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1

Mehmood, Hamid, Muhammad Aslam, Sadia Aslam, Ammara Waqar, Athar Khan, Yasir Hassan, Faryal Murtaza Cheema, Hassan Mujtaba, and Noor-e. Maham. "ELECTRONIC HEALTH RECORD SYSTEMS;." Professional Medical Journal 24, no. 01 (January 18, 2017): 182–87. http://dx.doi.org/10.29309/tpmj/2017.24.01.401.

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Introduction: e-Health is a combination of medical informatics, public health,business and information technology. Health information technology has increased theproductivity by reengineering of health care but it requires new measurement tools to monitorthe impact of it .e-health is not only for the development of technologies but also it includesproper planning, thinking, broad thinking to improve healthcare services with the help ofinformation and communication technology. Objectives: 1) To assess the perceptions ofphysicians towards the use, effectiveness and efficiency of EHR 2) To identify the differencesbetween electronic and paper based records 3) To evaluate the usage of Electronic HealthRecords.4) To analyze satisfaction and challenges face by the physicians using EHR. ResearchDesign: This is an Exploratory and Descriptive Research. In this study hybrid research methodis used which includes qualitative and quantitative research methods. Sampling technique:For this study, a purposive sample of 43 physicians was selected. The sample size was 60but 17 responses were incomplete so they were excluded and the final sample size was 43.Data was collected from two different hospitals of Pakistan which include the physicians fromShaukat Khanum Memorial Cancer Hospital and Research Centre, and Indus Hospital. Of the43 participants, 51% were from Indus Hospital and 49% were from Shaukat Khanum MemorialCancer Hospital and Research Centre. Instrument: A structured questionnaire was used tocollect data and it was collected by email responses and direct interview. EHR Questionnaire:A questionnaire was used in the study. The EHR Questionnaire has comprised of 24 items. Thisquestionnaire was developed by Msukwa. B.K.Martin.1 Data Analysis: Data analysis was doneby Statistical Package for Social Sciences (SPSS) and Microsoft Excel. Procedure: The sampleconsisted of physicians from Shaukat Khanum Memorial Cancer Hospital and Research Centre,and Indus Hospital from Karachi. EHR is a new technology and hospitals are moving towardsit, some are under process and very few like the above mentioned hospitals are using it. Thequestionnaire was not complicated. It was a structured questionnaire with easy questions withmultiple options to fill in. Respondents were also acknowledged for their cooperation andparticipation in the study. Conclusion: EHR should be used effectively, proper training is neededto ensure that physicians are able to operate the system and can have maximum benefits fromthe technology by utilizing all its applications. The government should encourage adoption ofElectronic Health l Records in Pakistan by developing a public-private partnership. The studyfocused also on EHR effectiveness by checking the working of EHR its quick and satisfactoryresults its accuracy, adequacy, timeliness, user- friendliness, availability and reliability.
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Seymour, Tom, Dean Frantsvog, and Tod Graeber. "Electronic Health Records (EHR)." American Journal of Health Sciences (AJHS) 3, no. 3 (July 13, 2012): 201–10. http://dx.doi.org/10.19030/ajhs.v3i3.7139.

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Electronic Health Records are electronic versions of patients’ healthcare records. An electronic health record gathers, creates, and stores the health record electronically. The electronic health record has been slow to be adopted by healthcare providers. The federal government has recently passed legislation requiring the use of electronic records or face monetary penalties. The electronic health record will improve clinical documentation, quality, healthcare utilization tracking, billing and coding, and make health records portable. The core components of an electronic health record include administrative functions, computerized physician order entry, lab systems, radiology systems, pharmacy systems, and clinical documentation. HL7 is the standard communication protocol technology that an electronic health record utilizes. Implementation of software, hardware, and IT networks are important for a successful electronic health record project. The benefits of an electronic health record include a gain in healthcare efficiencies, large gains in quality and safety, and lower healthcare costs for consumers. Electronic health record challenges include costly software packages, system security, patient confidentiality, and unknown future government regulations. Future technologies for electronic health records include bar coding, radio-frequency identification, and speech recognition.
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Galli, Brian J. "Ethics of Electronic Health Record Systems." International Journal of Information Systems and Social Change 9, no. 3 (July 2018): 53–69. http://dx.doi.org/10.4018/ijissc.2018070104.

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This article describes how healthcare and IT are combatting the ethical implications of electronic health records (EHRs) in order to make them adopted by over 90% of small practices. There is a lack of trust in EHRs and uneasiness about what they will accomplish. Furthermore, security concerns have become more prevalent as a result of increased hacker activity. The objective of this article is to analyze these ethical issues in an effort to eliminate them as a hinderance to EHR implementation. As of now, 98% of all hospitals use EHRs. Between 2009 and 2015, the government allocated money and resources for incentive programs to get EHRs into every healthcare providers' office. During this time period, over $800 million dollars facilitated EHR implementation. Using this as a tool EHRs negative perception can be revitalized and combated with the meaningful use program. This article will highlight the ethical implications of EHRs and suggest ways in which to avoid them to make EHRs available in every healthcare provider.
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Ohno-Machado, Lucila, Jihoon Kim, Rodney A. Gabriel, Grace M. Kuo, and Michael A. Hogarth. "Genomics and electronic health record systems." Human Molecular Genetics 27, R1 (April 18, 2018): R48—R55. http://dx.doi.org/10.1093/hmg/ddy104.

