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Background and Objective@#The adoption of electronic medical records (EMRs) in the Philippines has been initiated and adjusted since the last decade through the Philippine eHealth Agenda framework. EMRs are known to improve clinical management and have been widely adopted in advanced economies. However, empirical research on EMR implementation remains limited. This study aims to determine how public primary health care facilities in the country interacted with EMRs before and during the COVID-19 pandemic to understand EMR adoption.@*Methods@#More than 270,000 records generated from EMR usage logs in six rural primary health facilities in Western Visayas were analyzed. Average time of EMR use during work hours was estimated and compared before and during the pandemic. EMR adoption based on specific EMR features used was also determined. @*Results@#In 2020, EMR use ranged from less than one hour to more than eight hours in selected rural health units (RHUs). There was a statistical increase and decrease in use of features during the pandemic. Some EMR users had efficient use indicated by complete adoption of EMR features although such features were not as frequently used as those pertaining to basic adoption. @*Conclusion@#This study demonstrates that for EMR use in rural settings, progressive use from basic to complete may vary among users. Public health emergencies such as a pandemic may also affect EMR use. Future research directions should explore other mechanisms which affect user behavior and encourage full adoption of technology such as use of games or non-monetary incentives.
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AdoptionABSTRACT
Objective To develop a method for the simultaneous determination of 15mycotoxins in peanuts by ultra high performance liquid chromatography-tandem mass spectrometry with QuEChERS EMR-Lipid approach and stable isotope dilution. Methods The samples were extracted by 2% formic acid acetonitrile-water (50 : 50, V/V) and then purified with QuEChERS EMR-Lipid approach.The mycotoxins were fully separated on a pentafluorophenyl column under a gradient elution with methonal-0.01%formic acid aqueous solution.The mycotoxins were analyzed by UPLC-MS/MS with multiple reaction monitoring (MRM) mode and quantified by isotope internal standard method. Results Fifteen mycotoxins had good linear relationship in the certain correlation ranges with the correlation coefficients all above 0.995 and the detection limits were 0.1－10 μg/kg.The mean recoveries ranged from 81.2% to 115.3% with RSD (n=6) varying from 2.1% to 10.7%. Conclusion The method is simple, highly sensitive, practical, and proves to be suitable for quantitative analysis of 15 mycotoxins in peanuts.
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Mobile phone is an inevitable part of ones life. Once been luxury has now become necessity. It’s been used by all age group people for different application apart from calling and texting. The advance in mobile technology has brought many new applications using mobile. But while using cell phone for talking or being connected to someone the user gets exposed to harmful Electro Magnetic Radiations. The exposure rate to these radiations vary from handset to handset. When cell phones are used in close proximity to human body, the radiations emitted from cell phones penetrate deep inside the human skin. Penetrated radiations produce induced electric field inside the body, resulting in absorption of power, which can be analyzed using a parameter called specific absorption rate (SAR). But still one question arises in mind that are people really aware of Safety standard especially SAR value. What does SAR value mean? It’s the specific absorption ratio measure of amount of radio frequency intensity or energy absorbed by body while connected on cellular network. It is defined as the power absorbed per mass of tissue and has units of watts per kilogram (W/kg) and in a way defines safety range of mobile handset .This study aims to measure the knowledge and awareness of SAR value of handset and the factors that influence awareness of SAR value. This is the largest sample study about mobile usage and awareness of SAR amongst mobile users .
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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.
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Humans , Dataset , Delivery of Health Care , Electronic Health Records , Health Care Sector , Hospitals, General , Korea , Logistic Models , Surveys and QuestionnairesABSTRACT
Described in the paper are the outcomes and progress of the MEG standards in six years, along with the imperativeness and revision pathways of the standards for the purpose of further promoting the level of HIT development in China.
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Objective To study the effective text mining methods by mining the information in electronic medical records( EMR) in order to achieve their value in support of decision-making. Methods Two thousand and five hundred EMR of gastric cancer patients were randomly divided into training group ( n＝1500) and testing group( n＝1000) . The words in the text of EMR of training group were identified using dictionary in combination with statistical methods. The segmented words were clustered according to the co-occurrence frequency of each segmented word and the treatment plan extracted from EMR. The matched number of words in each cluster from the text of EMR of training group was recorded. A decision-making support model of Bayes discrimination function was established according to the matched number of words in each cluster from the text of EMR of training group and treatment plan to verify the EMR in training group and to evaluate the words segmenting methods and the discrimination model. Results Fifty randomly selected RME showed that the recall rate, accurate rate and F-1 value of segmented words were 74. 24%, 82.30% and 78.06% respectively. The accurate rate of the established discrimination model was 62% for the identification of EMR of testing group when the segmented words were clustered into 5 categories. Conclusion The efficiency of dictionary in combination with statistical methods is good for identifying words from the text of EMR. Cluster-based text mining of EMR can achieve the decision-making support value of EMR, but the accuracy of the established decision-making support model is not as high as expected. Further study is thus necessary to identify the words from the text of EMR and the process of segmented words in establishing the decision-making support model.
