Governance of Open Source Electronic Health Record Projects: A Successful Case of a Hybrid Model

2014 ◽  
Author(s):  
Placide Poba-Nzaou ◽  
Josianne Marsan ◽  
Guy Pare ◽  
Louis Raymond
Keyword(s):  
Electronic Health Record ◽  
Open Source ◽  
Hybrid Model ◽  
Health Record ◽  
Successful Case ◽  
Electronic Health

Assessing HIPAA Compliance of Open Source Electronic Health Record Applications

2021 ◽  
Vol 15 (2) ◽  
pp. 181-195
Author(s):  
Hossain Shahriar ◽  
Hisham M. Haddad ◽  
Maryam Farhadi
Keyword(s):  
Electronic Health Record ◽  
Open Source ◽  
Medical Decision ◽  
Patient Treatment ◽  
Health Record ◽  
Technical Requirements ◽  
Patient Health ◽  
Treatment Plans ◽  
Electronic Health ◽  
Quality In Healthcare

Electronic health record (EHR) applications are digital versions of paper-based patient health information. EHR applications are increasingly being adopted in many countries. They have resulted in improved quality in healthcare, convenient access to histories of patient medication and clinic visits, easier follow up of patient treatment plans, and precise medical decision-making process. The goal of this paper is to identify HIPAA technical requirements, evaluate two open source EHR applications (OpenEMR and OpenClinic) for security vulnerabilities using two open-source scanner tools (RIPS and PHP VulnHunter), and map the identified vulnerabilities to HIPAA technical requirements.

scholarly journals Semantic computational analysis of anticoagulation use in atrial fibrillation from real world data

2019 ◽  
Author(s):  
Daniel M. Bean ◽  
James Teo ◽  
Honghan Wu ◽  
Ricardo Oliveira ◽  
Raj Patel ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Natural Language Processing ◽  
Natural Language ◽  
Electronic Health Record ◽  
Open Source ◽  
Language Processing ◽  
Risk Scores ◽  
Free Text ◽  
Health Record ◽  
Electronic Health

AbstractAtrial fibrillation (AF) is the most common arrhythmia and significantly increases stroke risk. This risk is effectively managed by oral anticoagulation. Recent studies using national registry data indicate increased use of anticoagulation resulting from changes in guidelines and the availability of newer drugs.The aim of this study is to develop and validate an open source risk scoring pipeline for free-text electronic health record data using natural language processing.AF patients discharged from 1st January 2011 to 1st October 2017 were identified from discharge summaries (N=10,030, 64.6% male, average age 75.3 ± 12.3 years). A natural language processing pipeline was developed to identify risk factors in clinical text and calculate risk for ischaemic stroke (CHA2DS2-VASc) and bleeding (HAS-BLED). Scores were validated vs two independent experts for 40 patients.Automatic risk scores were in strong agreement with the two independent experts for CHA2DS2-VASc (average kappa 0.78 vs experts, compared to 0.85 between experts). Agreement was lower for HAS-BLED (average kappa 0.54 vs experts, compared to 0.74 between experts).In high-risk patients (CHA2DS2-VASc ≥2) OAC use has increased significantly over the last 7 years, driven by the availability of DOACs and the transitioning of patients from AP medication alone to OAC. Factors independently associated with OAC use included components of the CHA2DS2-VASc and HAS-BLED scores as well as discharging specialty and frailty. OAC use was highest in patients discharged under cardiology (69%).Electronic health record text can be used for automatic calculation of clinical risk scores at scale. Open source tools are available today for this task but require further validation. Analysis of routinely-collected EHR data can replicate findings from large-scale curated registries.

scholarly journals Open-Source Electronic Health Record Systems for Low-Resource Settings: Systematic Review

2017 ◽  
Vol 5 (4) ◽  
pp. e44 ◽  
Author(s):  
Assel Syzdykova ◽  
André Malta ◽  
Maria Zolfo ◽  
Ermias Diro ◽  
José Luis Oliveira
Keyword(s):  
Systematic Review ◽  
Electronic Health Record ◽  
Open Source ◽  
Health Record ◽  
Low Resource Settings ◽  
Low Resource ◽  
Electronic Health

scholarly journals Open source cardiology electronic health record development for DIGICARDIAC implementation

