scholarly journals The Adoption Level of Electronic Health Records in Turkish Hospitals and the Relation with Hospital Sizes

2019 ◽  
Author(s):  
Ilker Kose ◽  
John Rayner ◽  
Suayip Birinci ◽  
Mustafa Mahir Ulgu ◽  
Ismayil Yilmaz ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Medical Information ◽  
Clinical Care ◽  
Public Hospitals ◽  
Maturity Model ◽  
Health Records ◽  
Hospital Size ◽  
Electronic Health ◽  
Adoption Level ◽  
Better Than

Abstract Background Considering the benefits of using electronic health records (EHR) for maintaining the overall quality of clinical care, the nationwide adoption of EHR in hospitals has become a policy priority. The electronic medical record maturity model (EMRAM) is one of the most popular survey tools developed by the Healthcare Information and Management Systems Society (HIMSS) that measures the level of adoption for EHR functions in a hospital or a secondary care setting. This study aims to measure the digital capacity of public hospitals in Turkey and criticize the relation between adoption and hospital size. Methods EMRAM surveys were completed by 600 (68.9%) public hospitals of Turkey between 2014 and 2017. The availability and prevalence of medical information systems and EHR functions were measured. The association between hospital size and the availability/prevalence of EHR functions was also calculated.Results We found that 63.1% of all hospitals in Turkey have at least basic EHR functions, and 36% have comprehensive EHR functions, which is better than the results of Korean hospitals of 2017 but still lower than the USA hospitals of 2015 (1)[1]and 2017. Our findings suggest that small hospitals are better than larger hospitals at adopting certain EHR functions. Conclusion Measuring the overall adoption level of EHR functions is an emerging approach and a beneficial tool for the strategic management of countries. This study is the first one covering all public hospitals in a country by using EMRAM. The results are used by MoH of Turkey to disseminate the benefits of EHR functions overall in the country.

scholarly journals The Adoption Level of Electronic Health Records in Turkish Hospitals and the Relation with Hospital Sizes

2020 ◽  
Author(s):  
Ilker Kose ◽  
John Rayner ◽  
Suayip Birinci ◽  
Mustafa Mahir Ulgu ◽  
Ismayil Yilmaz ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Clinical Care ◽  
Public Hospitals ◽  
Health Records ◽  
Bottom Up ◽  
Hospital Size ◽  
The Usa ◽  
Electronic Health ◽  
Adoption Level ◽  
Better Than

Abstract Background: Considering the benefits of using electronic health records (EHR) for maintaining the overall quality of clinical care, the nationwide adoption of EHR in hospitals has become a policy priority. The electronic medical record maturity model (EMRAM) is one of the most popular survey tools developed by the Healthcare Information and Management Systems Society (HIMSS) that measures the level of adoption for EHR functions in a hospital or a secondary care setting. Turkey has accomplished many standardizations and infrastructural studies in the health IT domain as a part of the first phase of the Health Transformation Program between 2003 and 2017. The Turkish MoH applied a bottom-up approach to adopting EHR in public hospitals, as the USA did. This study aims to measure the EHR adoption level of public hospitals in Turkey and criticize the relation between adoption and hospital size. Methods: EMRAM surveys were completed by 600 (68.9%) public hospitals of Turkey between 2014 and 2017. The availability and prevalence of medical information systems and EHR functions were measured. The association between hospital size and the availability/prevalence of EHR functions was also calculated. Results: We found that 63.1% of all hospitals in Turkey have at least basic EHR functions, and 36% have comprehensive EHR functions, which is better than the results of Korean hospitals of 2017 but still lower than the USA hospitals of 2015 and 2017. Our findings suggest that small hospitals are better than larger hospitals at adopting certain EHR functions. Conclusion: Measuring the overall adoption level of EHR functions is an emerging approach and a beneficial tool for the strategic management of countries. This study is the first one covering all public hospitals in a country by using EMRAM. It can be suggested that using a bottom-up approach as applied by the USA on adopting EHR in public hospital gives successful results also in Turkey. The results are used by MoH of Turkey to disseminate the benefits of EHR functions overall in the country.