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Sanders, David S., Daniel J. Lattin, Sarah Read-Brown, Daniel C. Tu, David J. Wilson, Thomas S. Hwang, John C. Morrison, Thomas R. Yackel, and Michael F. Chiang. "Electronic Health Record Systems in Ophthalmology." Ophthalmology 120, no. 9 (September 2013): 1745–55. http://dx.doi.org/10.1016/j.ophtha.2013.02.017.

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Nøhr, C. "Evaluation of Electronic Health Record Systems." Yearbook of Medical Informatics 15, no. 01 (August 2006): 107–13. http://dx.doi.org/10.1055/s-0038-1638481.

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SummaryThe objective of this article is to present an overview of the various considerations to be made prior to evaluating electronic health record (EHR) systems.From the methodological literature, a number of themes for decisions are presented and related to the contemporary EHR situation. Special attention is paid to a number of important methodological themes.Definitive checklists for evaluation of EHR systems can not be recommended, but seven key steps are listed to guide the design of evaluation projects.It is concluded that the issues presented are not completely exhausted and the seven key steps might have to include iterative loops because of interdependencies between some of the steps.
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N., Gayathri. "A Model for Xml-based Electronic Health Record System." International Journal of Psychosocial Rehabilitation 24, no. 5 (April 20, 2020): 5785–807. http://dx.doi.org/10.37200/ijpr/v24i5/pr2020286.

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8

King, Jason, Ben Smith, and Laurie Williams. "Audit Mechanisms in Electronic Health Record Systems." International Journal of Computational Models and Algorithms in Medicine 3, no. 2 (April 2012): 23–42. http://dx.doi.org/10.4018/jcmam.2012040102.

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Inadequate audit mechanisms may result in undetected misuse of data in software-intensive systems. In the healthcare domain, electronic health record (EHR) systems should log the creating, reading, updating, or deleting of privacy-critical protected health information. The objective of this paper is to assess electronic health record audit mechanisms to determine the current degree of auditing for non-repudiation and to assess whether general audit guidelines adequately address non-repudiation. The authors analyzed the audit mechanisms of two open source EHR systems, OpenEMR and Tolven eCHR, and one proprietary EHR system. The authors base the qualitative assessment on a set of 16 general auditable events and 58 black-box test cases for specific auditable events. The authors find that OpenEMR satisfies 62.5% of the general criteria and passes 63.8% of the black-box test cases. Tolven eCHR and the proprietary EHR system each satisfy less than 19% of the general criteria and pass less than 11% of the black-box test cases.
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Winter, Alfred, Katsuhiko Takabayashi, Franziska Jahn, Eizen Kimura, Rolf Engelbrecht, Reinhold Haux, Masayuki Honda, et al. "Quality Requirements for Electronic Health Record Systems." Methods of Information in Medicine 56, S 01 (January 2017): e92-e104. http://dx.doi.org/10.3414/me17-05-0002.

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SummaryBackground: For more than 30 years, there has been close cooperation between Japanese and German scientists with regard to information systems in health care. Collaboration has been formalized by an agreement between the respective scientific associations. Following this agreement, two joint workshops took place to explore the similarities and differences of electronic health record systems (EHRS) against the background of the two national healthcare systems that share many commonalities.Objectives: To establish a framework and requirements for the quality of EHRS that may also serve as a basis for comparing different EHRS.Methods: Donabedian’s three dimensions of quality of medical care were adapted to the outcome, process, and structural quality of EHRS and their management. These quality dimensions were proposed before the first workshop of EHRS experts and enriched during the discussions.Results: The Quality Requirements Framework of EHRS (QRF-EHRS) was defined and complemented by requirements for high quality EHRS. The framework integrates three quality dimensions (outcome, process, and structural quality), three layers of information systems (processes and data, applications, and physical tools) and three dimensions of information management (strategic, tactical, and operational information management).Conclusions: Describing and comparing the quality of EHRS is in fact a multidimensional problem as given by the QRF-EHRS framework. This framework will be utilized to compare Japanese and German EHRS, notably those that were presented at the second workshop.
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McCormick, Danny, Stephanie Woolhandler, and David U. Himmelstein. "Electronic Health Record Systems: The Authors Reply." Health Affairs 31, no. 6 (June 2012): 1366. http://dx.doi.org/10.1377/hlthaff.2012.0475.

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Ohno-Machado, Lucila. "Electronic health record systems: risks and benefits." Journal of the American Medical Informatics Association 21, e1 (February 2014): e1-e1. http://dx.doi.org/10.1136/amiajnl-2014-002635.

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Spatar, Daria, Orhun Kok, Nuri Basoglu, and Tugrul Daim. "Adoption factors of electronic health record systems." Technology in Society 58 (August 2019): 101144. http://dx.doi.org/10.1016/j.techsoc.2019.101144.

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13

Almulhem, Ahmad. "Threat Modeling for Electronic Health Record Systems." Journal of Medical Systems 36, no. 5 (August 26, 2011): 2921–26. http://dx.doi.org/10.1007/s10916-011-9770-6.

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14

Cresswell, Kathrin, Allison Worth, and Aziz Sheikh. "Implementing and adopting electronic health record systems." Clinical Governance: An International Journal 16, no. 4 (October 18, 2011): 320–36. http://dx.doi.org/10.1108/14777271111175369.

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15

Kalra, D. "Electronic Health Record Standards." Yearbook of Medical Informatics 15, no. 01 (August 2006): 136–44. http://dx.doi.org/10.1055/s-0038-1638463.

