A Context-Aware Authorization Model for Process-Oriented Personal Health Record Systems

2011 ◽  
pp. 46-65
Author(s):  
Eleni Mytilinaiou ◽  
Vassiliki Koufi ◽  
Flora Matamateniou ◽  
George Vassilacopoulos
Keyword(s):  
Care Delivery ◽  
Personal Health Record ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Information Support ◽  
Personal Health ◽  
Health Record ◽  
Healthcare Organizations ◽  
Process Oriented

Healthcare delivery is a highly complex process involving a broad range of healthcare services, typically performed by a number of geographically distributed and organizationally disparate healthcare providers requiring increased collaboration and coordination of their activities in order to provide shared and integrated care. Under an IT-enabled, patient-centric model, health systems can integrate care delivery across the continuum of services, from prevention to follow-up, and also coordinate care across all settings. In particular, much potential can be realized if cooperation among disparate healthcare organizations is expressed in terms of cross-organizational healthcare processes, where information support is provided by means of Personal Health Record (PHR) systems. This chapter assumes a process-oriented PHR system and presents a security framework that addresses the authorization and access control issues arisen in these systems. The proposed framework ensures provision of tight, just-in-time permissions so that authorized users get access to specific objects according to the current context. These permissions are subject to continuous adjustments triggered by the changing context. Thus, the risk of compromising information integrity during task executions is reduced.

An Approach to Participative Personal Health Record System Development

2010 ◽  
Vol 2 (4) ◽  
pp. 1-16
Author(s):  
Vasso Koufi ◽  
Flora Malamateniou ◽  
George Vassilacopoulos
Keyword(s):  
System Development ◽  
Care Delivery ◽  
Personal Health Record ◽  
Healthcare Delivery ◽  
Radical Change ◽  
User Participation ◽  
Personal Health ◽  
Health Record ◽  
Record System ◽  
Behavioral Issues

Healthcare delivery is undergoing radical change in an attempt to meet increasing demands in the face of rising costs. Among the most intriguing concepts in this effort is shifting the focus of care management to patients by means of Personal Health Record (PHR) systems which can integrate care delivery across the continuum of services and also coordinate care across all settings. However, a number of organizational and behavioral issues can delay PHR adoption. This chapter presents a general approach to breaking down barriers that exist at the level of individual healthcare professionals and consumers. According to this approach, user participation in PHR system development is considered essential for achieving systems implementation success. Realizing a participative PHR system development, where users are full members of the development team, requires not only choosing an appropriate methodology but also organizing the participation process in a way that is tailored to the particular situation in order to achieve the desired results.

scholarly journals A worker-centered personal health record app using Fast Healthcare Interoperability Resources and national healthcare datasets: A design and development study (Preprint)

2021 ◽  
Author(s):  
Hyun Sang Park ◽  
Kwang Il Kim ◽  
Ho-Young Chung ◽  
Sung Moon Jeong ◽  
Jae Young Soh ◽  
...  
Keyword(s):  
Occupational Health ◽  
Health Information ◽  
Personal Health Record ◽  
Healthcare Services ◽  
Usability Evaluation ◽  
Economic Losses ◽  
Personal Health ◽  
Health Record ◽  
Medical Checkup ◽  
National Healthcare

