scholarly journals Tantangan Etika dan Hukum Penggunaan Rekam Medis Elektronik dalam Era Personalized Medicine

2019 ◽  
Vol 4 (1) ◽  
pp. 49
Author(s):  
Rani Tiyas Budiyanti ◽  
Penggalih Mahardika Herlambang ◽  
Nurhasmadiar Nandini
Keyword(s):  
Personalized Medicine ◽  
Electronic Medical Records ◽  
Data Security ◽  
Medical Records ◽  
Health Sector ◽  
Legal Responsibility ◽  
Ethical Aspects ◽  
Legal Challenges ◽  
Data Ownership ◽  
The Relationship

Background: Personalized medicine is one of the health treatment approaches that has developed in the last ten years. This treatment is specific because it considers the genomics of patients and requires a complete database or medical record covering clinical and genomic data. Nevertheless, there are ethical and legal challenges in the implementation of electronic medical records in personalized medicine.Objective: This study aimed  to determine the ethical and legal challenges in the use of electronic medical records in personalized medicine based on previous literature.Methods: The method used in this study was literature review with sources from journals, books, and articles on electronic medical records, personalized medicine, as well as legal and ethical aspects related both domestically and abroad. Results: Ethical and legal challenges that can occurred in the use of electronic medical records in the personalized medicine era include security and ownership of data, legal responsibility, genomic discrimination, and changes in the relationship between doctors and patients.Conclusion: Indonesia does not yet have specific regulations regarding data security, data ownership, and data sharing in the health sector. Further regulations regarding the use of electronic medical records in the personalized era are needed so that their implementation does not conflict with the ethics and laws that apply in Indonesia

scholarly journals Innovation and shortage: The Yin and Yang of the health sector

2018 ◽  
Vol 68 (s1) ◽  
pp. 99-114
Author(s):  
Karen Eggleston
Keyword(s):  
Quality Of Life ◽  
Personalized Medicine ◽  
Chinese Philosophy ◽  
Health Sector ◽  
Violent Conflict ◽  
Social Instability ◽  
Yin And Yang ◽  
Market Driven ◽  
The Relationship

The economic challenges countries face when adopting personalized medicine technologies provide an important illustration of many of the concepts articulated by János Kornai in his pioneering research on innovation in market-driven, capitalist surplus economies. In Chinese philosophy, Yin and Yang often represent contradictory yet inseparable opposites – two forces that not merely coexist, but are synergistic and mutually dependent. This concept is an apt analogy for the relationship between innovation and shortage in the health sector. Dangers arise from over-emphasizing the Yin of innovation over the Yang of access, and vice versa. If we over-constrain innovation, we die needlessly early and forfeit quality of life that innovations might have enabled. If we do not distribute access to innovations equitably, we diminish our humanity, suffer backlashes from populism and distrust of science and expertise, and risk social instability, even violent conflict.

scholarly journals CORRELATION BETWEEN FRACTURES AND ABUSE IN CHILDREN: A RETROSPECTIVE ANALYSIS

2021 ◽  
Vol 29 (1) ◽  
pp. 30-33
Author(s):  
VITOR LUIS PEREIRA ◽  
BERNARDO LOPES CRISOSTOMO ◽  
GIULIA CARVALHO SILVA ◽  
EIFFEL TSUYOSHI DOBASHI
Keyword(s):  
Retrospective Study ◽  
Electronic Medical Records ◽  
Medical Records ◽  
National Literature ◽  
Level Of Evidence ◽  
Fracture Patterns ◽  
Associated Lesions ◽  
Reference Hospital ◽  
The Subject ◽  
The Relationship

ABSTRACT Objective: The aim of this work is to provide evidence for the relationship between suspicion and diagnosis of cases of child abuse and fractures, since, in national literature, studies are still scarce on the subject. Methods: Retrospective study involving electronic medical records of a public reference hospital, in a city of the state of São Paulo, in a 8-year period (2010 to 2018). Cases involving children up to 12 years of age were selected when notified as abuse and presenting fractures; data were statistically analyzed. Results: Among 83 cases of abuse, 19 patients (20.5%) had 23 different fractures. The victims were mainly boys (68.42%) with a mean age of 5 years old, who suffered physical aggression (79%). The majority had no identified aggressor (52%) and 21% were related to the mother. The fracture patterns found involved, mostly, skull fractures (43.48%) and diaphysary fractures (34.78%). Seven patients (30.43%) had other associated lesions and four patients died (21%). Conclusion: Despite the number of cases, it was possible to identify relevant characteristics and patterns. These data indicate that the diagnosis is underestimated and show small epidemiological differences compared with international literature. Level of Evidence II, Retrospective study.

