scholarly journals Hyperledger blockchain based secure storage of electronic health record system in edge nodes

2021 ◽  
Vol 2115 (1) ◽  
pp. 012034
Author(s):  
P Arul ◽  
S Renuka
Keyword(s):  
Electronic Health Record ◽  
Private Information ◽  
Medical Information ◽  
Insurance Companies ◽  
Health Record ◽  
Hybrid Architecture ◽  
Record System ◽  
Edge Node ◽  
Hash Code ◽  
Electronic Health

Abstract An Electronic Health Record (EHR) is a database for storing patients medical information collected from different sources such as smart wearable devices, smart sensors and diagnostic imaging equipment. An EHR contains sensitive private information for the patients and the treatment of their diseases. Furthermore, it’s often shared among different members consists of healthcare providers, insurance companies, medical researchers, and others. The main difficulty for EHR information management is the result of gathering, storing, and sharing patient healthcare without affecting privacy and security. Blockchain has recently proposed an efficient way to manage EHR data. This paper provides hybrid architecture for EHR data management by using both Hyperledger blockchain network in on-chain and edge node in off-chain. In this architecture is used to authenticate user without affecting sensitive patient’s information and also used to authenticate the encrypted EHR information in edge node. In the on-chain approach EHR activities and Patient authentication activities are recorded in the blockchain for the purpose of accountability and traceability. Edge nodes stored the encrypted EHR data in the off-chain method. So the combination of on-chain and off-chain approaches only allows the authorized data user who has to meet the EHR access activities and to decrypt the EHR data. If the EHR information is alter by an unauthorized user, the hash code is newly generated which is different from old hash code stored in the blockchain. As the result the user can easily detect that their EHR information has been hacked.

Design Research on the Resident Electronic Health Recorder Systerm

2014 ◽  
Vol 644-650 ◽  
pp. 3085-3089
Author(s):  
Ning Liu
Keyword(s):  
Electronic Health Record ◽  
Design Research ◽  
Medical Information ◽  
Health Condition ◽  
Health Record ◽  
Record System ◽  
Core Technology ◽  
Medical Institutions ◽  
Function Modules ◽  
Electronic Health

Resident health record is not only to reflect health condition of people but also precious medical information, which offers great help to medical institutions and medical staff. The use of resident electronic health record system will be used more widely, even a necessity of people’s life. The core technology in developing this system was analyzed in this paper. In this system, the requirements of residents, doctors and managers were introduced in detail through the illustration and activity graphs. In the end, function modules of the common resident electronic health record were listed. These design schemes will provide references for relative researches.

Why Do Physicians Reject the Electronic Health Record: A Theoretical Perspective? (Preprint)

2018 ◽  
Author(s):  
Weam Alfayez ◽  
Arwa Alumran ◽  
Dr Saja A. Al-Rayes
Keyword(s):  
Information Technology ◽  
Electronic Health Record ◽  
Technology Acceptance ◽  
Technology Acceptance Model ◽  
Health Record ◽  
Record System ◽  
Factors Influencing ◽  
Tam Model ◽  
Electronic Health ◽  
Acceptance Model

BACKGROUND Many theories/ models adopted from behavioral sciences literature or developed within the field of information technologies could help in understanding the technology acceptance, usage, and effective adoption. OBJECTIVE The main aim of this paper is to review the different theories/ models that can help in understanding information technology/system acceptance and use, and to choose the most appropriate theoretical framework that could be applied to understand the factors influencing physicians’ use of the Electronic Health Record system (EHR) at King Fahd Military Medical Complex (KFMMC) in Dhahran city, Saudi Arabia. METHODS The theories/ models were reviewed using scientific databases. The inclusion criteria were if the theories/ models used to explain individual behaviors toward accepting and using of information technology including the once conducted within the healthcare. RESULTS The review showed that there were five theories/ models were used within information technology studies to understand the technology acceptance and used. There were Theory of Reasoned Action, Theory of Planned Behaviour, Innovation Diffusion Theory, Unified theory of acceptance and use of technology, and Technology Acceptance Model. Each has different explanatory power of technology use. The most appropriate theoretical framework to understand the reason behind physician use of the EHR at KFMMC would be the Technology Acceptance Model (TAM). TAM model could explain up to 75% of the variation in the behavioral intention (acceptance), and up to 62% of the variation in the actual use. It is the gold standard for assessing the usage of health technologies and systems. In fact, the TAM model is one of the core models used to explore the physician’s perceptions of the Electronic Health Record system adoption. CONCLUSIONS This review showed that there are different theories available in the literature can be used to justify the reason behind electronic health record acceptance. TAM is one of the effective, simplest models used to understand the factors influencing physicians to use the EHR-system. Further studies need to apply the TAM model to check its ability in explaining the reason behind EHR within different hospitals in Saudi Arabia

scholarly journals Developing Clinical Decision Support within a Commercial Electronic Health Record System to Improve Antimicrobial Prescribing in the Neonatal ICU

