Accessing an Existing Virtual Electronic Patient Record with a Secure Wireles Architecture

2010 ◽  
pp. 24-44
Author(s):  
Ana Ferreira ◽  
Luis Barreto ◽  
Pedro Brandao ◽  
Ricardo Correia
Keyword(s):  
Healthcare Professionals ◽  
Point Of Care ◽  
Daily Basis ◽  
University Hospital ◽  
Security Requirements ◽  
Wireless Technology ◽  
Electronic Patient Records ◽  
Network Attacks ◽  
Healthcare Information ◽  
Data Elements

Virtual electronic patient records (VEPR) enable the integration and sharing of healthcare information within large and heterogeneous organizations by aggregating known data elements about patients from different information systems in real-time. However, healthcare professionals need to access a terminal every time they treat a patient. This may not be trivial as computers are not available around every corner of big healthcare institutions. The use of wireless technology can improve and fasten healthcare treatment because it can bring information and decision to the point of care allowing also for healthcare professionals’ mobility. However, as healthcare information is of a very sensitive nature, it has to comply with important security requirements. The wireless technology makes it more difficult for these requirements to be achieved as it is harder to control disruptions and attempts to access information can be more common and less simple to detect. The main objective of this chapter is to model, develop and evaluate (e.g. in terms of efficiency, complexity, impact and against network attacks) a proposal for a secure wireless architecture in order to access a VEPR. This VEPR is being used within a university hospital by more than 1,000 doctors, on a daily basis. Its users would greatly benefit if this service would be extended to a wider part of the hospital and not only to their workstation, achieving this way faster and greater mobility in the treatment of their patients.

scholarly journals Point of Care Ultrasound Use by Interns in Emergency Department

2021 ◽  
Vol 9 (E) ◽  
pp. 588-591
Author(s):  
Kamonwon Ienghong ◽  
Takaaki Suzuki ◽  
Somsak Tiamkao ◽  
Dhanu Gaysonsiri ◽  
Vajarabhongsa Bhudhisawasdi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Research Team ◽  
Emergency Services ◽  
Response Rate ◽  
Point Of Care ◽  
Daily Basis ◽  
University Hospital ◽  
Point Of Care Ultrasound ◽  
Primary Obstacle ◽  
Morning Shift

BACKGROUND: Point of care ultrasound (POCUS) is required for use in many instances on a daily basis in the hospital, especially in the emergency department and other specialty treatment areas. While interns play a crucial role in running emergency services in Thailand, the POCUS usage of interns has not been well studied. METHODS: This was a retrospective observational study of the interns who worked at the Department of Emergency Medicine, a tertiary university hospital in Khon Kaen, Thailand between July 2020 and April 2021. The seven questions survey about participants’ experiences performing POCUS examinations was conceived and carried out by the research team. The primary aim of this study is to identify the frequency of POCUS examinations performed by interns in this or any other given rotation. RESULTS: The response rate was 81.25% with the frequency of POCUS examinations per physician coming in at 2.5 per shift. It should be noted that examinations occurred primarily during the morning shift (79%) and were for diagnostic purposes (100%). The highest POCUS use cases (80%) were found to take place for abdominal examinations and the most commonly used POCUS application was the FAST (Focused Assessment with Sonography for Trauma) examination (92%). The confidence level was rated as 3/5. The primary barrier to performing POCUS was lack of knowledge or ultrasound training (47%). CONCLUSIONS: POCUS is often used by interns though less than in some other specialties. The type of POCUS application employed was limited due to lack of training and the primary obstacle for POCUS use in the emergency department was patient overcrowding.  

scholarly journals 145 Point of care lung ultrasound in patient triage: integration of ultrasound into a streaming pathway for COVID-19

2020 ◽  
Vol 37 (12) ◽  
pp. 839.1-839
Author(s):  
Dominic Craver ◽  
Aminah Ahmad ◽  
Anna Colclough
Keyword(s):  
Point Of Care ◽  
District General Hospital ◽  
Training Programme ◽  
Service Evaluation ◽  
University Hospital ◽  
Junior Doctors ◽  
Point Of Care Ultrasound ◽  
Face To Face ◽  
Point Of Care Diagnostics ◽  
Audit Data