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SummaryThis paper seeks to provide an overview of the initiatives that are proceeding internationally to develop standards for the exchange of electronic health record (EHR) information between EHR systems.The paper reviews the clinical and ethico-legal requirements and research background on the representation and communication of EHR data, which primarily originates from Europe through a series of EU funded Health Telematics projects over the past thirteen years. The major concepts that underpin the information models and knowledge models are summarised. These provide the requirements and the best evidential basis from which HER communications standards should be developed.The main focus of EHR communications standardisation is presently occurring at a European level, through the Committee for European Normalisation (CEN). The major constructs of the CEN 13606 model are outlined. Complementary activity is taking place in ISO and in HL7, and some of these efforts are also summarised.There is a strong prospect that a generic EHR interoperability standard can be agreed at a European (and hopefully international) level. Parts of the challenge of EHR interoperability cannot yet be standardised, because good solutions to the preservation of clinical meaning across heterogeneous systems remain to be explored. Further research and empirical projects are therefore also needed.
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Khedr, Dr Ayman E., and Fahad Kamal Alsheref. "A Proposed Electronic Health Record Content Structure Based on Clinical Organizations Survey." INTERNATIONAL JOURNAL OF COMPUTERS & TECHNOLOGY 15, no. 13 (October 22, 2014): 5233–46. http://dx.doi.org/10.24297/ijct.v15i13.5283.

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Computer systems and communication technologies made a strong and influential presence in the different fields of medicine. The cornerstone of a functional medical information system is the Electronic Health Records (EHR) management system. Several electronic health records systems were implemented in different states with different clinical data structures that prevent data exchange between systems even in the same state. This leads to the important barrier in implementing EHR system which is the lack of standards of EHR clinical data structure. In this paper we made a survey on several in international and Egyptian medical organization for implementing electronic health record systems for finding the best electronic health record clinical data structure that contains all patient’s medical data. We proposed an electronic health record system with a standard clinical data structure based on the international and Egyptian medical organization survey and with avoiding the limitations in the other electronic health record that exists in the survey.
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Raymond, Louis, Guy Paré, and Marie Marchand. "Extended use of electronic health records by primary care physicians: Does the electronic health record artefact matter?" Health Informatics Journal 25, no. 1 (April 23, 2017): 71–82. http://dx.doi.org/10.1177/1460458217704244.

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The deployment of electronic health record systems is deemed to play a decisive role in the transformations currently being implemented in primary care medical practices. This study aims to characterize electronic health record systems from the perspective of family physicians. To achieve this goal, we conducted a survey of physicians practising in private clinics located in Quebec, Canada. We used valid responses from 331 respondents who were found to be representative of the larger population. Data provided by the physicians using the top three electronic health record software products were analysed in order to obtain statistically adequate sub-sample sizes. Significant differences were observed among the three products with regard to their functional capability. The extent to which each of the electronic health record functionalities are used by physicians also varied significantly. Our results confirm that the electronic health record artefact ‘does matter’, its clinical functionalities explaining why certain physicians make more extended use of their system than others.
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Kukafka, Rita, Jessica S. Ancker, Connie Chan, John Chelico, Sharib Khan, Selasie Mortoti, Karthik Natarajan, Kempton Presley, and Kayann Stephens. "Redesigning electronic health record systems to support public health." Journal of Biomedical Informatics 40, no. 4 (August 2007): 398–409. http://dx.doi.org/10.1016/j.jbi.2007.07.001.

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Giordanengo, Alain, Meghan Bradway, Rune Pedersen, Astrid Grøttland, Gunnar Hartvigsen, and Eirik Årsand. "Integrating data from apps, wearables and personal Electronic Health Record (pEHR) systems with clinicians’ Electronic Health Records (EHR) systems." International Journal of Integrated Care 16, no. 5 (November 9, 2016): 16. http://dx.doi.org/10.5334/ijic.2565.

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Berry, D., and J. Bisbal. "An Analysis Framework for Electronic Health Record Systems." Methods of Information in Medicine 50, no. 02 (2011): 180–89. http://dx.doi.org/10.3414/me09-01-0002.

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Summary Background: The timely provision of complete and up-to-date patient data to clinicians has for decades been one of the most pressing objectives to be fulfilled by information technology in the healthcare domain. The so-called electronic health record (EHR), which provides a unified view of all relevant clinical data, has received much attention in this context from both research and industry. This situation has given rise to a large number of research projects and commercial products that aim to address this challenge. Different projects and initiatives have attempted to address this challenge from various points of view, which are not easily comparable. Objectives: This paper aims to clarify the challenges, concepts, and approaches involved, which is essential in order to consistently compare existing solutions and objectively assess progress in the field. Methods: This is achieved by two different means. Firstly, the paper will identify the most significant issues that differentiate the points of view and intended scope of existing approaches. As a result, a framework for analysis of EHR systems will be produced. Secondly, the most representative EHR-related projects and initiatives will be described and compared within the context of this framework. Results: The main result of the present paper is an analysis framework for EHR systems. This is intended as an initial step towards an attempt to structure research on this field, clearly lacking sound principles to evaluate and compare results, and ultimately focusing its efforts and being able to objectively evaluate scientific progress. Conclusions: Evaluation and comparison of results in medical informatics, and specifically EHR systems, must address technical and nontechnical aspects. It is challenging to condensate in a single framework all potential views of such a field, and any chosen approach is bound to have its limitations. That being said, any well structured comparison approach, such as the framework presented here, is better than no comparison framework at all, as has been the current situation to date. This paper has presented the first attempt known to the authors to define such a framework.
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Retchin, S. M., and R. P. Wenzel. "Electronic medical record systems at academic health centers." Academic Medicine 74, no. 5 (May 1999): 493–8. http://dx.doi.org/10.1097/00001888-199905000-00013.

