EMR Access and Confidentiality Based on Patient and Hospital Staff Perspectives

Introductions: The Electronic Medical Records (EMR) system is a longitudinal electronic record consisting of all the information relevant to a patients’ health and well-being, generated by at least one encounter in a healthcare setting. It can be accessed within an institution with multi-level accessibility based on authentication customized to the type of user. Since the EMR system potentiates an organised and holistic medical history specific to a patient, it enables medical professionals to deliver a higher quality of healthcare services. Aims: The aims of this study were to understand the global perspective of EMR and its implementation as well as to locate the gaps of knowledge that still existed in the understanding and definition of EMR amongst patients and hospital staff. Methods: All major bibliographic databases such as PubMed and Google Scholar and several specialist datasets such as PsycINFO, MEDLINE and EBSCOhost from the previous 10 years (2007-2017) were employed in our search. Paper citations which utilised a reference standard were incorporated for quality assessment. An initial search found 2700 articles however after factoring in the inclusion and exclusion criteria, only 78 articles were included in this review. Results: Our findings indicated a discrepancy between the expectation of patients and what was actually practiced. Patient concerns mainly involved easy access of healthcare professionals other than doctors to their EMR in addition to non-medical information. The assumption of confidentiality was expected to be maintained by indifference; however, a good face-to-face explanation cannot be substituted with control over content and access to EMR. In the event of a breach in patient confidentiality, lawsuits against healthcare providers will rise exponentially as patients are now well-informed and more empowered to ask questions regarding the care they are receiving and information being disclosed to other parties. Conclusion: Security of information can be attained with better modelling protocols, end-user training and refresher courses done on a regular basis. Finally, controls of access will need to be implemented via passwords and digital signatures.

Download Full-text

Socio-Sexual Experiences and Access to Healthcare Among Informal PrEP Users in the Netherlands

AIDS and Behavior ◽

10.1007/s10461-020-03085-9 ◽

2020 ◽

Author(s):

Mart van Dijk ◽

John B. F. de Wit ◽

Rebecca Kamps ◽

Thomas E. Guadamuz ◽

Joel E. Martinez ◽

...

Keyword(s):

Sexual Behavior ◽

Qualitative Study ◽

The Netherlands ◽

Healthcare Providers ◽

Well Being ◽

Healthcare Services ◽

Interpretive Description ◽

Sex Partners ◽

Sex With Men ◽

Incorrect Information

AbstractThe aim of this qualitative study was to explore the experiences of informal PrEP users regarding access to PrEP and PrEP-related healthcare, community responses, sexual behavior and well-being. We interviewed 30 men who have sex with men (MSM) in semi-structured online interviews between March and August 2018. Interviews were analyzed using interpretive description. Informal PrEP users were well informed about the use of PrEP, but sometimes did not make use of renal testing. Participants reported a lack of PrEP knowledge among healthcare providers, which limited their access to PrEP and put them at risk, as they received incorrect information. Although some participants reported negative reactions from potential sex partners, most received positive reactions and were sometimes seen as more desirable sex partners. PrEP healthcare services should not only be accessible to formal PrEP users, but also to PrEP users who procure PrEP informally.

Download Full-text

Maternal Healthcare Services Along Indo-Bangladesh Bordering Districts: Exploring Effects of Social Determinants on Access to Maternal Healthcare Services.

10.21203/rs.3.rs-165636/v1 ◽

2021 ◽

Author(s):

Nayan Jyoti Nath ◽

Bedanga Talukdar ◽

Tanu Shukla ◽

Sangeeta Sharma

Keyword(s):

Geographical Location ◽

Well Being ◽

Healthcare Services ◽

Cross Sectional Study ◽

Peripheral Region ◽

Easy Access ◽

Maternal Healthcare ◽

Cross Sectional ◽

Younger Women ◽

Utilization Of Healthcare

Abstract Background Regardless of government efforts toward ameliorating easy access and utilization of healthcare services, the disparity in Maternal Mortality Rate (MMR) is significantly higher across states of India. Post-Sustainable Development Goals (SDGs), equity in healthcare largely remain in the health policy discourse. The policy implementation's effectiveness remained confined to the central geographical location, remotely reaching the peripheral region. The study seeks to assess socio-demographic and household wealth's effect on the access and utilization of healthcare services among women. A cross-sectional study was conducted among 355 women aged 15–49 years in three Indian districts of Assam that share an international border with Bangladesh. Results The study's findings reported that utilization and accessibility are primarily influenced by households' wealth and women's age. Education qualification has no significant effect on healthcare utilization. Younger women from wealthier households are more likely to utilize government healthcare services in India's borderline regions. Conclusion Besides educating women, the availability of healthcare resources and empowering the livelihood resources in the peripheral region should be prioritized. In these fragile areas, efforts to empower women and their families to seek healthcare should be strengthened, which shall enhance well-being.

