scholarly journals Towards a New Paradigm of Federated Electronic Health Records in Palestine

Informatics ◽  
2020 ◽  
Vol 7 (4) ◽  
pp. 41
Author(s):  
Carol El Jabari ◽  
Mario Macedo ◽  
Mohanad O. Al-jabari
Keyword(s):  
Electronic Health Records ◽  
New Paradigm ◽  
Privacy And Security ◽  
Health Records ◽  
Sound System ◽  
Middle Income ◽  
Clinical Document ◽  
Low Middle Income Countries ◽  
Electronic Health ◽  
And Control

While efforts are underway to create a sound system of electronic health records in Palestinian health institutions, there remain obstacles and challenges. Given modern day demands on health systems, we propose a federated electronic health system based on the clinical document architecture (CDA) that is compliant within the Palestine context. This architecture also brings a normalized electronic health record and a structure of blockchain to enhance interoperability with scalability, fault tolerance, privacy, and security. The new architecture and technologies will enhance services by allowing health care players, patients, and others to have the opportunity to obtain improved access and control of their health services. This may also serve as a useful model for other low-middle income countries.

A Web-Based Application to Exchange Electronic Health Records and Medical Images in Ophthalmology

2009 ◽  
pp. 152-164
Author(s):  
Isabel de la Torre Díez
Keyword(s):  
Electronic Health Records ◽  
Medical Images ◽  
Universal Access ◽  
Diabetic Patients ◽  
Health Records ◽  
Web Based ◽  
Clinical Document ◽  
Extensible Markup ◽  
Electronic Health ◽  
Web Based System

This chapter describes a Web -based application to store and exchange Electronic Health Records (EHR) and medical images in Ophthalmology: TeleOftalWeb 3.2. The Web -based system has been built on Java Servlet and Java Server Pages (JSP) technologies. Its architecture is a typical three-layered with two databases. The user and authentication information is stored in a relational database: MySQL 5.0. The patient records and fundus images are achieved in an Extensible Markup Language (XML) native database: dbXML 2.0. The application uses XML-based technologies and Health Level Seven/Clinical Document Architecture (HL7/CDA) specifications. The EHR standardization is carried out. The main application object is the universal access to the diabetic patients EHR by physicians wherever they are.

scholarly journals A Landscape Study Highlights the Urgent Need for Evidence Based Strategies to Enable Electronic Health Records Integration in the National Healthcare Systems of Low- and Middle-Income Countries

2021 ◽  
Vol 16 (3) ◽  
pp. 140-142
Author(s):  
Joanne M. Muellenbach
Keyword(s):  
Electronic Health Records ◽  
Grey Literature ◽  
Healthcare Systems ◽  
Health Records ◽  
Middle Income ◽  
Middle Income Countries ◽  
National Healthcare ◽  
Electronic Health ◽  
International Experts ◽  
Low And Middle Income

A Review of: Kumar, M., & Mostafa, J. (2020). Electronic health records for better health in lower- and middle-income countries: A landscape study. Library Hi Tech, 38(4), 751–767. https://doi.org/10.1108/LHT-09-2019-0179  Abstract Objective – To identify how low- and middle-income countries (LMICs) approached the development of national and subnational electronic health records (EHRs) and to understand the challenges related to EHR research priorities and sustainability. Design – Landscape study consisting of a review of the scientific literature, country-focused grey literature, and consultation with international experts.   Setting – Hospitals and healthcare systems within LMICs.  Subjects – The 402 publications retrieved through a systematic search of four scientific electronic databases along with 49 publications found through a country-focused analysis of grey literature and 14 additional publications found through consultation with two international experts.  Methods – On 15 May 2019, the authors comprehensively searched four major scientific databases: Global Health, PubMed, Scopus, and Web of Science. They also searched the grey literature and repositories in consultation with country-based international digital health experts. The authors subsequently used Mendeley reference management software to organize and remove duplicate publications. Peer-reviewed publications that focused on developing national EHRs within LMIC healthcare systems were included for the title and abstract screening. Data analysis was mainly qualitative, and the results were organized to highlight stakeholders, health information architecture (HIA), and sustainability. Main Results – The results were presented in three subsections. The first two described critical stakeholders for developing national and subnational EHRs and HIA, including country eHealth foundations, EHRs, and subsystems. The third section presented and discussed pressing challenges related to EHR sustainability. The findings of the three subsections were further explored through the presentation of three LMIC case studies that described stakeholders, HIA, and sustainability challenges. Conclusion – The results of this landscape study highlighted the scant evidence available to develop and sustain national and subnational EHRs within LMICs. The authors noted that there appears to be a gap in understanding how EHRs impact patient-level and population outcomes within the LMICs. The study revealed that EHRs were primarily designed to support monitoring and evaluating health programs focused on a particular disease or group of diseases rather than common health problems. While national governments and international donors focused on the role of EHRs to improve patient care, the authors highlighted the urgent need for further research on the development of EHRs, with a focus on efficiency, evaluation, monitoring, and quality within the national healthcare enterprise.

