scholarly journals Continuity of care in Ghana: the promise of smart-med

2014 ◽  
Vol 3 (4) ◽  
pp. 473
Author(s):  
Henry Ogoe ◽  
Odame Agyapong ◽  
Fredrick Troas Lutterodt
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Continuity Of Care ◽  
Medical Information ◽  
Care Delivery ◽  
Personal Health Records ◽  
Personal Health ◽  
Care Providers ◽  
Health Records ◽  
Fragmentation Of Care

Individuals tend to receive medical care from different health care providers as they drift from one location to another. Oftentimes, multiple providers operate disparate systems of managing patients medical records. These disparate systems, which are unable to share and/or exchange information, have the propensity to create fragmentation of care, which poses a serious threat to the realization of continuity of care in the Ghanaian health care delivery. Continuity of care, which is the ability to seamlessly access, update, and manage patients medical information as they visit multiple providers, is a crucial component of quality of care in any health delivery system. The current system of managing patients records in Ghanapaper-basedmakes continuity of care difficult to actualize. To this end, we have developed a smartcard based personal health records system, SMART-MED, which can effectively promote continuity of care in Ghana. SMART-MED is platform-independent; it can run as standalone or configured to plug into any Java-based electronic medical record system. Results of a lab simulation test suggest that it can effectively promote continuity of care through improved data security, support interoperability for disparate systems, and seamless access and update of patients health records. Keywords: Continuity of Care, Fragmentation of Care, Interoperability, Personal Health Records, Smartcard.

scholarly journals Making the Case for a P2P Personal Health Record

Information ◽  
2020 ◽  
Vol 11 (11) ◽  
pp. 512
Author(s):  
William Connor Horne ◽  
Zina Ben Miled
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Information ◽  
Third Party ◽  
Personal Health ◽  
Health Record ◽  
Care Providers ◽  
Health Records ◽  
Client Server ◽  
Proposed Model

Improved health care services can benefit from a more seamless exchange of medical information between patients and health care providers. This exchange is especially important considering the increasing trends in mobility, comorbidity and outbreaks. However, current Electronic Health Records (EHR) tend to be institution-centric, often leaving the medical information of the patient fragmented and more importantly inaccessible to the patient for sharing with other health providers in a timely manner. Nearly a decade ago, several client–server models for personal health records (PHR) were proposed. The aim of these previous PHRs was to address data fragmentation issues. However, these models were not widely adopted by patients. This paper discusses the need for a new PHR model that can enhance the patient experience by making medical services more accessible. The aims of the proposed model are to (1) help patients maintain a complete lifelong health record, (2) facilitate timely communication and data sharing with health care providers from multiple institutions and (3) promote integration with advanced third-party services (e.g., risk prediction for chronic diseases) that require access to the patient’s health data. The proposed model is based on a Peer-to-Peer (P2P) network as opposed to the client–server architecture of the previous PHR models. This architecture consists of a central index server that manages the network and acts as a mediator, a peer client for patients and providers that allows them to manage health records and connect to the network, and a service client that enables third-party providers to offer services to the patients. This distributed architecture is essential since it promotes ownership of the health record by the patient instead of the health care institution. Moreover, it allows the patient to subscribe to an extended range of personalized e-health services.

scholarly journals Personal health records in the Netherlands: potential user preferences quantified by a discrete choice experiment

2016 ◽  
Vol 24 (3) ◽  
pp. 529-536 ◽  
Author(s):  
Domino Determann ◽  
Mattijs S Lambooij ◽  
Dorte Gyrd-Hansen ◽  
Esther W de Bekker-Grob ◽  
Ewout W Steyerberg ◽  
...  
Keyword(s):  
Health Care ◽  
Data Storage ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Health Care Providers ◽  
Choice Experiment ◽  
Personal Health Records ◽  
Personal Health ◽  
Care Providers ◽  
Health Records

Objective: To identify groups of potential users based on their preferences for characteristics of personal health records (PHRs) and to estimate potential PHR uptake. Methods: We performed a discrete choice experiment, which consisted of 12 choice scenarios, each comprising 2 hypothetical PHR alternatives and an opt-out. The alternatives differed based on 5 characteristics. The survey was administered to Internet panel members of the Dutch Federation of Patients and Consumer Organizations. We used latent class models to analyze the data. Results: A total of 1,443 potential PHR users completed the discrete choice experiment. We identified 3 latent classes: “refusers” (class probability 43%), “eager adopters” (37%), and “reluctant adopters” (20%). The predicted uptake for the reluctant adopters ranged from 4% in the case of a PHR with the worst attribute levels to 68% in the best case. Those with 1 or more chronic diseases were significantly more likely to belong to the eager adopter class. The data storage provider was the most decisive aspect for the eager and reluctant adopters, while cost was most decisive for the refusers. Across all classes, health care providers and independent organizations were the most preferred data storage providers. Conclusion: We identified 3 groups, of which 1 group (more than one-third of potential PHR users) indicated great interest in a PHR irrespective of PHR characteristics. Policymakers who aim to expand the use of PHRs will be most successful when health care providers and health facilities or independent organizations store PHR data while refraining from including market parties.

