scholarly journals Do you want to receive bad news through your patient accessible electronic health record? A national survey on receiving bad news in an era of digital health

2021 ◽  
Vol 27 (3) ◽  
pp. 146045822110358
Author(s):  
Hanife Rexhepi ◽  
Jonas Moll ◽  
Isto Huvila ◽  
Rose-Mharie Åhlfeldt
Keyword(s):  
Educational Level ◽  
Medical Diagnosis ◽  
Digital Health ◽  
Patient Survey ◽  
Bad News ◽  
Health Records ◽  
National Patient ◽  
Electronic Health ◽  
To Receive ◽  
Diagnosis Age

Despite the fact that patient accessible electronic health records (PAEHRs) have been around for many years in several countries, there is a lack of research investigating patient’s preferences for receiving bad news, including through PAEHRs. Little is also known about the characteristics of the patients who prefer to receive bad news through the PAEHR in terms of, for example medical diagnosis, age and educational level. This study, based on a national patient survey in Sweden ( N = 2587), investigated this. Results show that, generally, receiving bad news by reading in the PAEHR is still among the least preferred options. Additionally, a higher proportion of men want to receive bad news in the PAEHR compared to women ( p = 0.001), and the same goes for those who are not working/have worked in healthcare ( p = 0.007). An effect of disease groups was also found, showing that diabetes patients in particular, want to receive bad news through the PAEHR.

scholarly journals Patients’ Experiences of Accessing Their Electronic Health Records: National Patient Survey in Sweden

2018 ◽  
Vol 20 (11) ◽  
pp. e278 ◽  
Author(s):  
Jonas Moll ◽  
Hanife Rexhepi ◽  
Åsa Cajander ◽  
Christiane Grünloh ◽  
Isto Huvila ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Patient Survey ◽  
Health Records ◽  
National Patient ◽  
Electronic Health

scholarly journals Online electronic healthcare records: Comparing the views of cancer patients and others

2020 ◽  
Vol 26 (4) ◽  
pp. 2915-2929
Author(s):  
Hanife Rexhepi ◽  
Jonas Moll ◽  
Isto Huvila
Keyword(s):  
Electronic Health Records ◽  
Cancer Patients ◽  
Patient Survey ◽  
General Interest ◽  
Health Records ◽  
Positive Effects ◽  
Health History ◽  
Survey Response Rate ◽  
National Patient ◽  
Electronic Health

This study investigates differences in attitudes towards, and experiences with, online electronic health records between cancer patients and patients with other conditions, highlighting what is characteristic to cancer patients. A national patient survey on online access to electronic health records was conducted, where cancer patients were compared with all other respondents. Overall, 2587 patients completed the survey (response rate 0.61%). A total of 347 respondents (13.4%) indicated that they suffered from cancer. Results showed that cancer patients are less likely than other patients to use online electronic health records due to general interest (p < 0.001), but more likely for getting an overview of their health history (p = 0.001) and to prepare for visits (p < 0.001). Moreover, cancer patients rate benefits of accessing their electronic health records online higher than other patients and see larger positive effects regarding improved communication with and involvement in healthcare.

scholarly journals Patients’ Experiences of Accessing Their Electronic Health Records: National Patient Survey in Sweden (Preprint)

2017 ◽  
Author(s):  
Jonas Moll ◽  
Hanife Rexhepi ◽  
Åsa Cajander ◽  
Christiane Grünloh ◽  
Isto Huvila ◽  
...  
Keyword(s):  
Health Care ◽  
Electronic Health Records ◽  
Health Care Professionals ◽  
Patient Survey ◽  
Patient Portal ◽  
Health Records ◽  
Web Based ◽  
Number Of Patients ◽  
National Patient ◽  
Electronic Health

