Electronic Health Records

2010 ◽  
Vol 49 (04) ◽  
pp. 320-336 ◽  
Author(s):  
E. Ammenwerth ◽  
A. Hoerbst
Keyword(s):  
Electronic Health Records ◽  
Qualitative Content Analysis ◽  
Computer Assisted ◽  
Literature Analysis ◽  
Expert Interviews ◽  
Functional Requirements ◽  
Health Records ◽  
Quality Requirements ◽  
Starting Point ◽  
Electronic Health

Summary Objectives: Since the first concepts for electronic health records (EHRs) in the 1990s, the content, structure, and technology of such records were frequently changed and adapted. The basic idea to support and enhance health care stayed the same over time. To reach these goals, it is crucial that EHRs themselves adhere to rigid quality requirements. The present review aims at describing the currently available, mainly non-functional, quality requirements with regard to electronic health records. Methods: A combined approach – systematic literature analysis and expert interviews – was used. The literature analysis as well as the expert interviews included sources /experts from different domains such as standards and norms, scientific literature and guidelines, and best practice. The expert interviews were performed by using problem-centric qualitative computer-assisted telephone interviews Methods Inf Med 2010; 49: 320–336 doi: 10.3414/ME10-01-0038 received: May 17, 2010 accepted: June 9, 2010 prepublished: July 6, 2010 (CATIs) or face-to-face interviews. All of the data that was obtained was analyzed using qualitative content analysis techniques. Results: In total, more than 1200 requirements were identified of which 203 requirements were also mentioned during the expert interviews. The requirements are organized according to the ISO 9126 and the eEurope 2002 criteria. Categories with the highest number of requirements found include global requirements, (general) functional requirements and data security. The number of nonfunctional requirements found is by contrast lower. Conclusion: The manuscript gives comprehensive insight into the currently available, primarily non-functional, EHR requirements. To our knowledge, there are no other publications that have holistically reported on this topic. The requirements identified can be used in different ways, e.g. the conceptual design, the development of EHR systems, as a starting point for further refinement or as a basis for the development of specific sets of requirements.

scholarly journals Quality and Certification of Electronic Health Records

2010 ◽  
Vol 01 (02) ◽  
pp. 149-164 ◽  
Author(s):  
E. Ammenwerth ◽  
A. Hoerbst
Keyword(s):  
Information Systems ◽  
Electronic Health Records ◽  
Qualitative Content Analysis ◽  
Real Life ◽  
Health Records ◽  
Selection Processes ◽  
Quality Certification ◽  
The Us ◽  
Service Oriented ◽  
Electronic Health

Summary Background: Numerous projects, initiatives, and programs are dedicated to the development of Electronic Health Records (EHR) worldwide. Increasingly more of these plans have recently been brought from a scientific environment to real life applications. In this context, quality is a crucial factor with regard to the acceptance and utility of Electronic Health Records. However, the dissemination of the existing quality approaches is often rather limited. Objectives: The present paper aims at the description and comparison of the current major quality certification approaches to EHRs. Methods: A literature analysis was carried out in order to identify the relevant publications with regard to EHR quality certification. PubMed, ACM Digital Library, IEEExplore, CiteSeer, and Google (Scholar) were used to collect relevant sources. The documents that were obtained were analyzed using techniques of qualitative content analysis. Results: The analysis discusses and compares the quality approaches of CCHIT, EuroRec, IHE, openEHR, and EN13606. These approaches differ with regard to their focus, support of service-oriented EHRs, process of (re-)certification and testing, number of systems certified and tested, supporting organizations, and regional relevance. Discussion: The analyzed approaches show differences with regard to their structure and processes. System vendors can exploit these approaches in order to improve and certify their information systems. Health care organizations can use these approaches to support selection processes or to assess the quality of their own information systems. Citation: Hoerbst A, Ammenwerth E. Quality and certification of electronic health records – An overview of current approaches from the US and Europe. Appl Clin Inf 2010; 1: 149–164 http://dx.doi.org/10.4338/ACI-2010-02-R-0009

Computer-assisted expert case definition in electronic health records

2016 ◽  
Vol 86 ◽  
pp. 62-70 ◽  
Author(s):  
Alexander M. Walker ◽  
Xiaofeng Zhou ◽  
Ashwin N. Ananthakrishnan ◽  
Lisa S. Weiss ◽  
Rongjun Shen ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Case Definition ◽  
Computer Assisted ◽  
Health Records ◽  
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.

“Why the Hell Do We Need Electronic Health Records?”