scholarly journals Association of neighbourhood socioeconomic status and diabetes burden using electronic health records in Madrid (Spain): the HeartHealthyHoods study

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e021143 ◽  
Author(s):  
Usama Bilal ◽  
Felicia Hill-Briggs ◽  
Luis Sánchez-Perruca ◽  
Isabel Del Cura-González ◽  
Manuel Franco
Keyword(s):  
Socioeconomic Status ◽  
Electronic Health Records ◽  
Composite Index ◽  
Glycated Haemoglobin ◽  
Diabetes Prevalence ◽  
Lower Prevalence ◽  
Health Records ◽  
Neighbourhood Socioeconomic Status ◽  
Electronic Health ◽  
And Control

ObjectiveTo study the association between neighbourhood socioeconomic status and diabetes prevalence, incidence, and control in the entire population of northeastern Madrid, Spain.SettingElectronic health records of the primary-care system in four districts of Madrid (Spain).Participants269 942 people aged 40 or older, followed from 2013 to 2014.ExposureNeighbourhoodsocioeconomic status (NSES), measured using a composite index of seven indicators from four domains of education, wealth, occupation and living conditions.Primary outcome measuresDiagnosis of diabetes based on ICPC-2 codes and glycated haemoglobin (HbA1c %).ResultsIn regression analyses adjusted by age and sex and compared with individuals living in low NSES neighbourhoods, men living in medium and high NSES neighbourhoods had 10% (95% CI: 6% to 15%) and 29% (95% CI: 25% to 32%) lower prevalence of diabetes, while women had 27% (95% CI: 23% to 30%) and 50% (95% CI: 47% to 52%) lower prevalence of diabetes. Moreover, the hazard of diabetes in men living in medium and high NSES neighbourhoods was 13% (95% CI: 1% to 23%) and 20% (95% CI: 9% to 29%) lower, while the hazard of diabetes in women living in medium and high NSES neighbourhoods was 17% (95% CI: 3% to 29%) and 31% (95% CI: 20% to 41%) lower. Individuals living in medium and high SES neighbourhoods had 8% (95% CI: 2% to 15%) and 15% (95% CI: 9% to 21%) lower prevalence of lack of diabetes control, and a decrease in average HbA1c % of 0.05 (95% CI: 0.01 to 0.10) and 0.11 (95% CI: 0.06 to 0.15).ConclusionsDiabetes prevalence, incidence and lack of control increased with decreasing NSES in a southern European city. Future studies should provide mechanistic insights and targets for intervention to address this health inequity.

scholarly journals Utilisation of Electronic Health Records for Public Health in Asia: A Review of Success Factors and Potential Challenges

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Lesley Dornan ◽  
Kanokporn Pinyopornpanish ◽  
Wichuda Jiraporncharoen ◽  
Ahmar Hashmi ◽  
Nisachol Dejkriengkraikul ◽  
...  
Keyword(s):  
Public Health ◽  
Electronic Health Records ◽  
Success Factors ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Direct Patient Care ◽  
Health Records ◽  
Middle Income ◽  
Implementation Challenges ◽  
Electronic Health

