scholarly journals Medical records: the first challenge in health care

Medwave ◽  
2016 ◽  
Vol 16 (10) ◽  
pp. e6601-e6601
Author(s):  
Marcos Tapia-Hernández ◽  
Belén Cerda-Mendoza ◽  
Esteban Parra-Valencia
Keyword(s):  
Health Care ◽  
Medical Records

scholarly journals Benefit-risk of Patients' Online Access to their Medical Records: Consensus Exercise of an International Expert Group

2018 ◽  
Vol 27 (01) ◽  
pp. 156-162 ◽  
Author(s):  
Harshana Liyanage ◽  
Siaw-Teng Liaw ◽  
Emmanouela Konstantara ◽  
Freda Mold ◽  
Richard Schreiber ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Informatics ◽  
Medical Records ◽  
Panel Discussion ◽  
Care Quality ◽  
Care Providers ◽  
Consensus Statements ◽  
Online Access ◽  
The Impact

Background: Patients' access to their computerised medical records (CMRs) is a legal right in many countries. However, little is reported about the benefit-risk associated with patients' online access to their CMRs. Objective: To conduct a consensus exercise to assess the impact of patients' online access to their CMRs on the quality of care as defined in six domains by the Institute of Medicine (IoM), now the National Academy of Medicine (NAM). Method: A five-round Delphi study was conducted. Round One explored experts' (n = 37) viewpoints on providing patients with access to their CMRs. Round Two rated the appropriateness of statements arising from Round One (n = 16). The third round was an online panel discussion of findings (n = 13) with the members of both the International Medical Informatics Association and the European Federation of Medical Informatics Primary Health Care Informatics Working Groups. Two additional rounds, a survey of the revised consensus statements and an online workshop, were carried out to further refine consensus statements. Results: Thirty-seven responses from Round One were used as a basis to initially develop 15 statements which were categorised using IoM's domains of care quality. The experts agreed that providing patients online access to their CMRs for bookings, results, and prescriptions increased efficiency and improved the quality of medical records. Experts also anticipated that patients would proactively use their online access to share data with different health care providers, including emergencies. However, experts differed on whether access to limited or summary data was more useful to patients than accessing their complete records. They thought online access would change recording practice, but they were unclear about the benefit-risk of high and onerous levels of security. The 5-round process, finally, produced 16 consensus statements. Conclusion: Patients' online access to their CMRs should be part of all CMR systems. It improves the process of health care, but further evidence is required about outcomes. Online access improves efficiency of bookings and other services. However, there is scope to improve many of the processes of care it purports to support, particularly the provision of a more effective interface and the protection of the vulnerable.

scholarly journals Inappropriate requests for tumor markers in patients aged 50 years and older: lessons not learned

2021 ◽  
Vol 15 ◽  
Author(s):  
Valter Paz Nascimento-Júnior ◽  
Einstein Francisco Camargos
Keyword(s):  
Internal Medicine ◽  
Health Care ◽  
Health Insurance ◽  
Medical Records ◽  
Private Health Insurance ◽  
Medical Specialty ◽  
Health Care Managers ◽  
Inappropriate Use ◽  
Care Managers ◽  
Previous Diagnosis

OBJECTIVE: To investigate, within a private health insurance, the ordering frequency and the costs related to inappropriate TM test orders. METHODS: This study analyzed data regarding TM requests within a private health insurance between 2010 and 2017. Patients included in this analysis were ≥ 50 years old, had available medical records, and had at least 1 TM tested within the study period. Tests were considered inappropriate when TMs were used in screening for neoplasms, ie, when there was no previous diagnosis. We evaluated data regarding age, sex, the ordering physician’s medical specialty, and test costs. RESULTS: Between 2010 and 2017, 1,112 TM tests were performed and increased from 52 to 262 per year. Our sample consisted mostly of women (69.50%) with a mean age of 59.40 (SD, 8.20) years. Most orders were inappropriate (87.80%) and represented 79.40% of all expenses with TM tests. Cardiology professionals were the medical specialty that requested the most TM tests (23.90%), followed by internal medicine specialists (22.70%) and gynecologists (19.20%). CONCLUSIONS: We observed a high percentage of inappropriate test orders in the study period, resulting in elevated costs. Studies of this nature deserve the attention of health care managers, and interventions should be performed in order to reduce the inappropriate use of TM tests in clinical practice.

