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1

Gregory, Judith. "Sorcerer's apprentice : creating the electronic health record, re-inventing medical records and patient care /." Diss., Connect to a 24 p. preview or request complete full text in PDF format. Access restricted to UC campuses, 2000. http://wwwlib.umi.com/cr/ucsd/fullcit?p9992380.

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2

Sonico, Eric A. "Implementation and utilization of electronic medical records| An analysis." Thesis, California State University, Long Beach, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=1522655.

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This master's thesis will present a literature review and analysis ofthe implementation and use of Electronic Medical Records (EMR). The literature review will discuss reasons that support implementation of EMRs, factors that are necessary for successful implementation and barriers that impede implementation. Also, real-world examples of implementation for medical billing in healthcare organizations will be discussed, as well as the disparity in implementation rates between larger and smaller healthcare organizations.

The analysis portion of this thesis will include data from the 2009 National Ambulatory Medical Survey (NAMCS) EMR Supplement and, through the application of the Chi-Square statistical test using SPSS, will assess whether size of the medical practice in terms of number of physicians is significantly associated with EMR implementation and functionality, the latter of which includes clinical reminders and prescription ordering. It will be shown that physician size is indeed significantly associated with implementation and functionality.

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Swanson, Abby Jo. "Electronic Medical Records in Acute Care Hospitals: Correlates, Efficiency, and Quality." VCU Scholars Compass, 2006. https://scholarscompass.vcu.edu/etd/871.

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The purpose of this dissertation is to examine the organizational and environmental correlates of hospital EMR use and to examine the relationship between hospital EMR use and performance. Using a theoretical framework that combines resource dependence theory with Donabedian's structure, process, outcome model, a conceptual model is created. To test the hypotheses of this model, logistic regression and Data Envelopment Analysis (DEA) are used. The data included in this analysis come from the AHA, HIMSS, CMS, ARF, and HQA. In the analysis of hospitals correlates of EMR use, three hypotheses were supported, and one was partially supported. Hospital system affiliation, bed size, and environmental uncertainty were found to be positively associated with hospital EMR use. Hospital rurality was found to be associated with EMR use for all categories except one; at every other level of rurality, as the hospital moves on a continuum from least rural to most urban, the likelihood of hospital EMR use also increases. Hospital EMR use was not found to be associated with teaching status, environmental munificence, competition, operating margin, ownership, or public payer mix. In the hospital performance analyses, one hypothesis was supported, and one was partially supported. Regarding quality, hospitals with EMRs were found to provide higher quality than those without EMRs. In efficiency performance, only small hospitals with EMRs were found to be more efficient than hospitals without EMRs. No support was found that hospitals with EMRs improve their efficiency over time more than hospitals without EMRs. Hospital EMR use does vary by certain organizational and environmental characteristics. For this reason, hospitals and policy makers must take action that enables and encourages all hospitals to implement and use EMRs because some hospitals do not have the motivation or resources to begin using EMRs on their own. Hospital EMR use is positively associated with high quality care, thus justifying the practice. Hospital efficiency was not found to be associated with EMR use in medium or large hospitals, but it was found to be associated with EMR use in small hospitals. Interestingly, larger hospitals are more likely to use EMRs than small hospitals. It is possible that the efficiency gains of EMR use in hospitals will not be realized until a standardized, fully interoperable system is developed, allowing health care provides to quickly and easily share the medical charts of their patients.
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Adeyeye, Adebisi. "Health care professionals' perceptions of the use of electronic medical records." Thesis, University of Phoenix, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10011612.

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ABSTRACT Electronic medical record (EMR) use has improved significantly in health care organizations. However, many barriers and factors influence the success of EMR implementation and adoption. The purpose of the descriptive qualitative single-case study was to explore health care professionals? perceptions of the use of EMRs at a hospital division of a major medical center. The study findings highlighted the challenges in transitioning from paper records to EMR despite the many benefits and potential improvement in health care. A description of the 16 health care professionals? perceptions of EMR use emerged by adopting the unified theory of acceptance and use of technology (UTAUT) model and NVivo 10 computer software to aid with the analysis of semi-structured, recorded, and transcribed interviews. Themes emerging from the analysis were in five categories: (a) Experience of health care professionals with a subtheme of workflow, (b) Challenges in transition from paper to EMR, (c) Barriers to EMR acceptance, with a subtheme of privacy, confidentiality, and security, (d) Leadership support, and (d) Success of EMR. The findings of the case study may inform health care industry decision makers of additional social and behavioral factors needed for successful EMR strategic planning, implementation, and maintenance.

