scholarly journals Digitalizing Health Services by Implementing a Personal Electronic Health Record in Germany: Qualitative Analysis of Fundamental Prerequisites From the Perspective of Selected Experts

10.2196/15102 ◽  
2020 ◽  
Vol 22 (1) ◽  
pp. e15102 ◽  
Author(s):  
Sabrina Pohlmann ◽  
Aline Kunz ◽  
Dominik Ose ◽  
Eva C Winkler ◽  
Antje Brandner ◽  
...  
Keyword(s):  
Health Care ◽  
Electronic Health Record ◽  
Health Care System ◽  
Health Care Professionals ◽  
Health Sector ◽  
Health Record ◽  
German Health Care System ◽  
German Health ◽  
Electronic Health ◽  
Care System

Background The implementation of a personal electronic health record (PHR) is a central objective of digitalization policies in the German health care system. Corresponding legislation was passed with the 2015 Act for Secure Digital Communication and Applications in the Health Sector (eHealth Act). However, compared with other European countries, Germany still lags behind concerning the implementation of a PHR. Objective In order to explore potential barriers and facilitators for the adoption of a PHR in routine health care in Germany, this paper aims to identify policies, structures, and practices of the German health care system that influence the uptake and use of a PHR. Methods A total of 33 semistructured interviews were conducted with a purposive sample of experts: 23 interviews with different health care professionals and 10 interviews with key actors of the German health care system who were telematics, eHealth, and information technology experts (eHealth experts). The interviews were transcribed verbatim and subjected to a content analysis. Results From the expert perspective, a PHR was basically considered desirable and unavoidable. At the same time, a number of challenges for implementation in Germany have been outlined. Three crucial themes emerged: (1) documentation standards: prevailing processes of the analog bureaucratic paper world, (2) interoperability: the plurality of actors and electronic systems, and (3) political structure: the lack of clear political regulations and political incentive structures. Conclusions With regard to the implementation of a PHR, an important precondition of a successful digitalization will be the precedent reform of the system to be digitized. Whether the recently passed Act for Faster Appointments and Better Care will be a step in the right direction remains to be seen.

scholarly journals Digitalizing Health Services by Implementing a Personal Electronic Health Record in Germany: Qualitative Analysis of Fundamental Prerequisites From the Perspective of Selected Experts (Preprint)

2019 ◽  
Author(s):  
Sabrina Pohlmann ◽  
Aline Kunz ◽  
Dominik Ose ◽  
Eva C Winkler ◽  
Antje Brandner ◽  
...  
Keyword(s):  
Health Care ◽  
Electronic Health Record ◽  
Health Care System ◽  
Health Care Professionals ◽  
Health Sector ◽  
Health Record ◽  
German Health Care System ◽  
German Health ◽  
Electronic Health ◽  
Care System

BACKGROUND The implementation of a personal electronic health record (PHR) is a central objective of digitalization policies in the German health care system. Corresponding legislation was passed with the 2015 Act for Secure Digital Communication and Applications in the Health Sector (eHealth Act). However, compared with other European countries, Germany still lags behind concerning the implementation of a PHR. OBJECTIVE In order to explore potential barriers and facilitators for the adoption of a PHR in routine health care in Germany, this paper aims to identify policies, structures, and practices of the German health care system that influence the uptake and use of a PHR. METHODS A total of 33 semistructured interviews were conducted with a purposive sample of experts: 23 interviews with different health care professionals and 10 interviews with key actors of the German health care system who were telematics, eHealth, and information technology experts (eHealth experts). The interviews were transcribed verbatim and subjected to a content analysis. RESULTS From the expert perspective, a PHR was basically considered desirable and unavoidable. At the same time, a number of challenges for implementation in Germany have been outlined. Three crucial themes emerged: (1) documentation standards: prevailing processes of the analog bureaucratic paper world, (2) interoperability: the plurality of actors and electronic systems, and (3) political structure: the lack of clear political regulations and political incentive structures. CONCLUSIONS With regard to the implementation of a PHR, an important precondition of a successful digitalization will be the precedent reform of the system to be digitized. Whether the recently passed Act for Faster Appointments and Better Care will be a step in the right direction remains to be seen.

scholarly journals Validation of a Crowdsourcing Methodology for Developing a Knowledge Base of Related Problem-Medication Pairs

2015 ◽  
Vol 06 (02) ◽  
pp. 334-344 ◽  
Author(s):  
A. Wright ◽  
M. Krousel-Wood ◽  
E. J. Thomas ◽  
J. A. McCoy ◽  
D. F. Sittig ◽  
...  
Keyword(s):  
Health Care ◽  
Electronic Health Record ◽  
Knowledge Base ◽  
Health Care System ◽  
Related Problem ◽  
Improve Patient Safety ◽  
Knowledge Bases ◽  
Health Record ◽  
Electronic Health ◽  
Care System