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Stead, W. W., J. C. Denny, D. Giuse, N. M. Lorenzi, S. H. Brown, K. B. Johnson, and S. T. Rosenbloom. "Generating Clinical Notes for Electronic Health Record Systems." Applied Clinical Informatics 01, no. 03 (2010): 232–43. http://dx.doi.org/10.4338/aci-2010-03-ra-0019.

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SummaryClinical notes summarize interactions that occur between patients and healthcare providers. With adoption of electronic health record (EHR) and computer-based documentation (CBD) systems, there is a growing emphasis on structuring clinical notes to support reusing data for subsequent tasks. However, clinical documentation remains one of the most challenging areas for EHR system development and adoption. The current manuscript describes the Vanderbilt experience with implementing clinical documentation with an EHR system. Based on their experience rolling out an EHR system that supports multiple methods for clinical documentation, the authors recommend that documentation method selection be made on the basis of clinical workflow, note content standards and usability considerations, rather than on a theoretical need for structured data.
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Shashi, Dr Manish. "Leveraging Blockchain-Based Electronic Health Record Systems in Healthcare 4.0." International Journal of Innovative Technology and Exploring Engineering 12, no. 1 (December 30, 2022): 1–5. http://dx.doi.org/10.35940/ijitee.a9359.1212122.

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Digitalization has become a crucial part of healthcare 4.0 by transforming systems such as electronic health records (EHR), electronic medical records (EMR), and electronic personal medical records (ePHR). Healthcare 4.0 is derived from industry 4.0 and aims to enhance collaboration, virtualization, coherence, and convergence, which helps transform modern healthcare into more personalized and predictive. Healthcare 4.0 also aims to develop digital enablers which will support coordination among various stakeholders and seamless information flow in the patient journey towards wellbeing. These systems enhance patient care through the timely sharing of patient data across different providers globally. Timely sharing helps, but it also makes the electronic system vulnerable to alteration and breaches. In healthcare, blockchain application is widely used in various areas, such as health information exchange, pharmaceutical counterfeit, clinical trials, health supply chain management, patient data management, insurance claims, and product recall in case of adverse events. This research paper aims to identify how blockchain technology can help enhance the privacy and security of electronic health record systems. This paper discusses various blockchain-based systems, which provide a more efficient and secure option than client-server architecture-based traditional EHR systems.
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Q.H., Hasan, Ali A. Yassin, and Oğuz ATA. "Electronic Health Records System Using Blockchain Technology." Webology 18, SI05 (October 30, 2021): 580–93. http://dx.doi.org/10.14704/web/v18si05/web18248.

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Blockchain technology is one of the most important and disruptive technologies in the world. Nowadays the healthcare center needs to share patient databases over all departments of the healthcare centers. Although, electronic healthcare records overcome several problems compared with manual records, but still suffer from many issues such as security, the privacy of patient data overall as we should transfer over a database from a central database to a decentralized database. In this paper, we proposed a good security system to manage the data of patients based on blockchain technology and a decentralized database. Depending on decentralized database and blockchain. Our proposed system provides the secure exchange of patient data, reliability, and high efficiency in sharing data during transaction data network equivalence checking to perform this validation of patient information in the blockchain and healthcare centers.
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Hawthorne, Kisha Hortman, and Lorraine Richards. "Personal health records: a new type of electronic medical record." Records Management Journal 27, no. 3 (November 20, 2017): 286–301. http://dx.doi.org/10.1108/rmj-08-2016-0020.

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Purpose This paper examines existing research on the topic of personal health records (PHRs). Areas covered include PHR/patient portal, recordkeeping, preservation planning, access and provider needs for future reuse of health information. Patient and physician PHR use and functionality, as well as adoption facilitators and barriers, are also reviewed. Design/methodology/approach The paper engages in a review of relevant literature from a variety of subject domains, including personal information management, medical informatics, medical literature and archives and records management literature. Findings The review finds that PHRs are extensions of electronic records. In addition, it finds a lack of literature within archives and records management that may lead to a less preservation-centric examination of the new PHR technologies that are desirable for controlling the lifecycle of these important new records-type. Originality/value Although the issues presented by PHRs are issues that can best be solved with the use of techniques from records management, there is no current literature related to PHRs in the records management literature, and that offered in the medical informatics literature treats the stewardship aspects of PHRs as insurmountable. This paper offers an introduction to the aspects of PHRs that could fruitfully be examined in archives and records management.
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Lavariega, Juan C., Roberto Garza, Lorena G. Gómez, Victor J. Lara-Diaz, and Manuel J. Silva-Cavazos. "EEMI - An Electronic Health Record for Pediatricians." International Journal of Healthcare Information Systems and Informatics 11, no. 3 (July 2016): 57–69. http://dx.doi.org/10.4018/ijhisi.2016070104.