Aims/Objectives/BackgroundRapid risk stratification of patients is vital for Emergency Department (ED) streaming during the COVID-19 pandemic. Ideally, patients should be split into red (suspected/confirmed COVID-19) and green (non COVID-19) zones in order to minimise the risk of patient-to-patient and patient-to-staff transmission. A robust yet rapid streaming system combining clinician impression with point-of-care diagnostics is therefore necessary.Point of care ultrasound (POCUS) findings in COVID-19 have been shown to correlate well with computed tomography (CT) findings, and it therefore has value as a front-door diagnostic tool. At University Hospital Lewisham (a district general hospital in south London), we recognised the value of early POCUS and its potential for use in patient streaming.Methods/DesignWe developed a training programme, ‘POCUS for COVID’ and subsequently integrated POCUS into streaming of our ED patients. The training involved Zoom lectures, a face to face practical, a 10 scan sign off process followed by a final triggered assessment. Patient outcomes were reviewed in conjunction with their scan reports.Results/ConclusionsCurrently, we have 21 ED junior doctors performing ultrasound scans independently, and all patients presenting to our department are scanned either in triage or in the ambulance. A combination of clinical judgement and scan findings are used to stream the patient to an appropriate area.Service evaluation with analysis of audit data has found our streaming to be 94% sensitive and 79% specific as an indicator of COVID 19. Further analysis is ongoing.Here we present both the structure of our training programme and our integrated streaming pathway along with preliminary analysis results.

scholarly journals Contagion Management at the Méditerranée Infection University Hospital Institute

2021 ◽  
Vol 10 (12) ◽  
pp. 2627
Author(s):  
Pierre-Edouard Fournier ◽  
Sophie Edouard ◽  
Nathalie Wurtz ◽  
Justine Raclot ◽  
Marion Bechet ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Early Diagnosis ◽  
Personal Protective Equipment ◽  
Early Stage ◽  
Point Of Care ◽  
University Hospital ◽  
Protective Equipment ◽  
Monitoring Point ◽  
Epidemiological Monitoring ◽  
Wide Range

The Méditerranée Infection University Hospital Institute (IHU) is located in a recent building, which includes experts on a wide range of infectious disease. The IHU strategy is to develop innovative tools, including epidemiological monitoring, point-of-care laboratories, and the ability to mass screen the population. In this study, we review the strategy and guidelines proposed by the IHU and its application to the COVID-19 pandemic and summarise the various challenges it raises. Early diagnosis enables contagious patients to be isolated and treatment to be initiated at an early stage to reduce the microbial load and contagiousness. In the context of the COVID-19 pandemic, we had to deal with a shortage of personal protective equipment and reagents and a massive influx of patients. Between 27 January 2020 and 5 January 2021, 434,925 nasopharyngeal samples were tested for the presence of SARS-CoV-2. Of them, 12,055 patients with COVID-19 were followed up in our out-patient clinic, and 1888 patients were hospitalised in the Institute. By constantly adapting our strategy to the ongoing situation, the IHU has succeeded in expanding and upgrading its equipment and improving circuits and flows to better manage infected patients.

scholarly journals Electronic patient record and its effects on social aspects of interprofessional collaboration and clinical workflows in hospitals (eCoCo): a mixed methods study protocol

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marina Beckmann ◽  
Kerstin Dittmer ◽  
Julia Jaschke ◽  
Ute Karbach ◽  
Juliane Köberlein-Neu ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Health Services ◽  
Healthcare Professionals ◽  
Social Research ◽  
Interprofessional Collaboration ◽  
Participant Observation ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Daily Work ◽  
Network Analyses