scholarly journals Frequent Mobile Electronic Medical Records Users Respond More Quickly to Emergency Department Consultation Requests: Retrospective Quantitative Study

10.2196/14487 ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. e14487 ◽  
Author(s):  
Kwang Yul Jung ◽  
SuJin Kim ◽  
Kihyung Kim ◽  
Eun Ju Lee ◽  
Kyunga Kim ◽  
...  
Keyword(s):  
Emergency Department ◽  
Response Time ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Inverse Relationship ◽  
Secondary Outcome ◽  
Time Interval ◽  
Care Providers ◽  
Significant Inverse Relationship ◽  
The Relationship

Background Specialty consultation is a critical aspect of emergency department (ED) practice, and a delay in providing consultation might have a significant clinical effect and worsen ED overcrowding. Although mobile electronic medical records (EMR) are being increasingly used and are known to improve the workflow of health care providers, limited studies have evaluated their effectiveness in real-life clinical scenarios. Objective For this study, we aimed to determine the association between response duration to an ED specialty consultation request and the frequency of mobile EMR use. Methods This retrospective study was conducted in an academic ED in Seoul, South Korea. We analyzed EMR and mobile EMR data from May 2018 to December 2018. Timestamps of ED consultation requests were retrieved from a PC-based EMR, and the response interval was calculated. Doctors’ log frequencies were obtained from the mobile EMR, and we merged data using doctors’ deidentification numbers. Pearson’s product-moment correlation was performed to identify this association. The primary outcome was the relationship between the frequency of mobile EMR usage and the time interval from ED request to consultation completion by specialty doctors. The secondary outcome was the relationship between the frequency of specialty doctors’ mobile EMR usage and the response time to consultation requests. Results A total of 25,454 consultations requests were made for 15,555 patients, and 252 specialty doctors provided ED specialty consultations. Of the 742 doctors who used the mobile EMR, 208 doctors used it for the specialty consultation process. After excluding the cases lacking essential information, 21,885 consultations with 208 doctors were included for analysis. According to the mobile EMR usage pattern, the average usage frequency of all users was 13.3 logs/day, and the average duration of the completion of the specialty consultation was 51.7 minutes. There was a significant inverse relationship between the frequency of mobile EMR usage and time interval from ED request to consultation completion by specialty doctors (coefficient=–0.19; 95% CI –0.32 to –0.06; P=.005). Secondary analysis with the response time was done. There was also a significant inverse relationship between the frequency of specialty doctors’ mobile EMR usage and the response time to consultation requests (coefficient=–0.18; 95% CI –0.30 to –0.04; P=.009). Conclusions Our findings suggest that frequent mobile EMR usage is associated with quicker response time to ED consultation requests.

Readiness of Application of Electronic Medical Records in Health Services (Literature Study)

2022 ◽  
Vol 2 (1) ◽  
pp. 1-12
Author(s):  
Lilis Masyfufah ◽  
Mrs. Sriwati ◽  
Amir Ali ◽  
Bambang Nudji
Keyword(s):  
Health Services ◽  
Electronic Medical Records ◽  
Communication Technology ◽  
Medical Records ◽  
Critical Appraisal ◽  
Health Sector ◽  
Background Information ◽  
Literature Study ◽  
Information And Communication ◽  
Scientific Research Articles