The Future of Oncology Care with Personal Health Records

2012 ◽  
pp. e66-e69 ◽  
Author(s):  
Henry Feldman ◽  
Elizabeth S. Rodriguez
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Records ◽  
Clinical Information ◽  
Personal Health Records ◽  
Personal Health ◽  
Patient Portal ◽  
Care Providers ◽  
Health Records ◽  
Improve Patient

Overview: Personal health records (PHRs) and patients' access to their own clinical information through a patient portal are changing the patient-physician relationship. Historically, health care providers have been gatekeepers of patients' medical records. Now, these portals provide patients access to clinical information, electronic messaging with the clinical team, and appointment and billing information. This type of access supports patient empowerment by engaging patients in their own care. Patients desire online access to information. The health care industry, like any other, must respond to the needs of its consumers. Oncology practices face unique challenges to meeting this need because of the complex nature of medical records of patients with cancer. Health care providers worry about the consequences of patients receiving “bad news” online, thereby increasing patient anxiety. This anxiety may, in turn, increase providers' workload by creating additional calls or visits to the office. These valid concerns require careful consideration when implementing a PHR or patient portal into a practice. Providers will benefit from a clear understanding of actual compared with potential risks and benefits. Much of the concerns about the negative effect on providers' workload and the potential increase in patients' anxiety have not been borne out. On the other hand, the implementation strategy, governance structure, and end-user education are crucial components to ensuring success. Successful implementation of a PHR or patient portal affords the opportunity to improve patient satisfaction and increase efficiency in provider workflow. The possibility exists to improve patient outcomes by engaging the patient in decision making and follow through.

Advanced Patient Records: Some Ethical and Legal Considerations Touching Medical Information Space

1993 ◽  
Vol 32 (02) ◽  
pp. 95-103 ◽  
Author(s):  
E.-H. W. Kluge
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Information ◽  
Ethical Issues ◽  
Care Delivery ◽  
Patient Records ◽  
Care Providers ◽  
Physician Patient Relationship ◽  
Resource Base ◽  
Ethical Problems

Abstract:The application of advanced computer-based information technology to patient records presents an opportunity for expanding the informational resource base that is available to health-care providers at all levels. Consequently, it has the potential for fundamentally restructuring the ethics of the physician/patient relationship and the ethos of contemporary health-care delivery. At the same time, the technology raises several important ethical problems. This paper explores some of these implications. It suggests that the fundamental ethical issue at stake in these developments is the status of the electronic record which functions as the analog of the health-care consumer in health-care decision making. Matters such as control and patient dignity are implicated. Other important ethical issues requiring solution include data ownership, data liability, informed consent to use and retrieval, security and access. The paper suggests that the ethical problems that arise cannot be solved in piecemeal fashion and on a purely national basis. They should be addressed in a coordinated international fashion and receive appropriate legal expression in the relevant countries and be incorporated into appropriate codes of ethics.

Medical Record Confidentiality Law, Scientific Research, and Data Collection in the Information Age

1997 ◽  
Vol 25 (2-3) ◽  
pp. 113-129 ◽  
Author(s):  
Richard C. Turkington
Keyword(s):  
Health Care ◽  
Data Collection ◽  
Health Information ◽  
Delivery System ◽  
Health Care Providers ◽  
Care Delivery ◽  
Scientific Research ◽  
The United States ◽  
Care Providers ◽  
Health Records

A powerful movement is afoot to create a national computerized system of health records. Advocates claim it could save the health delivery system billions of dollars and improve the quality of health services. According to Lawrence Gostin, a leading commentator on privacy and health records, this new infrastructure is “already under way and [has] an aura of inevitability.” When it is in place, almost any information that is viewed as relevant to a decision in the health care delivery system would be available to a large and yet undetermined number of individuals. The transformation of the collection and communication of health information from texts housed by health care providers and facilities to data electronically transmitted through networks of linked computers has significant implications for confidentiality and for data collection in scientific research. The best evidence clearly indicates that most people in the United States consider confidentiality for health information important and worry that the increased computerization of health records will result in inappropriate disclosure.

scholarly journals The impact of training on the use of electronic health records

1970 ◽  
Vol 9 (3) ◽  
pp. 140-147
Author(s):  
B Devkota ◽  
JF Lamia ◽  
N Pommer ◽  
J Smith ◽  
B Whitman
Keyword(s):  
Health Care ◽  
Electronic Health Records ◽  
Learning Outcomes ◽  
Health Care Providers ◽  
Positive Impact ◽  
Care Delivery ◽  
Care Providers ◽  
Health Records ◽  
Electronic Health ◽  
The Impact