scholarly journals Adoption Rates of Electronic Health Records in Turkish Hospitals and the Relation with Hospital Sizes

2020 ◽  
Author(s):  
Ilker Kose ◽  
John Rayner ◽  
Suayip Birinci ◽  
Mustafa Mahir Ulgu ◽  
Ismayil Yilmaz ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Medical Information ◽  
Clinical Care ◽  
The United States ◽  
Health Records ◽  
Bottom Up ◽  
Hospital Size ◽  
Survey Tool ◽  
State Hospitals ◽  
Electronic Health

Abstract Background : Nation-wide adoption of electronic health records (EHRs) in hospitals has become a Turkish policy priority in recognition of their benefits in maintaining the overall quality of clinical care. The electronic medical record maturity model (EMRAM) is a widely used survey tool developed by the Healthcare Information and Management Systems Society (HIMSS) to measure the rate of adoption of EHR functions in a hospital or a secondary care setting. Turkey completed many standardizations and infrastructural improvement initiatives in the health information technology (IT) domain during the first phase of the Health Transformation Program between 2003 and 2017. Like the United States of America (USA), the Turkish Ministry of Health (MoH) applied a bottom-up approach to adopting EHRs in state hospitals. This study aims to measure adoption rates and levels of EHR use in state hospitals in Turkey and investigate any relationship between adoption and use and hospital size. Methods : EMRAM surveys were completed by 600 (68.9%) state hospitals in Turkey between 2014 and 2017. The availability and prevalence of medical information systems and EHR functions and their use were measured. The association between hospital size and the availability/prevalence of EHR functions was also calculated. Results: We found that 63.1% of all hospitals in Turkey have at least basic EHR functions, and 36% have comprehensive EHR functions, which compares favourably to the results of Korean hospitals in 2017, but unfavorably to the results of US hospitals in 2015 and 2017. Our findings suggest that smaller hospitals are better at adopting certain EHR functions than larger hospitals. Conclusion: Measuring the overall adoption rates of EHR functions is an emerging approach and a beneficial tool for the strategic management of countries. This study is the first one covering all state hospitals in a country using EMRAM. The bottom-up approach to adopting EHR in state hospitals that was successful in the USA has also been found to be successful in Turkey. The results are used by the Turkish MoH to disseminate the nation-wide benefits of EHR functions.

scholarly journals Adoption rates of electronic health records in Turkish Hospitals and the relation with hospital sizes

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ilker Kose ◽  
◽  
John Rayner ◽  
Suayip Birinci ◽  
Mustafa Mahir Ulgu ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Medical Information ◽  
Clinical Care ◽  
The United States ◽  
Health Records ◽  
Bottom Up ◽  
Hospital Size ◽  
Survey Tool ◽  
State Hospitals ◽  
Electronic Health

Abstract Background Nation-wide adoption of electronic health records (EHRs) in hospitals has become a Turkish policy priority in recognition of their benefits in maintaining the overall quality of clinical care. The electronic medical record maturity model (EMRAM) is a widely used survey tool developed by the Healthcare Information and Management Systems Society (HIMSS) to measure the rate of adoption of EHR functions in a hospital or a secondary care setting. Turkey completed many standardizations and infrastructural improvement initiatives in the health information technology (IT) domain during the first phase of the Health Transformation Program between 2003 and 2017. Like the United States of America (USA), the Turkish Ministry of Health (MoH) applied a bottom-up approach to adopting EHRs in state hospitals. This study aims to measure adoption rates and levels of EHR use in state hospitals in Turkey and investigate any relationship between adoption and use and hospital size. Methods EMRAM surveys were completed by 600 (68.9%) state hospitals in Turkey between 2014 and 2017. The availability and prevalence of medical information systems and EHR functions and their use were measured. The association between hospital size and the availability/prevalence of EHR functions was also calculated. Results We found that 63.1% of all hospitals in Turkey have at least basic EHR functions, and 36% have comprehensive EHR functions, which compares favourably to the results of Korean hospitals in 2017, but unfavorably to the results of US hospitals in 2015 and 2017. Our findings suggest that smaller hospitals are better at adopting certain EHR functions than larger hospitals. Conclusion Measuring the overall adoption rates of EHR functions is an emerging approach and a beneficial tool for the strategic management of countries. This study is the first one covering all state hospitals in a country using EMRAM. The bottom-up approach to adopting EHR in state hospitals that was successful in the USA has also been found to be successful in Turkey. The results are used by the Turkish MoH to disseminate the nation-wide benefits of EHR functions.

