Implement an International Interoperable PHR by FHIR—A Taiwan Innovative Application

Personal health records (PHRs) have lots of benefits for things such as health surveillance, epidemiological surveillance, self-control, links to various services, public health and health management, and international surveillance. The implementation of an international standard for interoperability is essential to accessing personal health records. In Taiwan, the nationwide exchange platform for electronic medical records (EMRs) has been in use for many years. The Health Level Seven International (HL7) Clinical Document Architecture (CDA) was used as the standard of the EMRs. However, the complication of implementing CDA became a barrier for many hospitals to realize the standard EMRs. In this study, we implemented a Fast Healthcare Interoperability Resources (FHIR)-based PHR transformation process including a user interface module to review the contents of PHRs. We used “My Health Bank, MHB”, a PHR data book developed and issued to all people by the Taiwan National Health Insurance, as the PHRs contents in this study. Network Time Protocol (NTP)/Simple Network Time Protocol (SNTP) was used in the security and user authentication mechanism when processing and applying personal health information. Transport Layer Security (TLS) 1.2 (such as HyperText Transfer Protocol Secure (HTTPS) was used for protection in data communication. User authentication is important in the platform. OAuth (OAuth 2.0) was used as a user authentication mechanism to confirm legitimate user access to ensure data security. The contents of MHB were analyzed and mapped to the FHIR, and then converted to FHIR format according to the mapping logic template. The function of format conversion was carried out by using ASP.NET. XPath and JSPath technologies filtered out specific information tags. The converted data structure was verified through an HL7 Application Programming Interface (HAPI) server, and a new JSON file was finally created. This platform can not only capture any PHR based on the FHIR format but also publish FHIR-based MHB records to any other platform to bridge the interoperability gap between different PHR systems. Therefore, our implementation/application with the automatic transformation from MHB to FHIR format provides an innovative method for people to access their own PHRs (MHB). No one has published a similar application like us using a nationwide PHR standard, MHB, in Taiwan. The application we developed will be very useful for a single person to use or for other system developers to implement their own standard PHR software.

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Characteristics of personal health information management groups: findings from an online survey using Amazon’s mTurk

Journal of the Medical Library Association JMLA ◽

10.5195/jmla.2017.312 ◽

2017 ◽

Vol 105 (4) ◽

Cited By ~ 3

Author(s):

Sujin Kim ◽

Jeffrey T. Huber

Keyword(s):

Health Information ◽

Information Management ◽

Personal Health Records ◽

Health Information Management ◽

Personal Health Information ◽

The Other ◽

Personal Health ◽

Health Records ◽

Basic Group ◽

Personal Health Information Management

Objective: The study characterized three groups with different levels of familiarity with personal health information management (PHIM) in terms of their demographics, health knowledge, technological competency, and information sources and barriers. In addition, the authors examined differences among PHIM groups in subjective self-ratings and objective test scores for health literacy.Methods: A total of 202 survey participants were recruited using Amazon’s Mechanical Turk (mTurk) service, a crowdsourcing Internet service. Using K-means clustering, three groups with differing levels of familiarity with PHIM were formed: Advanced, Intermediate, and Basic.Results: The Advanced group was the youngest, and the Basic group contained the highest proportion of males, whereas the Intermediate group was the oldest and contained the fewest males. The Advanced group was significantly more likely to engage in provider- or hospital-initiated PHIM activities such as emailing with providers, viewing test results online, and receiving summaries of hospital visits via email or websites than the other groups. The Basic group had significantly lower information management skills and Internet use than the other groups. Advanced and Basic groups reported significant differences in several information barriers. While the Advanced group self-reported the highest general literacy, they scored lowest on an objective health literacy test.Conclusions: For effective personal health records management, it is critical to understand individual differences in PHIM using a comprehensive measure designed to assess personal health records–specific activities. Because they are trained to perform an array of information management activities, medical librarians or patient educators are well positioned to promote the effective use of personal health records by health consumers.

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Using the technology acceptance model to predict patient attitude toward personal health records in regional communities

Information Technology and People ◽

10.1108/itp-07-2016-0160 ◽

2018 ◽

Vol 31 (2) ◽

pp. 306-326 ◽

Cited By ~ 14

Author(s):

Jamil Razmak ◽

Charles Bélanger

Keyword(s):