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Objective: To gradually implement electronic signature in medical records included outpatient prescription, examination report, test report, hospitalization record and others so as to realize paperless archiving for electronic medical record(EMR) of hospital. Methods: The national law of electronic signature was used as the legal basis and the electronic signature technique was used as the technological foundation to establish electronic signature mechanism about signature, encryption and authentication. The dean who was responsible for informatization of hospital was appointed group leader, and section chief of each relevantly functional department, director of clinical department and head nurse were members of the group. Through perfect the leading group for informatization to ensure electronic signature was effectively implemented. Results: Through adhered to some principles included top-level design, gradual implementation and from easiness to difficulty, the electronic signatures about out-patient prescription, examination reports, test reports, documents of medical record and the paperless archiving for hospitalization record were realized after technique development of many years. Conclusion: The implementation of electronic signature can ensure the legality and authenticity of EMR, and the traceability of modified behavior. And it has realized paperless management for medical archives and has strengthened internal sharing of medical information in hospital.
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The paper preprocesses the data including basic information,admission and discharge record and progress note of diabetes Electronic Medical Records (EMR),implementing decision tree,Artificial Neural Network (ANN),Naive bayesian and K-Nearest Neighbor (KNN) classifications respectively on data that have been processed with Weka 3.9.The result shows that Naive bayesian classification,which is superior to the others in predicting and classifying such data,can provide basis for the classification and prediction of diabetes.
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Taking Hebei General Hospital as an example,the paper carries out sample comparison on the overall quality of final operation medical records before and after the implementation of step-by-step quality control,analyzes the defects of Electronic Medical Records (EMR) and the causes of them during perioperative period,and expatiates on the necessity of step-by-step quality control of EMR,the setting of specific quality control points and its advantages.
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Taking Chongqing Three Gorges Central Hospital as an example,the paper discusses on the practice process of building hospital information platform centering on Electronic Medical Records (EMR).It elaborates on problems in the building of hospital information by focusing on platform planning,building content and specific application,of which,building content includes aspects like restructuring the system and standardization building.
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The paper introduces the concept of blockchain and its impact on the development of medical industry,solves problems including medical data management,sharing and privacy based on decentralization,non-tampering and traceability of blockchain,points out problems and challenges confronting the combination of blockchain with medical industry,feasible solutions and outlooks into future development as well as providing reference for better support for medical studies and precision care.
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Objective To investigate the influence of EMR and ESD of endoscopic surgery on perioperative clinical parameters, complete resection rate and complications of patients with neuroendocrine tumors of digestive tract. Methods 40 patients with neuroendocrine tumors of digestive tract were chosen from June 2009 to June 2016 and randomly divided into 2 groups: A group (20 patients) with EMR and B group (20 patients) with ESD; and the operation time, the treatment cost, the lesion size, the lesion thickness, the complete resection of tumor, the negative rate of vertical margin and the complication incidence of the two groups were compared. Results The operation time and the treatment cost of B group were significant better than A group (P < 0.05). There was no significant difference in the lesion size and the lesion thickness between the two groups (P < 0.05). The completed resection rate of B group were significant higher than A group (P < 0.05). There was no significant difference in the negative rate of vertical margin between the two groups (P < 0.05). The complication incidence of B group were significant higher than A group (P < 0.05). Conclusion EMR and ESD of endoscopic surgery in the treatment of patients with neuroendocrine tumors of digestive tract possess the same clinical effects; EMR application can efficiently shorten the operation time and decrease the economic burden and ESD application maybe helpful to reduce the complication risk.
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Objective To investigate the influence of EMR and ESD of endoscopic surgery on perioperative clinical parameters, complete resection rate and complications of patients with neuroendocrine tumors of digestive tract. Methods 40 patients with neuroendocrine tumors of digestive tract were chosen from June 2009 to June 2016 and randomly divided into 2 groups: A group (20 patients) with EMR and B group (20 patients) with ESD; and the operation time, the treatment cost, the lesion size, the lesion thickness, the complete resection of tumor, the negative rate of vertical margin and the complication incidence of the two groups were compared. Results The operation time and the treatment cost of B group were significant better than A group (P < 0.05). There was no significant difference in the lesion size and the lesion thickness between the two groups (P < 0.05). The completed resection rate of B group were significant higher than A group (P < 0.05). There was no significant difference in the negative rate of vertical margin between the two groups (P < 0.05). The complication incidence of B group were significant higher than A group (P < 0.05). Conclusion EMR and ESD of endoscopic surgery in the treatment of patients with neuroendocrine tumors of digestive tract possess the same clinical effects; EMR application can efficiently shorten the operation time and decrease the economic burden and ESD application maybe helpful to reduce the complication risk.
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Based on the big data of Electronic Medical Records (EMR),information retrieval and the deep learning method,an auxiliary diagnosis Question Answering (QA) system is designed.The paper introduces the design of general framework,EMR database,value network and policy-based network of the system,provides the system operation process.This system can not only help patients to examine their conditions independently,but also provide reference for doctors when they make the diagnosis and treatment schemes.