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Jacobs, Ellen Mueller Keith J. "In search of a message to promote personal health information management." Click here for access, 2009. http://www.csm.edu/Academics/Library/Institutional_Repository.

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Thesis (Ph. D.)--University of Nebraska -- Omaha, 2009.
Presented to the faculty of the Graduate College in the University of Nebraska in partial fulfillment of the requirements for the degree of Doctor of Philosophy. Medical Sciences Interdepartmental Area Health Services Research and Administration. Under the supervision of Professor Keith J. Mueller. Includes bibliographical references.
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Byrd, Linda W. Kavookjian Jan. "An examination of information technology and its perceived quality issues in single system hospitals in the United States." Auburn, Ala., 2009. http://hdl.handle.net/10415/1987.

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Ho, Kenneth. "Improving the quality of the documentation system in a health care environment." [Denver, Colo.] : Regis University, 2006. http://165.236.235.140/lib/KHo2006.pdf.

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8

Mathebeni-, Bokwe Pyrene. "Management of medical records for healthcare service delivery at the Victoria Public Hospital in the Eastern Cape Province :South Africa." Thesis, University of Fort Hare, 2015. http://hdl.handle.net/10353/6517.

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The study sought to investigate the management of medical records for healthcare service at the Victoria Public Hospital in the Eastern Cape Province. The objectives of the study were to describe the present records management practices in Victoria Hospital; find out the existing infrastructure for the management of patient medical records at the Victoria Hospital; determine the compliance of patient medical records management in Victoria Hospital with relevant national legislative and regulatory framework; find out the security of patient medical records at the Victoria Hospital. Quantitative and qualitative approaches were employed. The sample was drawn from the service providers and from the healthcare service users. Questionnaires, interviews and observation were used to collect data. The findings showed that Victoria Hospital uses manual records management system in the creation, maintenance and usage of records. In the findings, there were challenges related to misfiling and missing patient folders which sometimes lead to the creation of new patient folders. Also, the study discovered that the time spent in the retrieval of patient folders could negatively affect the timely delivery of healthcare services. The study recommended the adoption of electronic records management system as most public healthcare institutions in the country are rapidly shifting to electronic records management system. The use of electronic records management system is believed to be efficiently and effectively promoting easy accessibility, retrieval of patient medical records and allows easy communication amongst the healthcare service institutions and healthcare practitioners.
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English, Thomas MacAndrew. "Impact of an electronic medical record on adherence to current diabetes guidelines in a family medical center." Thesis, Birmingham, Ala. : University of Alabama at Birmingham, 2008. https://www.mhsl.uab.edu/dt/2008p/english.pdf.

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Erdil, Nadiye Özlem. "Systems analysis of electronic health record adoption in the U.S. healthcare system." Diss., Online access via UMI:, 2009.

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Thesis (Ph. D.)--State University of New York at Binghamton, Thomas J. Watson School of Engineering and Applied Science, Department of Systems Science and Industrial Engineering, 2009.
Includes bibliographical references.
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11

Spinks, Karolyn Annette. "The impact of the introduction of a pilot electronic health record system on general practioners' work practices in the Illawarra." Access electronically, 2006. http://www.library.uow.edu.au/adt-NWU/public/adt-NWU20060712.153053/index.html.

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12

Ogundaini, Oluwamayowa Oaikhena. "Adoption and use of electronic healthcare information systems to support clinical care in public hospitals of the Western Cape, South Africa." Thesis, Cape Peninsula University of Technology, 2016. http://hdl.handle.net/20.500.11838/2417.