BACKGROUND Internationally, there is a movement toward providing patients a Web-based access to their electronic health records (EHRs). In Sweden, Region Uppsala was the first to introduce patient-accessible EHRs (PAEHRs) in 2012. By the summer of 2016, 17 of 21 county councils had given citizens Web-based access to their medical information. Studies on the effect of PAEHRs on the work environment of health care professionals have been conducted, but up until now, few extensive studies have been conducted regarding patients’ experiences of using PAEHRs in Sweden or Europe, more generally. OBJECTIVE The objective of our study was to investigate patients’ experiences of accessing their EHRs through the Swedish national patient portal. In this study, we have focused on describing user characteristics, usage, and attitudes toward the system. METHODS A national patient survey was designed, based on previous interview and survey studies with patients and health care professionals. Data were collected during a 5-month period in 2016. The survey was made available through the PAEHR system, called Journalen, in Sweden. The total number of patients that logged in and could access the survey during the study period was 423,141. In addition to descriptive statistics reporting response frequencies on Likert scale questions, Mann-Whitney tests, Kruskal-Wallis tests, and chi-square tests were used to compare answers between different county councils as well as between respondents working in health care and all other respondents. RESULTS Overall, 2587 users completed the survey with a response rate of 0.61% (2587/423,141). Two participants were excluded from the analysis because they had only received care in a county council that did not yet show any information in Journalen. The results showed that 62.97% (1629/2587) of respondents were women and 39.81% (1030/2587) were working or had been working in health care. In addition, 72.08% (1794/2489) of respondents used Journalen about once a month, and the main reason for use was to gain an overview of one’s health status. Furthermore, respondents reported that lab results were the most important information for them to access; 68.41% (1737/2539) of respondents wanted access to new information within a day, and 96.58% (2454/2541) of users reported that they are positive toward Journalen. CONCLUSIONS In this study, respondents provided several important reasons for why they use Journalen and why it is important for them to be able to access information in this way—several related to patient empowerment, involvement, and security. Considering the overall positive attitude, PAEHRs seem to fill important needs for patients.

scholarly journals Designing Decentralized Ledger Technology for Electronic Health Records

2018 ◽  
Vol 1 (2) ◽  
Author(s):  
Vikram Dhillon
Keyword(s):  
Electronic Health Records ◽  
Open Source ◽  
Digital Health ◽  
Health Records ◽  
Distributed Ledger ◽  
Distributed Ledger Technology ◽  
Electronic Health

No abstract available. Editor’s note: A proposal to implement distributed ledger technology for electronic health records is outlined here. The rationale for integration of distributed ledgers in the healthcare domain is introduced, followed by a discussion of the features enabled by the use of a blockchain. An open source implementation of a distributed ledger is then presented. The article concludes with an examination of opportunities and challenges ahead in deploying blockchains for digital health.

scholarly journals Enrichment sampling for a multi-site patient survey using electronic health records and census data

2018 ◽  
Vol 26 (3) ◽  
pp. 219-227 ◽  
Author(s):  
Nathaniel D Mercaldo ◽  
Kyle B Brothers ◽  
David S Carrell ◽  
Ellen W Clayton ◽  
John J Connolly ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Census Data ◽  
Sampling Strategy ◽  
Fold Increase ◽  
Patient Survey ◽  
United States Census ◽  
Sampling Frame ◽  
Health Records ◽  
Adult Age ◽  
Electronic Health

Abstract Objective We describe a stratified sampling design that combines electronic health records (EHRs) and United States Census (USC) data to construct the sampling frame and an algorithm to enrich the sample with individuals belonging to rarer strata. Materials and Methods This design was developed for a multi-site survey that sought to examine patient concerns about and barriers to participating in research studies, especially among under-studied populations (eg, minorities, low educational attainment). We defined sampling strata by cross-tabulating several socio-demographic variables obtained from EHR and augmented with census-block-level USC data. We oversampled rarer and historically underrepresented subpopulations. Results The sampling strategy, which included USC-supplemented EHR data, led to a far more diverse sample than would have been expected under random sampling (eg, 3-, 8-, 7-, and 12-fold increase in African Americans, Asians, Hispanics and those with less than a high school degree, respectively). We observed that our EHR data tended to misclassify minority races more often than majority races, and that non-majority races, Latino ethnicity, younger adult age, lower education, and urban/suburban living were each associated with lower response rates to the mailed surveys. Discussion We observed substantial enrichment from rarer subpopulations. The magnitude of the enrichment depends on the accuracy of the variables that define the sampling strata and the overall response rate. Conclusion EHR and USC data may be used to define sampling strata that in turn may be used to enrich the final study sample. This design may be of particular interest for studies of rarer and understudied populations.

scholarly journals Provider and Patient Determinants of Generic Levothyroxine Prescribing: An Electronic Health Records–Based Study

2017 ◽  
Vol 51 (8) ◽  
pp. 640-648 ◽  
Author(s):  
Robert J. Romanelli ◽  
Vani Nimbal ◽  
Sarah K. Dutcher ◽  
Xia Pu ◽  
Jodi B. Segal
Keyword(s):  
Electronic Health Records ◽  
Intraclass Correlation ◽  
Fixed Effect ◽  
Cross Sectional ◽  
Mixed Effect ◽  
Health Records ◽  
Residual Variation ◽  
Generic Prescribing ◽  
Electronic Health ◽  
To Receive