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Objectives To investigate the clinical, pathological and endoscopic characteristics of colorectal polyps treated by endoscopic mucosal resection (EMR), then evaluate its therapeutic effect and security, and analyze its significance in diagnosis and treatment. Methods Clinical and pathological data of 437 patients (687 lesions), who underwent EMR from August, 2014 to August, 2015 were collected. A retrospective analysis was made, and lesions were statistically analyzed by variables such as age, sex, endoscopic features and clinical and pathological characteristics, and so on, according to the group procedure of adenoma cancerization and 'high risk adenomas - low risk adenomas - non-adenoma polyps' to observe the curative effect and safety on EMR. Results 48.28% of the patients who received colonoscopy examines were detected with polyps, and 34.90% of them were operated EMR, including advanced adenomas, which were 17.08% of the total quantity. From non-adenoma to advanced adenoma, with a increasing possibility of carcinogenesis, the location of polyps are transferred from proximal colon to distal colon and lesions are readily to be pedunculated ones with a higher level of mucosal lobulation and other kinds of mucosal changing. The degeneration of the colorectum is associated with pedunculated polyps, distal colorectal polyps, the size (>1.0 cm), adenomas containing villous structures and mucosal lobulation. As for EMR treatment, the en bloc resection rate can reach as high as 99.70%, with a complication rate of 1.14%. Conclusions Some special characteristics can be found in the site and the endoscopic feature of advanced adenomas and degenerated adenomas. To polyps sizing in 0.5 ~ 3.0 cm, EMR with endoclips has a remarkable effect and a low complication incidence. It can reduce the process of colorectal adenoma degenerates to multiple colorectal adenocarcinoma, which can be regarded as an effective method to prevent and cure the colorectal carcinoma.
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Through the practice of outpatient doctor station cored by the outpatient Electronic Medical Records (EMR),the paper discusses the disadvantages of outpatient paper medical records and the advantages of outpatient EMR,summarizes the key points and difficulties in promoting outpatient EMR,and meanwhile points out to pay attention to the integration with other information system,data standardization,perfection of the management system,integrated consultation system and other issues in the practice process.
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The paper retrieves the Electronic Medical Records (EMR) literatures from the journals included in A Guide to the Core Journals of China and Citation Report of Chinese Sci-tech periodicals (core board) from 2012-2016,carries out bibliometric analysis from the aspects of time,source journals,citation status,high frequency keywords and so on,so as to obtain the study status and tendency of EMR in recent years.
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Based on the introduction to the clinical phenotype extraction technique,the paper conducts systematic review on the extraction of clinical phenotype from Electronic Medical Records (EMR) of diabetes by taking advantages of the clinical decision support technique,natural language processing technique and machine learning method,and indicates that the deep learning method can be used to extract clinical phenotype from the EMR data more effectively and accurately,help clinical researchers better conduct clinical tests,and improve the medical care level.
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Taking the Sixth Affiliated Hospital of Sun Yat-Sen University as an example,the paper gives detailed examples in clinical and scientific research fields to indicate that the effective utilization of medical data through function reconstruction of the Electronic Medical Records (EMR) system not only brings conveniences to clinical and scientific researchers,but also strengthens medical protection for patients.
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Debido al incremento exponencial de la información almacenada en las organizaciones, la Sociedad de la Información está siendo superada por la necesidad de nuevos métodos capaces de procesar la información y asegurar su uso productivo. Esto se hace lógicamente extensible a los centros hospitalarios, a partir del uso extendido de las Historias Clínicas en formato electrónico. Disponer de información sistematizada, gestionarla de forma eficiente y segura es esencial para garantizar mejores prácticas en salud. A esto se le añade la necesidad de soportar estándares que permitan el intercambio entre las instituciones de salud; específicamente HL7 se ha convertido en uno de los más utilizados debido a que proporciona el intercambio a partir del metalenguaje XML. En este trabajo se propone una metodología para el descubrimiento de conocimiento implícito en Historias Clínicas en formato semi-estructurado utilizando el contenido y la estructura de los mismos. Los principales resultados son: (1) La metodología para el agrupamiento de Historias Clínicas; (2) La interpretación de los resultados del agrupamiento para asistir la toma de decisiones diagnósticas; (3) La implementación del estándar HL7, para la manipulación de documentos médicos a partir de CDA(AU)
Due to the exponential increase of stored information the organizations, the information society is being overtaken by the need for new methods capable of processing information and ensuring its productive use. This is logically extended to the hospitals, from the widespread use of clinical histories in electronic format. To have systematized information, manage it efficiently and securely is essential to ensure better health practices. In addition, there is the need for standards to support the exchange among health institutions; specifically hl7 has become one of the most widely used because it provides the exchange from xml. In this paper is presented a methodology for the discovery of implicit knowledge in medical records with semi-structured format, using their content and structure. The main results are: (1) the methodology for the clustering of medical records; (2) the interpretation of the results of the clustering to assist diagnostic decision-making; (3) the implementation of the hl7 standard for handling medical records from CDA(AU)