Introduction. Electronic health records offer a valuable resource to improve health surveillance and evaluation as well as informing clinical decision making. They have been introduced in many different settings, including low- and middle-income countries, yet little is known of the progress and effectiveness of similar information systems within Asia. This study examines the implementation of EHR systems for use at a population health level in Asia and to identify their current role within public health, key success factors, and potential barriers in implementation. Material and Methods. A systematic search process was implemented. Five databases were searched with MeSH key terms and Boolean phrases. Articles selected for this review were based on hospital provider electronic records with a component of implementation, utilisation, or evaluation for health systems or at least beyond direct patient care. A proposed analytic framework considered three interactive components: the content, the process, and the context. Results. Thirty-two articles were included in the review. Evidence suggests that benefits are significant but identifying and addressing potential challenges are critical for success. A comprehensive preparation process is necessary to implement an effective and flexible system. Discussion. Electronic health records implemented for public health can allow the identification of disease patterns, seasonality, and global trends as well as risks to vulnerable populations. Addressing implementation challenges will facilitate the development and efficacy of public health initiatives in Asia to identify current health needs and mitigate future risks.

scholarly journals Artificial intelligence and multi agent based distributed ledger system for better privacy and security of electronic healthcare records

2020 ◽  
Vol 6 ◽  
pp. e323
Author(s):  
Fahad F. Alruwaili
Keyword(s):  
Artificial Intelligence ◽  
Electronic Health Records ◽  
Privacy Preservation ◽  
Security And Privacy ◽  
Privacy And Security ◽  
Health Records ◽  
Agent Based ◽  
Distributed Ledger ◽  
Multi Agent ◽  
Electronic Health

Background Application of Artificial Intelligence (AI) and the use of agent-based systems in the healthcare system have attracted various researchers to improve the efficiency and utility in the Electronic Health Records (EHR). Nowadays, one of the most important and creative developments is the integration of AI and Blockchain that is, Distributed Ledger Technology (DLT) to enable better and decentralized governance. Privacy and security is a critical piece in EHR implementation and/or adoption. Health records are updated every time a patient visits a doctor as they contain important information about the health and wellbeing of the patient and describes the history of care received during the past and to date. Therefore, such records are critical to research, hospitals, emergency rooms, healthcare laboratories, and even health insurance providers. Methods In this article, a platform employing the AI and the use of multi-agent based systems along with the DLT technology for privacy preservation is proposed. The emphasis of security and privacy is highlighted during the process of collecting, managing and distributing EHR data. Results This article aims to ensure privacy, integrity and security metrics of the electronic health records are met when such copies are not only immutable but also distributed. The findings of this work will help guide the development of further techniques using the combination of AI and multi-agent based systems backed by DLT technology for secure and effective handling EHR data. This proposed architecture uses various AI-based intelligent based agents and blockchain for providing privacy and security in EHR. Future enhancement in this work can be the addition of the biometric based systems for improved security.

Abstract 16554: Rapid Identification of Familial Hypercholesterolemia From Electronic Health Records

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Maya S Safarova ◽  
Hongfang Liu ◽  
Iftikhar J Kullo
Keyword(s):  
Electronic Health Records ◽  
Familial Hypercholesterolemia ◽  
Rapid Identification ◽  
Study Cohort ◽  
Atherosclerotic Cardiovascular Disease ◽  
Inclusion Criteria ◽  
Health Records ◽  
Predictive Values ◽  
Electronic Health ◽  
And Control