2015 ◽  
Author(s):  
Nelson Dugarte ◽  
Rubén Medina ◽  
Lourdes Huiracocha ◽  
Rubén Rojas
Keyword(s):  
Electronic Health Record ◽  
Open Source ◽  
Health Record ◽  
Electronic Health

scholarly journals Functionalities of free and open electronic health record systems

2010 ◽  
Vol 26 (4) ◽  
pp. 382-389 ◽  
Author(s):  
Alejandro Enrique Flores Zuniga ◽  
Khin Than Win ◽  
Willy Susilo
Keyword(s):  
Electronic Health Record ◽  
Open Source ◽  
Security Requirements ◽  
Health Record ◽  
Reference Architecture ◽  
Functional Requirements ◽  
Privacy And Security ◽  
Record System ◽  
Iso Standards ◽  
Electronic Health

Objectives: The aim of this study was to examine open-source electronic health record (EHR) software to determine their level of functionalities according to the International Organization for Standardization (ISO) standards.Methods: ISO standards were used as a guideline to determine and describe the reference architecture and functionalities of a standard electronic health record system as well the environmental context for which the software has been built. Twelve open-source EHR systems were selected and evaluated according to two-dimensional criteria based on ISO/TS 18308:2004 functional requirements and ISO/TR 20514:2005 context of the EHR system.Results: Open EHR software programs mostly fulfill structural, procedural, evolutional, and medicolegal requirements at the minimal and full functionality levels. Communication, privacy, and security requirements are accomplished in less than 23 percent of the cases, mainly at minimal functional level. Ethical, cultural, and consumer requirements still need to be fulfilled by free and open-source EHR applications.Conclusions: Most analyzed systems had several functional limitations. Nevertheless, especially for clinicians and decision makers in developing countries, open-source EHR systems are an option. The limited functionalities are likely to become requirements for further releases of open-source EHR systems.

scholarly journals Implementing an Open Source Electronic Health Record System in Kenyan Health Care Facilities: Case Study (Preprint)

2017 ◽  
Author(s):  
Naomi Muinga ◽  
Steve Magare ◽  
Jonathan Monda ◽  
Onesmus Kamau ◽  
Stuart Houston ◽  
...  
Keyword(s):  
Health Care ◽  
Electronic Health Record ◽  
Open Source ◽  
Health Information ◽  
Health Care Facilities ◽  
Health Record ◽  
Record System ◽  
Care Facilities ◽  
Electronic Health

BACKGROUND The Kenyan government, working with international partners and local organizations, has developed an eHealth strategy, specified standards, and guidelines for electronic health record adoption in public hospitals and implemented two major health information technology projects: District Health Information Software Version 2, for collating national health care indicators and a rollout of the KenyaEMR and International Quality Care Health Management Information Systems, for managing 600 HIV clinics across the country. Following these projects, a modified version of the Open Medical Record System electronic health record was specified and developed to fulfill the clinical and administrative requirements of health care facilities operated by devolved counties in Kenya and to automate the process of collating health care indicators and entering them into the District Health Information Software Version 2 system. OBJECTIVE We aimed to present a descriptive case study of the implementation of an open source electronic health record system in public health care facilities in Kenya. METHODS We conducted a landscape review of existing literature concerning eHealth policies and electronic health record development in Kenya. Following initial discussions with the Ministry of Health, the World Health Organization, and implementing partners, we conducted a series of visits to implementing sites to conduct semistructured individual interviews and group discussions with stakeholders to produce a historical case study of the implementation. RESULTS This case study describes how consultants based in Kenya, working with developers in India and project stakeholders, implemented the new system into several public hospitals in a county in rural Kenya. The implementation process included upgrading the hospital information technology infrastructure, training users, and attempting to garner administrative and clinical buy-in for adoption of the system. The initial deployment was ultimately scaled back due to a complex mix of sociotechnical and administrative issues. Learning from these early challenges, the system is now being redesigned and prepared for deployment in 6 new counties across Kenya. CONCLUSIONS Implementing electronic health record systems is a challenging process in high-income settings. In low-income settings, such as Kenya, open source software may offer some respite from the high costs of software licensing, but the familiar challenges of clinical and administration buy-in, the need to adequately train users, and the need for the provision of ongoing technical support are common across the North-South divide. Strategies such as creating local support teams, using local development resources, ensuring end user buy-in, and rolling out in smaller facilities before larger hospitals are being incorporated into the project. These are positive developments to help maintain momentum as the project continues. Further integration with existing open source communities could help ongoing development and implementations of the project. We hope this case study will provide some lessons and guidance for other challenging implementations of electronic health record systems as they continue across Africa.

