Patient perspectives on the digitization of personal health information in the emergency department: a mixed-methods study during the COVID-19 pandemic (Preprint)

2021 ◽  
Author(s):  
Sophia Ly ◽  
Ricky Tsang ◽  
Kendall Ho
Keyword(s):  
Emergency Department ◽  
Mixed Methods ◽  
Electronic Health Records ◽  
Health Information ◽  
Mixed Methods Study ◽  
Personal Health Information ◽  
Personal Health ◽  
Patient Portals ◽  
Health Records ◽  
Key Informant

BACKGROUND While the digitization of personal health information (PHI) has been shown to improve patient engagement in the primary care setting, patient perspectives on its impact in the emergency department (ED) are unknown. OBJECTIVE The primary objective was to characterize the views of British Columbia (BC) ED users on the impacts of PHI digitization on ED care. METHODS This was a mixed-methods study consisting of an online survey followed by key informant interviews with a subset of survey respondents. ED users in British Columbia were asked about their ED experiences and attitudes towards PHI digitization in the ED. RESULTS One hundred and eight participants submitted survey responses between January and April 2020. Most survey respondents were interested in the use of electronic health records (75%) and patient portals (85%) in the ED and were amenable to sharing their ED PHI with ED staff (up to 90% in emergencies), family physicians (up to 91%), and family caregivers (up to 75%). Sixteen survey respondents provided key informant interviews in August 2020. Interviewees expected PHI digitization in the ED to enhance PHI access by health providers, patient-provider relationships, patient self-advocacy, and post-discharge care management, although some voiced concerns about privacy risk and limited access to digital technologies (eg, smart devices, internet connection). COVID-19 was thought to provide momentum for the digitization of healthcare. CONCLUSIONS Patients overwhelmingly support PHI digitization in the form of electronic health records and patient portals in the ED. The COVID-19 pandemic may represent a critical moment for the development and implementation of these tools.

Data Security in Electronic Health Records

2011 ◽  
pp. 1934-1947
Author(s):  
Stefane M Kabene ◽  
Raymond W. Leduc ◽  
Candace J Gibson
Keyword(s):  
Electronic Health Records ◽  
Health Information ◽  
Data Security ◽  
Value Added ◽  
Personal Health Information ◽  
Personal Health ◽  
Health Records ◽  
Healthcare Facilities ◽  
Shared Information ◽  
Electronic Health

Traditionally, patient information has been recorded on paper and stored in file folders at healthcare facilities and within physicians’ offices. The implementation of electronic health records (EHRs), the lifetime record of an individual’s health and health services delivered, allows for information to be stored on computers and offers the opportunity to store considerably more data, in much less space, with new efficiencies and value added as information is easier to access, legible, timely, non-redundant and readily available. However, there are many issues to consider with the implementation of a fully shared EHR. The protection of the information contained in the record is of the utmost importance as individuals stand to become quite vulnerable if that personal health information is compromised or accessed by unauthorized users. Therefore, one of the goals of this chapter is to uncover ways in which personal health information is being protected in EHR systems. The second objective, a broader one, examines what regulations, legislation and policies are in place that remove some of the uncertainty and risk and make the use of shared information safe and secure. Many of the techniques and technologies used so far are adopted from the corporate world, where data security has been an issue for some time. Current legislation in the United States and Canada at both the federal and state/provincial levels has addressed the general principles of data security and privacy but are still lacking in specifics with regard to cross-jurisdictional sharing of health information and the implementation and use of EHRs. Many of the researchers and studies on the subject find this to be one of the most important areas of concern moving forward. The opportunities for EHR implementation and use are exciting as they have the strong potential to improve both individual health care and population health, but without proper regulation and policies in place it is possible that the risks may outweigh the benefits.

scholarly journals User Experience of Mobile Personal Health Records for the Emergency Department: Mixed Methods Study

10.2196/24326 ◽  
2020 ◽  
Vol 8 (12) ◽  
pp. e24326
Author(s):  
Su Min Kim ◽  
Taerim Kim ◽  
Won Chul Cha ◽  
Jae-Ho Lee ◽  
In Ho Kwon ◽  
...  
Keyword(s):  
Emergency Department ◽  
Mixed Methods ◽  
User Experience ◽  
Patient Experience ◽  
Medical Information ◽  
Personal Health Records ◽  
Mixed Methods Study ◽  
Health Conditions ◽  
Personal Health ◽  
Health Records