Technology Acceptance ◽

Health Information ◽

Technology Acceptance Model ◽

Personal Health Records ◽

Personal Health Information ◽

Personal Health ◽

Canadian Study ◽

Health Records ◽

Content Type ◽

Acceptance Model

Purpose The purpose of this paper is to statistically measure (quantify) how a sample of Canadians perceives the usability of electronic personal health records (PHRs) and, in the process, to increase Canadian patients’ awareness of PHRs and improve physicians’ confidence in their patients’ ability to manage their own health information through PHRs. Design/methodology/approach The authors surveyed 325 Canadian patients living in Northern Ontario to assess a research model consisting of seven perceptions of PHR systems used to manage personal health information electronically, and to assess their perceived ability to use PHR systems. The survey questions were adapted from the 2014 National Physician Survey in Canada. The authors compared the patients’ results with physicians’ own perceptions of their patients’ ability to use PHR systems. Findings First, there was a positive relationship between surveyed patients’ prior experiences, needs, values, and their attitude toward adopting the PHR system. Second, how patients saw a PHR system’s user-friendliness was the strongest predictor of how useful they considered it would be. Finally, of the 243 physician respondents, 90.3 percent believed their patients would not be able to manage their own e-health information via a PHR system, but 54.8 percent of the 325 patient respondents indicated they would be able to do so. Originality/value This study is unique in that the authors know of no other Canadian study that purports to predict, using the technology acceptance model factors, people’s attitudes toward adopting a PHR system. As well, this is the first Canadian study to compare the perspectives of healthcare providers and their patients on e-health applications.

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The Future of Personal Health Records and Patient Portals

Medical Research Archives ◽

10.18103/mra.v9i12.2641 ◽

2021 ◽

Vol 9 (12) ◽

Author(s):

Kim Nazi

Keyword(s):

Care Delivery ◽

Clinical Care ◽

Personal Health Record ◽

Personal Health Records ◽

Personal Health Information ◽

Personal Health ◽

Patient Portals ◽

Health Records ◽

The Future ◽

The Impact

Over the last two decades, the early development of standalone Personal Health Records (PHRs), and later tethered patient portals, have had a transformative effect on engaging patients by providing them with tools to manage their health and unprecedented access to their heath data. However, despite anticipated benefits and continued high consumer demand for online access to personal health information, adoption and sustained use has been less than expected. Moreover, powerful forces are transforming healthcare, necessitating change and adaptation. This aim of this paper is to examine several significant trends that are influencing the intersection of health care and technology and provide an assessment of the impact of these trends on the future of PHRs and patient portals. An aging population with an increased prevalence of chronic disease and mental health conditions, coupled with rising consumerism and more diverse care settings, has significant implications for patient-facing tools such as patient portals. Similarly, the proliferation of data generating consumer health technology and technical advances such as artificial intelligence and emerging data standards calls for the next iteration of tools to support care delivery. Moreover, the acceleration of virtual care driven by national policy changes and the COVID 19 pandemic requires better tools to realize the promising potential of the technology in an increasingly complex and interconnected world. Taken together, these factors may provide the perfect storm that will enable a critical shift to envision a more holistic patient-centric information and resource hub that is characterized by improved architecture, optimized design and content, a robust set of well-designed tools and functions, and enhanced integration with clinical care processes and structures. This personal health portal could provide a long desired single comprehensive longitudinal personal health record with best of breed design and features to empower patients as they navigate their health journey.

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A reliable authentication scheme of personal health records in cloud computing

Wireless Networks ◽

10.1007/s11276-021-02743-7 ◽

2021 ◽

Author(s):

Chia-Hui Liu ◽

Tzer-Long Chen ◽

Chien-Yun Chang ◽

Zhen-Yu Wu

Keyword(s):

Cloud Computing ◽

Personal Information ◽

Personal Health Records ◽

Health Improvement ◽

Personal Health ◽

Computing Environment ◽

Health Records ◽

Cloud Computing Environment ◽

Authentication Mechanism

AbstractA patient-centered personal health records system has been actively promoted in recent years. Its purpose is to maintain long-term personal records and health improvement plans. It combines a cloud computing environment to build a personal health records system to quickly collect personal information and transfer it to the back end for storage for future access. However, in a cloud environment, the message transmission process is more open. Therefore, a lack of an authority security mechanism for the users of such an architecture will result in distrust and doubt by the users. This adversely affects the implementation and quality of long-term health plans. To protect the crucial privacy of the users from malicious attacks or theft, it is necessary to ensure that the users have different authority to access their personal health records under the cloud computing environment and manage the openness of their authority to other users. A secured identify authentication mechanism can ensure that only legitimate users can log in to the system and obtain system service resources through verification. For a personal health records system in the cloud computing environment, this study proposes a secure and reliable user authentication mechanism allowing relevant users access to the user’s PHR in the cloud based on their authority. The proposed authentication method uses a password combined with a smart card, allowing the owner and authorized users to log in to the system and access the relevant personal records. In this study, an authentication method based on bilinear pairing was used to verify the identity of users and to effectively prevent malicious intrusion and theft.

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