scholarly journals Is Blockchain Technology Suitable for Managing Personal Health Records? Mixed-Methods Study to Test Feasibility

10.2196/12533 ◽  
2019 ◽  
Vol 21 (2) ◽  
pp. e12533 ◽  
Author(s):  
Yu Rang Park ◽  
Eunsol Lee ◽  
Wonjun Na ◽  
Sungjun Park ◽  
Yura Lee ◽  
...  
10.2196/24326 ◽  
2020 ◽  
Vol 8 (12) ◽  
pp. e24326
Author(s):  
Su Min Kim ◽  
Taerim Kim ◽  
Won Chul Cha ◽  
Jae-Ho Lee ◽  
In Ho Kwon ◽  
...  

Background Personal health records (PHRs) can be useful in the emergency department, as they provide patient information in an accurate and timely manner and enable it to be used actively. This has an effect on patients’ health outcomes and patient experience. Despite the importance of PHRs in emergencies, there are only a few studies related to PHRs in emergencies that evaluate patient experience. Objective This study aims to introduce the novel mobile PHR (mPHR) platform to emergency environments and assess user experience. Methods The study was conducted from October 2019 to November 2019. In total, 1000 patients or carers in the emergency departments of 3 hospitals were provided an application-based service called FirstER, which was developed to collect and utilize medical information for patients in the emergency department. This study was performed as a mixed methods study. After using FirstER, we investigated its usability and conducted a survey on the experience of obtaining medical information with a legacy system and with FirstER. Additionally, we interviewed 24 patients to gain insight into their experiences regarding medical information using FirstER. For the quantitative analysis, the survey results were analyzed using descriptive statistics (mean and standard deviation). For the qualitative analysis, we determined the keywords and their frequencies from each survey question and interview question. Results In total, 1000 participants, consisting of both patients and carers, were recruited in this study. Their mean age was 41.4 (SD 13.3) years. We ascertained participants’ satisfaction with FirstER and their mPHR needs through a survey and an in-depth interview. With the current system, participants were not well aware of their health conditions and medical information, and they were passive in the use of their medical information and treatment. However, they wanted their medical information for several reasons, such as information sharing and managing their health conditions. FirstER provided participants with their needed information and an easy way to access it. The mean System Usability Scale (SUS) value was 67.1 (SD 13.8), which was considered very near to acceptable. Conclusions This study is the first to implement mPHRs in the emergency department of large tertiary hospitals in the Republic of Korea. FirstER was found to enhance user experience in emergencies, as it provided necessary medical information and proper user experience. Moreover, the average SUS was 67.1, which means that participants found FirstER to be very near to acceptable. This is very encouraging in that FirstER was developed within a very short time, and it was a pilot study. Trial Registration Clinicaltrials.gov NCT04180618; https://clinicaltrials.gov/ct2/show/NCT04180618


2018 ◽  
Author(s):  
Yu Rang Park ◽  
Eunsol Lee ◽  
Wonjun Na ◽  
Sungjun Park ◽  
Yura Lee ◽  
...  

BACKGROUND There are many perspectives on the advantages of introducing blockchain in the medical field, but there are no published feasibility studies regarding the storage, propagation, and management of personal health records (PHRs) using blockchain technology. OBJECTIVE The purpose of this study was to investigate the usefulness of blockchains in the medical field in relation to transactions with and propagation of PHRs in a private blockchain. METHODS We constructed a private blockchain network using Ethereum version 1.8.4 and conducted verification using the de-identified PHRs of 300 patients. The private blockchain network consisted of one hospital node and 300 patient nodes. In order to verify the effectiveness of blockchain-based PHR management, PHRs at a time were loaded in a transaction between the hospital and patient nodes and propagated to the whole network. We obtained and analyzed the time and gas required for data transaction and propagation on the blockchain network. For reproducibility, these processes were repeated 100 times. RESULTS Of 300 patient records, 74 (24.7%) were not loaded in the private blockchain due to the data block size of the transaction block. The remaining 226 individual health records were classified into groups A (80 patients with outpatient visit data less than 1 year old), B (84 patients with outpatient data from between 1 and 3 years before data collection), and C (62 patients with outpatient data 3 to 5 years old). With respect to mean transaction time in the blockchain, C (128.7 seconds) had the shortest time, followed by A (132.2 seconds) and then B (159.0 seconds). The mean propagation times for groups A, B, and C were 1494.2 seconds, 2138.9 seconds, and 4111.4 seconds, respectively; mean file sizes were 5.6 KB, 18.6 KB, and 45.38 KB, respectively. The mean gas consumption values were 1,900,767; 4,224,341; and 4,112,784 for groups A, B, and C, respectively. CONCLUSIONS This study confirms that it is possible to exchange PHR data in a private blockchain network. However, to develop a blockchain-based PHR platform that can be used in practice, many improvements are required, including reductions in data size, improved personal information protection, and reduced operating costs.