Background Personal health records (PHRs) can be useful in the emergency department, as they provide patient information in an accurate and timely manner and enable it to be used actively. This has an effect on patients’ health outcomes and patient experience. Despite the importance of PHRs in emergencies, there are only a few studies related to PHRs in emergencies that evaluate patient experience. Objective This study aims to introduce the novel mobile PHR (mPHR) platform to emergency environments and assess user experience. Methods The study was conducted from October 2019 to November 2019. In total, 1000 patients or carers in the emergency departments of 3 hospitals were provided an application-based service called FirstER, which was developed to collect and utilize medical information for patients in the emergency department. This study was performed as a mixed methods study. After using FirstER, we investigated its usability and conducted a survey on the experience of obtaining medical information with a legacy system and with FirstER. Additionally, we interviewed 24 patients to gain insight into their experiences regarding medical information using FirstER. For the quantitative analysis, the survey results were analyzed using descriptive statistics (mean and standard deviation). For the qualitative analysis, we determined the keywords and their frequencies from each survey question and interview question. Results In total, 1000 participants, consisting of both patients and carers, were recruited in this study. Their mean age was 41.4 (SD 13.3) years. We ascertained participants’ satisfaction with FirstER and their mPHR needs through a survey and an in-depth interview. With the current system, participants were not well aware of their health conditions and medical information, and they were passive in the use of their medical information and treatment. However, they wanted their medical information for several reasons, such as information sharing and managing their health conditions. FirstER provided participants with their needed information and an easy way to access it. The mean System Usability Scale (SUS) value was 67.1 (SD 13.8), which was considered very near to acceptable. Conclusions This study is the first to implement mPHRs in the emergency department of large tertiary hospitals in the Republic of Korea. FirstER was found to enhance user experience in emergencies, as it provided necessary medical information and proper user experience. Moreover, the average SUS was 67.1, which means that participants found FirstER to be very near to acceptable. This is very encouraging in that FirstER was developed within a very short time, and it was a pilot study. Trial Registration Clinicaltrials.gov NCT04180618; https://clinicaltrials.gov/ct2/show/NCT04180618

Data Security in Electronic Health Records

2010 ◽  
pp. 182-194
Author(s):  
Stefane M Kabene ◽  
Raymond W. Leduc ◽  
Candace J Gibson
Keyword(s):  
Electronic Health Records ◽  
Health Information ◽  
Data Security ◽  
Value Added ◽  
Personal Health Information ◽  
Personal Health ◽  
Health Records ◽  
Healthcare Facilities ◽  
Shared Information ◽  
Electronic Health

Traditionally, patient information has been recorded on paper and stored in file folders at healthcare facilities and within physicians’ offices. The implementation of electronic health records (EHRs), the lifetime record of an individual’s health and health services delivered, allows for information to be stored on computers and offers the opportunity to store considerably more data, in much less space, with new efficiencies and value added as information is easier to access, legible, timely, non-redundant and readily available. However, there are many issues to consider with the implementation of a fully shared EHR. The protection of the information contained in the record is of the utmost importance as individuals stand to become quite vulnerable if that personal health information is compromised or accessed by unauthorized users. Therefore, one of the goals of this chapter is to uncover ways in which personal health information is being protected in EHR systems. The second objective, a broader one, examines what regulations, legislation and policies are in place that remove some of the uncertainty and risk and make the use of shared information safe and secure. Many of the techniques and technologies used so far are adopted from the corporate world, where data security has been an issue for some time. Current legislation in the United States and Canada at both the federal and state/provincial levels has addressed the general principles of data security and privacy but are still lacking in specifics with regard to cross-jurisdictional sharing of health information and the implementation and use of EHRs. Many of the researchers and studies on the subject find this to be one of the most important areas of concern moving forward. The opportunities for EHR implementation and use are exciting as they have the strong potential to improve both individual health care and population health, but without proper regulation and policies in place it is possible that the risks may outweigh the benefits.

scholarly journals User Experience of Mobile Personal Health Records for the Emergency Department: Mixed Methods Study (Preprint)

2020 ◽  
Author(s):  
Su Min Kim ◽  
Taerim Kim ◽  
Won Chul Cha ◽  
Jae-Ho Lee ◽  
In Ho Kwon ◽  
...  
Keyword(s):  
Emergency Department ◽  
Mixed Methods ◽  
User Experience ◽  
Patient Experience ◽  
Medical Information ◽  
Personal Health Records ◽  
Mixed Methods Study ◽  
Health Conditions ◽  
Personal Health ◽  
Health Records