Download Full-text

Access Control for Healthcare

Encyclopedia of Information Ethics and Security ◽

10.4018/978-1-59140-987-8.ch002 ◽

2011 ◽

pp. 7-14

Author(s):

Yifeng Shen

Keyword(s):

Information Technology ◽

Information Systems ◽

Medical Information ◽

Rapid Development ◽

Healthcare Providers ◽

Healthcare Services ◽

Test Results ◽

High Quality ◽

Quality Healthcare ◽

Administrative Services

Thanks to the rapid development in the field of information technology, healthcare providers rely more and more on information systems to deliver professional and administrative services. There are high demands for those information systems that provide timely and accurate patient medical information. High-quality healthcare services depend on the ability of the healthcare provider to readily access the information such as a patient’s test results and treatment notes. Failure to access this information may delay diagnosis, resulting in improper treatment and rising costs (Rind et al., 1997).

Download Full-text

Implementation of Primary Healthcare Services in Community Health Stations in Highly Urbanized City

Philippine Social Science Journal ◽

10.52006/main.v4i3.385 ◽

2021 ◽

Vol 4 (3) ◽

pp. 123-132

Author(s):

Hanna B. Gella ◽

Merlita V. Caelian

Keyword(s):

Community Health ◽

Primary Healthcare ◽

Healthcare Providers ◽

Well Being ◽

Healthcare Services ◽

Health Improvement ◽

Patient Centeredness ◽

Sustainable Development Goal ◽

The Sustainable Development ◽

Child Healthcare

Primary healthcare is integral to the Sustainable Development Goal (SDG) of ensuring healthy lives and promoting well-being. A descriptive study assessed the implementation of primary healthcare services in community health stations through a researcher-made questionnaire among healthcare providers and beneficiaries of 30 community health stations. The results revealed that, as a whole, the implementation of primary healthcare services in community health stations is great, with maternal and child healthcare implemented to a very great extent while the treatment of non-communicable diseases to a great extent only. The major challenges encountered are the lack of medical drugs, supplies and equipment, and medical professionals. Primary healthcare has made contributions to the community's health improvement; however, challenges imply that the quality and efficiency of the services need improvement. The study contributed to new knowledge on implementing healthcare at the lowest level of government, emphasizing patient-centeredness.

Download Full-text

Vaccination programmes and health systems in the European Union. Report of the Expert Panel on effective ways of investing in Health

European Journal of Public Health ◽

10.1093/eurpub/ckz185.373 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

M McKee ◽

L Siziliani ◽

C Wild ◽

D Kringos ◽

M M Barry ◽

...

Keyword(s):

Vaccination Coverage ◽

Expert Panel ◽

Healthcare Providers ◽

Main Tool ◽

Cost Effective ◽

Risk Groups ◽

Vaccine Safety ◽

Healthcare Services ◽

Easy Access ◽

The European Union

Abstract Background Vaccination is one of the most cost-effective public health interventions available and the main tool for primary prevention of communicable diseases. However, the EU is facing increasing outbreaks of vaccine preventable diseases, while some fatal cases of measles and diphtheria have been reported. Methods The presented report is based on the work of the Expert Panel on effective ways of investing in Health, which was informed by a literature review on the main factors (enablers and obstacles) influencing vaccination uptake. Results Obstacles to vaccination coverage include individuals’ and parents’ concerns or fears about vaccine safety and side effects, lack of trust, social norms, exposure to rumours and myths undermining confidence in vaccines, failure by some healthcare providers to counter these myths and provide evidence-informed advice, access barriers (e.g. poor availability, co-payments), and failure to understand the underlying mechanisms that decrease vaccination confidence. Enablers include sources of reliable information about vaccination, exposure to positive media messages, building trust in institutions and providers, building confidence in vaccination, easy access and availability to healthcare services, ease of administration, active involvement and engagement by healthcare providers, and targeting of high-risk groups. Conclusions There is a range of policy options that countries can implement to increase vaccination coverage. Communication strategies about the benefits of vaccination are important but need to be combined with opportunities for dialogue with vaccine hesitant groups and participatory approaches. These strategies need to be targeted not only at the uninformed (i.e. the lack of information) but also at the misinformed (when the information is incorrect) or disinformed (when information is spread with the intention to deceive).