SummaryBackground: Clinical knowledge bases of problem-medication pairs are necessary for many informatics solutions that improve patient safety, such as clinical summarization. However, developing these knowledge bases can be challenging.Objective: We sought to validate a previously developed crowdsourcing approach for generating a knowledge base of problem-medication pairs in a large, non-university health care system with a widely used, commercially available electronic health record.Methods: We first retrieved medications and problems entered in the electronic health record by clinicians during routine care during a six month study period. Following the previously published approach, we calculated the link frequency and link ratio for each pair then identified a threshold cutoff for estimated problem-medication pair appropriateness through clinician review; problem-medication pairs meeting the threshold were included in the resulting knowledge base. We selected 50 medications and their gold standard indications to compare the resulting knowledge base to the pilot knowledge base developed previously and determine its recall and precision.Results: The resulting knowledge base contained 26,912 pairs, had a recall of 62.3% and a precision of 87.5%, and outperformed the pilot knowledge base containing 11,167 pairs from the previous study, which had a recall of 46.9% and a precision of 83.3%.Conclusions: We validated the crowdsourcing approach for generating a knowledge base of problem-medication pairs in a large non-university health care system with a widely used, commercially available electronic health record, indicating that the approach may be generalizable across health-care settings and clinical systems. Further research is necessary to better evaluate the knowledge, to compare crowdsourcing with other approaches, and to evaluate if incorporating the knowledge into electronic health records improves patient outcomes.Citation: McCoy AB, Wright A, Krousel-Wood M, Thomas EJ, McCoy JA, Sittig DF. Validation of a crowdsourcing methodology for developing a knowledge base of related problem-medication pairs. Appl Clin Inf 2015; 6: 334–344http://dx.doi.org/10.4338/ACI-2015-01-RA-0010

scholarly journals Electronic Health Record Use by Sex Among Physicians in an Academic Health Care System

2020 ◽  
Author(s):  
Sarah D. Tait ◽  
Sachiko M. Oshima ◽  
Yi Ren ◽  
Alexander E. Fenn ◽  
Mina Boazak ◽  
...  
Keyword(s):  
Health Care ◽  
Electronic Health Record ◽  
Health Care System ◽  
Health Record ◽  
Academic Health ◽  
Electronic Health ◽  
Care System

scholarly journals Utilization, satisfaction and barriers of medical care among adults of Turkish descent in Germany

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
C Dornquast ◽  
S Solak ◽  
M Durak ◽  
L Krist ◽  
K H Jöckel ◽  
...  
Keyword(s):  
Health Care ◽  
Cohort Study ◽  
Medical Care ◽  
Health Care System ◽  
Self Report ◽  
German Health Care System ◽  
Screening Programs ◽  
Preliminary Results ◽  
German Health ◽  
Care System

Abstract Background The growing proportion of people with a migration background poses major challenges for public health and the health care system in Germany. People of Turkish descent represent the largest group within this specific population. The aim of this study was therefore to examine the use and satisfaction of medical services and barriers to health care access among adults of Turkish descent in Germany. Methods A cohort study of a group of nearly 1200 Turkish adults in Berlin and Essen constitutes the basis of this analysis. The baseline examination was carried out as part of the pretests of the German National Cohort study. This follow-up survey assessed utilization, satisfaction and subjectively perceived barriers in the German health care system, as well as socio-demography, lifestyle, health status and quality of life via self-report (paper based or online) in Turkish or German. Descriptive preliminary results are presented in this abstract. Results The first 287 participants interviewed until December 31, 2018 were on average 49 years old, with 64% being female. 90% of the participants had a family doctor and in the last 12 months, 17% were in a hospital for in-patient treatment and 23% in an emergency room. The use of screening programs varied from 15% (skin cancer screening) to 87% (mammography). The most frequently visited physician was the general practitioner (86%). The participants were satisfied regarding many aspects, with the best values for the communication with their doctor. However, 22% reported problems or barriers in the context of medical care in the last five years. Conclusions These preliminary results provide a first insight into the utilization behaviour among adults of Turkish descent, their satisfaction as well as barriers with the German health care system. However, possible consequences of our study should only be discussed after all analyses have been completed. Key messages This is one of the few cohort studies in a migrant population in Germany. Knowledge of barriers could provide indications of problems of adults of Turkish descent in the German health care system.

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