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Thesis (MTech (Information Technology))--Cape Peninsula University of Technology, 2016.
In the Western Cape, South Africa, despite the prospective benefits that e-Health information systems (e-Health IS) offer to support the healthcare sector; there are limitations in terms of usability, functionality and peculiar socio-technical factors. Thus, healthcare professionals do not make the most use of the implemented e-Health IS. Unfortunately, explanations remain tentative and unclear, yet non-usage of the e-Health IS defeats the objectives of its adoption, in the sense that the plan to improve and deliver quality healthcare service in the public sector may not be achieved as envisaged. The aim of the study was to acquire explanations to the causes of the limitations regarding the adoption and, particularly, the use (or non-use) of e-Health IS by clinical staff in the public healthcare institutions in South Africa. The choice of research approach was informed by the research problem, objectives, and the main research question. By the reasons of the subjective and socio-technical nature of the phenomenon, a deductive approach was adopted for this investigation. The nominalist ontology and interpretivist epistemology positions were taken by the researcher as a lens to conduct this research; which informed a qualitative methodology for this investigation. The purposive sampling technique was used to identify the appropriate participants from different hospital levels consisting of Hospital Administrative staff, and Clinical staff (Clinicians and Nurses) of relative experiences in their clinical units. Subsequently, the Unified Theory of Acceptance and Use of Technology (UTAUT) and content analysis technique were used to contextualize, simplify, and analysis the text data transcripts. The findings indicate that healthcare professionals have a high level of awareness and acceptance to use implemented e-Health IS. There are positive perceptions on the expected outcomes, that e-Health IS would improve processes and enhance healthcare services delivery in the public healthcare sector. Also, findings indicate that social influence plays a vital role especially on the willingness of individuals (or groups); as the clinical staff are influenced by their colleagues despite the facilitating conditions provided by the hospital management. Further, findings indicate that it is somewhat problematic to maintain balance in running a parallel paper-electronic system in the hospital environment. Hence, the core factors that influence successful adoption and use of e-Health IS include; willingness of an individual (or group) to accept and use a technology, the performance expectancy, social influence among professionals in the healthcare scenery and adequate facilitating conditions. In summary, it is recommended that there should be an extensive engagement inclusive of all respective stakeholders involved in the adoption processes. This would ensure that e-Health IS are designed to meet both practical organizational and clinical needs (and expectations) with respect to the hospital contexts.
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Pascoe, Shane William. "Primary care medical records : Comleteness, correctness and predictive utility of data from patients with cancer." Thesis, University of York, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.519840.

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14

Okoro, Chris U. "Perspectives of Primary Care Physicians on Adopting Electronic Medical Records in the Atlanta, Georgia Area." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5923.

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Slow adoption of electronic medical records (EMR) by primary care physicians in medical office practices has not facilitated the EMR adoption process. The problem is the slow pace of EMR adoption by primary care physicians in the Atlanta, Georgia area has become a public health concern. Research regarding the lived experiences of these physicians with EMR implementation and utilization may identify reasons for the slow adoption. The purpose of this phenomenological study was to explore the lived experiences of primary care physicians, who practice in the Atlanta area, regarding their perception, successes, barriers, and urgency of adoption of EMR in their healthcare practice. Lewin's change management model of health services served as the framework for the study. Data was collected during face-to-face interviews with 19 primary care physicians at Grady's Ponce de Leon Clinic and Grady's East Point Clinic in Atlanta, Georgia. Participants were physicians or residents and not those in authority to make decisions about the EMR at the two clinics. NVivo 10 and automatic coding was used for data analysis to develop themes from the interviews. The findings revealed that the adoption of EMR has enabled primary care physicians to spend more time with their patients, but the barriers such as a lack of interoperability and lack of training, has fostered a feeling of disinterestedness towards EMR adoption. This study supports positive social change that EMR adoption aids in improving patient safety and outcome.
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Van, der Westhuizen Eldridge Welner. "A framework for personal health records in online social networking." Thesis, Nelson Mandela Metropolitan University, 2012. http://hdl.handle.net/10948/d1012382.