Abstract Background The need for and usage of electronic patient records within hospitals has steadily increased over the last decade for economic reasons as well as the proceeding digitalization. While there are numerous benefits from this system, the potential risks of using electronic patient records for hospitals, patients and healthcare professionals must also be discussed. There is a lack in research, particularly regarding effects on healthcare professionals and their daily work in health services. The study eCoCo aims to gain insight into changes in interprofessional collaboration and clinical workflows resulting from introducing electronic patient records. Methods eCoCo is a multi-center case study integrating mixed methods from qualitative and quantitative social research. The case studies include three hospitals that undergo the process of introducing electronic patient records. Data are collected before and after the introduction of electronic patient records using participant observation, interviews, focus groups, time measurement, patient and employee questionnaires and a questionnaire to measure the level of digitalization. Furthermore, documents (patient records) as well as structural and administrative data are gathered. To analyze the interprofessional collaboration qualitative network analyses, reconstructive-hermeneutic analyses and document analyses are conducted. The workflow analyses, patient and employee assessment analyses and classification within the clinical adoption meta-model are conducted to provide insights into clinical workflows. Discussion This study will be the first to investigate the effects of introducing electronic patient records on interprofessional collaboration and clinical workflows from the perspective of healthcare professionals. Thereby, it will consider patients’ safety, legal and ethical concerns and quality of care. The results will help to understand the organization and thereby improve the performance of health services working with electronic patient records. Trial registration The study was registered at the German clinical trials register (DRKS00023343, Pre-Results) on November 17, 2020.

scholarly journals Burnout of Healthcare Workers amid the COVID-19 Pandemic: A Japanese Cross-Sectional Survey

2021 ◽  
Vol 18 (5) ◽  
pp. 2434
Author(s):  
Yoshito Nishimura ◽  
Tomoko Miyoshi ◽  
Hideharu Hagiya ◽  
Yoshinori Kosaki ◽  
Fumio Otsuka
Keyword(s):  
Healthcare Workers ◽  
Healthcare Professionals ◽  
Healthcare Delivery ◽  
General Medicine ◽  
Maslach Burnout Inventory ◽  
University Hospital ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The Past

The coronavirus disease 2019 (COVID-19) global pandemic has drastically changed how we live and work. Amid the prolonged pandemic, burnout of the frontline healthcare professionals has become a significant concern. We conducted a cross-sectional survey study to provide data about the relationship between the COVID-19 pandemic and the prevalence of burnout in healthcare professionals in Japan. Healthcare workers in a single Japanese national university hospital participated in the survey, including basic demographics, whether a participant engaged in care of COVID-19 patients in the past 2 weeks and the Maslach Burnout Inventory. Of those, 25.4% fully answered the survey; 33.3% were doctors and 63.6% were nurses, and 36.3% engaged in care of COVID-19 patients in the past 2 weeks. Compared to those belonging to General Medicine, those in Emergency Intensive Care Unit were at higher risk of burnout (odds ratio (OR), 6.7; 95% CI, 1.1–42.1; p = 0.031). Of those who engaged in care of COVID-19 patients, 50% reported burnout while 6.1% did not (OR 8.5, 95% CI; 1.3–54.1; p = 0.014). The burnout of healthcare workers is a significant concern amid the pandemic, which needs to be addressed for sustainable healthcare delivery.

scholarly journals Ontology-based semantic similarity to metadata analysis in the information security domain

2021 ◽  
pp. 034-041
Author(s):  
A.Y. Gladun ◽  
◽  
K.A. Khala ◽  
Keyword(s):  
Big Data ◽  
Information Security ◽  
Data Analytics ◽  
Big Data Analytics ◽  
Network Attacks ◽  
Semantic Level ◽  
Operational Information ◽  
Metadata Analysis ◽  
Data Elements ◽  
Different Levels

It is becoming clear with growing complication of cybersecurity threats, that one of the most important resources to combat cyberattacks is the processing of large amounts of data in the cyber environment. In order to process a huge amount of data and to make decisions, there is a need to automate the tasks of searching, selecting and interpreting Big Data to solve operational information security problems. Big data analytics is complemented by semantic technology, can improve cybersecurity, and allows you to process and interpret large amounts of information in the cyber environment. Using of semantic modeling methods in Big Data analytics is necessary for the selection and combination of heterogeneous Big Data sources, recognition of the patterns of network attacks and other cyber threats, which must occur quickly to implement countermeasures. Therefore to analyze Big Data metadata, the authors propose pre-processing of metadata at the semantic level. As analysis tools, it is proposed to create a thesaurus of the problem based on the domain ontology, which should provide a terminological basis for the integration of ontologies of different levels. To build a thesaurus of the problem, it is proposed to use the standards of open information resources, dictionaries, encyclopedias. The development of an ontology hierarchy formalizes the relationships between data elements that will be used in future for machine learning and artificial intelligence algorithms to adapt to changes in the environment, which in turn will increase the efficiency of big data analytics for the cybersecurity domain.

