ABSTRACT
The beginning of EHR (Electronic Health Record) can be traced back to the development of the Medical Markup Language (MML) from 1995 to 2000. In 2001, EHR with MML as a database structure was developed and expanded to Kumamoto, Miyazaki, Tokyo, and Kyoto (Dolphin Project). After that, the need for medical information management at the national level was recognized, and the need for secondary use of medical information was also recognized, and in 2015, the national level version of the EHR, the “Millennial Medical Record Project” began. The number of connected medical institutions reached 106 in the four years up to FY2018. In December 2019, the Life Data Initiative, a general incorporated association, became the first certified company under the Next Generation Medical Infrastructure Law, and is operating with the aim of achieving independent profitability, including the EHR department, which does not depend on subsidies.
ABSTRACT
Actualmente, la gestión de datos en el departamento de oncología es compleja y requiere sistemas de información avanzados para procesar datos donde la información "ómica" debe integrarse junto con los datos clínicos del paciente para mejorar el análisis de datos y el proceso de toma de decisiones. Este trabajo de investigación presenta una experiencia práctica en este contexto. Se ha diseñado un Modelo Conceptual (MC) para desarrollar un Sistema de Información (SI) con el fin de gestionar datos clínicos, patológicos y moleculares de manera integral en el departamento de oncología de dos hospitales principales en Paraguay. Además, se han propuesto arquetipos basados en modelos para especificar la estrategia de interacción del usuario. El MC y los arquetipos asociados son la base para desarrollar un SI clínico con el fin de cargar -primero- y gestionar -segundo- todos los datos clínicos que requiere el dominio, mostrando cuán factible es el enfoque en la práctica y cuánto se mejora la gestión de datos. En este trabajo, queremos reforzar con esta experiencia real, cómo el uso correcto de un MC junto con los arquetipos ayuda a diseñar, desarrollar y administrar mejores sistemas de información, enfatizando la relevancia del dominio clínico seleccionado.
Currently, data management in oncology department is complex and requires advanced Information Systems (ISs) to process data where "omic" information should be integrated together with patient's clinical data to improve data analysis and decision-making process. This research paper reports a practical experience in this context. A Conceptual Model (CM) has been designed to develop an Information System (IS) in order to manage clinical, pathological, and molecular data in a holistic way at the oncology department of two main Hospitals in Paraguay. Additionally, model-based archetypes have been proposed to specify the selected user interaction strategy. The CM and its associated archetypes are the basis to develop a clinical IS in order to load -firstly- and manage -secondly- all the clinical data that the domain requires, showing how feasible the approach is in practice, and how much the corresponding clinical data management is improved. In this work, we want to reinforce with this real experience how using a CM along with archetypes correctly helps to design, develop and manage better information systems, emphasizing the relevance of the selected clinical domain.
ABSTRACT
Actualmente, la gestión de datos en el departamento de oncología es compleja y requiere sistemas de información avanzados para procesar datos donde la información "ómica" debe integrarse junto con los datos clínicos del paciente para mejorar el análisis de datos y el proceso de toma de decisiones. Este trabajo de investigación presenta una experiencia práctica en este contexto. Se ha diseñado un Modelo Conceptual (MC) para desarrollar un Sistema de Información (SI) con el fin de gestionar datos clínicos, patológicos y moleculares de manera integral en el departamento de oncología de dos hospitales principales en Paraguay. Además, se han propuesto arquetipos basados en modelos para especificar la estrategia de interacción del usuario. El MC y los arquetipos asociados son la base para desarrollar un SI clínico con el fin de cargar -primero- y gestionar -segundo- todos los datos clínicos que requiere el dominio, mostrando cuán factible es el enfoque en la práctica y cuánto se mejora la gestión de datos. En este trabajo, queremos reforzar con esta experiencia real, cómo el uso correcto de un MC junto con los arquetipos ayuda a diseñar, desarrollar y administrar mejores sistemas de información, enfatizando la relevancia del dominio clínico seleccionado.
