark.Findings. The patients’ efforts to share their significant stories triggered predominantly an adaptation or resistance behaviour, conceptualized as “fitting in” and “fighting back” behaviour, explaining the patients’ counterreactions to unrecognized needs during the medical encounter.Conclusion. Firstly this study allows for a better understanding of patients’ counterreactions in the time-pressured and, simultaneously, tight structured guidance program in the outpatient clinic. Secondly the study offers practical and ethical implications as to how health care professionals’ attitudes towards patients can increase their ability to support emotional suffering and increase patient participation and responsiveness to guidance in the lifestyle changes.

May We Support Your Decision?

1996 ◽  
Vol 1 (3) ◽  
pp. 175-178 ◽  
Author(s):  
Colin Gordon
Keyword(s):  
Artificial Intelligence ◽  
Health Care ◽  
Decision Making ◽  
Clinical Practice ◽  
Decision Support ◽  
Health Care Professionals ◽  
Medical Decision Making ◽  
Electronic Patient Record ◽  
Medical Decision ◽  
Technical Developments

Expert systems to support medical decision-making have so far achieved few successes. Current technical developments, however, may overcome some of the limitations. Although there are several theoretical currents in medical artificial intelligence, there are signs of them converging. Meanwhile, decision support systems, which set themselves more modest goals than replicating or improving on clinicians' expertise, have come into routine use in places where an adequate electronic patient record exists. They may also be finding a wider role, assisting in the implementation of clinical practice guidelines. There is, however, still much uncertainty about the kinds of decision support that doctors and other health care professionals are likely to want or accept.

scholarly journals How is patient activation related to healthcare service utilisation? Evidence from electronic patient records in England

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Feifei Bu ◽  
Daisy Fancourt
Keyword(s):  
Health Care ◽  
Healthcare Service ◽  
Patient Activation ◽  
Outcome Variable ◽  
Service Utilisation ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Emergency Admissions ◽  
Gp Visits

Abstract Background There is increasing awareness of the importance of patient activation (knowledge, skills, and confidence for managing one’s health and health care) among clinicians and policy makers, with emerging evidence showing higher levels of patient activation are associated with better health outcomes and experiences of health care. This study aimed to examine the association between patient activation and a wide range of specific types of healthcare service utilisation in England, including GP and non-GP primary care, elective and emergency hospital admissions, outpatient visits, and attendances at the Accident and Emergency department. Methods Data were derived from linked electronic patient records collected by primary and secondary healthcare providers in North West London between January 2016 and November 2019. Our analyses focused on adults (18+) with a valid Patient Activation Measure (PAM). After excluding patients with missing data, we had an analytical sample of 15,877 patients. Data were analysed using negative binomial regression and logistic regression models depending on the outcome variable. Results Patients had a mean activation score of 55.1 and a standard deviation (SD) of 17.7 (range: 0–100). They had an average of 5.4 GP visits (SD = 8.0), 26.8 non-GP visits (SD = 23.4) and 6.0 outpatient attendances (SD = 7.9) within a one-year follow-up. About 24.7% patients had at least one elective admission, 24.2% had one or more emergency admissions, and 42.3% had one or more A&E attendance within the follow-up. After accounting for a number of demographic and health factors, we found a linear (or proximately linear) association between patient activation and the number of GP visits, emergency admissions and A&E attendance, but a non-linear relationship between patient activation and the number of non-GP visits, the number of outpatient attendance and elective inpatient admission. Conclusions This study has provided strong empirical evidence from England linking patient activation with healthcare service utilisation. It suggests the value of supporting patient activation as a potential pathway to ease the burden of healthcare system.

Health Information, the Fair Information Principles and Ethics

1994 ◽  
Vol 33 (04) ◽  
pp. 336-345 ◽  
Author(s):  
E.-H.W. Kluge
Keyword(s):  
Health Information ◽  
Information Space ◽  
Regulatory Mechanisms ◽  
Patient Records ◽  
Electronic Patient Records ◽  
New Paradigm ◽  
Ethical Implications ◽  
Property Model

Abstract:If advanced electronic patient records are construed as epistemic patient analogues in information space, then the traditional property-model of patient records is longer appropriate. A new paradigm is required. This paper suggests a new paradigm, examines its ethical implications and explores ways in which these could be reflected in legal and regulatory mechanisms. Special attention is paid to privacy, security and access relative to the so-called “fair information principles”.

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.

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