scholarly journals Adoption Rates of Electronic Health Records in Turkish Hospitals and the Relation with Hospital Sizes

2020 ◽  
Author(s):  
Ilker Kose ◽  
John Rayner ◽  
Suayip Birinci ◽  
Mustafa Mahir Ulgu ◽  
Ismayil Yilmaz ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Medical Information ◽  
Clinical Care ◽  
The United States ◽  
Health Records ◽  
Bottom Up ◽  
Hospital Size ◽  
Survey Tool ◽  
State Hospitals ◽  
Electronic Health

Abstract Background: Nation-wide adoption of electronic health records (EHRs) in hospitals has become a Turkish policy priority in recognition of their benefits in maintaining the overall quality of clinical care. The electronic medical record maturity model (EMRAM) is a widely used survey tool developed by the Healthcare Information and Management Systems Society (HIMSS) to measure the rate of adoption of EHR functions in a hospital or a secondary care setting. Turkey completed many standardizations and infrastructural improvement initiatives in the health information technology (IT) domain during the first phase of the Health Transformation Program between 2003 and 2017. Like the United States of America (USA), the Turkish Ministry of Health (MoH) applied a bottom-up approach to adopting EHRs in state hospitals. This study aims to measure adoption rates and levels of EHR use in state hospitals in Turkey and investigate any relationship between adoption and use and hospital size. Methods: EMRAM surveys were completed by 600 (68.9%) state hospitals in Turkey between 2014 and 2017. The availability and prevalence of medical information systems and EHR functions and their use were measured. The association between hospital size and the availability/prevalence of EHR functions was also calculated. Results: We found that 63.1% of all hospitals in Turkey have at least basic EHR functions, and 36% have comprehensive EHR functions, which compares favourably to the results of Korean hospitals in 2017, but unfavorably to the results of US hospitals in 2015 and 2017. Our findings suggest that smaller hospitals are better at adopting certain EHR functions than larger hospitals. Conclusion: Measuring the overall adoption rates of EHR functions is an emerging approach and a beneficial tool for the strategic management of countries. This study is the first one covering all state hospitals in a country using EMRAM. The bottom-up approach to adopting EHR in state hospitals that was successful in the USA has also been found to be successful in Turkey. The results are used by the Turkish MoH to disseminate the nation-wide benefits of EHR functions.

scholarly journals Determinants and extent of weight recording in UK primary care: an analysis of 5 million adults’ electronic health records from 2000 to 2017

BMC Medicine ◽  
2019 ◽  
Vol 17 (1) ◽  
Author(s):  
B. D. Nicholson ◽  
P. Aveyard ◽  
C. R. Bankhead ◽  
W. Hamilton ◽  
F. D. R. Hobbs ◽  
...  
Keyword(s):  
Primary Care ◽  
Electronic Health Records ◽  
Negative Binomial ◽  
Cox Regression ◽  
Clinical Care ◽  
Negative Binomial Regression ◽  
Routine Activity ◽  
Health Records ◽  
Clinical Events ◽  
Electronic Health