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Since the early 20th century, the view has developed that high quality health care can be delivered only when all the pertinent data about the health of a patient is available to the clinician. Various types of health records have emerged to serve the needs of healthcare providers and more recently, patients or consumers. These health records include, but are not limited to, Personal Health Records, Electronic Heath Records, Electronic Medical Records and Payer-Based Health Records. Payer-Based Health Records emerged to serve the needs of medical aids or health care plans. Electronic Medical Records and Electronic Health Records were targeted at the healthcare provider market, whereas a gap developed in the patient market. Personal Health Records were developed to address the patient market, but adoption was slow at first. The success of online social networking reignited the flame that Personal Health Records needed and online consumer-based Personal Health Records were developed. Despite all the various types of health records, there still seems to be a lack of meaningful use of personal health records in modern society. The purpose of this dissertation is to propose a framework for Personal Health Records in online social networking, to address the issue of a lack of a central, accessible repository for health records. In order for a Personal Health Record to serve this need it has to be of meaningful use. The capability of a PHR to be of meaningful use is core to this research. In order to determine whether a Personal Health Record is of meaningful use, a tool is developed to evaluate Personal Health Records. This evaluation tool takes into account all the attributes that a Personal Health Record which is of meaningful use should comprise of. Suitable ratings are allocated to enable measuring of each attribute. A model is compiled to facilitate the selection of six Personal Health Records to be evaluated. One of these six Personal Health Records acts as a pilot site to test the evaluation tool in order to determine the tool’s utility and effect improvements. The other five Personal Health Records are then evaluated to measure their adherence to the attributes of meaningful use. These findings, together with a literature study on the various types of health records and the evaluation tool, inform the building blocks used to present the framework. It is hoped that the framework for Personal Health Records in online social networking proposed in this research, may be of benefit to provide clear guidance for the achievement of a central or integrated, accessible repository for health records through the meaningful use of Personal Health Records.
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Ntsoele, Motsegoane Monica Naomi. "An evaluation of the effective use of computer-based nursing information system in patient care by professional nurses at Dr George Mukhari Hospital." Thesis, University of Limpopo ( Medunsa Campus), 2011. http://hdl.handle.net/10386/408.

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Thesis (M Cur)--University of Limpopo, 2011.
An evaluation of the effective use of Computer-based Nursing Information System (CNIS) in patient care by Professional nurses at Dr George Mukhari Hospital. The aim of the study was to evaluate if the CNIS is being used effectively for patient care by professional nurses in different nursing units. The objectives of the study were to describe the perceptions of professional nurses regarding the role of CNIS, to determine the effective use of CNIS, and to identify barriers to the effective use of CNIS in patient care. Quantitative descriptive simple survey research design was used. The setting was at Dr George Mukhari Hospital. The population was all professional nurses who are working on day and night shifts in the wards that have computers installed for the purpose of patient care. Non probability, convenience sample of 120 professional nurses was used. Data was collected utilising a self report questionnaire with 41 closed ended and one open ended questions. Raw data was fed into a SPSS with the assistance of a statistician. Data analysis was conducted through the use of descriptive statistics. The findings are that professional nurses are not using CNIS effectively in patient care. In a unit with a bed occupancy rate of 30-40 patients, and where 30-40 patients are attended to on a daily basis, only 0-2 Nursing Care Plans (NCP) or entries are performed by professional nurses. The majority of professional nurses (56%) never updated NCPs or made an entry before. This is despite the fact that they have indicated positive perceptions with regard to the role of CNIS in patient care. Increased workload, inadequate number of computers, and lack of continuous in-service training were cited by the majority as barriers to the effective use of CNIS in patient care. A problem of increased workload will remain a challenge for as long as available technology is not used appropriately. Hence, hand held devices such as Personal Digital Assistants (PDAs), Electronic Health Records (EHRs) and bedside terminals, are highly recommended. Key concepts: Computer, Nursing, Information, System, Evaluation, Effective, Professional Nurses, Patient care.
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Moomba, Kaala. "Perceptions and experiences of health care workers on the use of electronic medical records at two health centres in Livingstone, Zambia." University of the Western Cape, 2017. http://hdl.handle.net/11394/5683.

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Magister Commercii (Information Management) - MCom(IM)
Health information systems (HIS) have much to offer in managing healthcare costs and in improving the quality of care for patients. However, the adoption of HIS can cause problems to health professionals in terms of efficiency as well as to the entire health organization in terms of acceptability and adaptability. The development of a national Information and Communication Technology (ICT) policy in Zambia was initiated in 2001 through an extensive consultation process which involved academics and civil society organizations. The aim of using ICT is to improve the quality of health service delivery at local levels. Maramba and Mahatma Gandhi Clinics are the largest primary health care (PHC) clinics in Livingstone and have been prioritized for the implementation of an electronic medical record (EMR) system. The current study explored health care workers' perceptions and experiences of the use of ICTbased EMR and factors that could determine acceptability of EMR at Maramba and Mahatma Gandhi clinics to feed into future program improvement.
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Alzubaidi, Abdulhakeem. "The attitudes and beliefs of primary health care physicians toward electronic medical records : the impact of using electronic medical records on the care of patients seen in a diabetes mini-clinic in the United Arab Emirates." Thesis, University of Aberdeen, 2006. http://digitool.abdn.ac.uk/R?func=search-advanced-go&find_code1=WSN&request1=AAIU494611.