2020 ◽  
Author(s):  
Su Min Kim ◽  
Taerim Kim ◽  
Won Chul Cha ◽  
Jae-Ho Lee ◽  
In Ho Kwon ◽  
...  

BACKGROUND Personal health records (PHRs) can be useful in the emergency department, as they provide patient information in an accurate and timely manner and enable it to be used actively. This has an effect on patients’ health outcomes and patient experience. Despite the importance of PHRs in emergencies, there are only a few studies related to PHRs in emergencies that evaluate patient experience. OBJECTIVE This study aims to introduce the novel mobile PHR (mPHR) platform to emergency environments and assess user experience. METHODS The study was conducted from October 2019 to November 2019. In total, 1000 patients or carers in the emergency departments of 3 hospitals were provided an application-based service called FirstER, which was developed to collect and utilize medical information for patients in the emergency department. This study was performed as a mixed methods study. After using FirstER, we investigated its usability and conducted a survey on the experience of obtaining medical information with a legacy system and with FirstER. Additionally, we interviewed 24 patients to gain insight into their experiences regarding medical information using FirstER. For the quantitative analysis, the survey results were analyzed using descriptive statistics (mean and standard deviation). For the qualitative analysis, we determined the keywords and their frequencies from each survey question and interview question. RESULTS In total, 1000 participants, consisting of both patients and carers, were recruited in this study. Their mean age was 41.4 (SD 13.3) years. We ascertained participants’ satisfaction with FirstER and their mPHR needs through a survey and an in-depth interview. With the current system, participants were not well aware of their health conditions and medical information, and they were passive in the use of their medical information and treatment. However, they wanted their medical information for several reasons, such as information sharing and managing their health conditions. FirstER provided participants with their needed information and an easy way to access it. The mean System Usability Scale (SUS) value was 67.1 (SD 13.8), which was considered very near to acceptable. CONCLUSIONS This study is the first to implement mPHRs in the emergency department of large tertiary hospitals in the Republic of Korea. FirstER was found to enhance user experience in emergencies, as it provided necessary medical information and proper user experience. Moreover, the average SUS was 67.1, which means that participants found FirstER to be very near to acceptable. This is very encouraging in that FirstER was developed within a very short time, and it was a pilot study. CLINICALTRIAL Clinicaltrials.gov NCT04180618; https://clinicaltrials.gov/ct2/show/NCT04180618


2019 ◽  
Vol 7 (1) ◽  
pp. 53-66
Author(s):  
Azad Ali ◽  
David Smith

Blockchain technology is on the rise and considered to be a revolutionary technology. It has been applied to many domains including personal health records, regulatory investigation, and global supply chain. Applications that may potentially benefit from blockchain technology are those, which involve multiple parties across the different organization, each performing a subset of many steps needed to complete a given transaction and involve different technologies. In addition, security and trust is a major concern. Given this, a good candidate for blockchain technology is mortgage lending. The purpose of this paper is to prepare a model that identifies different elements that are needed when applying blockchain technology in the mortgage origination process. This paper uses a popular framework used in customer relationship management (CRM) that combines three constructs: People, Process and Technology to develop the intended model.


