Digital solutions for providing patients access to hospital-held health information: what are the design issues that need to be addressed?

A patient and whanau centred healthcare system includes patients having easy access to their health records when and where they need it. Accessible digital solutions providing patients with access to their health information, including hospital-held healthcare records, will support patients and whanau to be active and informed participants in their health. A Northern Region proof-of-concept, providing patients with electronic access to their hospital-held health information, identified several challenges in the design of such "portals". The purpose of this paper is to present a discussion of these challenges, and to present a review of the literature on how other countries and health settings have managed them. The review has led to recommendations around how delegated access, auditing access, adding and correcting of information, the timing of test result availability, and retrospective records should be handled. However, more investigation is required into the challenges surrounding how various types of more sensitive information should be handled. There is still considerable work to be done on how to technically and operationally transform these "default design principles" into reality within the complexity of New Zealand hospitals' electronic health information systems.

Intake of Raw Fruits and Vegetables Is Associated With Better Mental Health Than Intake of Processed Fruits and Vegetables.

Background: Higher intakes of fruits and vegetables, rich in micronutrients, have been associated with better mental health. However, cooking or processing may reduce the availability of these important micronutrients. This study investigated the differential associations between intake of raw fruits and vegetables, compared to processed (cooked or canned) fruits and vegetables, and mental health in young adults. Methods: In a cross-sectional survey design, 422 young adults ages 18-25 (66.1% female) living in New Zealand and the United States completed an online survey that assessed typical consumption of raw vs. cooked/canned/processed fruits and vegetables, negative and positive mental health (depressive symptoms, anxiety, negative mood, positive mood, life satisfaction, and flourishing), and covariates (including socio-economic status, body mass index, sleep, physical activity, smoking, and alcohol use). Results: Controlling for covariates, raw fruit and vegetable intake (FVI) predicted reduced depressive symptoms and higher positive mood, life satisfaction, and flourishing; processed FVI only predicted higher positive mood. The top 10 raw foods related to better mental health were carrots, bananas, apples, dark leafy greens like spinach, grapefruit, lettuce, citrus fruits, fresh berries, cucumber, and kiwifruit. Conclusions: Raw FVI, but not processed FVI, significantly predicted higher mental health outcomes when controlling for the covariates. Applications include recommending the consumption of raw fruits and vegetables to maximize mental health benefits.