scholarly journals ACTION-EHR: Patient-Centric Blockchain-Based Electronic Health Record Data Management for Cancer Care (Preprint)

2019 ◽  
Author(s):  
Alevtina Dubovitskaya ◽  
Furqan Baig ◽  
Zhigang Xu ◽  
Rohit Shukla ◽  
Pratik Sushil Zambani ◽  
...  
Keyword(s):  
Health Care ◽  
Data Management ◽  
Patient Care ◽  
Data Sharing ◽  
Cancer Care ◽  
Health Care Services ◽  
Health Records ◽  
Care Services ◽  
Electronic Health ◽  
Patient Centric

BACKGROUND With increased specialization of health care services and high levels of patient mobility, accessing health care services across multiple hospitals or clinics has become very common for diagnosis and treatment, particularly for patients with chronic diseases such as cancer. With informed knowledge of a patient’s history, physicians can make prompt clinical decisions for smarter, safer, and more efficient care. However, due to the privacy and high sensitivity of electronic health records (EHR), most EHR data sharing still happens through fax or mail due to the lack of systematic infrastructure support for secure, trustable health data sharing, which can also cause major delays in patient care. OBJECTIVE Our goal was to develop a system that will facilitate secure, trustable management, sharing, and aggregation of EHR data. Our patient-centric system allows patients to manage their own health records across multiple hospitals. The system will ensure patient privacy protection and guarantee security with respect to the requirements for health care data management, including the access control policy specified by the patient. METHODS We propose a permissioned blockchain-based system for EHR data sharing and integration. Each hospital will provide a blockchain node integrated with its own EHR system to form the blockchain network. A web-based interface will be used for patients and doctors to initiate EHR sharing transactions. We take a hybrid data management approach, where only management metadata will be stored on the chain. Actual EHR data, on the other hand, will be encrypted and stored off-chain in Health Insurance Portability and Accountability Act–compliant cloud-based storage. The system uses public key infrastructure–based asymmetric encryption and digital signatures to secure shared EHR data. RESULTS In collaboration with Stony Brook University Hospital, we developed ACTION-EHR, a system for patient-centric, blockchain-based EHR data sharing and management for patient care, in particular radiation treatment for cancer. The prototype was built on Hyperledger Fabric, an open-source, permissioned blockchain framework. Data sharing transactions were implemented using chaincode and exposed as representational state transfer application programming interfaces used for the web portal for patients and users. The HL7 Fast Healthcare Interoperability Resources standard was adopted to represent shared EHR data, making it easy to interface with hospital EHR systems and integrate a patient’s EHR data. We tested the system in a distributed environment at Stony Brook University using deidentified patient data. CONCLUSIONS We studied and developed the critical technology components to enable patient-centric, blockchain-based EHR sharing to support cancer care. The prototype demonstrated the feasibility of our approach as well as some of the major challenges. The next step will be a pilot study with health care providers in both the United States and Switzerland. Our work provides an exemplar testbed to build next-generation EHR sharing infrastructures.

scholarly journals ACTION-EHR: Patient-Centric Blockchain-Based Electronic Health Record Data Management for Cancer Care

10.2196/13598 ◽  
2020 ◽  
Vol 22 (8) ◽  
pp. e13598
Author(s):  
Alevtina Dubovitskaya ◽  
Furqan Baig ◽  
Zhigang Xu ◽  
Rohit Shukla ◽  
Pratik Sushil Zambani ◽  
...  
Keyword(s):  
Health Care ◽  
Data Management ◽  
Patient Care ◽  
Data Sharing ◽  
Cancer Care ◽  
Health Care Services ◽  
Health Records ◽  
Care Services ◽  
Electronic Health ◽  
Patient Centric