2021 ◽  
Author(s):  
Sophia Ly ◽  
Ricky Tsang ◽  
Kendall Ho

BACKGROUND While the digitization of personal health information (PHI) has been shown to improve patient engagement in the primary care setting, patient perspectives on its impact in the emergency department (ED) are unknown. OBJECTIVE The primary objective was to characterize the views of British Columbia (BC) ED users on the impacts of PHI digitization on ED care. METHODS This was a mixed-methods study consisting of an online survey followed by key informant interviews with a subset of survey respondents. ED users in British Columbia were asked about their ED experiences and attitudes towards PHI digitization in the ED. RESULTS One hundred and eight participants submitted survey responses between January and April 2020. Most survey respondents were interested in the use of electronic health records (75%) and patient portals (85%) in the ED and were amenable to sharing their ED PHI with ED staff (up to 90% in emergencies), family physicians (up to 91%), and family caregivers (up to 75%). Sixteen survey respondents provided key informant interviews in August 2020. Interviewees expected PHI digitization in the ED to enhance PHI access by health providers, patient-provider relationships, patient self-advocacy, and post-discharge care management, although some voiced concerns about privacy risk and limited access to digital technologies (eg, smart devices, internet connection). COVID-19 was thought to provide momentum for the digitization of healthcare. CONCLUSIONS Patients overwhelmingly support PHI digitization in the form of electronic health records and patient portals in the ED. The COVID-19 pandemic may represent a critical moment for the development and implementation of these tools.


2020 ◽  
Author(s):  
Hao Sen Andrew Fang ◽  
Teng Hwee Tan ◽  
Yan Fang Cheryl Tan ◽  
Marcus Tan

BACKGROUND Blockchain technology has the potential to enable more secure, transparent and equitable data management. In the healthcare domain, it has been most frequently applied to electronic health records (EHRs). Apart from securely managing data, blockchain also has a significant advantage of distributing data access, control and ownership to the end-users. This attribute, among others, makes it especially appealing when used to power personal health records (PHRs). OBJECTIVE In this review, we aim to examine the current landscape, design choices and limitations of blockchain-based PHRs. METHODS Adopting the PRISMA guidelines, a cross-discipline systematic review was performed in July 2020 on all eligible articles, including grey literature, from the following eight databases: ACM, IEEE Xplore, MEDLINE, ScienceDirect, Scopus, SpringerLink, Web of Science and Google Scholar. Three reviewers independently performed a full-text review and data abstraction using a standardized data collection form. RESULTS 58 articles fulfilled the inclusion criteria. The review found that the blockchain PHR space has been maturing over the past five years, from purely conceptual ideas initially to an increasing trend of publications describing prototypes and even implementations. Although the eventual PHR application is purposed for the healthcare industry, majority of the articles came from Engineering or Computer Science publications. Among the blockchain PHRs described, permissioned blockchains and off-chain storage were the more common design choices. While eighteen articles described a tethered blockchain PHR, all of these were at the conceptual stage. CONCLUSIONS This review revealed that research interest in using blockchain for PHRs is increasing and that the space is maturing. With further experimentation, this trend will very likely lead to breakthroughs to address existing limitations which could ultimately accelerate the adoption of blockchain PHRs.


2020 ◽  
Vol 27 (1) ◽  
pp. e100046
Author(s):  
Elisavet Andrikopoulou ◽  
Philip J Scott ◽  
Helena Herrera

BackgroundNational Health Service policy suggests that increasing usage of electronic personal health records (PHR) by patients will result in cost savings and improved public health. Medication adherence means that patients take their prescribed medication as agreed with their doctors. Some of the claimed benefits of PHRs are decreasing healthcare costs and improving medication adherence and patient outcomes.MethodsThis is a mixed methods convergent study, primarily qualitative. The qualitative and quantitative data collection and analysis will occur in parallel, and then be synthesised. We are interviewing and surveying adults with long-term conditions to identify what are the most important and useful features of their current PHR. The data collection comprises patient demographics, the Medication Adherence Questionnaire, the personality scale Big Five Inventory-2 Extra-Short Form and the WHO Quality of Life-BREF scale. Qualitative data will be analysed using the Framework method.EthicsWe have received a favourable ethical opinion from the Health Research Authority/Research Ethics Committee.


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