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The use of paper health records and handwritten prescriptions are prone to preset errors of misunderstanding instructions or interpretations that derive in affecting patients' health. Electronic Health Records (EHR) systems are useful tools that among other functions can assists physicians' tasks such as finding recommended medicines, their contraindications, and dosage for a given diagnosis, filling prescriptions and support data sharing with other systems. This paper presents EEMI, a Children EHR focused on assisting pediatricians in their daily office practice. EEMI functionality keeps the relationships among diagnosis, treatment, and medications. EEMI also calculates dosages and automatically creates prescriptions which can be personalized by the physician. The system also validates patient allergies. This paper also presents the current use of EHRs in Mexico, the Mexican Norm (NOM-024-SSA3-2010), standards for the development of electronic medical records and its relationships with other standards for data exchange and data representation in the health area.
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Olson, Lisa. "Electronic Record Challenges for Clinical Systems." Drug Information Journal 35, no. 3 (July 2001): 721–30. http://dx.doi.org/10.1177/009286150103500310.

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Ross, M. K., Wei Wei, and L. Ohno-Machado. "“Big Data” and the Electronic Health Record." Yearbook of Medical Informatics 23, no. 01 (August 2014): 97–104. http://dx.doi.org/10.15265/iy-2014-0003.

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Summary Objectives: Implementation of Electronic Health Record (EHR) systems continues to expand. The massive number of patient encounters results in high amounts of stored data. Transforming clinical data into knowledge to improve patient care has been the goal of biomedical informatics professionals for many decades, and this work is now increasingly recognized outside our field. In reviewing the literature for the past three years, we focus on “big data” in the context of EHR systems and we report on some examples of how secondary use of data has been put into practice. Methods: We searched PubMed database for articles from January 1, 2011 to November 1, 2013. We initiated the search with keywords related to “big data” and EHR. We identified relevant articles and additional keywords from the retrieved articles were added. Based on the new keywords, more articles were retrieved and we manually narrowed down the set utilizing predefined inclusion and exclusion criteria. Results: Our final review includes articles categorized into the themes of data mining (pharmacovigilance, phenotyping, natural language processing), data application and integration (clinical decision support, personal monitoring, social media), and privacy and security. Conclusion: The increasing adoption of EHR systems worldwide makes it possible to capture large amounts of clinical data. There is an increasing number of articles addressing the theme of “big data”, and the concepts associated with these articles vary. The next step is to transform healthcare big data into actionable knowledge.
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Wardhana, Erdianto Setya, Suryono Suryono, Ari Hernawan, and Lukito Edi Nugroho. "EVALUATION OF FORMAT AND SECURITY OF DENTAL ELECTRONIC MEDICAL RECORD SYSTEMS IN GENERAL HOSPITAL BASED ON LEGISLATION." ODONTO : Dental Journal 9 (April 8, 2022): 80. http://dx.doi.org/10.30659/odj.9.0.80-89.

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Background: Electronic medical records in dentistry are the latest implementation in the health sector, especially dental health history to the services needed by patients by health care facilities and affect the format of dental, medical records and electronic medical record security systems. This study aimed to review the completeness of the medical record format and the electronic medical record security system of the dental polyclinic of the General Hospital in Batam City. Method: This study used a descriptive cross-sectional observational design with two samples. Processing data in the form of tables and texts and conclusions as a result of research. Result: The results showed incomplete dental electronic medical record formats at hospital A, such as patient identity, required medical data, odontogram, intraoral examination, and treatment chart, while Hospital B included patient identity, required medical data, intraoral analysis, treatment chart, and appendix. The two samples did not meet the integrity and non-repudiation aspects of the electronic medical record security system. Conclusion: According to the Indonesian Dental Medical Record Guidelines, both samples have an incomplete dental electronic medical record format and security system.
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Blijleven, Vincent, Florian Hoxha, and Monique Jaspers. "Workarounds in Electronic Health Record Systems and the Revised Sociotechnical Electronic Health Record Workaround Analysis Framework: Scoping Review." Journal of Medical Internet Research 24, no. 3 (March 15, 2022): e33046. http://dx.doi.org/10.2196/33046.

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Background Electronic health record (EHR) system users devise workarounds to cope with mismatches between workflows designed in the EHR and preferred workflows in practice. Although workarounds appear beneficial at first sight, they frequently jeopardize patient safety, the quality of care, and the efficiency of care. Objective This review aims to aid in identifying, analyzing, and resolving EHR workarounds; the Sociotechnical EHR Workaround Analysis (SEWA) framework was published in 2019. Although the framework was based on a large case study, the framework still required theoretical validation, refinement, and enrichment. Methods A scoping literature review was performed on studies related to EHR workarounds published between 2010 and 2021 in the MEDLINE, Embase, CINAHL, Cochrane, or IEEE databases. A total of 737 studies were retrieved, of which 62 (8.4%) were included in the final analysis. Using an analytic framework, the included studies were investigated to uncover the rationales that EHR users have for workarounds, attributes characterizing workarounds, possible scopes, and types of perceived impacts of workarounds. Results The SEWA framework was theoretically validated and extended based on the scoping review. Extensive support for the pre-existing rationales, attributes, possible scopes, and types of impact was found in the included studies. Moreover, 7 new rationales, 4 new attributes, and 3 new types of impact were incorporated. Similarly, the descriptions of multiple pre-existing rationales for workarounds were refined to describe each rationale more accurately. Conclusions SEWA is now grounded in the existing body of peer-reviewed empirical evidence on EHR workarounds and, as such, provides a theoretically validated and more complete synthesis of EHR workaround rationales, attributes, possible scopes, and types of impact. The revised SEWA framework can aid researchers and practitioners in a wider range of health care settings to identify, analyze, and resolve workarounds. This will improve user-centered EHR design and redesign, ultimately leading to improved patient safety, quality of care, and efficiency of care.
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Kaukinen, Daniel L. "JSON-LD as an Interchange Technology to Facilitate Health Information Exchange." International Journal of Extreme Automation and Connectivity in Healthcare 1, no. 1 (January 2019): 66–78. http://dx.doi.org/10.4018/ijeach.2019010107.