2011 ◽  
Vol 50 (01) ◽  
pp. 53-61 ◽  
Author(s):  
A. Hoerbst ◽  
E. Ammenwerth ◽  
W. O. Hackl
Keyword(s):  
Electronic Health Records ◽  
Private Practice ◽  
Cost Benefit Analysis ◽  
Qualitative Content Analysis ◽  
Negative Emotions ◽  
Cost Benefit ◽  
Daily Practice ◽  
Record System ◽  
Health Records ◽  
Electronic Health

Summary Background: Progress in the medical sciences, together with related technologies, in the past has led to higher specialization and has created a strong need to exchange health information across institutional borders. The concept of electronic health records (EHR) was introduced to fulfill these needs. Remarkably, many EHR introduction projects ran into trouble, not least because they lacked the acceptance of EHR among physicians. Negative emotions, such as anxiety and fear due to a lack of information, may cause change barriers and hamper physicians’ acceptance of such projects. Objectives: The goal of this study was to gain deeper insight into the negative emotions related to the intended implementation of a mandatory national electronic health record system (called ELGA) in Austria among physicians in private practice. Methods: Qualitative, problem-centered interviews were conducted with eight physicians in private practice in the capital region of Tyrol. The methods of qualitative content analysis were used to analyze the data. Results: Three hundred and twenty-eight pas sages in the interviews were selected, annotated, and paraphrased. These passages were assigned to 139 different primary categories. Finally, 18 main categories in the form of statements were derived. They were correlated and a theoretical model was formed to explain the genesis of the detected fears and anxiety related to the ELGA project. The results show that the physicians feel uninformed and snubbed. They fear unknown changes, increased costs, as well as workload and surveillance without obtaining any advantages from using electronic health records in their daily practice. Conclusion: Impartial information campaigns that are tailored to the physicians’ needs and questions as along with a comprehensive cost-benefit analysis could benefit the physicians’ opinion of EHRs.

scholarly journals Application of openEHR archetypes to automate data quality rules for electronic health records: a case study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qi Tian ◽  
Zhexi Han ◽  
Ping Yu ◽  
Jiye An ◽  
Xudong Lu ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Data Quality ◽  
Query Language ◽  
Clinical Decision ◽  
Data Repository ◽  
Health Records ◽  
Quality Requirements ◽  
Electronic Health ◽  
Data Tables

Abstract Background Ensuring data is of appropriate quality is essential for the secondary use of electronic health records (EHRs) in research and clinical decision support. An effective method of data quality assessment (DQA) is automating data quality rules (DQRs) to replace the time-consuming, labor-intensive manual process of creating DQRs, which is difficult to guarantee standard and comparable DQA results. This paper presents a case study of automatically creating DQRs based on openEHR archetypes in a Chinese hospital to investigate the feasibility and challenges of automating DQA for EHR data. Methods The clinical data repository (CDR) of the Shanxi Dayi Hospital is an archetype-based relational database. Four steps are undertaken to automatically create DQRs in this CDR database. First, the keywords and features relevant to DQA of archetypes were identified via mapping them to a well-established DQA framework, Kahn’s DQA framework. Second, the templates of DQRs in correspondence with these identified keywords and features were created in the structured query language (SQL). Third, the quality constraints were retrieved from archetypes. Fourth, these quality constraints were automatically converted to DQRs according to the pre-designed templates and mapping relationships of archetypes and data tables. We utilized the archetypes of the CDR to automatically create DQRs to meet quality requirements of the Chinese Application-Level Ranking Standard for EHR Systems (CARSES) and evaluated their coverage by comparing with expert-created DQRs. Results We used 27 archetypes to automatically create 359 DQRs. 319 of them are in agreement with the expert-created DQRs, covering 84.97% (311/366) requirements of the CARSES. The auto-created DQRs had varying levels of coverage of the four quality domains mandated by the CARSES: 100% (45/45) of consistency, 98.11% (208/212) of completeness, 54.02% (57/87) of conformity, and 50% (11/22) of timeliness. Conclusion It’s feasible to create DQRs automatically based on openEHR archetypes. This study evaluated the coverage of the auto-created DQRs to a typical DQA task of Chinese hospitals, the CARSES. The challenges of automating DQR creation were identified, such as quality requirements based on semantic, and complex constraints of multiple elements. This research can enlighten the exploration of DQR auto-creation and contribute to the automatic DQA.

scholarly journals User perspectives on barriers to and facilitators of the implementation of electronic health records in behavioral health hospitals: A qualitative study (Preprint)