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Many studies have been conducted in the USA and Europe to explore the attitudes and beliefs of physicians toward the use of Electronic Medical Record (EMR) systems and to examine the impact of using EMR in the management of diabetes mellitus.  However, no such study has been conducted in the United Arab Emirates (UAE). This study was designed to fill this gap.  The study consists of two parts. The first examines the Primary Health care (PHC) physicians’ attitudes and beliefs towards the implementation of EMR and the second, examines the impact of EMR on the management of diabetes in a diabetes mini-clinic in a PHC health centre. The overall finding was that non-users of EMR had higher expectations of what computers could achieve than did users.  The majority of EMR users and non-users believed that (1) physicians should computerise their medical records; (2) EMR were a useful tool for physicians; and (3) using EMR will improve the quality of healthcare in the health centre and in the UAE overall.  A significantly higher proportion of non-users than EMR users believed that using EMR would enable them to accomplish tasks more quickly and reduce their risk of making medical errors. The intervention part of the study found that the introduction of an EMR system has significantly improved documentation and the performance of processes of care for diabetic patients.  However, its impact on outcomes was limited.  A significant improvement in the proportion of patients with blood pressure <140/80 mm Hg and a significant reduction in the proportion of patients with blood pressure >160/95 mm Hg was found.  An improvement in the proportion of patients with LDL-C<100 mg/dl was also found.  The limitations of the study should be considered before generalising these results.
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Törnvall, Eva. "Carrying out electronic nursing documentation : use and development in primary health care /." Linköping : Department of Social and Welfare Studies, Linköping University, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-11268.

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20

Mason, Patricia Lynn. "Diffusion of Electronic Health Records in Rural Primary Care Clinics." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/466.

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By the end of 2015, Medicare-eligible physicians at primary care practices (PCP) who do not use an electronic health record (EHR) system will incur stiff penalties if they fail to meet the deadline for using EHRs. Yet, less than 30% of rural primary clinics have fully functional EHR systems. The purpose of this phenomenology study was to explore rural primary care physicians and physician assistants' experiences regarding overcoming barriers to implementing EHRs. Complex adaptive systems formed the conceptual framework for this study. Data were collected through face-to-face interviews with a purposeful sample of 21 physicians and physician assistants across 2 rural PCPs in the southeastern region of Missouri. Participant perceptions were elicited regarding overcoming barriers to implementing EHRs under the American Recovery and Reinvestment Act, Health Information Technology for Economic and Clinical Health, and the Patient Protection and Affordable Care Act legislation. Interview questions were transcribed and processed through qualitative software to discern themes of how rural PCP physicians and physician assistants might overcome barriers to implementing electronic health records. Through the exploration of the narrative segments, 4 emergent themes were common among the participants: (a) limited finances to support EHRs, (b) health information exchange issues, (c) lack of business education, and (d) lack of transformation at rural medical practices. The implications for positive social change include the potential implementation of EHRs particularly in physician practices in rural communities, which could provide cost-efficient health care services for those communities and a more sustainable future at primary care practices.
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Mostert-Phipps, Nicolette. "Health information technologies for improved continuity of care: a South African perspective." Thesis, Nelson Mandela Metropolitan University, 2011. http://hdl.handle.net/10948/1619.

