electronic healthcare record
Recently Published Documents


TOTAL DOCUMENTS

75
(FIVE YEARS 20)

H-INDEX

9
(FIVE YEARS 1)

2021 ◽  
Vol 6 ◽  
pp. 349
Author(s):  
Paul H. Lee ◽  
Anna L. Guyatt ◽  
Catherine John ◽  
Altaf Ali ◽  
Xueyang Wang ◽  
...  

Background: New data collection in established longitudinal population studies provides an opportunity for studying the risk factors and sequelae of the novel coronavirus disease 2019 (COVID-19), plus the indirect impacts of the COVID-19 pandemic on wellbeing. The Extended Cohort for E-health, Environment and DNA (EXCEED) cohort is a population-based cohort (N>11,000), recruited from 2013 in Leicester, Leicestershire and Rutland. EXCEED includes consent for electronic healthcare record (EHR) linkage, spirometry, genomic data, and questionnaire data. Methods: Between May 2020 and July 2021, a new questionnaire was deployed in EXCEED, which captured COVID-19 symptoms, general physical and mental health, plus socioeconomic and environmental factors during the pandemic. An online system was developed to invite new participants to join EXCEED, with informed consent being provided online. New and existing participants then completed the COVID-19 questionnaire online. A subset of the new questionnaire respondents were invited to participate in COVID-19 serology substudies, using home antibody testing kits. Results: In total, 3,693 participants provided COVID-19 infection status (median age 62.9 (IQR 54.7-69.2), 58.9% female). Trends of monthly incidence proportions of COVID-19 in EXCEED (self-report or symptom-predicted) approximated local and national figures. Regression analysis of 2,768 participants with linked EHR data showed no obvious monotonic relationship between number of chronic diseases (of 16 pre-specified diseases) and COVID-19 infection. There were 2,144 participants with valid results from a kit allowing differentiation between antibodies due to vaccination or infection. Of these, 8.5% had results consistent with previous COVID-19 infection, and 85.9% had evidence of COVID-19 vaccination, but without evidence of infection. Conclusions: Enriching EXCEED with a new COVID-19 questionnaire and serology data may improve understanding of the risk factors, clinical sequelae and broader impacts of the COVID-19 pandemic in the general population. Controlled access to these data for bona fide researchers is via application to the EXCEED study.


Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1724
Author(s):  
Tasuku Okui ◽  
Jinsang Park ◽  
Akie Hirata ◽  
Naoki Nakashima

In recent years, the prescription trends of benzodiazepine receptor agonists (BZRAs) have not been investigated in Japan despite the publication of guidelines that promote cautious use of BZRAs. The prescription trend of BZRAs was assessed using the electronic healthcare records data of a University Hospital in Japan. The data from April 2009 to March 2021 were used. The following three types of outcomes were set: the proportion of patients who were prescribed with BZRAs within those prescribed hypnotics or anxiolytics; the mean number of the types of prescribed BZRAs, and the mean average daily doses of BZRAs. The same analysis was conducted for benzodiazepines (BZDs) and non-benzodiazepines (Z-drugs). As a result, we found that the proportions of patients prescribed BZRAs within those prescribed hypnotics or anxiolytics began to decrease, particularly from 2015 for patients aged <75 years and those aged ≥75 years. Further, the degree of decrease was larger in patients aged ≥75 years. The proportion for BZDs decreased particularly in the study period, and the proportion for Z-drugs also began to decrease approximately from 2016 in patients aged ≥75 years. The results suggest a possibility that guidelines affected the decreased prescriptions of BZRAs.