BACKGROUND Personal Health Record (PHR) is a healthcare technology that can be used to support workplace health promotion, and prevent social and economic losses related to workers’ health management. PHR services can not only ensure interoperability, security, privacy, and data quality, but also consider the user's perspective in their design. OBJECTIVE This study aimed to design and develop a PHR app using Fast Healthcare Interoperability Resources (FHIR) and national healthcare datasets to provide worker-centered, interconnected PHR services. METHODS This study considered the user's perspective using the Human-Centered Design (HCD) methodology to develop a PHR app suitable for occupational health. A prototype was developed by analyzing quantitative and qualitative data collected from workers and an expert group, following which a usability evaluation was performed. We structured the workers’ PHR items based on the analyzed data and then ensured structural and semantic interoperability using FHIR, Systematized Nomenclature of Medicine-Clinical Terms (SNOMED-CT), and logical observation identifiers names and codes (LOINC). This study integrated workers’ health information that was scattered across different Korean institutions through a linkage method, and workers’ PHRs were managed through a cloud server using Azure API for FHIR. RESULTS In total, 562 workers participated in the quantitative study. The preferred data items for the PHR were medication, number of steps walked, diet, blood pressure, weight, and blood glucose. The preferred functions were accessing medical checkup results, content provision for health information, consultation record inquiry, and teleconsultation. The worker-centered PHR app collected data on topics such as life-logs, vital signs, and medical checkup results; offered healthcare services such as reservation and teleconsultation; and provided occupational safety and health information through material safety data sheet search and health questionnaires. The app reflected the improvements regarding user convenience and app usability that were proposed by 19 participants (7 experts and 12 end-users) who partook in the usability evaluation. The After Scenario Questionnaire (ASQ) was evaluated at 5.90 (± 0.34) out of 7, and the System Usability Scale (SUS) was evaluated at 88.7 (± 4.83) out of 100. CONCLUSIONS The worker-centered PHR app integrates workers’ health information that is scattered across different institutions, providing a variety of healthcare services from linked institutions through workers’ shared PHR. This app is expected to allow workers to have autonomy over their health information and support medical personnel’s decision making regarding workers’ health in the workplace. Particularly, the PHR app we developed would provide solutions for the major challenges of PHR, and its design, which would consider the user's perspective, thereby satisfying the prerequisites for its utilization in occupational health.

Application of the Relationship-Based Care Model to Improve Health Outcomes via the Electronic Personal Health Record

2012 ◽  
Vol 18 (1) ◽  
pp. 30-33 ◽  
Author(s):  
Toni Hebda ◽  
Carol Patton
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Interprofessional Collaboration ◽  
Care Delivery ◽  
Personal Health Record ◽  
Personal Health ◽  
Health Record ◽  
Electronic Personal Health Record ◽  
Relationship Based Care ◽  
The Relationship

This article examines the metaparadigm of the relationship-based care (RBC) model in health care delivery, delineates selected characteristics of the electronic personal health record (ePHR), provides an example of how RBC applies to integration of the ePHR in the health care delivery setting, discusses the utility of RBC for interprofessional collaboration using the ePHR, and examines how application of RBC in conjunction with the ePHR has the potential to significantly improve patient outcomes.

Requirements for a mobile personal health record to improve cardiovascular healthcare services

2017 ◽  
Author(s):  
Sofia Ouhbi ◽  
Ali Idri ◽  
Rachid Hakmi ◽  
Halima Benjelloun ◽  
José Luis Fernández-Alemán ◽  
...  
Keyword(s):  
Personal Health Record ◽  
Healthcare Services ◽  
Personal Health ◽  
Health Record

scholarly journals Defining Access Management in Healthcare Delivery Organizations

2019 ◽  
Author(s):  
Susanne Hempel ◽  
Lara G. Hilton ◽  
Susan Stockdale ◽  
Peter Kaboli ◽  
Isomi Miake-Lye ◽  
...  
Keyword(s):  
Management Practice ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Access Management ◽  
Healthcare Organizations ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Care Access ◽  
Evidence Review

Abstract Background: Managing patient access to care in healthcare delivery organizations is complex, yet instrumental in shaping patient healthcare experiences. Conceptual work to understand the dimensions of access and access management is critical for improvement initiatives. This work aims to advance primary care access management practice and research to support healthcare delivery organizations. Methods: We convened a stakeholder panel, informed by evidence review, to establish access and access management definitions. Stakeholders were selected based on a patient-centered framework and included patients, healthcare providers, policy makers, product makers, payers, and purchasers of healthcare. Methods included evidence review; written surveys; in-person stakeholder panel discussions; and concurrent sub-panels to establish recurring, cross-panel themes. Results: Literature review results showed variation in access concept definition but consistent use of the temporal measure “time to third next available appointment” as an indicator of access. Panel deliberations highlighted the importance of patient-centeredness and resulted in three comprehensive definitions: 1) “ Access management encompasses the set of goals, evaluations, actions and resources needed to achieve patient-centered healthcare services that maximize access for defined eligible populations of patients; ” 2) “ Optimal access management engages patients, providers, and teams in continuously improving care design and delivery to achieve optimal access;” and 3) “ Optimal access balances considerations of equity, patient preferences, patient needs, provider and staff needs, and value.” Conclusions: Access to healthcare is substantially determined by how healthcare delivery organizations manage it. The developed concepts of access management suggest that access management, improvement initiatives, and research studies require ongoing attention to organizational processes and multiple relevant outcomes. Healthcare organizations and researchers can use the definitions as starting points for initiatives to improve access management and evaluations of access initiative success.