2020 ◽  
Author(s):  
Se Young Jung ◽  
Hee Hwang ◽  
Keehyuck Lee ◽  
Donghyun Lee ◽  
Sooyoung Yoo ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Electronic Health Records ◽  
Behavioral Health ◽  
Successful Implementation ◽  
Health Records ◽  
Behavioral Healthcare ◽  
System P ◽  
Starting Point ◽  
The Us ◽  
Electronic Health

BACKGROUND Despite the rapid adoption of electronic health records (EHRs) thanks to the reimbursement program of the US government, the adoption of EHRs in behavioral health hospitals continues to lag behind that of other hospitals, and there remains a lack of evidence regarding barriers to and facilitators of the implementation of behavioral healthcare electronic health records (bhEHRs). OBJECTIVE The aim of this study was to analyze the experience of behavioral health professionals to explore the perceived barriers, facilitators, and critical ideas influencing the implementation and usability of bhEHRs. METHODS In this qualitative study, we interviewed physicians, nurses, pharmacists, behavioral health clinicians, and administrative professionals separately at 4 behavioral health hospitals in the US. We conducted semistructured interviews (N= 43) at behavioral health hospitals involved in the adoption of bhEHRs. We used purposeful sampling to maximize diversity. Transcripts were coded and analyzed for emergent domains. Exploratory data analysis was applied. RESULTS Content analyses revealed 4 barriers and 4 facilitators. The most important barriers to implementing bhEHRs were the low level of computer proficiency among nurses, the complexity of the system, alert fatigue, and resistance due to legacy systems. These barriers led to poor usability and acceptability and a distrust of the system. Among the major facilitators identified were well-executed training programs, improved productivity, better quality of care, and the good usability of the bhEHR system. CONCLUSIONS Healthcare professionals are keen to use bhEHRs, which may enhance their work productivity and interprofessional collaboration. Routine education for end users is the essential starting point to provide support for decision making and successful implementation of bhEHRs. When adopting bhEHRs, managers need to focus on common practices in behavioral health hospitals, such as documenting structured data in their organizations and adopting a seamless workflow of behavioral healthcare into the system.

scholarly journals REGISTRO DAS ATIVIDADES CLÍNICAS DO FARMACÊUTICO HOSPITALAR: UMA REVISÃO INTEGRATIVA

2020 ◽  
Vol 20 (38) ◽  
pp. 101-112
Author(s):  
Émilin Dreher De Lima ◽  
Carine Raquel Blatt ◽  
Rita Catalina Aquino Caregnato
Keyword(s):  
Electronic Health Records ◽  
Medical Records ◽  
Retrieval System ◽  
Web Of Science ◽  
Medical Literature ◽  
Pharmaceutical Services ◽  
Pharmacy Service ◽  
Literature Analysis ◽  
Health Records ◽  
Electronic Health

Objetivo: Investigar como os farmacêuticos registram as intervenções clínicas no âmbito hospitalar. Método: Utilizou-se como método de pesquisa a revisão integrativa. Para realizar a busca dos artigos foram consultadas as fontes de informação Biblioteca Virtual em Saúde, Medical Literature Analysis and Retrieval System Online, Scientific Eletronic Library Online, ScienceDirect e Web of Science, utilizando a combinação de termos e operadores booleanos “("pharmacist" OR "pharmaceutical services" OR "pharmacy service, hospital") AND ("hospitals") AND ("medical records" OR "health records, personal" OR "electronic health records" OR "registries")”. O nível de evidência foi avaliado segundo Melnyk e Fineout-Overholt (2011). Os artigos foram agrupados por proximidade de assunto. Resultados: 26 preencheram os critérios de inclusão do estudo. A maioria dos estudos foram realizados em instituições dos Estados Unidos, publicados nos anos de 2014 e 2015. Apenas 31% dos estudos reportam o registro das atividades clínicas do farmacêutico em prontuário. Conclusões: Uma pequena parcela dos artigos sobre atividades clínicas do farmacêutico em hospital deixa claro que o registro referente à prática de cuidado ao paciente foi realizado em prontuário. A maioria dos artigos relata o registro das atividades clínicas em um banco de dados distinto. O fato de o farmacêutico inserir informações referentes à suas atividades clínicas em bases de dados distinta do prontuário pode facilitar mensuração de desfechos clínicos e econômicos. Contudo, o registro da ação clínica no prontuário do paciente não pode ser negligenciado visto que é um direito do paciente e dever do profissional de saúde.

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