Download Full-text

Lived experiences of people living with HIV: a descriptive qualitative analysis of their perceptions of themselves, their social spheres, healthcare professionals and the challenges they face daily

BMC Public Health ◽

10.1186/s12889-021-10881-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Gamze Senyurek ◽

Mustafa Volkan Kavas ◽

Yesim Isil Ulman

Keyword(s):

Lived Experiences ◽

Healthcare Professionals ◽

Healthcare Providers ◽

Partner Notification ◽

Healthcare Setting ◽

Healthcare Services ◽

People Living With Hiv ◽

Structural Factors ◽

Hiv Diagnosis ◽

Living With Hiv

Abstract Background Human immunodeficiency virus (HIV) infection rates have been gradually increasing in Istanbul, Turkey. Many people living with HIV (PLWH) here encounter difficulties, for example, in adapting to the chronic disease and obtaining continuous access to healthcare services. In this study, we aimed to explore the challenges PLWH face in their daily lives and understand their perceptions of themselves, healthcare professionals and services, and their social spheres via their expressed lived experiences in the healthcare setting. Method Individual semi-structured in-depth interviews were conducted face-to-face with 20 PLWH in Istanbul. All the interviews were voice-recorded and transcribed verbatim except one, upon participant request, for which the interviewer took notes. These logs and the interviewer’s notes were analyzed thematically using the inductive content analysis method. Results The themes concerned experiences in three distinct contexts: 1) Interactions with healthcare providers; 2) Participants’ responses to their HIV diagnosis; and 3) Interactions with their social networks. Firstly, the results highlighted that the participants perceived that healthcare professionals did not inform them about the diagnosis properly, failed to protect patients’ confidentiality and exhibited discriminative behaviors towards them. Secondly, after the diagnosis the participants had difficulty in coping with their unsettled emotional state. While many ceased sexual activities and isolated themselves, some sought support. Lastly, living with HIV affected their relationships with their families and friends either positively or negatively. Moreover, they had to face the difficulties concerning spouse/partner notification issues about which many needed professional support. Conclusion Healthcare professionals’ discriminative or inappropriate attitudes and customs in healthcare institutions are perceived to impair PLWH’s utilization of healthcare services. Structural factors such as social pressure, societal ignorance about HIV, limited access to HIV prevention, and regulatory barriers might contribute to these challenges. The results suggest that it is necessary to raise healthcare professionals’ and society’s awareness about HIV and develop national policies to establish a well-functioning referral system and appropriate spouse/partner notification services.

Download Full-text

Differentially Private Medical Texts Generation Using Generative Neural Networks

ACM Transactions on Computing for Healthcare ◽

10.1145/3469035 ◽

2022 ◽

Vol 3 (1) ◽

pp. 1-27

Author(s):

Md Momin Al Aziz ◽

Tanbir Ahmed ◽

Tasnia Faequa ◽

Xiaoqian Jiang ◽

Yiyu Yao ◽

...

Keyword(s):

Data Science ◽

Medical Information ◽

Healthcare Providers ◽

Well Being ◽

Original Text ◽

Sensitive Information ◽

Classification Problems ◽

Medical Texts ◽

Health Records ◽

Content Type

Technological advancements in data science have offered us affordable storage and efficient algorithms to query a large volume of data. Our health records are a significant part of this data, which is pivotal for healthcare providers and can be utilized in our well-being. The clinical note in electronic health records is one such category that collects a patient’s complete medical information during different timesteps of patient care available in the form of free-texts. Thus, these unstructured textual notes contain events from a patient’s admission to discharge, which can prove to be significant for future medical decisions. However, since these texts also contain sensitive information about the patient and the attending medical professionals, such notes cannot be shared publicly. This privacy issue has thwarted timely discoveries on this plethora of untapped information. Therefore, in this work, we intend to generate synthetic medical texts from a private or sanitized (de-identified) clinical text corpus and analyze their utility rigorously in different metrics and levels. Experimental results promote the applicability of our generated data as it achieves more than 80\% accuracy in different pragmatic classification problems and matches (or outperforms) the original text data.