scholarly journals A Longitudinal Perspective on User Uptake of an Electronic Personal Health Record for Diabetes, With Respect To Patient Demographics

2021 ◽  
pp. 193229682110057
Author(s):  
Nicholas T Conway ◽  
Michael Bluett ◽  
Cathy Shields ◽  
Andrew Taylor ◽  
Deborah J Wake ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Health Inequalities ◽  
Personal Health Record ◽  
Healthcare Providers ◽  
Personal Health ◽  
Health Record ◽  
Potential Health ◽  
Demographic Groups ◽  
Electronic Personal Health Record ◽  
Chi Squared

Introduction: The growing prevalence of diabetes has increased the need for scalable technologies to improve outcomes. My Diabetes My Way (MDMW) is an electronic personal health record (ePHR) available to all people with diabetes in Scotland since 2010, associated with improved clinical outcomes among users. MDMW pulls data from a national clinician-facing informatics platform and provides self-management and educational information. This study aims to describe MDMW user demographics through time with respect to the national diabetes population, with a view to addressing potential health inequalities. Methods: Aggregate data were obtained retrospectively from the MDMW database and annual Scottish Diabetes Survey (SDS) from 2010 to 2020. Variables included diabetes type, sex, age, socioeconomic status, ethnicity, and glycemic control. Prevalence of MDMW uptake was calculated using corresponding SDS data as denominators. Comparisons between years and demographic sub-groups were made using Chi- Squared tests. Results: Overall uptake of MDMW has steadily increased since implementation. By 2020, of all people with T1D or T2D in Scotland, 13% were fully enrolled to MDMW (39,881/312,326). There was proportionately greater numbers of users in younger, more affluent demographic groups (with a clear social gradient) with better glycemic control. As uptake has increased through time, so too has the observed gaps between different demographic sub-groups. Conclusions: The large number of MDMW users is encouraging, but remains a minority of people with diabetes in Scotland. There is a risk that innovations like MDMW can widen health inequalities and it is incumbent upon healthcare providers to identify strategies to prevent this.

scholarly journals Use and effects of patient online access to medical records in general practice through a personal health record in the Netherlands. A protocol for a mixed methods study. (Preprint)

2018 ◽  
Author(s):  
Maria Margaretha Tjitske Vreugdenhil ◽  
Rudolf Bertijn Kool ◽  
C van Boven ◽  
WJJ Assendelft ◽  
J.A.M Kremer
Keyword(s):  
General Practice ◽  
Patient Involvement ◽  
Personal Health Record ◽  
Healthcare Providers ◽  
Mixed Methods Study ◽  
Personal Health ◽  
Health Record ◽  
Practice Staff ◽  
Online Access ◽  
Staff Level

BACKGROUND In the Dutch healthcare system general practitioners have a central position and include in their electronic health records information from all healthcare providers who are involved with their patients. Online access to the summary record in general practice through a personal health record may increase patients’ insight into their conditions and help them to be involved in their care. OBJECTIVE We describe the protocol that we will use to investigate utilisation and effects on patient involvement experienced by patients and general practice staff of patient online access to the summary of their medical record in general practice through a personal health record. METHODS A multi-level mixed methods study in which the personal health record and online access to the summary record will be offered for six months to a random sample of 500 polypharmacy patients, 500 parents of under-fours and 500 adults who do not belong to the former two groups. At patient level a controlled before- and-after study will be conducted using surveys and concurrently qualitative data will be collected from focus groups, think-aloud observations and semi-structured interviews. At general practice staff level focus groups will be conducted at baseline and Q-methodology inquiry at the end of the study period. Main outcomes at patient level are barriers and facilitators for using the personal health record and summary record and changes in taking an active role in decision-making and management of care and medication adherence. Outcomes at general practice staff level are attitudes before and opinions after implementation of the intervention. Comparisons of patient characteristics and changes in outcomes related to patient involvement over the study period will be made between users and non-users of the intervention using chi-square tests and t-tests. Thematic content analysis of qualitative data will be done and the results will be used to interpret quantitative findings. RESULTS Results are expected to be published in 2019. CONCLUSIONS We expect that the findings of this study will be useful healthcare providers and healthcare organizations that consider introducing personal health records and online access to records or recently have done so. CLINICALTRIAL Netherlands Trial Registry NTR6395

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