BACKGROUND Personal health records (PHRs) can be useful in the emergency department, as they provide patient information in an accurate and timely manner and enable it to be used actively. This has an effect on patients’ health outcomes and patient experience. Despite the importance of PHRs in emergencies, there are only a few studies related to PHRs in emergencies that evaluate patient experience. OBJECTIVE This study aims to introduce the novel mobile PHR (mPHR) platform to emergency environments and assess user experience. METHODS The study was conducted from October 2019 to November 2019. In total, 1000 patients or carers in the emergency departments of 3 hospitals were provided an application-based service called FirstER, which was developed to collect and utilize medical information for patients in the emergency department. This study was performed as a mixed methods study. After using FirstER, we investigated its usability and conducted a survey on the experience of obtaining medical information with a legacy system and with FirstER. Additionally, we interviewed 24 patients to gain insight into their experiences regarding medical information using FirstER. For the quantitative analysis, the survey results were analyzed using descriptive statistics (mean and standard deviation). For the qualitative analysis, we determined the keywords and their frequencies from each survey question and interview question. RESULTS In total, 1000 participants, consisting of both patients and carers, were recruited in this study. Their mean age was 41.4 (SD 13.3) years. We ascertained participants’ satisfaction with FirstER and their mPHR needs through a survey and an in-depth interview. With the current system, participants were not well aware of their health conditions and medical information, and they were passive in the use of their medical information and treatment. However, they wanted their medical information for several reasons, such as information sharing and managing their health conditions. FirstER provided participants with their needed information and an easy way to access it. The mean System Usability Scale (SUS) value was 67.1 (SD 13.8), which was considered very near to acceptable. CONCLUSIONS This study is the first to implement mPHRs in the emergency department of large tertiary hospitals in the Republic of Korea. FirstER was found to enhance user experience in emergencies, as it provided necessary medical information and proper user experience. Moreover, the average SUS was 67.1, which means that participants found FirstER to be very near to acceptable. This is very encouraging in that FirstER was developed within a very short time, and it was a pilot study. CLINICALTRIAL Clinicaltrials.gov NCT04180618; https://clinicaltrials.gov/ct2/show/NCT04180618

scholarly journals The use of smartphones on General Internal Medicine wards

2014 ◽  
Vol 05 (03) ◽  
pp. 814-816 ◽  
Author(s):  
D. Morra ◽  
V. Lo ◽  
S. Quan ◽  
R. Wu ◽  
K. Tran
Keyword(s):  
Internal Medicine ◽  
Mixed Methods ◽  
Health Information ◽  
General Internal Medicine ◽  
Mixed Methods Study ◽  
Personal Health Information ◽  
Medical Specialties ◽  
General Internal ◽  
Work Related ◽  
Internal Medicine Wards

Summary Objective: To describe the uses of institutional and personal smartphones on General Internal Medicine wards and highlight potential consequences from their use. Methods: A mixed methods study consisting of both quantitative and qualitative research methods was conducted in General Internal Medicine wards across four academic teaching hospitals in Toronto, Ontario. Participants included medical students, residents, attending physicians and allied health professionals. Data collection consisted of work shadowing observations, semi-structured interviews and surveys. Results: Personal smartphones were used for both clinical communication and non-work-related activities. Clinicians used their personal devices to communicate with their medical teams and with other medical specialties and healthcare professionals. Participants understood the risks associated with communicating confidential health information via their personal smartphones, but appear to favor efficiency over privacy issues. From survey responses, 9 of 23 residents (39%) reported using their personal cell phones to email or text patient information that may have contained patient identifiers. Although some residents were observed using their personal smartphones for non-work-related activities, personal use was infrequent and most residents did not engage in this activity. Conclusion: Clinicians are using personal smartphones for work-related purposes on the wards. With the increasing popularity of smartphone devices, it is anticipated that an increasing number of clinicians will use their personal smartphones for clinical work. This trend poses risks to the secure transfer of confidential personal health information and may lead to increased distractions for clinicians. Citation: Tran K, Morra D, Lo V, Quan S, Wu R. The use of smartphones on General Internal Medicine wards: A mixed methods study. Appl Clin Inf 2014; 5: 814–823http://dx.doi.org/10.4338/ACI-2014-02-RA-0011

scholarly journals Research using electronic health records: Balancing confidentiality and public good