scholarly journals Wounds: an overlooked burden (Part 1) – effective wound management starts with proper wound assessment

2020 ◽  
pp. 196-198
Author(s):  
H Parkar ◽  
AD Cromarty
Keyword(s):  
Wound Healing ◽  
General Practice ◽  
Healthcare Professionals ◽  
Chronic Wound ◽  
Treatment Strategies ◽  
Daily Basis ◽  
Wound Management ◽  
Wound Treatment ◽  
Wound Assessment ◽  
Wound Type

Healthcare professionals in general practice are tasked with treatment and management of wounds on a daily basis. The prognoses of these wounds are directly affected by the ability of the clinician to assess these wounds according to several parameters, including the wound type and the features which determine whether a wound is acute or transforming to a chronic wound. This can be achieved by proper and continuous wound assessment, which should guide wound treatment strategies to ensure optimal wound healing and prevent progression to complicated wounds.

scholarly journals The Electronic Patient Record as an Organizational Artifact

2011 ◽  
pp. 78-89 ◽  
Author(s):  
Pieter Toussaint ◽  
Marc Berg
Keyword(s):  
Electronic Patient Record ◽  
Healthcare Professionals ◽  
Research Effort ◽  
Patient Record ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Specific Research ◽  
Technological Bias

The research effort on Electronic Patient Records (EPRs) has rapidly increased in the last decade. Much of this research focussed on standardisation and technical realizations. We will describe such a research effort in this chapter and evaluate its success. Our main finding is that the lack of success of this specific research effort is mainly due to its technological bias. Although standards (both conceptual and technical) are important prerequisites for the realisation of an EPR, organisational issues are decisive for success. The role played by these organisational issues will be illustrated by analysing the findings of the case study presented in the chapter. We will argue that research on EPRs should be more focussed on the role of an EPR as an organisational artefact that coordinates the work of healthcare professionals, in order to lead to successful implementations.

scholarly journals Developing an intervention to optimise the outcome of cardiac surgery in people with diabetes: the OCTOPuS pilot study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Richard I. G. Holt ◽  
Katharine Barnard-Kelly ◽  
Giorgos Dritsakis ◽  
Kerensa I. Thorne ◽  
Lauren Cohen ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Healthcare Professionals ◽  
Diabetes Management ◽  
Controlled Trial ◽  
Qualitative Interviews ◽  
Cardiothoracic Surgery ◽  
University Hospital ◽  
Major Surgery ◽  
Biomedical Data ◽  
Randomised Controlled

Abstract Background Cardiothoracic surgical outcomes are poorer in people with diabetes compared with those without diabetes. There are two important uncertainties in the management of people with diabetes undergoing major surgery: (1) how to improve diabetes management in the weeks leading up to an elective procedure and (2) whether that improved management leads to improved postoperative outcomes. The aim of this study was to develop and pilot a specialist diabetes team-led intervention to improve surgical outcomes in people with diabetes. Design Open pilot feasibility study Setting Diabetes and cardiothoracic surgery departments, University Hospital Southampton NHS Foundation Trust Participants Seventeen people with diabetes undergoing cardiothoracic surgery Intervention Following two rapid literature reviews, a prototype intervention was developed based on a previously used nurse-led outpatient intervention and tested. Primary outcome Feasibility and acceptability of delivering the intervention Secondary outcomes Biomedical data were collected at baseline and prior to surgery. We assessed how the intervention was used. In depth qualitative interviews with participants and healthcare professionals were used to explore perceptions and experiences of the intervention and how it might be improved. Results Thirteen of the 17 people recruited completed the study and underwent cardiothoracic surgery. All components of the OCTOPuS intervention were used, but not all parts were used for all participants. Minor changes were made to the intervention as a result of feedback from the participants and healthcare professionals. Median (IQR) HbA1c was 10 mmol/mol (3, 13) lower prior to surgery than at baseline. Conclusion This study has shown that it is possible to develop a clinical pathway to improve diabetes management prior to admission. The clinical and cost-effectiveness of this intervention will now be tested in a multicentre randomised controlled trial in cardiothoracic centres across the UK. Trial registration ISRCTN; ISRCTN10170306. Registered 10 May 2018.

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