Background: Information and Communication Technology is advancing rapidly and has a major impact on all life, especially in the health sector, especially medical records. This is manifested in the Electronic Medical Record (EMR), which has now been further developed into an Electronic Health Record (EHR). This technology is used to replace or complement paper medical records. The purpose of this literature study is to determine the readiness to apply electronic medical records in health services.Methods: This study uses a literature study obtained from searching scientific research articles from the 2010–2020 range. Keywords used in this study is readiness and DOQ-IT. The database used comes from Google Sholar, Garuda, Neliti, and One Search. The search found 130 articles, then a critical appraisal process was carried out to produce 10 suitable manuscripts.Results: Various literatures found that the readiness to apply electronic medical records using the DOQ-IT method was influencedby 4 factors including the readiness of human resources, orgnizational culture, insfrastructure, and leadership governance. It can be concluded that the readiness for the application of  electronic medical recors in health services with the very ready category is 30%, the moderately ready category is 50%, then the unready category is 20%.Conclusions: From the discussion above, it can be concluded that EMR readiness in health services is categorized as quite ready (50%), very ready (30%), and not ready (20%).

scholarly journals Thiamine Deficiency and Neurological Symptoms in Patients with Hematological Cancer Receiving Chemotherapy: A Retrospective Analysis

2021 ◽  
Author(s):  
Yohei Iimura ◽  
Shohei Andoh ◽  
Toyotaka Kawamata ◽  
Aki Sato ◽  
Kazuaki Yokoyama ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Thiamine Deficiency ◽  
Medical Records ◽  
Serum Levels ◽  
Neurological Status ◽  
Neurological Symptoms ◽  
Hematological Cancer ◽  
Wilcoxon Rank Sum Test ◽  
Attention Impairment ◽  
The Relationship

Abstract Objectives Patients with hematological cancer receiving chemotherapy have a high risk of thiamine deficiency due to accelerated thiamine usage by tumor cells. Mild or severe thiamine deficiency can lead to varying degrees of neurological symptoms. We evaluated the relationship between thiamine deficiency and neurological symptoms, including mild or nonspecific symptoms, and the influence of chemotherapy on thiamine serum levels in patients with hematological cancer receiving chemotherapy. Materials and Methods We retrospectively identified 42 patients diagnosed with hematological cancer at our hospital, using electronic medical records collected from March 2019 to March 2020. We evaluated the risk factors associated with neurological symptoms (mild-to-severe cognitive impairment, attention impairment, and mood or emotional disorder), the relationship between the presence of neurological symptoms and thiamine serum levels, and changes in thiamine serum levels after chemotherapy. Results Thiamine deficiency was significantly associated with neurological symptoms. The thiamine serum levels in the group with neurological symptoms were significantly lower than those in the group without neurological symptoms. The Wilcoxon rank-sum test showed that thiamine serum levels after chemotherapy were significantly lower than those before administration of chemotherapy. Conclusion Thiamine serum levels in patients with hematological cancer may be used as a reference to maintain neurological status during chemotherapy.

scholarly journals Synchronization of Electronic Medical Record Implementation Guidelines in National E-Health Strategies

SOEPRA ◽  
2020 ◽  
Vol 5 (2) ◽  
pp. 209
Author(s):  
Rezky Ami Cahyaharnita
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Electronic Medical Records ◽  
Time Management ◽  
Medical Records ◽  
Service Providers ◽  
Health Sector ◽  
Health Strategy ◽  
Implementation Guidelines ◽  
The Government

Medical records are made in writing, complete and clear or electronically. Medical records are the basis of medical services to patients. Paper medical records increase the amount of paper waste in Indonesia. A national e-health strategy is a comprehensive approach to efforts in the national health sector. Electronic medical records are more effective because of better time management. The formulation of the problem in this article covers the reasons, criteria, and implementation of electronic medical records. The research method used is descriptive qualitative research with a statute approach. The criteria for a good electronic medical record are integrated data from various sources, data collected at the service point, and supporting service providers in decision making. The expected electronic medical record is to be integrated with the health service facility information system program without neglecting the confidentiality aspect. Therefore, the government needs to make regulations on the technical implementation of electronic medical records.

scholarly journals Factors influencing Adoption of Electronic Medical Records in Government Hospitals of Sri Lanka

2020 ◽  
pp. 190-199
Author(s):  
Maheesa Dayananda
Keyword(s):  
Developing Countries ◽  
Sri Lanka ◽  
Human Factors ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Digital Health ◽  
Health Sector ◽  
Organizational Factors ◽  
Primary Data ◽  
Government Hospitals