Author(s):  
Ryno Adlam ◽  
Bertram Haskins

The centralised architecture employed by electronic health records (EHRs) may constitute a single point of failure. From the perspective of availability, an alternative cloud-based EHR infrastructure is effective and efficient. However, this increased availability has created challenges related to the security and privacy of patients’ medical records. The sensitive nature of EHRs attracts the attention of cyber-criminals. There has been a rise in the number of data breaches related to EHRs. The infrastructure used by EHRs does not assure the privacy and security of patients’ medical records. Features of blockchain platforms, such as decentralisation, immutability, auditability, and transparency, may provide a viable means of augmenting or improving services related to the security of EHRs. This study presents a series of experimental data flow configurations to test the application of blockchain technology to aspects of EHRs. The insights gained from these experiments are founded on a theoretical base to provide recommendations for applying blockchain technology to services related to the security of EHR infrastructure. These recommendations may be employed by developers when redesigning existing EHR systems or deploying new EHR systems.


Author(s):  
Diana González‐Bermejo ◽  
Belén Castillo‐Cano ◽  
Alfonso Rodríguez‐Pascual ◽  
Mª. Félix García‐Martín ◽  
Arturo Álvarez‐Gutiérrez ◽  
...  

2021 ◽  
Vol 26 (4) ◽  
pp. 393-402
Author(s):  
Katru Rama Rao ◽  
Satuluri Naganjaneyulu

Healthcare data is very sensitive as many healthcare organizations will be very reluctant to share health data. However, sharing the healthcare data is having many more uses for both the patients as well as the research institutions too. Moreover, the existing Electronic Healthcare Record (EHR) management system will be stored in the central database in the form of plaintext. Whenever the data needs to be accessed from the database, the users will be requesting the required EHRs. However, this mechanism possesses the several challenges such as single point of failure, takes more time for user identification, interoperability issues, data recoverability issues, lack of privacy and security. This paper mainly focuses on providing security for the healthcare data, which can be shared among the various health institutions. Authentication and authorization are provided by establishing multiple certification authorities on the permissioned healthcare blockchain network. In this proposed model data integrity is also achieved by the concept of hashing of the electronic health records rather than storing it directly onto the permissioned healthcare block chain network.


2021 ◽  
Author(s):  
Kamatamu Amanda Mbonye ◽  
Alireza Yazdi ◽  
Shane Cashin ◽  
Nikhil Ahluwalia ◽  
Nabila Laskar ◽  
...  

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Ella J Marson ◽  
Adam H Botkai ◽  
Jamie J Coleman ◽  
Felicity Evison ◽  
Jolene Atia ◽  
...  

Abstract Background The COVID-19 pandemic has introduced further challenges into Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions. Existing evidence suggests success rates for CPR in COVID-19 patients is low and the risk to healthcare professionals from this aerosol-generating procedure complicates the benefit/harm balance of CPR. Methods The study is based at a large teaching hospital in the United Kingdom where all DNACPR decisions are documented on an electronic healthcare record (EHR). Data from all DNACPR/TEAL status forms between 1st January 2017 and 30th April 2020 were collected and analysed. We compared patterns of decision making and rates of form completion during the 2-month peak pandemic phase to an analogous period during 2019. Results A total of 16,007 forms were completed during the study period with a marked increase in form completion during the COVID-19 pandemic. Patients with a form completed were on average younger and had fewer co-morbidities during the COVID-19 period than in March-April 2019. Several questions on the DNACPR/TEAL forms were answered significantly differently with increases in patients being identified as suitable for CPR (23.8% versus 9.05%; p &lt; 0.001) and full active treatment (30.5% versus 26.1%; p = 0.028). Whilst proportions of discussions that involved the patient remained similar during COVID-19 (95.8% versus 95.6%; p = 0.871), fewer discussions took place with relatives (50.6% versus 75.4%; p &lt; 0.001). Conclusion During the COVID-19 pandemic, the emphasis on senior decision making and conversations around ceilings of treatment appears to have changed practice, with a higher proportion of patients having DNACPR/TEAL status documented. Understanding patient preferences around life-sustaining treatment versus comfort care is part of holistic practice and supports shared decision making. It is unclear whether these attitudinal changes will be sustained after COVID-19 admissions decrease.


Sign in / Sign up

Export Citation Format

Share Document