Currently, data management in oncology department is complex and requires advanced Information Systems (ISs) to process data where "omic" information should be integrated together with patient's clinical data to improve data analysis and decision-making process. This research paper reports a practical experience in this context. A Conceptual Model (CM) has been designed to develop an Information System (IS) in order to manage clinical, pathological, and molecular data in a holistic way at the oncology department of two main Hospitals in Paraguay. Additionally, model-based archetypes have been proposed to specify the selected user interaction strategy. The CM and its associated archetypes are the basis to develop a clinical IS in order to load -firstly- and manage -secondly- all the clinical data that the domain requires, showing how feasible the approach is in practice, and how much the corresponding clinical data management is improved. In this work, we want to reinforce with this real experience how using a CM along with archetypes correctly helps to design, develop and manage better information systems, emphasizing the relevance of the selected clinical domain
Subject(s)
Electronic Health RecordsABSTRACT
OBJECTIVES: The aim of this study is to explore the enabling factors associated with readiness in Electronic Health Record (EHR) implementation and to identify the barriers related to readiness regarding the situation of primary health cares in developed and developing countries. METHODS: A narrative review of open-source literature was conducted using the ProQuest, ScienceDirect, MEDLINE, and PMC databases to identify the enabling factors and barriers to EHR readiness. The keywords applied were ‘electronic health record’, ‘readiness’, ‘primary health care’, and ‘primary care’. RESULTS: Some barriers were found that may affect readiness, specifically individual barriers and organizational barriers. In developing countries, organizational barriers such as a lack of skilled manpower, insufficient senior management, and a lack of interaction among team members were the common barriers, while in developed countries individual barriers such as unfamiliarity with new systems and a lack of time to use computers were frequently found as barriers to readiness. CONCLUSIONS: This study summarized the enabling factors and barriers with regard to EHR readiness in developed and developing countries.
Subject(s)
Causality , Developed Countries , Developing Countries , Electronic Health Records , Primary Health CareABSTRACT
OBJECTIVES: The objective of this study was to investigate the relationship between the level of Electronic Medical Record (EMR) system adoption and healthcare information technology (IT) infrastructure. METHODS: Both survey and various healthcare administrative datasets in Korea were used. The survey was conducted during the period from June 13 to September 25, 2017. The chief information officers of hospitals were respondents. Among them, 257 general hospitals and 273 small hospitals were analyzed. A logistic regression analysis was conducted using the SAS program. RESULTS: The odds of having full EMR systems in general hospitals statistically significantly increased as the number of IT department staff members increased (odds ratio [OR] = 1.058, confidence interval [CI], 1.003–1.115; p = 0.038). The odds of having full EMR systems was significantly higher for small hospitals that had an IT department than those of small hospitals with no IT department (OR = 1.325; CI, 1.150–1.525; p < 0.001). Full EMR system adoption had a positive relationship with IT infrastructure in both general hospitals and small hospitals, which was statistically significant in small hospitals. The odds of having full EMR systems for small hospitals increased as IT infrastructure increased after controlling the covariates (OR = 1.527; CI, 1.317–4.135; p = 0.004). CONCLUSIONS: This study verified that full EMR adoption was closely associated with IT infrastructure, such as organizational structure, human resources, and various IT subsystems. This finding suggests that political support related to these areas is indeed necessary for the fast dispersion of EMR systems into the healthcare industry.
Subject(s)
Humans , Dataset , Delivery of Health Care , Electronic Health Records , Health Care Sector , Hospitals, General , Korea , Logistic Models , Surveys and QuestionnairesABSTRACT
The development of Electronic Health Records (EHR) is a necessary trend of global digitization.The paper introduces the building of EHR and relevant national policies,states the construction practice of EHR in Deyang,Shanghai,Beijing,Guangzhou,Nanchang,etc.,outlooks further development,and provides helpful references for the construction of EHR of other province and city.
ABSTRACT
The semantic construction of EHR information model has experienced a developmental process from es-tablishing core data set and modeling to two-level modeling, which are usually used in combination in construction of information models at present. In general, the framework (reference model), necessary elements (core data set) and technical specifications for EHR information model were first established when its top architecture was de-signed, which was followed by the establishment of different medical concepts, subjects and special archetypes for different departments according to the framework standards.
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The paper introduces the overall architecture,technique construction,functional modules and application effects of the system.Using the B/S mode,it designs and develops the network platform for the management of Electronic Health Records (EHR) of veteran cadres.This platform fills the gap in the informatization development in sanatoriums for retired cadres,and facilitates the provision of individualized medical service and health guarantee for veteran cadres.