Background: Familial hypercholesterolemia (FH) is an important public health burden as it is a relatively common Mendelian genetic disorder which is associated with dramatically increased lifetime risk for premature atherosclerotic cardiovascular disease (ASCVD) due to elevated plasma low-density lipoprotein cholesterol (LDL-C) levels. Little is known about prevalence and control of FH in the US. Objective: To develop an electronic phenotyping algorithm for rapid identification of FH in electronic health records (EHRs) and thereby address knowledge gaps in prevalence and control of FH. Methods: We identified patients in the Mayo Employee and Community Health (ECH) system who met the following inclusion criteria: 1) gave research authorization, 2) any LDL-C in EHR ≥190 mg/dL; 2) triglycerides <400 mg/dL; 3) absence of secondary causes of hyperlipidemia (hypothyroidism, cholestatic liver diseases, nephrotic syndrome, renal failure, and pregnancy). Next we applied the Dutch Lipid Clinic Network (DLCN) criteria to ascertain FH cases. ASCVD-related diagnosis codes, laboratory data, and medications were obtained from structured EHR datasets. We used the Mayo natural language processing (NLP) system to ascertain presence of family and personal history of premature ASCVD, xanthomas and corneal arcus from clinical text notes. Results: Of a total of 131,000 patients seen in ECH clinics between July 1993 and December 2014, 6018 met the inclusion criteria. Implementing the electronic phenotyping algorithm for FH in these patients identified 178 definite and 369 probable cases (DLCN score >8 and 6-8 points, respectively) with an overall FH prevalence of 0.4% (1:240). Blinded expert review of 160 randomly chosen patients showed positive and negative predictive values for electronic phenotyping algorithm at 85% and 90%, respectively. Only 40% of these patients achieved LDL-C ≤100 mg/dL on treatment. Conclusions: 1) An EHR-based phenotyping algorithm that included NLP had reasonable accuracy in ascertaining FH cases. 2) Implementing this algorithm revealed the prevalence of FH in the study cohort to be nearly twice the current estimate of 1:500 in the general population. 3) Less than half of the FH patients had optimal LDL-C levels on treatment.

Electronic health records for better health in the lower- and middle-income countries

2020 ◽  
Vol 38 (4) ◽  
pp. 751-767
Author(s):  
Manish Kumar ◽  
Javed Mostafa
Keyword(s):  
Electronic Health Records ◽  
Health Information ◽  
Digital Health ◽  
Information Architecture ◽  
Health Records ◽  
Middle Income ◽  
Content Type ◽  
Middle Income Countries ◽  
Use Of Data ◽  
Electronic Health

PurposeElectronic health records (EHR) can enable collection and use of data for achieving better health both at the patient and population health levels. The World Health Organization's (WHO) draft 2019 four-year global digital health strategy aims to “improve health for everyone, everywhere by accelerating the adoption of appropriate digital health” and EHRs are key to achieving better health goals. Despite the fact that EHRs can help to achieve better health, there is lack of evidence explaining national and sub-national EHR development in the limited resource settings.Design/methodology/approachWe conducted a landscape study to describe the EHR development and use in the low- and middle-income countries for achieving better health. We reviewed literature from four scientific databases and analyzed gray literature identified in consultation with 17 international experts.FindingsThe findings of this literature review are presented in three subsections. The first two subsections describe key stakeholders for development of national and sub-national EHR and health information architecture which includes status of ehealth foundations, EHR, and sub-systems in the country. The third subsection presents and discusses key challenges related to sustainability of national and sub-national EHRs. The findings in these three subsections are further explored through examples of health information flow in Uganda, and electronic medical record/EHR implementation in Sierra Leone and Malawi. These examples briefly describe stakeholders, information architecture, and sustainability challenges.Originality/valueThis paper fills an important research gap and clearly explains the urgent research need to build context-specific EHR development models to enable use of data for better health.

scholarly journals Opportunities and challenges in utilizing electronic health records for infection surveillance, prevention, and control

2008 ◽  
Vol 36 (3) ◽  
pp. S37-S46 ◽  
Author(s):  
Ashish Atreja ◽  
Steven M. Gordon ◽  
Daniel A. Pollock ◽  
Russell N. Olmsted ◽  
Patrick J. Brennan
Keyword(s):  
Electronic Health Records ◽  
Prevention And Control ◽  
Health Records ◽  
Infection Surveillance ◽  
Electronic Health ◽  
And Control
Sign in / Sign up

Export Citation Format

Share Document