Background With increased specialization of health care services and high levels of patient mobility, accessing health care services across multiple hospitals or clinics has become very common for diagnosis and treatment, particularly for patients with chronic diseases such as cancer. With informed knowledge of a patient’s history, physicians can make prompt clinical decisions for smarter, safer, and more efficient care. However, due to the privacy and high sensitivity of electronic health records (EHR), most EHR data sharing still happens through fax or mail due to the lack of systematic infrastructure support for secure, trustable health data sharing, which can also cause major delays in patient care. Objective Our goal was to develop a system that will facilitate secure, trustable management, sharing, and aggregation of EHR data. Our patient-centric system allows patients to manage their own health records across multiple hospitals. The system will ensure patient privacy protection and guarantee security with respect to the requirements for health care data management, including the access control policy specified by the patient. Methods We propose a permissioned blockchain-based system for EHR data sharing and integration. Each hospital will provide a blockchain node integrated with its own EHR system to form the blockchain network. A web-based interface will be used for patients and doctors to initiate EHR sharing transactions. We take a hybrid data management approach, where only management metadata will be stored on the chain. Actual EHR data, on the other hand, will be encrypted and stored off-chain in Health Insurance Portability and Accountability Act–compliant cloud-based storage. The system uses public key infrastructure–based asymmetric encryption and digital signatures to secure shared EHR data. Results In collaboration with Stony Brook University Hospital, we developed ACTION-EHR, a system for patient-centric, blockchain-based EHR data sharing and management for patient care, in particular radiation treatment for cancer. The prototype was built on Hyperledger Fabric, an open-source, permissioned blockchain framework. Data sharing transactions were implemented using chaincode and exposed as representational state transfer application programming interfaces used for the web portal for patients and users. The HL7 Fast Healthcare Interoperability Resources standard was adopted to represent shared EHR data, making it easy to interface with hospital EHR systems and integrate a patient’s EHR data. We tested the system in a distributed environment at Stony Brook University using deidentified patient data. Conclusions We studied and developed the critical technology components to enable patient-centric, blockchain-based EHR sharing to support cancer care. The prototype demonstrated the feasibility of our approach as well as some of the major challenges. The next step will be a pilot study with health care providers in both the United States and Switzerland. Our work provides an exemplar testbed to build next-generation EHR sharing infrastructures.

Informatics and Health Services

2017 ◽  
pp. 215-241
Author(s):  
Nelson Ravka
Keyword(s):  
Health Care ◽  
Electronic Health Records ◽  
Health Care Providers ◽  
Health Care Services ◽  
Electronic Record ◽  
Inappropriate Drug ◽  
Health Records ◽  
Record Keeping ◽  
Care Services ◽  
Electronic Health

Personal electronic health records are seen as a key component to improved health care for patients, empowering motivated patients by giving them access to their own records resulting in increased self-care, shared decision making, and better clinical outcomes. Benefits through electronic record keeping would also accrue to health care providers through the availability and retrievability of data, reduced duplication of medical tests, more effective physician diagnosis and treatment, reduced incidence of prescription errors, and flagging inappropriate drug combinations. Utilizing information technology could also moderate the cost of health care services. Electronic health records would also improve clinical research through access to a large database of patient electronic records for research and determining best practices. Although potential benefits are considerable, many challenges to implementation must be addressed and resolved before this potential of improved health care provision and cost efficiency can be realized.

Informatics and Health Services

2017 ◽  
pp. 543-569
Author(s):  
Nelson Ravka
Keyword(s):  
Health Care ◽  
Electronic Health Records ◽  
Health Care Providers ◽  
Health Care Services ◽  
Electronic Record ◽  
Inappropriate Drug ◽  
Health Records ◽  
Record Keeping ◽  
Care Services ◽  
Electronic Health

Personal electronic health records are seen as a key component to improved health care for patients, empowering motivated patients by giving them access to their own records resulting in increased self-care, shared decision making, and better clinical outcomes. Benefits through electronic record keeping would also accrue to health care providers through the availability and retrievability of data, reduced duplication of medical tests, more effective physician diagnosis and treatment, reduced incidence of prescription errors, and flagging inappropriate drug combinations. Utilizing information technology could also moderate the cost of health care services. Electronic health records would also improve clinical research through access to a large database of patient electronic records for research and determining best practices. Although potential benefits are considerable, many challenges to implementation must be addressed and resolved before this potential of improved health care provision and cost efficiency can be realized.