Electronic medical records (EMR) is a popular topic in the literature with the increasing use of EMR in both developed and developing countries. It supports to achieve health sector goals including but not limited to; improved quality, efficiency, cost reduction and patients’ safety and contributes to the sustainable development goal “ensure healthy lives and wellbeing for all at all ages”. Developing countries like Sri Lanka have a critical requirement of having innovative solutions to improve health outcomes while controlling the cost. EMR identified as a better solution to fulfil this requirement. However, it is questionable whether the rate of adoption is at a satisfactory level compared to the importance and benefits of the EMR. This study aimed at identifying critical success and failure factors in adopting EMR in Sri Lanka and propose strategies for successful adoption. Both primary and secondary data were used for the study. The study focused on experience of forty Government hospitals where the EMR systems established under the Digital Health Project, Sri Lanka. Primary data were collected from the health professionals and the regional project officers of Information and Communication Technology Agency of Sri Lanka who managed and coordinated the EMR implementation process in the hospitals. Focus group discussions (FGD), key informant interviews (KII) were mainly used as data collection tools. Further, the research papers published in peer-reviewed journals were reviewed. During the study, twenty-six factors that influence the success and failure of EMR adoption were identified. These factors were categorized and analyzed under six themes – i.e., human factors, technical factors, organizational factors, financial factors, legal factors and change management factors. The most influential category of factors was human factors. Even though the EMR implementation involves applying technology in the health sector, ‘people’ factor should not be forgotten. Ideally, the future EMR implementations should be based on the lessons learnt and best practices of the previous projects in order to achieve successful adoption and to avoid waste of resources.

scholarly journals Frequent Mobile Electronic Medical Records (EMR) Users Respond More Quickly to Emergency Department Consultation Requests (Preprint)

2019 ◽  
Author(s):  
Kwang Yul Jung ◽  
Su Jin Kim ◽  
Ki Hyung Kim ◽  
Eun Ju Lee ◽  
Kyunga Kim ◽  
...  
Keyword(s):  
Emergency Department ◽  
Response Time ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Inverse Relationship ◽  
Secondary Outcome ◽  
Time Interval ◽  
Significant Inverse Relationship ◽  
Clinical Scenarios ◽  
The Relationship

BACKGROUND Specialty consultation is a critical aspect of an emergency department (ED) practice, and a delay in providing consultation might have a significant clinical effect and worsen the ED overcrowding. Although mobile electronic medical records (mEMR) are being increasingly utilized and are known to improve the workflow of healthcare providers, limited studies have evaluated its effectiveness in real-life clinical scenarios. OBJECTIVE We aimed to determine the association between response duration to ED specialty consultation request and frequency of mEMR use. METHODS This retrospective study was conducted in an academic ED in Seoul, South Korea. We analyzed EMR and mEMR data from May 2018 to December 2018. Timestamps of ED consultation requests were retrieved from the PC-based EMR, and the response interval was calculated. Doctors’ log frequencies were obtained from the mEMR. We merged both data using doctors’ de-identification numbers. Pearson’s product-moment correlation was performed to identify this association. The primary outcome was the relationship between the frequency of mEMR usage and time interval from ED request to the completion of the consultation by specialty doctors. Secondary outcome was the relationship between the frequency of specialty doctors’ mEMR usage and the response time to consultation requests. RESULTS A total of 25,454 consultations requests were made for 15,555 patients, and 271 specialty doctors provided ED specialty consultations. Of the 742 doctors who used the mEMR, 212 doctors used mEMR in specialty consultation process. According to the mEMR usage pattern, the average usage frequency of all users was 13.3/day, and the average duration of the completion of the specialty consultation was 51.0 min. For 21,885 completed consultations, there was a significant inverse relationship between the frequency of mEMR usage and time interval from ED request to consultation completion by specialty doctors. (Coefficient: -0.19 (-0.32 to -0.06), P<.01) Of 23,692 consultations had response time stamp among inclusions. There was also a significant inverse relationship between the frequency of specialty doctors’ mEMR usage and the response time to consultation requests (coefficient: -0.17 (-0.30 to -0.04), P=.01). CONCLUSIONS Our findings suggest that frequent mEMR usage is associated with quicker response time to ED consultation requests.

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