Background: Studies have found that health information technology can improve the quality and efficiency of care delivery through better decision support. Objective: To gauge the effectiveness of electronic health records (EHR) training that was delivered to health care providers in an academic practice, to leverage feedback from the training evaluation to inform the content and process of training health care providers and to understand the impact of EHR implementation on all facets of health care delivery. Methods: A mixed methods instrument was designed to assess learning outcomes (cognitive, attitudinal and behavioral) associated with EHR training. A sample of 220 health care providers who regularly interacted with the EHR system was included. Participants were asked to evaluate cognitive, attitudinal, and behavioral aspects of their training with the EHR system. A multidimensional assessment of learning outcomes was selected. Results: On behavioral theme, 50% of our survey respondents answered the questions positively, 28% did not, 16% had mixed feelings, 3% felt EHR had negative impacts and 3% were neutral. On cognitive theme 31% felt EHR had a positive impact, 33% felt it had drawbacks whereas 35% left the answers blank and 1% felt they had no idea. On attitudinal theme, there was positive response from 45%, 21% had negative feelings about the system, 5% were neutral and the rest 25% did not answer. Conclusions: In this study, we found that majority of the respondents were satisfied with the EHR for behavioral and attitudinal themes. Future studies with mandatory response to cognitive theme will help figure out the satisfaction of survey respondents on all themes. DOI: http://dx.doi.org/10.3126/hren.v9i3.5580   HR 2011; 9(3): 140-147

scholarly journals Perception and Willingness to Maintain Continuity of Care by Parents of Children with Asthma in Taiwan

2021 ◽  
Vol 18 (7) ◽  
pp. 3600
Author(s):  
Christy Pu ◽  
Yu-Chen Tseng ◽  
Gau-Jun Tang ◽  
Yen-Hsiung Lin ◽  
Chien-Heng Lin ◽  
...  
Keyword(s):  
Health Care ◽  
Willingness To Pay ◽  
Health Care Providers ◽  
Continuity Of Care ◽  
Care Providers ◽  
Exact Matching ◽  
Extra Effort ◽  
Referral Management ◽  
Children With Asthma ◽  
Outpatient Departments

To investigate caregivers’ attitudes toward continuity of care (COC) and their willingness to maintain continuity for their children with asthma under a national health insurance (NHI) system without strict referral management. We sampled 825 individuals from six pediatric outpatient departments in different parts of Taiwan from 2017 to 2018. We used a contingent valuation with a payment card method. Post-stratification weighting adjustment and coarsened exact matching were utilized. Multiple logistic regression was used to compare the willingness to pay and spend extra time maintaining continuity by parents. More than 80% of caregivers in the asthma group believed having a primary pediatrician was important for children’s health. Only 27.5% and 15.8% of caregivers in the asthma and control groups, respectively, believed changing pediatricians would negatively affect therapeutic outcomes. Regression analysis showed that the predicted willingness to pay for the asthma and non-asthma groups were NT$508 (SD = 196) and NT$402 (SD = 172), respectively, and there was a significant positive dose–response relationship between household income and willingness to pay for maintaining health care provider continuity. Caregivers’ free choices among health care providers may reduce willingness to spend extra effort to maintain high COC. Caregivers should be educated on the importance of COC.

Genetic Predispositions, Prophylactic Treatments and Private Health Insurance: Nothing is Better Than a Good Pair of Genes

1997 ◽  
Vol 23 (1) ◽  
pp. 45-68 ◽  
Author(s):  
Alexandra K. Glazier
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Genetic Predisposition ◽  
Genetic Linkage ◽  
Dna Analysis ◽  
Care Delivery ◽  
Medical Community ◽  
Care Providers ◽  
Linkage Studies ◽  
Prophylactic Measures

Discovering the genetic basis of a particular disease is not only of great interest to the medical community; private health insurers are also anxiously awaiting the results of genetic linkage studies. Apart from the scientific value of DNA studies, the results of genetic linkage research are relevant to health care delivery in two principal ways. First, identifying the genetic origin of a disease may allow doctors to detect the disease earlier. If doctors know that an individual is genetically predisposed to a particular disease, then health care providers can increase screening efforts and watch for early symptoms. Second, if an individual has a genetic predisposition to a particular disease, health care providers may employ preventive or “prophylactic" measures to reduce or eliminate the risk of developing the disease or condition to which the individual is genetically predisposed. Genetic linkage studies will soon allow more individuals to learn of their own genetic predispositions to certain diseases. Currently genetic predisposition tests (both pedigrees of family history and DNA analysis) can indicate that an individual is at high risk for developing a disease.

Nurse Practitioner Challenges to the Orthodox Structure of Health Care Delivery: Regulation and Restraints on Trade

1985 ◽  
Vol 11 (2) ◽  
pp. 195-225
Author(s):  
Karla Kelly
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Allied Health ◽  
Care Delivery ◽  
The United States ◽  
Care Providers ◽  
Allied Health Care

AbstractUntil recently, physicians have been the primary health care providers in the United States. In response to the rising health care costs and public demand of the past decade, allied health care providers have challenged this orthodox structure of health care delivery. Among these allied health care providers are nurse practitioners, who have attempted to expand traditional roles of the registered nurse.This article focuses on the legal issues raised by several major obstacles to the expansion of nurse practitioner services: licensing restrictions, third party reimbursement policies, and denial of access to medical facilities and physician back-up services. The successful judicial challenges to discriminatory practices against other allied health care providers will be explored as a solution to the nurse practitioners’ dilemma.

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