2018 ◽  
Vol 10 (4) ◽  
pp. 288 ◽  
Author(s):  
Katharine A. Wallis ◽  
Kyle S. Eggleton ◽  
Susan M. Dovey ◽  
Sharon Leitch ◽  
Wayne K. Cunningham ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Ethical Issues ◽  
Personal Health Information ◽  
Personal Health ◽  
Quality And Safety ◽  
Patient Relationship ◽  
Health Records ◽  
Patient Consent ◽  
Information Research ◽  
Electronic Health

ABSTRACTGeneral practitioners are increasingly approached to participate in research and share de-identified patient information. Research using electronic health records has considerable potential for improving the quality and safety of patient care. Obtaining individual patient consent for the use of the information is usually not feasible. In this article we explore the ethical issues in using personal health information in research without patient consent including the threat to confidentially and the doctor-patient relationship, and we discuss how the risks can be minimised and managed drawing on our experience as general practitioners and researchers.

scholarly journals Patient portals and personal health information online: perception, access, and use by US adults

2016 ◽  
Vol 24 (e1) ◽  
pp. e173-e177 ◽  
Author(s):  
Sue Peacock ◽  
Ashok Reddy ◽  
Suzanne G Leveille ◽  
Jan Walker ◽  
Thomas H Payne ◽  
...  
Keyword(s):  
Health Care ◽  
Health Information ◽  
Health Care Providers ◽  
Race And Ethnicity ◽  
Personal Health Information ◽  
Personal Health ◽  
Care Providers ◽  
Patient Portals ◽  
The Past ◽  
Patient Race

Background: Access to online patient portals is key to improving care, but we have limited understanding of patient perceptions of online portals and the characteristics of people who use them. Methods: Using a national survey of 3677 respondents, we describe perceptions and utilization of online personal health information (PHI) portals. Results: Most respondents (92%) considered online PHI access important, yet only 34% were offered access to online PHI by a health care provider, and just 28% accessed online PHI in the past year. While there were no differences across race or ethnicity in importance of access, black and Hispanic respondents were significantly less likely to be offered access (P = .006 and <.001, respectively) and less likely to access their online PHI (P = .041 and <.001, respectively) compared to white and non-Hispanic respondents. Conclusion: Health care providers are crucial to the adoption and use of online patient portals and should be encouraged to offer consistent access regardless of patient race and ethnicity.

scholarly journals Characteristics of personal health information management groups: findings from an online survey using Amazon’s mTurk

2017 ◽  
Vol 105 (4) ◽  
Author(s):  
Sujin Kim ◽  
Jeffrey T. Huber
Keyword(s):  
Health Information ◽  
Information Management ◽  
Personal Health Records ◽  
Health Information Management ◽  
Personal Health Information ◽  
The Other ◽  
Personal Health ◽  
Health Records ◽  
Basic Group ◽  
Personal Health Information Management

Objective: The study characterized three groups with different levels of familiarity with personal health information management (PHIM) in terms of their demographics, health knowledge, technological competency, and information sources and barriers. In addition, the authors examined differences among PHIM groups in subjective self-ratings and objective test scores for health literacy.Methods: A total of 202 survey participants were recruited using Amazon’s Mechanical Turk (mTurk) service, a crowdsourcing Internet service. Using K-means clustering, three groups with differing levels of familiarity with PHIM were formed: Advanced, Intermediate, and Basic.Results: The Advanced group was the youngest, and the Basic group contained the highest proportion of males, whereas the Intermediate group was the oldest and contained the fewest males. The Advanced group was significantly more likely to engage in provider- or hospital-initiated PHIM activities such as emailing with providers, viewing test results online, and receiving summaries of hospital visits via email or websites than the other groups. The Basic group had significantly lower information management skills and Internet use than the other groups. Advanced and Basic groups reported significant differences in several information barriers. While the Advanced group self-reported the highest general literacy, they scored lowest on an objective health literacy test.Conclusions: For effective personal health records management, it is critical to understand individual differences in PHIM using a comprehensive measure designed to assess personal health records–specific activities. Because they are trained to perform an array of information management activities, medical librarians or patient educators are well positioned to promote the effective use of personal health records by health consumers.

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