scholarly journals Patients’ Experiences of Accessing Their Electronic Health Records: National Patient Survey in Sweden (Preprint)

2017 ◽  
Author(s):  
Jonas Moll ◽  
Hanife Rexhepi ◽  
Åsa Cajander ◽  
Christiane Grünloh ◽  
Isto Huvila ◽  
...  
Keyword(s):  
Health Care ◽  
Electronic Health Records ◽  
Health Care Professionals ◽  
Patient Survey ◽  
Patient Portal ◽  
Health Records ◽  
Web Based ◽  
Number Of Patients ◽  
National Patient ◽  
Electronic Health

BACKGROUND Internationally, there is a movement toward providing patients a Web-based access to their electronic health records (EHRs). In Sweden, Region Uppsala was the first to introduce patient-accessible EHRs (PAEHRs) in 2012. By the summer of 2016, 17 of 21 county councils had given citizens Web-based access to their medical information. Studies on the effect of PAEHRs on the work environment of health care professionals have been conducted, but up until now, few extensive studies have been conducted regarding patients’ experiences of using PAEHRs in Sweden or Europe, more generally. OBJECTIVE The objective of our study was to investigate patients’ experiences of accessing their EHRs through the Swedish national patient portal. In this study, we have focused on describing user characteristics, usage, and attitudes toward the system. METHODS A national patient survey was designed, based on previous interview and survey studies with patients and health care professionals. Data were collected during a 5-month period in 2016. The survey was made available through the PAEHR system, called Journalen, in Sweden. The total number of patients that logged in and could access the survey during the study period was 423,141. In addition to descriptive statistics reporting response frequencies on Likert scale questions, Mann-Whitney tests, Kruskal-Wallis tests, and chi-square tests were used to compare answers between different county councils as well as between respondents working in health care and all other respondents. RESULTS Overall, 2587 users completed the survey with a response rate of 0.61% (2587/423,141). Two participants were excluded from the analysis because they had only received care in a county council that did not yet show any information in Journalen. The results showed that 62.97% (1629/2587) of respondents were women and 39.81% (1030/2587) were working or had been working in health care. In addition, 72.08% (1794/2489) of respondents used Journalen about once a month, and the main reason for use was to gain an overview of one’s health status. Furthermore, respondents reported that lab results were the most important information for them to access; 68.41% (1737/2539) of respondents wanted access to new information within a day, and 96.58% (2454/2541) of users reported that they are positive toward Journalen. CONCLUSIONS In this study, respondents provided several important reasons for why they use Journalen and why it is important for them to be able to access information in this way—several related to patient empowerment, involvement, and security. Considering the overall positive attitude, PAEHRs seem to fill important needs for patients.

scholarly journals Patients’ Experiences of Accessing Their Electronic Health Records: National Patient Survey in Sweden

2018 ◽  
Vol 20 (11) ◽  
pp. e278 ◽  
Author(s):  
Jonas Moll ◽  
Hanife Rexhepi ◽  
Åsa Cajander ◽  
Christiane Grünloh ◽  
Isto Huvila ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Patient Survey ◽  
Health Records ◽  
National Patient ◽  
Electronic Health

HealthChain: A Blockchain for Electronic Health Records (Preprint)

2019 ◽  
Author(s):  
Yonggang Xiao ◽  
Yanbing Liu ◽  
Yunjun Wu ◽  
Tun Li ◽  
Xingping Xian ◽  
...  
Keyword(s):  
Health Care ◽  
Electronic Health Records ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Functional Requirements ◽  
Care Providers ◽  
Health Records ◽  
Blockchain Technology ◽  
Distributed Ledger ◽  
Electronic Health

BACKGROUND The maintenance of accurate health records of patients is a requirement of health care professionals. Furthermore, these records should be shared across different health care organizations in order for professionals to have a complete review of medical history and avoid missing important information. Nowadays, health care providers use electronic health records (EHRs) as a key to accomplishment of these jobs and delivery of quality care. However, there are technical and legal hurdles that prevent the adoption of these systems, such as the concern about performance and privacy issues. OBJECTIVE The aim of this paper is to build and evaluate an experimental blockchain for EHRs, named HealthChain, which addresses the disadvantages of traditional EHR systems. METHODS HealthChain is built based on consortium blockchain technology. Specifically, three stakeholders, namely hospitals, insurance providers, and governmental agencies, form a consortium that operates under a governance model, which enforces the business logic agreed by all participants. Peer nodes host instance of the distributed ledger consisting of EHRs, and instance of chaincode regulating the permissions of participants; designated orderers establish consensus on the order of EHRs and then disseminate blocks to peers. RESULTS HealthChain achieves the functional and non-functional requirements. While it can store EHRs in distributed ledger and share them among different participants, it demonstrates superior features, such as privacy preserving, security, and high throughout. These are the main reasons why HealthChain is proposed. CONCLUSIONS Consortium blockchain technology can help build EHR system and solve the problems that prevent the adoption of traditional ones.

scholarly journals A Simulated Graphical Interface for Integrating Patient-Generated Health Data From Smartwatches With Electronic Health Records: Usability Study

10.2196/19769 ◽  
2020 ◽  
Vol 7 (4) ◽  
pp. e19769
Author(s):  
Jordan M Alpert ◽  
Naga S Prabhakar Kota ◽  
Sanjay Ranka ◽  
Tonatiuh V Mendoza ◽  
Laurence M Solberg ◽  
...  
Keyword(s):  
Health Care ◽  
Electronic Health Records ◽  
Health Care Professionals ◽  
Health Data ◽  
Graphical Interface ◽  
Usability Study ◽  
Health Records ◽  
Information Navigation ◽  
Key Stakeholders ◽  
Electronic Health