2014 ◽  
Vol 05 (02) ◽  
pp. 368-387 ◽  
Author(s):  
K. Cato ◽  
B. Sheehan ◽  
S. Patel ◽  
J. Duchon ◽  
P. DeLaMora ◽  
...  
Keyword(s):  
Decision Support ◽  
Electronic Health Record ◽  
Clinical Decision Support ◽  
Clinical Decision ◽  
Electronic Health Record System ◽  
Health Record ◽  
Record System ◽  
Antimicrobial Prescribing ◽  
Neonatal Icu ◽  
Electronic Health

SummaryObjective: To develop and implement a clinical decision support (CDS) tool to improve antibiotic prescribing in neonatal intensive care units (NICUs) and to evaluate user acceptance of the CDS tool.Methods: Following sociotechnical analysis of NICU prescribing processes, a CDS tool for empiric and targeted antimicrobial therapy for healthcare-associated infections (HAIs) was developed and incorporated into a commercial electronic health record (EHR) in two NICUs. User logs were reviewed and NICU prescribers were surveyed for their perceptions of the CDS tool.Results: The CDS tool aggregated selected laboratory results, including culture results, to make treatment recommendations for common clinical scenarios. From July 2010 to May 2012, 1,303 CDS activations for 452 patients occurred representing 22% of patients prescribed antibiotics during this period. While NICU clinicians viewed two culture results per tool activation, prescribing recommendations were viewed during only 15% of activations. Most (63%) survey respondents were aware of the CDS tool, but fewer (37%) used it during their most recent NICU rotation. Respondents considered the most useful features to be summarized culture results (43%) and antibiotic recommendations (48%).Discussion: During the study period, the CDS tool functionality was hindered by EHR upgrades, implementation of a new laboratory information system, and changes to antimicrobial testing methodologies. Loss of functionality may have reduced viewing antibiotic recommendations. In contrast, viewing culture results was frequently performed, likely because this feature was perceived as useful and functionality was preserved.Conclusion: To improve CDS tool visibility and usefulness, we recommend early user and information technology team involvement which would facilitate use and mitigate implementation challenges.Citation: Hum RS, Cato K, Sheehan B, Patel S, Duchon J, DeLaMora P, Ferng YH, Graham P, Vawdrey DK, Perlman J, Larson E, Saiman L. Developing clinical decision support within a commercial electronic health record system to improve antimicrobial prescribing in the neonatal ICU. Appl Clin Inf 2014; 5: 368–387 http://dx.doi.org/10.4338/ACI-2013-09-RA-0069

Implementation and evaluation of Stanford Health Care store-and-forward teledermatology consultation workflow built within an existing electronic health record system

2018 ◽  
Vol 26 (3) ◽  
pp. 125-131 ◽  
Author(s):  
Grace E Kim ◽  
Olga K Afanasiev ◽  
Chris O’Dell ◽  
Christopher Sharp ◽  
Justin M Ko
Keyword(s):  
Health Care ◽  
Electronic Health Record ◽  
Primary Care Physicians ◽  
Health Record ◽  
Record System ◽  
Privacy Concerns ◽  
Successful Model ◽  
Dermatology Clinic ◽  
Electronic Health ◽  
Store And Forward

Introduction Teledermatology services that function separately from patients’ primary electronic health record (EHR) can lead to fragmented care, poor provider communication, privacy concerns and billing challenges. This study addresses these challenges by developing PhotoCareMD, a store-and-forward (SAF) teledermatology consultation workflow built entirely within an existing Epic-based EHR. Methods Thirty-six primary care physicians (PCPs) from eight outpatient clinics submitted 215 electronic consults (eConsults) for 211 patients to a Stanford Health Care dermatologist via PhotoCareMD. Comparisons were made with in-person referrals for this same dermatologist prior to initiation of PhotoCareMD. Results Compared to traditional in-person dermatology clinic visits, eConsults decreased the time to diagnosis and treatment from 23 days to 16 hours. The majority (73%) of eConsults were resolved electronically. In-person referrals from PhotoCareMD (27%) had a 50% lower cancellation rate compared with traditional referrals (11% versus 22%). The average in-person visit and documentation was 25 minutes compared with 8 minutes for an eConsult. PhotoCareMD saved 13 additional clinic hours to be made available to the dermatologist over the course of the pilot. At four patients per hour, this opens 52 dermatology clinic slots. Over 96% of patients had a favourable experience and 95% felt this service saved them time. Among PCPs, 100% would recommend PhotoCareMD to their colleagues and 95% said PhotoCareMD was a helpful educational tool. Discussion An internal SAF teledermatology workflow can be effectively implemented to increase access to and quality of dermatologic care. Our workflow can serve as a successful model for other hospitals and specialties.

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