scholarly journals A filosofia web 2.0 e os OPSAS: Reflexões iniciais sobre a cultura participativa em saúde

2019 ◽  
Author(s):  
Louise Amaral
Keyword(s):  
Health Care ◽  
Electronic Health Records ◽  
Web 2.0 ◽  
Health Care Services ◽  
Systematic Observation ◽  
Health Records ◽  
Care Services ◽  
Web Tools ◽  
Electronic Health ◽  
The Web

The proposal of this study, with an exploratory and descriptive approach, was to identify the use of Web Tools 2.0 of production, circulation, sharing, storage and access to electronic health records (RES) by the organisms producers of Health care Services (OPSAS) in Bahia. The immersion of OPSAS in cyberspace requires the competencies of health agents to produce, receive, accumulate, access, use and migrate electronic health records (RES) directed to digital repositories. The adoption of the Web 2.0 philosophy allows the expansion of the OPSAS relationship with health agents and stakeholders and extends to the participation of citizens. As a result of this research, from a questionnaire applied in 26 hospitals in the state of Bahia (linked to a network of innovation and learning in hospital management), it was found that OPSAS use the Web Tools 1.0 well more than the Web 2.0. We opted to conduct a direct and systematic observation on the websites of 38 bodies producing health care services, in order to verify the incorporation or not of the devices of the Web 2.0 and the possible advances and/or setbacks on the incorporation of the Web 2.0 Philosophy in the OPSAS.

Informatics and Health Services

2013 ◽  
pp. 89-114 ◽  
Author(s):  
Nelson Ravka
Keyword(s):  
Health Care ◽  
Electronic Health Records ◽  
Health Care Providers ◽  
Health Care Services ◽  
Electronic Record ◽  
Inappropriate Drug ◽  
Health Records ◽  
Record Keeping ◽  
Care Services ◽  
Electronic Health

Personal electronic health records are seen as a key component to improved health care for patients, empowering motivated patients by giving them access to their own records resulting in increased self-care, shared decision making, and better clinical outcomes. Benefits through electronic record keeping would also accrue to health care providers through the availability and retrievability of data, reduced duplication of medical tests, more effective physician diagnosis and treatment, reduced incidence of prescription errors, and flagging inappropriate drug combinations. Utilizing information technology could also moderate the cost of health care services. Electronic health records would also improve clinical research through access to a large database of patient electronic records for research and determining best practices. Although potential benefits are considerable, many challenges to implementation must be addressed and resolved before this potential of improved health care provision and cost efficiency can be realized.

scholarly journals Development of a Natural Language Processing Algorithm to Identify and Evaluate Transgender Patients in Electronic Health Record System

2019 ◽  
Vol 29 (Supp2) ◽  
pp. 441-450 ◽  
Author(s):  
Jesse M. Ehrenfeld ◽  
Keanan Gabriel Gottlieb ◽  
Lauren Brittany Beach ◽  
Shelby E. Monahan ◽  
Daniel Fabbri
Keyword(s):  
Health Care ◽  
Natural Language ◽  
Language Processing ◽  
Health Care Services ◽  
False Positive Rate ◽  
Health Condition ◽  
Record System ◽  
Care Services ◽  
Electronic Health ◽  
Hormone Use

Objective: To create a natural language pro­cessing (NLP) algorithm to identify transgen­der patients in electronic health records.Design: We developed an NLP algorithm to identify patients (keyword + billing codes). Patients were manually reviewed, and their health care services categorized by billing code.Setting: Vanderbilt University Medical CenterParticipants: 234 adult and pediatric trans­gender patientsMain Outcome Measures: Number of transgender patients correctly identified and categorization of health services utilized.Results: We identified 234 transgender pa­tients of whom 50% had a diagnosed men­tal health condition, 14% were living with HIV, and 7% had diabetes. Largely driven by hormone use, nearly half of patients attended the Endocrinology/Diabetes/Me­tabolism clinic. Many patients also attended the Psychiatry, HIV, and/or Obstetrics/Gyne­cology clinics. The false positive rate of our algorithm was 3%.Conclusions: Our novel algorithm correctly identified transgender patients and provided important insights into health care utiliza­tion among this marginalized population. Ethn Dis. 2019;29(Suppl 2): 441-450. doi:10.18865/ed.29.S2.441