Abstract Background Excess weight and unexpected weight loss are associated with multiple disease states and increased morbidity and mortality, but weight measurement is not routine in many primary care settings. The aim of this study was to characterise who has had their weight recorded in UK primary care, how frequently, by whom and in relation to which clinical events, symptoms and diagnoses. Methods A longitudinal analysis of UK primary care electronic health records (EHR) data from 2000 to 2017. Descriptive statistics were used to summarise weight recording in terms of patient sociodemographic characteristics, health professional encounters, clinical events, symptoms and diagnoses. Negative binomial regression was used to model the likelihood of having a weight record each year, and Cox regression to the likelihood of repeated weight recording. Results A total of 14,049,871 weight records were identified in the EHR of 4,918,746 patients during the study period, representing 26,998,591 person-years of observation. Around a third of patients had a weight record each year. Forty-nine percent of weight records were repeated within a year with an average time to a repeat weight record of 1.92 years. Weight records were most often taken by nursing staff (38–42%) and GPs (37–39%) as part of a routine clinical care, such as chronic disease reviews (16%), medication reviews (6–8%) and health checks (6–7%), or were associated with consultations for contraception (5–8%), respiratory disease (5%) and obesity (1%). Patient characteristics independently associated with an increased likelihood of weight recording were as follows: female sex, younger and older adults, non-drinkers, ex-smokers, low or high BMI, being more deprived, diagnosed with a greater number of comorbidities and consulting more frequently. The effect of policy-level incentives to record weight did not appear to be sustained after they were removed. Conclusion Weight recording is not a routine activity in UK primary care. It is recorded for around a third of patients each year and is repeated on average every 2 years for these patients. It is more common in females with higher BMI and in those with comorbidity. Incentive payments and their removal appear to be associated with increases and decreases in weight recording.

scholarly journals Propuesta metodológica de intercambio electrónico de información clínica basada en estándares de telemedicina/Methodological proposal of electronic data interchange and clinical information based on telemedicine standards

2020 ◽  
Author(s):  
P. Moreno ◽  
G. Bastidas ◽  
P. Moreno
Keyword(s):  
Electronic Health Records ◽  
Information And Communication Technologies ◽  
Web Application ◽  
Medical Information ◽  
Reference Model ◽  
Clinical Information ◽  
Electronic Data Interchange ◽  
Records Management ◽  
Health Records ◽  
Electronic Health

El avance de las tecnologías de la información ha permitido un cambio sustancial en el desarrollo de la Salud, por lo que el uso de estándares de telemedicina como el HL7 y CEN TC 251-13606 permiten que los sistemas de información médica se comuniquen vía mensajes estandarizados facilitando el uso de los mismos. El propósito de este estudio es crear una guía metodológica de intercambio electrónico de información clínica basada en el análisis de los estándares de telemedicina HL7 y CEN TC 251- 13606 para mejorar la eficiencia de la gestión de Historias Clínicas de los pacientes. La metodología consta de 2 fases, la primera plantea el diseño e implementación del modelo de referencia de la Historia Clínica Electrónica, el mismo que define entidades necesarias en la construcción de una Historia Clínica Electrónica, en la fase 2 se define la arquitectura de la historia clínica especificando la estructura y semántica del documento mediante el lenguaje XML, el cual se utiliza en los procesos de gestión de las historias clínicas electrónicas dentro del sistema médico desarrollado. Este sistema permite control clínico a distancia facilitando la interacción médico-paciente. El sistema posee una aplicación web, una aplicación de escritorio y una plataforma hardware e- Salud. La aplicación de la metodología planteada mejora la eficiencia de la gestión de historias clínicas, puesto que el 83.32% de los médicos de la clínica consideran que se agiliza el proceso de acceso, creación e ingreso de historias clínicas y reduce recursos en el proceso de control de pacientes domiciliarios. The advance of Information and Communication Technologies has improved Health Care in last years; by providing new ways of accessing medical information. In particular, the use of telemedicine standards such as HL7 and CENTC 251-13606 allows standard communication, integration, and retrieval of electronic health records among medical systems. This article aims to create a methodological guide for the electronic exchange of clinical information based on telemedicine standards in order to improve the efficiency of electronic health records management. The proposed methodology consists of two phases: The first one states the design and implementation of the reference model of an electronic health records, which defines entities of the electronic health record. In phase 2, this methodology describes electronic health records architecture. The architecture is defined by the structure and semantics of the document using XML. In order to test the proposed methodology, a medical system was implemented that consists of a web application, desktop application, and hardware platform e- Health. This system allows the electronic exchange of clinical information to ease patient-doctor interaction. The results show 83,32% of doctors at the clinic where the system was tested agree the proposed methodology for electronic exchange improves the efficiency of electronic health records management since it speeds up the process of creation and retrieval of an electronic health records. Moreover, the system reduces resources in the control of home patients. Palabras clave: Telemedicina, HCE, HL7, CENTC 251-13606, e-Salud. Keywords: Telemedicine, EHR, HL7, CENTC 251-13606, e-Health.