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Sharing information between medical records to form a comprehensive electronic health record leads to effective health management. However, full implementation of an electronic health record has met various barriers including companies wanting to protect their proprietary data storage formats and resisting conversion to a common data exchange format. Through the development of prototype systems, this article investigates the use of JSON-LD as an interpreter to aid in data interchange and data encapsulation. The prototypes demonstrate that JSON-LD can be applied, with nominal code changes, to an existing electronic medical record system employing JSON as a serialization protocol. This article concludes that JSON-LD works as an efficient wrapper that, when well designed, allows for simplified and robust consumption from and serving of data to other JSON-LD enabled medical systems, thereby elevating the usability and effective interconnectivity of new and existing electronic medical record systems.
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Sachdeva, Shelly, and Subhash Bhalla. "Semantic interoperability in standardized electronic health record databases." Journal of Data and Information Quality 3, no. 1 (April 2012): 1–37. http://dx.doi.org/10.1145/2166788.2166789.

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Esserman, Denise. "From screening to ascertainment of the primary outcome using electronic health records: Challenges in the STRIDE trial." Clinical Trials 17, no. 4 (May 14, 2020): 346–50. http://dx.doi.org/10.1177/1740774520920898.

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Electronic health record data are a rich resource and can be utilized to answer a wealth of research questions. It is important when using electronic health record data in clinical trials that systems be put in place and vetted prior to enrollment to ensure data elements can be collected consistently across all health care systems. It is often overlooked how something conceptualized on paper (e.g. use of the electronic health record in a study) can be difficult to implement in practice. This article discusses some of the challenges in using electronic health records in the conduct of the STRIDE (Strategies to Reduce Injuries and Develop Confidence in Elders) trial, how we handled those challenges, and the lessons we learned for the conduct of future trials looking to employ the electronic health record.
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Katamanin, Olivia, and Alex M. Glazer MD. "Dermatologists' Perceptions and Use of Electronic Health Record Systems." SKIN The Journal of Cutaneous Medicine 4, no. 5 (August 29, 2020): 404–7. http://dx.doi.org/10.25251/skin.4.5.2.

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Introduction: Electronic Health Records (EHR) have been adopted and integrated into medical practices over the past 20 years. Many positive and negative implications have been described by physicians using EHR. This study aims to US dermatologists' perceptions and use of EHR within their clinical practice. Methods: A validated survey was administered to US dermatologists at a national educational conference to assess use and perceptions of EHR. Results Seventy-two percent (291/400) of those sampled completed greater than 90% survey and were included in outcome analysis. Eighty-six percent of the participants were currently using or had used EHR. Most dermatologists felt that EHR negatively impacted their workflow efficiency and face-to-face time with patients. A portion of dermatologists thought that EHR improved their documentation. Limitations: Selection bias may have led those with strong beliefs with EHR more likely to complete the entire survey. Conclusion: Despite widespread adoption, most dermatologists have a negative impression of EHR and felt that it interfered with their ability to effectively see patients. Interventions to improve EHR should focus on improving workflow efficiency and maximizing the amount of time dermatologists can spend with patients.
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Serwer, Gerald A. "Data Management and Integration with Electronic Health Record Systems." Cardiac Electrophysiology Clinics 13, no. 3 (September 2021): 473–81. http://dx.doi.org/10.1016/j.ccep.2021.05.001.

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Bloom, Benjamin Michael, Jason Pott, Stephen Thomas, David Ramon Gaunt, and Thomas C. Hughes. "Usability of electronic health record systems in UK EDs." Emergency Medicine Journal 38, no. 6 (March 3, 2021): 410–15. http://dx.doi.org/10.1136/emermed-2020-210401.

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BackgroundThe large volume of patients, rapid staff turnover and high work pressure mean that the usability of all systems within the ED is important. The transition to electronic health records (EHRs) has brought many benefits to emergency care but imposes a significant burden on staff to enter data. Poor usability has a direct consequence and opportunity cost in staff time and resources that could otherwise be employed in patient care. This research measures the usability of EHR systems in UK EDs using a validated assessment tool.MethodsThis was a survey completed by members and fellows of the Royal College of Emergency Medicine conducted during summer 2019. The primary outcome was the System Usability Scale Score, which ranges from 0 (worst) to 100 (best). Scores were compared with an internationally recognised measure of acceptable usability of 68. Results were analysed by EHR system, country, healthcare organisation and physician grade. Only EHR systems with at least 20 responses were analysed.ResultsThere were 1663 responses from a total population of 8794 (19%) representing 192 healthcare organisations (mainly UK NHS), and 25 EHR systems. Fifteen EHR systems had at least 20 responses and were included in the analysis. No EHR system achieved a median usability score that met the industry standard of acceptable usability.The median usability score was 53 (IQR 35–68). Individual EHR systems’ scores ranged from 35 (IQR 26–53) to 65 (IQR 44–80).ConclusionIn this survey, no UK ED EHR system met the internationally validated standard of acceptable usability for information technology.
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Kasiri, Narges, Ramesh Sharda, and Daniel Adomako Asamoah. "Evaluating electronic health record systems: a system dynamics simulation." SIMULATION 88, no. 6 (August 15, 2011): 639–48. http://dx.doi.org/10.1177/0037549711416244.