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The fragmented nature of modern health care provision makes it increasingly difficult to achieve continuity of care. This is equally true in the context of the South African healthcare landscape. This results in a strong emphasis on the informational dimension of continuity of care which highlights the importance of the continuity of medical records. Paper-based methods of record keeping are inadequate to support informational continuity of care which leads to an increased interest in electronic methods of record keeping through the adoption of various Health Information Technologies (HITs). This research project investigates the role that various HITs such as Personal Health Records (PHRs), Electronic Medical Records (EMRs), and Health Information Exchanges (HIEs) can play in improving informational continuity of care resulting in the development of a standards-based technological model for the South African healthcare sector. This technological model employs appropriate HITs to address the problem of informational continuity of care in the South African healthcare landscape The benefits that are possible through the adoption of the proposed technological model can only be realized if the proposed HITs are used in a meaningful manner once adopted and implemented. The Delphi method is employed to identify factors that need to be addressed to encourage the adoption and meaningful use of such HITs in the South African healthcare landscape. Lastly, guidelines are formulated to encourage the adoption and meaningful use of HITs in the South African healthcare landscape to improve the continuity of care. The guidelines address both the technological requirements on a high level, as well as the factors that need to be addressed to encourage the adoption and meaningful use of the technological components suggested. These guidelines will play a significant role in raising awareness of the factors that need to be addressed to create an environment conducive to the adoption and meaningful use of appropriate HITs in order to improve the continuity of care in the South African healthcare landscape.
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DeBlasio, Julia Marie. "Documentation in a medical setting with young and older adults." Thesis, Georgia Institute of Technology, 2010. http://hdl.handle.net/1853/33897.

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The presence of a device meant to enhance the medical encounter may alter the nature of the doctor-patient interaction in a way that affects patient satisfaction. The focus of this study was to examine the social impact of introducing advanced exam-room technologies to the doctor-patient interaction. By comparing cohorts (young: 18-39 and older: 62-89) we examined a possible age-related interaction. Participants viewed one of several video conditions portraying a physician conducting a medical interview in which he uses one of various documenting technologies (Nothing, Pen and Paper, PDA, Desktop Computer, Wearable Computer). After viewing the interaction, participants completed a series of questionnaires evaluating their general satisfaction with the quality of care (QoC) given during the medical interview. Patient satisfaction levels did significantly vary depending on the technology condition, participant cohort, and participant gender. Overall, young adults and females rated the doctor more favorably. The favorability of ratings for each technology condition depended on the aspect of QoC examined.
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von, Michaelis Carol. "Health Care Team Members' Perceptions of Changes to an Electronic Documentation System." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2701.

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Policy makers view electronic medical records as a way of increasing efficiency in the U.S. health care system. However, hospital administrators may not have the clinical background to choose a documentation system that helps the health care team safely increase efficiency. The purpose of this case study was to examine health care team members' attitudes and perceptions of quality of care and efficiency amid a documentation system change. The theory of change was the theoretical foundation for the study. The 6 research questions were designed to elicit information about what the health care team experienced when a documentation system changed and how the change affected health care workers' stress level, chance of medical errors, ability to deliver quality care, and attitudes about hospital efficiency. Semi-structured interviews were conducted with the 15 members of a health care team who volunteered from the group and met the inclusion criteria for the study (i.e., employed during the documentation system change). The participants represented all aspects of the health care team to create a bounded case. The interview responses were hand coded to find common themes among the participants. Most participants revealed that the implementation of the new system increased their efficiency and the quality of care they offered to patients. Participants felt that the training and implementation of the system was inadequate and not specific enough for their group. By providing health care administrators with more information about the health care teams' perceptions during a change in documentation systems, they may be able to improve implementation of a new system, creating more sustainable change with less negative impact.
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Bantom, Simlindile Abongile. "Accessibility to patients’ own health information: a case in rural Eastern Cape, South Africa." Thesis, Cape Peninsula University of Technology, 2016. http://hdl.handle.net/20.500.11838/2411.