Download Full-text

The future of rehabilitation in the United Kingdom National Health Service: Using the COVID-19 crisis to promote change, increasing efficiency and effectiveness

Clinical Rehabilitation ◽

10.1177/0269215520971145 ◽

2020 ◽

pp. 026921552097114

Author(s):

Derick T Wade

Keyword(s):

Healthcare Providers ◽

Organisational Change ◽

Well Being ◽

Healthcare Services ◽

Rehabilitation Services ◽

Complex Needs ◽

Cord Injury ◽

Palliative Care Services ◽

The Uk ◽

Rehabilitation Needs

The problem: Rehabilitation services in the UK are inadequate, with insufficient capacity or flexibility to meet the needs of patients after Covid-19. History: Rehabilitation developed in a piecemeal way, focused on specific problems: spinal cord injury, burns, polio, stroke, back pain, equipment and adaptations etc. Rehabilitation is also provided using other names (e.g. intermediate care). Patients with complex needs do not fit easily within this system. System failure: After Covid-19, patients have problems that cross existing condition-specific and/or treatment-specific services. Covid-19 has exposed the lack of any coherent organisational principle underlying development or commissioning of rehabilitation services. Consequently, in order to have their needs met, patients either have to engage with two or more separate services or they receive good management for some problems and sub-optimal management for other problems. The goals: The multitude of small specific services need to coalesce into an integrated service able to meet all the needs of any patient referred. Second, rehabilitation needs to be fully integrated into all healthcare services. A solution: The purpose of healthcare is to ‘ improve our health and well-being . . . to stay as well as we can to the end of our lives’. (NHS constitution) All healthcare services need to consider patients holistically, giving equal attention to disease, disability, and distress. Rehabilitation, acute care, mental health and palliative care services need to work in parallel to achieve this purpose. Healthcare providers, supported by commissioners and rehabilitation experts, could achieve structural and organisational change, meeting the needs of patients.

Download Full-text

Reorienting Norwegian mental healthcare services: listen to patients’ learning appetite

Health Promotion International ◽

10.1093/heapro/day012 ◽

2018 ◽

Vol 34 (3) ◽

pp. 541-551

Author(s):

Nina Helen Mjøsund ◽

Monica Eriksson ◽

Geir Arild Espnes ◽

Hege Forbech Vinje

Keyword(s):

Mental Health ◽

Health Promotion ◽

Lived Experience ◽

Interpretative Phenomenological Analysis ◽

Mental Healthcare ◽

User Involvement ◽

Healthcare Setting ◽

Well Being ◽

Healthcare Services ◽

Health Promoting

Summary Reorientation of healthcare services towards more efficient health promotion interventions is an urgent matter. Despite policies and guidelines being in place, it is the least developed key action area of the Ottawa charter. User involvement, or the voice of the patient, is missing from the knowledge base of health promotion in the mental healthcare services. The aim of this study was to add experiential knowledge from former patients. We explored the lived experience of 12 former inpatients at a mental healthcare hospital. We describe what they perceive as mental health promoting efforts. A salutogenic theoretical framework and the methodology of interpretative phenomenological analysis were used. The analysis revealed an appetite for learning in order to develop an in depth understanding of their former experiences. This was motivated by a desire to master daily life despite living with an illness and to increase health and well-being. The participants perceived the learning processes within the healthcare setting as mental health promoting. This craving for a better life is compatible with health promotion. It may turn out to be an opportunity to complement the curative activity of healthcare services with health promotion educational activities.

Download Full-text

Promoting the Psychological Well-Being of Healthcare Providers Facing the Burden of Adverse Events: A Systematic Review of Second Victim Support Resources

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105080 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5080

Author(s):

Isolde Martina Busch ◽

Francesca Moretti ◽

Irene Campagna ◽

Roberto Benoni ◽

Stefano Tardivo ◽

...

Keyword(s):

Adverse Events ◽

Program Implementation ◽

Negative Impact ◽

Data Extraction ◽

Healthcare Providers ◽

Well Being ◽

Easy Access ◽

Support Resources ◽

Victim Support ◽

Second Victim

Given the negative impact of adverse events on the wellbeing of healthcare providers, easy access to psychological support is crucial. We aimed to describe the types of support resources available in healthcare organizations, their benefits for second victims, peer supporters’ experiences, and implementation challenges. We also explored how these resources incorporate aspects of Safety I and Safety II. We searched six databases up to 19 December 2019 and additional literature, including weekly search alerts until 21 January 2021. Two reviewers independently performed all methodological steps (search, selection, quality assessment, data extraction, formal narrative synthesis). The 16 included studies described 12 second victim support resources, implemented between 2006 and 2017. Preliminary data indicated beneficial effects not only for the affected staff but also for the peer responders who considered their role to be challenging but gratifying. Challenges during program implementation included persistent blame culture, limited awareness of program availability, and lack of financial resources. Common goals of the support programs (e.g., fostering coping strategies, promoting individual resilience) are consistent with Safety II and may promote system resilience. Investing in second victim support structures should be a top priority for healthcare institutions adopting a systemic approach to safety and striving for just culture.

Download Full-text