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Ohno-Machado, Lucila. "Use of electronic health record systems for decision support." Journal of the American Medical Informatics Association 18, no. 6 (November 2011): 729. http://dx.doi.org/10.1136/amiajnl-2011-000577.

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Campion, Thomas R., Stephen B. Johnson, Elizabeth W. Paxton, Alvin I. Mushlin, and Art Sedrakyan. "Implementing Unique Device Identification in Electronic Health Record Systems." Medical Care 52, no. 1 (January 2014): 26–31. http://dx.doi.org/10.1097/mlr.0000000000000012.

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Flores Zuniga, Alejandro Enrique, Khin Than Win, and Willy Susilo. "Functionalities of free and open electronic health record systems." International Journal of Technology Assessment in Health Care 26, no. 4 (October 2010): 382–89. http://dx.doi.org/10.1017/s0266462310001121.

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Objectives: The aim of this study was to examine open-source electronic health record (EHR) software to determine their level of functionalities according to the International Organization for Standardization (ISO) standards.Methods: ISO standards were used as a guideline to determine and describe the reference architecture and functionalities of a standard electronic health record system as well the environmental context for which the software has been built. Twelve open-source EHR systems were selected and evaluated according to two-dimensional criteria based on ISO/TS 18308:2004 functional requirements and ISO/TR 20514:2005 context of the EHR system.Results: Open EHR software programs mostly fulfill structural, procedural, evolutional, and medicolegal requirements at the minimal and full functionality levels. Communication, privacy, and security requirements are accomplished in less than 23 percent of the cases, mainly at minimal functional level. Ethical, cultural, and consumer requirements still need to be fulfilled by free and open-source EHR applications.Conclusions: Most analyzed systems had several functional limitations. Nevertheless, especially for clinicians and decision makers in developing countries, open-source EHR systems are an option. The limited functionalities are likely to become requirements for further releases of open-source EHR systems.
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Chiang, Michael F., Michael V. Boland, Allen Brewer, K. David Epley, Mark B. Horton, Michele C. Lim, Colin A. McCannel, et al. "Special Requirements for Electronic Health Record Systems in Ophthalmology." Ophthalmology 118, no. 8 (August 2011): 1681–87. http://dx.doi.org/10.1016/j.ophtha.2011.04.015.

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Hewitt, Barbara, and Alexander McLeod. "Modeling Security in Acceptance of Electronic Health Record Systems." Journal of Information Privacy and Security 7, no. 3 (July 2011): 23–45. http://dx.doi.org/10.1080/15536548.2011.10855916.

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Blobel, Bernd. "Authorisation and access control for electronic health record systems." International Journal of Medical Informatics 73, no. 3 (March 2004): 251–57. http://dx.doi.org/10.1016/j.ijmedinf.2003.11.018.

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Madden, Connie, and Allen Hanberg. "Integrating Electronic Health Record Systems With Human Patient Simulation." Clinical Simulation in Nursing 5, no. 3 (May 2009): e145. http://dx.doi.org/10.1016/j.ecns.2009.04.057.

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Spooner, S. A. "Special Requirements of Electronic Health Record Systems in Pediatrics." PEDIATRICS 119, no. 3 (March 1, 2007): 631–37. http://dx.doi.org/10.1542/peds.2006-3527.

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46

Vreeman, Daniel J., Samuel L. Taggard, Michael D. Rhine, and Teddy W. Worrell. "Evidence for Electronic Health Record Systems in Physical Therapy." Physical Therapy 86, no. 3 (March 1, 2006): 434–46. http://dx.doi.org/10.1093/ptj/86.3.434.

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Abstract With increasing pressures to better manage clinical information, we investigated the role of electronic health record (EHR) systems in physical therapist practice through a critical review of the literature. We reviewed studies that met our predefined criteria after independent review by 3 authors. The investigators in all of the reviewed studies reported benefits, including improved reporting, operational efficiency, interdepartmental communication, data accuracy, and capability for future research. In 7 studies, the investigators reported barriers, including challenges with behavior modification, equipment inadequacy, and training. The investigators in all studies reported key success factors, including end-user participation, adequate training, workflow analysis, and data standardization. This review suggests that EHRs have potential benefits for physical therapists. The authors formed the following recommendations based on the studies’ themes: (1) incorporate workflow analysis into system design and implementation; (2) include end users, especially clinicians, in system development; (3) devote significant resources for training; (4) plan and test carefully to ensure adequate software and hardware performance; and (5) commit to data standards. [Vreeman DJ, Taggard SL, Rhine MD, Worrell TW. Evidence for electronic health record systems in physical therapy.
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Alami, MasoomehRahimi, Mahdieh Nemayande, Omid Yousefianzadeh, Mahnaz Samadbeik, Amir Abbas Azizi, Robabeh Motaghedi, Atefeh Zare, et al. "Personal Electronic Health Record for Patients with Diabetes; Health Technology Assessment Protocol." Internal Medicine and Medical Investigation Journal 2, no. 4 (October 5, 2017): 132. http://dx.doi.org/10.24200/imminv.v2i4.100.