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Thesis (MTech (Information Technology))--Cape Peninsula University of Technology, 2016.
Access to healthcare is regarded as a basic and essential human right. It is widely known that ICT solutions have potential to improve access to healthcare, reduce healthcare cost, reduce medical errors, and bridge the digital divide between rural and urban healthcare centres. The access to personal healthcare records is, however, an astounding challenge for both patients and healthcare professionals alike, particularly within resource-restricted environments (such as rural communities). Most rural healthcare institutions have limited or non-existent access to electronic patient healthcare records. This study explored the accessibility of personal healthcare records by patients and healthcare professionals within a rural community hospital in the Eastern Cape Province of South Africa. The case study was conducted at the St. Barnabas Hospital with the support and permission from the Faculty of Informatics and Design, Cape Peninsula University of Technology and the Eastern Cape Department of Health. Semi-structured interviews, observations, and interactive co-design sessions and focus groups served as the main data collection methods used to determine the accessibility of personal healthcare records by the relevant stakeholders. The data was qualitatively interpreted using thematic analysis. The study highlighted the various challenges experienced by healthcare professionals and patients, including time-consuming manual processes, lack of infrastructure, illegible hand-written records, missing records and illiteracy. A number of recommendations for improved access to personal healthcare records are discussed. The significance of the study articulates the imperative need for seamless and secure access to personal healthcare records, not only within rural areas but within all communities.
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Williams, Faustine. "The role of electronic medical record in nation care delivery, development case study on Ghana /." Diss., Columbia, Mo. : University of Missouri-Columbia, 2007. http://hdl.handle.net/10355/4919.

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Thesis (M.S.)--University of Missouri-Columbia, 2007.
The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. "May 2007" Includes bibliographical references.
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Hong, Wing-yee Veronica. "A comparative study of healthcare financing systems in US, UK and HK." Click to view the E-thesis via HKUTO, 2008. http://sunzi.lib.hku.hk/hkuto/record/B41709858.

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So, Ping-cham. "Development of medical services in Hong Kong." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B43780556.

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McEwen, Timothy Ryan. "Creating Safety in the Diagnostic Testing Processes of Family Medical Practices." Wright State University / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=wright1243428996.

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Pelletier, Lori Rebecca. "Information-Enabled Decision-Making in Health Care: EHR-Enabled Standardization, Physician Profiling and Medical Home." Digital WPI, 2010. https://digitalcommons.wpi.edu/etd-dissertations/166.

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Health care today harms too frequently and routinely fails to deliver its potential benefits. Significant evidence suggests that high quality primary care can positively affect health outcomes. I explored three related topics mentioned frequently in current United States health reform €“ Electronic Health Records (EHR), physician profiling and Medical Home. An investment in these areas is expected to significantly improve quality of care and efficiency; however, there is only a patchwork of evidence supporting such claims. To achieve EHR promises, my research employed a standardization lens to study the dynamics between EHR embedded structures and primary care processes. Using grounded theory, a standardization dynamics model was created describing the influencers, conditions and consequences of the process state. A matrix of two conditions, information exchange and patient complexity, identified four distinct pathways that require a different balance between standardization and flexibility. The value of such pathways is that they frame choices about how to use embedded IT structures to support effective delivery processes. Physician profiling is an emerging methodology used in health care quality improvement programs. Efforts to measure performance at the individual physician level face a number of challenges, including the need for sufficient sample size to support reliable measurement. A process for creating a physician profiling model was developed, and a model designed for a case study site. Results indicate that reliable physician profiling is possible across care domains using a hierarchical composite model. Patient-Centered Medical Home (PCMH) is a new care delivery approach for providing comprehensive primary care that seeks to strengthen the physician-patient relationship. This exploratory study utilizes Pearson correlation coefficients to test four hypotheses about relationships between two sources of data: (1) PPC-PCMH Survey results that measure adoption of PCMH structures and (2) patient experience data from Massachusetts Health Quality Partners (MHQP). The results showed that the PPC-PCMH structures of access and communication were negatively correlated with the related patient experience measure. This study contributes to the literature by addressing deficiencies in how EHR-enabled processes, physician profiling models and Medical Home constructs are measured, to support improved outcomes.
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Liu, Hanjun. "Financial incentives and the type of specialty practices impact on the physician use of electronic medical records." Thesis, California State University, Long Beach, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=1527725.

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Electronic Medical Records (EMRs) are increasingly being used in healthcare organizations. However, there are few factors influencing the physician adoption rate of EMRs. The purpose of this paper is to investigate the meaningful use incentives, and the type of specialty practices in relationship to the physician use of EMRs. Data from the National Ambulatory Medical Care Survey (NAMCS) were analyzed to how meaningful use incentives and the type of physician practices affect the physician use of EMRs. The Chi-Square test and ANOVA test have been use to examine the hypothesis, and the association was found to be statistically significant.