scholarly journals Federated Learning of Electronic Health Records Improves Mortality Prediction in Patients Hospitalized with COVID-19

2020 ◽  
Author(s):  
Akhil Vaid ◽  
Suraj K Jaladanki ◽  
Jie Xu ◽  
Shelly Teng ◽  
Arvind Kumar ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Large Datasets ◽  
Mortality Prediction ◽  
Patient Privacy ◽  
Local Data ◽  
Health Records ◽  
Electronic Health ◽  
Mlp Model ◽  
Combined Data ◽  
Better Than

Machine learning (ML) models require large datasets which may be siloed across different healthcare institutions. Using federated learning, a ML technique that avoids locally aggregating raw clinical data across multiple institutions, we predict mortality within seven days in hospitalized COVID-19 patients. Patient data was collected from Electronic Health Records (EHRs) from five hospitals within the Mount Sinai Health System (MSHS). Logistic Regression with L1 regularization (LASSO) and Multilayer Perceptron (MLP) models were trained using local data at each site, a pooled model with combined data from all five sites, and a federated model that only shared parameters with a central aggregator. Both the federated LASSO and federated MLP models performed better than their local model counterparts at four hospitals. The federated MLP model also outperformed the federated LASSO model at all hospitals. Federated learning shows promise in COVID-19 EHR data to develop robust predictive models without compromising patient privacy.

scholarly journals The Digitization of Patient Care: A Review of the Effects of Electronic Health Records on Health Care Quality and Utilization

2019 ◽  
Vol 40 (1) ◽  
pp. 487-500 ◽  
Author(s):  
Hilal Atasoy ◽  
Brad N. Greenwood ◽  
Jeffrey Scott McCullough
Keyword(s):  
Electronic Health Records ◽  
Health Informatics ◽  
Health Care Quality ◽  
Clinical Care ◽  
Academic Research ◽  
Care Quality ◽  
Health Records ◽  
Policy Practice ◽  
Electronic Health ◽  
Cost Implications

Electronic health records (EHRs) adoption has become nearly universal during the past decade. Academic research into the effects of EHRs has examined factors influencing adoption, clinical care benefits, financial and cost implications, and more. We provide an interdisciplinary overview and synthesis of this literature, drawing on work in public and population health, informatics, medicine, management information systems, and economics. We then chart paths forward for policy, practice, and research.

scholarly journals Human Computer Interaction During Clinical Decision Support With Electronic Health Records Improvement

2020 ◽  
Vol 11 (1) ◽  
pp. 93-106
Author(s):  
Katerina V. Bolgova ◽  
Sergey V. Kovalchuk ◽  
Marina A. Balakhontceva ◽  
Nadezhda E. Zvartau ◽  
Oleg G. Metsker
Keyword(s):  
Electronic Health Records ◽  
Human Computer Interaction ◽  
Medical Research ◽  
Medical Information ◽  
Clinical Decision ◽  
Medical Information System ◽  
Health Records ◽  
Electronic Health ◽  
Positive Effect ◽  
Computer Interaction

This study investigated the most common challenges of human-computer interaction (HCI) while using electronic health records (EHR) based on the experience of a large Russian medical research center. The article presents the results of testing DSS implemented in the mode of an additional interface with the EHR. The percentage of erroneous data for two groups of users (with and without notifications) is presented for the entire period of the experiment and the weekly dynamics of changes. The implementation of CDSS in the supplemented interface mode of the main medical information system (MIS) has had a positive effect in reducing user errors in the data. The results of users' survey are presented, showing a satisfactory evaluation of the implemented system. This study is part of a larger project to develop complex CDSS on cardiovascular disorders for medical research centers.

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