Background Wearable technology, such as smartwatches, can capture valuable patient-generated data and help inform patient care. Electronic health records provide logical and practical platforms for including such data, but it is necessary to evaluate the way the data are presented and visualized. Objective The aim of this study is to evaluate a graphical interface that displays patients’ health data from smartwatches, mimicking the integration within the environment of electronic health records. Methods A total of 12 health care professionals evaluated a simulated interface using a usability scale questionnaire, testing the clarity of the interface, colors, usefulness of information, navigation, and readability of text. Results The interface was positively received, with 14 out of the 16 questions generating a score of 5 or greater among at least 75% of participants (9/12). On an 8-point Likert scale, the highest rated features of the interface were quick turnaround times (mean score 7.1), readability of the text (mean score 6.8), and use of terminology/abbreviations (mean score 6.75). Conclusions Collaborating with health care professionals to develop and refine a graphical interface for visualizing patients’ health data from smartwatches revealed that the key elements of the interface were acceptable. The implementation of such data from smartwatches and other mobile devices within electronic health records should consider the opinions of key stakeholders as the development of this platform progresses.

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.

scholarly journals Online electronic healthcare records: Comparing the views of cancer patients and others

2020 ◽  
Vol 26 (4) ◽  
pp. 2915-2929
Author(s):  
Hanife Rexhepi ◽  
Jonas Moll ◽  
Isto Huvila
Keyword(s):  
Electronic Health Records ◽  
Cancer Patients ◽  
Patient Survey ◽  
General Interest ◽  
Health Records ◽  
Positive Effects ◽  
Health History ◽  
Survey Response Rate ◽  
National Patient ◽  
Electronic Health

This study investigates differences in attitudes towards, and experiences with, online electronic health records between cancer patients and patients with other conditions, highlighting what is characteristic to cancer patients. A national patient survey on online access to electronic health records was conducted, where cancer patients were compared with all other respondents. Overall, 2587 patients completed the survey (response rate 0.61%). A total of 347 respondents (13.4%) indicated that they suffered from cancer. Results showed that cancer patients are less likely than other patients to use online electronic health records due to general interest (p < 0.001), but more likely for getting an overview of their health history (p = 0.001) and to prepare for visits (p < 0.001). Moreover, cancer patients rate benefits of accessing their electronic health records online higher than other patients and see larger positive effects regarding improved communication with and involvement in healthcare.

scholarly journals Digital Health and the State of Interoperable Electronic Health Records

10.2196/12712 ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. e12712 ◽  
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

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.

scholarly journals A Simulated Graphical Interface for Integrating Patient-Generated Health Data From Smartwatches With Electronic Health Records: Usability Study (Preprint)

2020 ◽  
Author(s):  
Jordan M Alpert ◽  
Naga S Prabhakar Kota ◽  
Sanjay Ranka ◽  
Tonatiuh V Mendoza ◽  
Laurence M Solberg ◽  
...  
Keyword(s):  
Health Care ◽  
Electronic Health Records ◽  
Health Care Professionals ◽  
Health Data ◽  
Graphical Interface ◽  
Usability Study ◽  
Health Records ◽  
Information Navigation ◽  
Key Stakeholders ◽  
Electronic Health

BACKGROUND Wearable technology, such as smartwatches, can capture valuable patient-generated data and help inform patient care. Electronic health records provide logical and practical platforms for including such data, but it is necessary to evaluate the way the data are presented and visualized. OBJECTIVE The aim of this study is to evaluate a graphical interface that displays patients’ health data from smartwatches, mimicking the integration within the environment of electronic health records. METHODS A total of 12 health care professionals evaluated a simulated interface using a usability scale questionnaire, testing the clarity of the interface, colors, usefulness of information, navigation, and readability of text. RESULTS The interface was positively received, with 14 out of the 16 questions generating a score of 5 or greater among at least 75% of participants (9/12). On an 8-point Likert scale, the highest rated features of the interface were quick turnaround times (mean score 7.1), readability of the text (mean score 6.8), and use of terminology/abbreviations (mean score 6.75). CONCLUSIONS Collaborating with health care professionals to develop and refine a graphical interface for visualizing patients’ health data from smartwatches revealed that the key elements of the interface were acceptable. The implementation of such data from smartwatches and other mobile devices within electronic health records should consider the opinions of key stakeholders as the development of this platform progresses.

scholarly journals Oncology health-care professionals’ perceived effects of patient accessible electronic health records 6 years after launch: A survey study at a major university hospital in Sweden

2019 ◽  
Vol 26 (2) ◽  
pp. 1392-1403 ◽  
Author(s):  
Jonas Moll ◽  
Åsa Cajander
Keyword(s):  
Health Care ◽  
Electronic Health Records ◽  
Health Care Professionals ◽  
University Hospital ◽  
Survey Study ◽  
Negative Effects ◽  
Health Records ◽  
Perceived Effects ◽  
Oncology Care ◽  
Electronic Health

Patient accessible electronic health records have been launched in many countries, and generally, health-care professionals have had strong initial concerns related to the areas patient contact, documentation practices and quality of care. Especially, oncology care was discussed in media when launching patient accessible electronic health records in Sweden. However, few studies have investigated clinician-perceived effects several years after the launch. A survey covering these areas, as well as supposed effects for patients, was distributed to oncology health-care professionals 6 years after the launch of patient accessible electronic health records and answered by N = 176. Results show that patient accessible electronic health records have had small effects within the covered areas, and that the area most affected was documentation practices. Very few significant differences could be found between physicians and nurses. A comparison with results from interviews and surveys conducted shortly after the launch of patient accessible electronic health records clearly indicates that the experienced negative effects are not as big as originally feared.

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