Anthropology and Informatics in Health Care

2020 ◽  
Author(s):  
Laurie Novak ◽  
Joyce Harris
Keyword(s):  
Health Care ◽  
Delivery Of Health Care ◽  
Health Informatics ◽  
Health Care Services ◽  
Collaborative Work ◽  
Health Records ◽  
Care Services ◽  
Care Workers ◽  
Health And Illness ◽  
Using Data

Information technology increasingly figures into the activities of health-care workers, patients, and their informal caregivers. The growing intersection of anthropology and health informatics is reviewed, a field dedicated to the science of using data, information, and knowledge to improve human health and the delivery of health-care services. Health informatics as a discipline wrestles with complex issues of information collection, classification, and presentation to patients and working clinical personnel. Anthropologists are well-suited as collaborators in this work. Topics of collaborative work include the construction of health and illness, patient-focused research, the organization and delivery of health-care services, the design and implementation of electronic health records, and ethics, power, and surveillance. The application of technology to social roles, practices, and power relations that is inherent in health informatics provides a rich source of empirical data to advance anthropological theory and methods.

scholarly journals Digital Health and the State of Interoperable Electronic Health Records (Preprint)

2018 ◽  
Author(s):  
Jessica Germaine Shull
Keyword(s):  
Health Care ◽  
Best Practices ◽  
Electronic Health Records ◽  
Health Systems ◽  
Health Care Services ◽  
Care Delivery ◽  
Digital Health ◽  
Health Records ◽  
Number Of Patients ◽  
Electronic Health

UNSTRUCTURED Digital health systems and innovative care delivery within these systems have great potential to improve national health care and positively impact the health outcomes of patients. However, currently, very few countries have systems that can implement digital interventions at scale. This is partly because of the lack of interoperable electronic health records (EHRs). It is difficult to make decisions for an individual or population when the data on that person or population are dispersed over multiple incompatible systems. This viewpoint paper has highlighted some key obstacles of current EHRs and some promising successes, with the goal of promoting EHR evolution and advocating for frameworks that develop digital health systems that serve populations—a critical goal as we move further into this data-rich century with an ever-increasing number of patients who live longer and depend on health care services where resources may already be strained. This paper aimed to analyze the evolution, obstacles, and current landscape of EHRs and identify fundamental areas of hindrance for interoperability. It also aimed to highlight countries where advances have been made and extract best practices from these examples. The obstacles to EHR interoperability are not easily solved, but improving the current situation in countries where a national policy is not in place will require a focused inquiry into solutions from various sources in the public and private sector. Effort must be made on a national scale to seek solutions for optimally interoperable EHRs beyond status quo solutions. A list of considerations for best practices is suggested.

The ERDs: Part One – The Social Mission of Catholic Health Care Services

2021 ◽  
pp. 002436392110381
Author(s):  
Christine Sybert
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Human Dignity ◽  
Health Care Services ◽  
Social Mission ◽  
Secular Culture ◽  
Care Services ◽  
The Social ◽  
Catholic Health Care ◽  
History Of

The Ethical and Religious Directives for Catholic Health Care Services (ERDs) exist to guide administrators, providers, and patients regarding the Church’s principles for maintaining human dignity while providing ethical patient care. A brief history of the document itself is presented followed by a discussion of selected portions of Part One of the ERDs, which relate directly to the mission of Catholic healthcare and why this is important as the secular culture becomes increasingly hostile to religious beliefs.

Sign in / Sign up

Export Citation Format

Share Document