Background: Despite the availability of generic levothyroxine products for more than a decade, uptake of these products is poor. Objective: We sought to evaluate determinants of generic prescribing of levothyroxine. Methods: In a cross-sectional analysis of electronic health records data between 2010 and 2013, we identified adult patients with a levothyroxine prescription from a primary-care physician (PCP) or endocrinologist. We used mixed-effect logistic regression models with random intercepts for prescribing provider to examine predictors of generic levothyroxine prescribing. Models include patient, prescription, and provider fixed-effect covariates. Odds ratios (ORs) and 95% CIs were generated. Between-provider random variation was quantified by the intraclass correlation coefficient (ICC). Results: Study patients (n = 63 838) were clustered among 941 prescribing providers within 25 ambulatory care clinics. The overall prevalence of generic prescribing of levothyroxine was 73%. In the multivariable mixed-effect model, patients were significantly less likely to receive generic levothyroxine from an endocrinologist than a PCP (OR = 0.43; 95% CI = 0.33-0.55; P < 0.001). Women were less likely to receive generic levothyroxine than men from endocrinologists (OR = 0.68; 95% CI = 0.59-0.78; P < 0.001) but not from PCPs. Between-provider variation in generic prescribing was 18.3% in the absence of fixed-effect covariates and could be explained marginally by patient, prescription, and provider factors (ICC = 15.9%). Conclusions: Generic levothyroxine prescribing differed by PCPs and endocrinologists. Residual variation in generic prescribing, after accounting for measurable factors, indicates the need for provider interventions or patient education aimed at improving levothyroxine generic uptake.

scholarly journals Best Paper Selection

2021 ◽  
Vol 30 (01) ◽  
pp. 103-104
Keyword(s):  
Primary Care ◽  
Health Status ◽  
Skin Cancer ◽  
Health Informatics ◽  
Digital Health ◽  
Health Record ◽  
Health Records ◽  
After Hours ◽  
Electronic Health ◽  
Primary Care Clinicians

Adler-Milstein J, Zhao W, Willard-Grace R, Knox M, Grumbach K. Electronic health records and burnout: Time spent on the electronic health record after hours and message volume associated with exhaustion but not with cynicism among primary care clinicians. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7647261/ Brewer LC, Fortuna KL, Jones C, Walker R, Hayes SN, Patten CA, Cooper LA. Back to the Future: Achieving Health Equity Through Health Informatics and Digital Health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6996775/ Reading Turchioe M, Grossman LV, Myers AC, Baik D, Goyal P, Masterson Creber RM. Visual analogies, not graphs, increase patients' comprehension of changes in their health status. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7309237 Tschandl P, Rinner C, Apalla Z, Argenziano G, Codella N, Halpern A, Janda M, Lallas A, Longo C, Josep Malvehy J, Paoli J, Puig S, Rosendahl C, Soyer HP, Zalaudek I, Kittler H. Human-computer collaboration for skin cancer recognition. https://www.nature.com/articles/s41591-020-0942-0

scholarly journals Policy Update: Federal Incentives for the Adoption of Electronic Health Records

2009 ◽  
Vol 5 (5) ◽  
pp. 262-263
Author(s):  
Chantal Worzala
Keyword(s):  
Electronic Health Records ◽  
Financial Incentives ◽  
Health Records ◽  
Bonus Payments ◽  
Electronic Health ◽  
To Receive

The American Recovery and Reinvestment Act of 2009 provides financial incentives for physicians and hospitals to adopt electronic health records. Practices can take initial steps outlined here to receive bonus payments and avoid penalties.

scholarly journals A Mechanism for Verifying the Integrity and Immutability of Tuberculosis Data Using IOTA Distributed Ledger Technology

2021 ◽  
Author(s):  
Vinícius Lima ◽  
Filipe Bernardi ◽  
Rui Rijo ◽  
Jó Ueyama ◽  
Domingos Alves
Keyword(s):  
Electronic Health Records ◽  
Digital Health ◽  
Health Records ◽  
Related Information ◽  
Research And Innovation ◽  
Distributed Ledger ◽  
Collective Process ◽  
Supporting Tool ◽  
Electronic Health ◽  
Digital Transactions

Background: Intensified research and innovation and rapid uptake of new tools, interventions, and strategies are crucial to fight Tuberculosis, the world’s deadliest infectious disease. The sharing of health data remains a significant challenge. Data consumers must be able to verify the consistency and integrity of data. Solutions based on distributed ledger technologies may be adequate, where each member in a network holds a unique credential and stores an identical copy of the ledger and contributes to the collective process of validating and certifying digital transactions. Objectives: This work proposes a mechanism and presents a use case in Digital Health to allow the verification of integrity and immutability of TB electronic health records. Methods: IOTA was selected as a supporting tool due to its data immutability, traceability and tamper-proof characteristics. Results: A mechanism to verify the integrity of data through hash functions and the IOTA network is proposed. Then, a set of TB related information systems was integrated with the network. Conclusion: IOTA technology offers performance and flexibility to enable a reliable environment for electronic health records.

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