Analyzing Health Information Technology and Electronic Medical Record System-Related Patient Safety Incidents Using Data from the Korea Patient Safety Reporting and Learning System

Purpose: At present, there are a variety of serious patient safety incidents related to problems in health information technology (HIT), specifically involving electronic medical records (EMRs). This emphasizes the need for an enhanced electronic medical record system (EMRS). As such, this study analyzed both the nature of and potential to prevent incidents associated with HIT/EMRS based on data from the Korea Patient Safety Reporting and Learning System (KOPS).Methods: This study analyzed patient safety incidents submitted to KOPS between August 2016 and December 2019. HIT keywords were used to extract HIT/EMRS incidents. Each case was reviewed to confirm whether the contributing factors were related to HIT/EMRS (HIT/EMRS-related incidents) and if the incident could have been prevented (HIT/EMRS-preventable incidents). The selected reports were summarized for general clarity (e.g., incident type, and degree of harm).Results: Of the 25,515 obtained reports, 2,664 incidents (10.4%) were HIT-related, while 2,525 (9.9%) were EMRS-related. HIT/EMRS-related incidents were the third largest type of incident followed by 'fall' and 'medication incidents.' More than 80% of HIT/EMRS-related incidents were medication-related, accounting for approximately one-third of the total number of medication incidents. Approximately 10% of HIT/EMRS-related incidents resulted in patient harm, with more than 94% of these deemed as preventable; further, sentinel events were wholly preventable.Conclusion: This study provides basic data for improving EMR use/safety standards based on real-world patient safety incidents. Such improvements entail the establishment of long-term plans, research, and incident analysis, thus ensuring a safe healthcare environment for patients and healthcare providers.

Perioperative Nurses’ Perceptions Pre-Implementation of an Electronic Medical Record System

The use of electronic medical record (EMR) systems is transforming health care delivery in hospitals. Perioperative nurses work in a unique high-risk health setting, hence require specific considerations for EMR implementation. This research explored perioperative nurses’ perceptions of facilitators and barriers to the implementation of an EMR in their workplace to make context-specific recommendations about strategies to optimise EMR adoption. Using a qualitative exploratory descriptive design, focus group data were collected from 27 perioperative nurses across three hospital sites. Thematic analyses revealed three themes: 1) The world is going to change; 2) What does it mean for me? and 3) We can do it, but we have some reservations. Mapping coded data to the Theoretical Domains Framework identified prominent facilitators and barriers, and informed recommended implementation strategies for EMR adoption by perioperative nurses.

Facilitators and Barriers to the Adoption of an Electronic Medical Record System by Intensive Care Nurses

Introducing new technology, such as an electronic medical record (EMR) into an Intensive Care Unit (ICU), can contribute to nurses’ stress and negative consequences for patient safety. The aim of this study was to explore ICU nurses’ perceptions of factors expected to influence their adoption of an EMR in their workplace. The objectives were to: 1) measure psychological factors expected to influence ICU nurses’ adoption of EMR, and 2) explore perceptions of facilitators and barriers to the implementation of an EMR in their workplace. Using an explanatory sequential mixed method approach, data were collected using surveys and focus groups. ICU nurses reported high scores for motivation, work engagement and wellbeing. Focus group analyses revealed two themes: Hope the EMR will bring a new world and Fear of unintended consequences. Recommendations relate to strategies for education and training, environmental restructuring and enablement. Overall, ICU nurses were optimistic about EMR implementation.

Development of Nursing Workflows and Device Requirement Principles with the Implementation of an Electronic Medical Record System

The past decade has seen the implementation of electronic medical record (EMR) systems being implemented across large-scale healthcare organisations throughout Australia. A first-time implementation of an organisational-wide EMR system required a multi-modal approach to the development of new nursing workflows and appropriate selection of hardware devices to ensure acceptance and adoption of the EMR. The aim of this work was to develop new nursing workflows and associated device requirement principles to allow for continuation of safe, high quality nursing care with an EMR implementation. The incorporation of multi-disciplinary consultations, an audit, observational study and clinical and governance stakeholder engagement was used to develop device requirement principles. This ensured development of standardised nursing workflows were successfully adopted throughout the organisation with the EMR implementation.

Authorized Shared Electronic Medical Record System with Proxy Re-Encryption and Blockchain Technology

With the popularity of the internet 5G network, the network constructions of hospitals have also rapidly developed. Operations management in the healthcare system is becoming paperless, for example, via a shared electronic medical record (EMR) system. A shared electronic medical record system plays an important role in reducing diagnosis costs and improving diagnostic accuracy. In the traditional electronic medical record system, centralized database storage is typically used. Once there is a problem with the data storage, it could cause data privacy disclosure and security risks. Blockchain is tamper-proof and data traceable. It can ensure the security and correctness of data. Proxy re-encryption technology can ensure the safe sharing and transmission of relatively sensitive data. Based on the above situation, we propose an electronic medical record system based on consortium blockchain and proxy re-encryption to solve the problem of EMR security sharing. Electronic equipment in this process is connected to the blockchain network, and the security of data access is ensured through the automatic execution of blockchain chaincodes; the attribute-based access control method ensures fine-grained access to the data and improves the system security. Compared with the existing electronic medical records based on cloud storage, the system not only realizes the sharing of electronic medical records, but it also has advantages in privacy protection, access control, data security, etc.

P070 THE IMPACT OF THE COVID 19 PANDEMY ON HERNIA SURGERY IN UNIVERSITY HOSPITAL IN CZECH REPUBLIC

Aim The SARS- CoV-2 pandemic has greatly affected health care systems worldwide, including the Czech Republic. However, the degree to which Covid-19 has impacted on hernia surgery is unknown. The aim of this study was to review the hernia surgery workload in a large university teaching hospital department. Material and Methods A computer based medical record system was used to identify all patients undergoing elective and emergency hernia repair of all types from March 1 to November 30, 2020 and for a similar time period in 2019 at the Motol University Hospital, Prague. Results 194 elective hernia operations were undertaken over the study period in 2020, a reduction from the 285 over a similar period in 2019. The number of emergency hernia operations in 2020 was 13 compared to 25 in 2019. Conclusions The SARS –CoV- 2 pandemic has reduced both the number of elective and emergency hernia operations in 2020 compared to 2019. Time will tell if the reduced elective workload will subsequently increase the emergency hernia workload during the recovery from the pandemic.