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Papers on electronic health record ( EHR) were retrieved from CNKI core journals database and CNKI patents full-text database.The papers on HER and patent literature were comparatively analyzed by co-words clus-tering analysis, which showed that technologies used in community health service, remote medical treatment, HL7 and XML are the promise technologies used in EHR.
ABSTRACT
Big data of electronic health records ( EHR) are faced with the challenge of both information security and privacy protection in theInternet+ era. The bottleneck of information technology in centralized and relational databases-covered EHR was described, application of block chain technology in decentralization, privacy protec-tion and gene sequencing was elaborated in order to usher in new ideas for the construction of EHR.
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〔Abstract〕 The paper retrieves different difinitions of Electronic Medical Records ( EHR) through PubMed database, domestic and international standards, analyzes the terms and definitions of EMR using concept analysis method.The definitions are divided into 3 at-tributes namely, noun, characteristics and objective, providing ideas for developing EMR system at various levels in China.
ABSTRACT
OBJECTIVE: The aim of the study was to identify factors influencing the willingness of healthcare consumers to use personal health records (PHR) and to investigate the requirements for PHR services. METHODS: A face-to-face interview was conducted with 400 healthcare consumers from the 3rd-18th of July 2008 using a structured questionnaire. To identity factors affecting the willingness to use PHR and to pay for PHR services, logistic regression analysis was performed. To investigate the requirements for PHR services according to the willingness of the consumers to use PHR and to pay for PHR services, t-test analysis was conducted. RESULTS: Of the 400 healthcare consumers, 239 (59.8%) were willing to use PHR and 111 (27.8%) were willing to pay for PHR services. The willingness to use PHR was higher in the elderly, those with a disease, and those with experience to use health information on the Internet, and the willingness to pay for PHR services was higher in those with a relatively high income (p6,000,000 won and 4,500,000-6,000,000 won, respectively, than in those earning <1,500,000 won, and approximately 1.96 times (95% CI=1.18-3.27) higher in those with experience using health information on the Internet than in those without experience. The willingness to pay for PHR services was approximately 5.9 times (95% CI=1.84-19.06) higher in those with an income of 4,500,000-6,000,000 won than in those with an income <1,500,000 won (p<0.05). Demands for test results, medication history, family history, problem list, genetic information, clinical trial information, and social history were significantly higher in those with a willingness to use PHR and those with a willingness to pay for PHR services than in those without willingness to use PHR and those without a willingness to pay for PHR services (p<0.05). Compared to those without a willingness to pay for PHR services, those with a willingness to pay for PHR services showed a significantly higher demand for all the functions (p<0.01). CONCLUSION: The results of this study suggest that healthcare consumers potentially have a considerable demand for PHR services, and although it is not recognized and used widely yet, PHR is an essential service. In order to enhance people's awareness of PHR and to promote people to use PHR services, we need efforts and initiatives to execute campaigns and education for people to ease access to the service, and to reduce the gap in service utilization skills.
Subject(s)
Aged , Humans , Delivery of Health Care , Electronic Health Records , Family Characteristics , Health Records, Personal , Internet , Korea , Logistic Models , Surveys and QuestionnairesABSTRACT
The demand for high quality, safe and quantity for healthcare is increasing while the resources remain unchanged. Adoption of better information technology can achieve significant improvements in quality and safety of healthcare delivery in the environment of increasing pressure on healthcare systems. This will also contribute to contain healthcare cost in the long run. Many developed and developing countries in the world pay attention on appropriate use of information communication technology(ICT) in healthcare domain. Some countries such as the US, UK, Australia, Canada and others adopted strategic plan of National Health Information Infrastructure for next 10 years. The objectives for ICT application of developed countries are summarized as: - To improve access to clinical records; - To reduce clinical errors and improve safety of patients; - To improve access to quality information on health for patients and healthcare professionals; - To improve efficiency of healthcare processes; and - To contain healthcare costs. The core of the ICT adoption in health is to have universal availability of electronic health and clinical records(EHR) at the point of care. This review, therefore, briefly described the definition, architectures, essential functionalities and applicable standards of EHR.