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Introduction: In recent decades, diabetes has contributed significantly to the burden of disease in developed and developing countries, due to the considerable prevalence and involvement of various age groups in the communities.Today, a variety of ways to manage and control the disease are used, one of which is the use of personal electronic health records. Recently there has been a remarkable upsurge in activity surrounding the adoption of personal electronic health records systems for patients and consumers. personal electronic health records systems are more than just static repositories for patient data; they combine data, knowledge, and software tools, which help patients to become active participants in their own care.The present study was conducted with the goal of Health Technology Assessment the impact of personal electronic health records in Patients with Diabetes.Methods: Writing is based on PRISMA standards. This was a Health Technology Assessment study. It aimed to evaluate the technology of personal electronic health record . The scoping review was conducted to evaluate 8 dimensions (Health Problem and Current Use of the Technology, Description and technical characteristics of technology, Safety, Costs and economic evaluation, Ethical analysis, Organisational aspects, Patients and Social aspects, Legal aspects) of Personal electronic health record . This study was based on answering questions which were developed based on Health Diagnostics Technology Assessment Documents Framework and HTA Core Model 3.0 . A systematic review was conducted to evaluate the Clinical Effectiveness dimension of personal electronic health record in controlling diabetes. In order to gather evidences, Ovid databases, Cochrane Library, PubMed, CRD, Trip database and EMBASE, and Randomized Controlled Trial Registries, such as the Clinical Trial and Trial Registry, were searched using specific keywords and strategies. .Articles are evaluated on the basis of the quality criteria of JADAD.The data is analyzed by the STATA software.Dissemination:The results of the study will be published in a peer-reviewed journal and presented at relevant conferences.Policy makers and healthcare decision-makers can use these results.
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Katić, Milica, Dragan Soldo, Zlata Ozvačić, Sanja Blažeković-Milaković, Mladenka Vrcić-Keglević, Biserka Bergman-Marković, Hrvoje Tiljak, Djurdjica Lazić, Venija Nekić, and Goranka Petriček. "Information systems and the electronic health record in primary health care." Journal of Innovation in Health Informatics 15, no. 3 (September 1, 2007): 187–92. http://dx.doi.org/10.14236/jhi.v15i3.658.

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Mavrov, Momchil, and Mariya Hristozova. "E- HEALTH: THE MODERN INSTRUMENT FOR IMPROVING HEALTH SYSTEMS AND PROVIDING ACCESSIBLE AND HIGH-QUALITY HEALTH CARE." Knowledge International Journal 34, no. 5 (October 4, 2019): 1581–86. http://dx.doi.org/10.35120/kij34051581m.

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In the last two decades, information and communication technologies have significantly changed the development of relations in all sectors of public life. The modern information еra has provided unlimited opportunities for free exchange of information on all issues of public importance and the use of new technologies in order to raise the standard of living of members of society and their financial well-being. Information and communication technologies (ICT) are increasingly used in healthcare. A major factor in this trend is the extreme importance of information in medical practice. The way in which information about patients' health status is received and used by healthcare providers has a significant impact on the quality of care. The information itself, the selection and its completeness, becomes a decisive factor for the behavior of the participants in the national health systems - state bodies, medical establishments, professional companies, patient organizations and others.In this sense, the integration of information systems for electronic data interchange provides enormous opportunities for the rapid and efficient management of health information and hence for the more efficient operation of healthcare facilities and healthcare professionals. That's why, one of the most important tools for enhancing the effectiveness of any national health system is the construction of e-health (e-health). E-health is a valuable tool for improving national health systems and providing affordable and high quality health services. The successful construction and use of e-Health improves the communication environment and provides a number of benefits for the relevant national health system as well as for the whole community. In addition to building e-health, an effective healthcare system also requires the creation of an electronic health record for each patient, also referred to as electronic medical records. An electronic health record is a record that contains certain health information for one person in a format suitable for computer processing and use. Creating electronic health records is of great benefit to both patients and healthcare professionals. For example, the introduction of electronic medical records provides quick and easy access for physicians to patients' medical records, enabling them to track all important circumstances and changes in the patient's health status, and to tailor them to conduct specific diagnostic and healing activities.
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Bhalerao, Makarand, Soham Moghe, and Parth Nimbalkar. "Unicare – A Electronic Health Record Platform." International Journal for Research in Applied Science and Engineering Technology 10, no. 7 (July 31, 2022): 5073–76. http://dx.doi.org/10.22214/ijraset.2022.46095.

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Abstract: Ever since the advent of the internet i.e interconnected computer technology, nearly every sector has joined the bandwagon and has shifted towards a centralized, robust and a highly organized database. Furthermore, the advancements in newly emerging fields like big data, data mining and warehousing has made it possible to obtain crucial and valuable insights from the enormous amounts of data being saved in various databases. As a result, several sectors have invested in having their own data analysis systems to gain better understanding of their works and possible improvements they can make in their current workings. Healthcare however seems to have been a bit behind in making optimum use of these tools and methodologies. Electronic health records carry significant potential in improving the quality of healthcare through easy access to information, precisely by helping to make prudent prognoses and thus saving the patient's time and finances. Unicare is a seamless electronic health records platform designed to address this issue with an aim of having a centralized health care portal, accessible to both the medical experts and patients. Medical professionals can access the patient’s history and make informed decisions regarding their ailments.
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