Future Developments of Medical Informatics from the Viewpoint of Networked Clinical Research

2009 ◽  
Vol 48 (01) ◽  
pp. 45-54 ◽  
Author(s):  
W. Kuchinke ◽  
C. Ohmann
Keyword(s):  
Clinical Research ◽  
Electronic Health Record ◽  
Open Source ◽  
Medical Informatics ◽  
Data Capture ◽  
Health Record ◽  
Electronic Data Capture ◽  
Electronic Data ◽  
Future Developments ◽  
Electronic Health

Summary Objectives: To be prepared for future developments, such as enabling support of rapid innovation transfer and personalized medicine concepts, interoperability of basic research, clinical research and medical care is essential. It is the objective of our paper to give an overview of developments, indicate problem areas and to specify future requirements. Methods: In this paper recent and ongoing large-scaled activities related to interoper-ability and integration of networked clinical research are described and evaluated. The following main topics are covered: necessity for general IT-conception, open source/open community approach, acceptance of eSource in clinical research, interoperability of the electronic health record and electronic data capture and harmonization and bridging of standards for technical and semantic inter-operability. Results: National infrastructures and programmes have been set up to provide general IT-conceptions to guide planning and development of software tools (e.g. TMF, ca BIG, NIHR). The concept of open research described by transparency achieved through open access, open data, open communication and open source software is becoming more and more important in clinical research infrastructure development (e.g. ca BIG, ePCRN). Meanwhile visions and rules for using eSource in clinical research are available, with the potential to improve interoperability between the electronic health record and electronic data capture (e.g. CDISC e SDI, eClinical Forum/PhRMA EDC/eSource Taskforce). Several groups have formulated user requirements, use cases and technical frameworks to advance these issues (e.g. NHIN Slipstream-project, EHR/CR-project, IHE). In order to achieve technical and semantic interoperability, existing standards (e.g. CDISC) have to be harmonized and bridged. Major consortia have been formed to provide semantical inter-operability (e.g. HL7 RCRIM under joint leadership of HL7, CDISC and FDA, or BRIDG covering CDISC, HL7, FDA, NCI) and to provide core sets of data collection fields (CDASH). Conclusions: The essential tasks for medical informatics within the next ten years will now be the development and implementation of encompassing IT conceptions, strong support of the open community and open source approach, the acceptance of eSource in clinical research, the uncompromising continuity of standardization and bridging of technical standards and the widespread use of electronic health record systems.

scholarly journals Implementing an Open Source Electronic Health Record System in Kenyan Health Care Facilities: Case Study

2018 ◽  
Vol 6 (2) ◽  
pp. e22 ◽  
Author(s):  
Naomi Muinga ◽  
Steve Magare ◽  
Jonathan Monda ◽  
Onesmus Kamau ◽  
Stuart Houston ◽  
...  
Keyword(s):  
Health Care ◽  
Electronic Health Record ◽  
Open Source ◽  
Health Care Facilities ◽  
Electronic Health Record System ◽  
Health Record ◽  
Record System ◽  
Care Facilities ◽  
Electronic Health
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