scholarly journals An Integrated Influenza Surveillance Framework Based on National Influenza-Like Illness Incidence and Multiple Hospital Electronic Medical Records for Early Prediction of Influenza Epidemics: Design and Evaluation (Preprint)

2018 ◽  
Author(s):  
Cheng-Yi Yang ◽  
Ray-Jade Chen ◽  
Wan-Lin Chou ◽  
Yuarn-Jang Lee ◽  
Yu-Sheng Lo
Keyword(s):  
Health Care ◽  
Infectious Diseases ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Predictive Power ◽  
Influenza Surveillance ◽  
Early Prediction ◽  
Influenza Like Illness ◽  
Reporting Systems ◽  
Positive Results

BACKGROUND Influenza is a leading cause of death worldwide and contributes to heavy economic losses to individuals and communities. Therefore, the early prediction of and interventions against influenza epidemics are crucial to reduce mortality and morbidity because of this disease. Similar to other countries, the Taiwan Centers for Disease Control and Prevention (TWCDC) has implemented influenza surveillance and reporting systems, which primarily rely on influenza-like illness (ILI) data reported by health care providers, for the early prediction of influenza epidemics. However, these surveillance and reporting systems show at least a 2-week delay in prediction, indicating the need for improvement. OBJECTIVE We aimed to integrate the TWCDC ILI data with electronic medical records (EMRs) of multiple hospitals in Taiwan. Our ultimate goal was to develop a national influenza trend prediction and reporting tool more accurate and efficient than the current influenza surveillance and reporting systems. METHODS First, the influenza expertise team at Taipei Medical University Health Care System (TMUHcS) identified surveillance variables relevant to the prediction of influenza epidemics. Second, we developed a framework for integrating the EMRs of multiple hospitals with the ILI data from the TWCDC website to proactively provide results of influenza epidemic monitoring to hospital infection control practitioners. Third, using the TWCDC ILI data as the gold standard for influenza reporting, we calculated Pearson correlation coefficients to measure the strength of the linear relationship between TMUHcS EMRs and regional and national TWCDC ILI data for 2 weekly time series datasets. Finally, we used the Moving Epidemic Method analyses to evaluate each surveillance variable for its predictive power for influenza epidemics. RESULTS Using this framework, we collected the EMRs and TWCDC ILI data of the past 3 influenza seasons (October 2014 to September 2017). On the basis of the EMRs of multiple hospitals, 3 surveillance variables, TMUHcS-ILI, TMUHcS-rapid influenza laboratory tests with positive results (RITP), and TMUHcS-influenza medication use (IMU), which reflected patients with ILI, those with positive results from rapid influenza diagnostic tests, and those treated with antiviral drugs, respectively, showed strong correlations with the TWCDC regional and national ILI data (r=.86-.98). The 2 surveillance variables—TMUHcS-RITP and TMUHcS-IMU—showed predictive power for influenza epidemics 3 to 4 weeks before the increase noted in the TWCDC ILI reports. CONCLUSIONS Our framework periodically integrated and compared surveillance data from multiple hospitals and the TWCDC website to maintain a certain prediction quality and proactively provide monitored results. Our results can be extended to other infectious diseases, mitigating the time and effort required for data collection and analysis. Furthermore, this approach may be developed as a cost-effective electronic surveillance tool for the early and accurate prediction of epidemics of influenza and other infectious diseases in densely populated regions and nations.

Understanding the Need for a Non-invasive Wearable Real-time Database Device for Diabetic Patients

2018 ◽  
Vol 20 (2) ◽  
pp. 190-196 ◽  
Author(s):  
Elmer Jeto Gomes Ataide ◽  
Rajesh Kumar Sinha ◽  
G. Arun Maiya
Keyword(s):  
Health Care ◽  
Real Time ◽  
Medical Records ◽  
Wearable Devices ◽  
Care Process ◽  
Diabetic Patients ◽  
Quality Health Care ◽  
Non Invasive ◽  
Quality Health ◽  
Real Time Database

Diabetes occurs when the pancreas in the human body does not secrete sufficient insulin. It is a disease that is growing rapidly and affecting many lives. Hence, it needs constant monitoring. Wearable devices are those devices that are present on your person at all times. If the monitoring of this disease could be paired with wearable devices along with enabling real-time documentation in the patients’ medical records, it would benefit both the caregivers and the patients by saving time, money, effort and the amount of work put in by both during the health care process, hence, aiding in the delivery of quality health care. This article deals with identifying the existing wearable devices in detecting diabetes or risk of diabetes non-invasively and further scope of research in the respective area.

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