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31

Cucciniello, Maria. "Investigation of the use of ICT in the modernization of the health care sector : a comparative analysis." Thesis, University of Edinburgh, 2011. http://hdl.handle.net/1842/8733.

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This Ph.D. project started from a broad analysis aiming at investigating the key issues in the development of Information and Communication Technologies (ICT) in the health care sector, with the aim of making an in depth investigation to evaluate the effects of Electronic Medical Record (EMR) implementation on the organizations adopting them. Furthermore the study examined two study settings which have adopted the same EMR system produced by the same provider. This comparative study aims, in particular, to analyse how EMR systems are adopted by different health organizations focusing on the antecedents of the EMR project, on the implementation processes used and on the impacts produced. Diffusion theory, through the lens of socio-technical approach, represents the theoretical framework of the analysis. The research results are based on policy evaluation and case studies. The two hospitals selected for the case study analysis are the Regional Hospital of Local Health Authority in Aosta, Italy and the Royal Infirmary of Edinburgh, Scotland. In conducting the data collection several strategies have been used: documentary analysis, interviews and observations have been carried out. This work provides an overview of the key issues arising over e-health policy development through a comparative analysis of the UK and Italy and provides an insight into how EMR systems are adopted, implemented and evaluated within acute care organizations. The thesis is a comparative international research about the development of e-health and the use of ICT in health care sector. This approach makes a both a theoretical and methodological contribution. By focusing, in particular, on EMR systems, it offers to practitioners and policy makers a better basis of analysing ICT usage and its impacts on health care service delivery.
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Suen, Yuk-lam Kelvin. "A comparative study of the health care policies in Hong Kong and Singapore." Click to view the E-thesis via HKUTO, 2002. http://sunzi.lib.hku.hk/hkuto/record/B42576350.

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33

Ehrenberg, Anna. "In pursuit of the common thread : Nursing content in patient records with special reference to nursing home care." Doctoral thesis, Uppsala University, Department of Public Health and Caring Sciences, 2000. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-495.

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The purpose of this thesis was to study different aspects of nursing content in patient records with special reference to nursing home care. The thesis focused on the content, comprehensiveness, accuracy and auditing of records, as well as the practice and perceptions of nurses in relation to recording. A national sample of nurses was asked to complete a questionnaire. The effects on recording and nurses' practice and perceptions in nursing homes following educational intervention were studied. Accuracy was examined through record reviews and interviews with nurses and patients. A literature review of record auditing methods was performed and findings from this search were applied in the assessment of a set of records.

The results indicate that the VIPS model, as a structure for nursing recording, is widespread and shows validity across various areas in Swedish health care. After the educational intervention program, documentation in nursing home care improved significantly in the study group concerning notes on nursing history, nursing status, nursing diagnoses, interventions and discharge notes. Systematic and comprehensive assessment grounded in research-based criteria were not used in the records. Accuracy varied considerably and was significantly better for some areas in the study group. After intervention, the nurses in the study group indicated that they recorded assessments of patients with greater frequency, showed greater satisfaction with their documentation and spent less time on oral reports. Procedures in auditing patient records were found to encompass four approaches: formal structure, process comprehensiveness, knowledge based and accuracy.

In conclusion, the evidence suggests that there are serious flaws in the nursing content of nursing home records though improvements can be achieved through educational means. Presently, there are serious limitations in using the patient record as the sole source of data for care delivery, quality assessment and evaluation of care.

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Fong, Ho-nam. "A comparison of the colonial medical systems in British Hong Kong (1841-1914) and German Qingdao(1897-1914)." Click to view the E-thesis via HKUTO, 2005. http://sunzi.lib.hku.hk/hkuto/record/B35051073.

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35

Weagraff, Joseph B. "Health Care Leaders' Experiences of Electronic Medical Record Adoption and Use." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3216.

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Adoption of electronic medical record (EMR) technology systems of meaningful use has been slow despite the mandate by the U.S. government. The purpose of this single case study was to explore strategies used by health care leaders to implement EMR technology systems of meaningful use to take advantage of federal incentive payments. Diffusion of innovation theory provided the conceptual framework for the study. Semistructured interviews were conducted with 6 health care leaders from a military installation in the Southeast United States. Data were analyzed using software, coding, and inductive analyses. The 3 prominent themes were patient, provider, and champion. Alerts from an EMR technology system can increase providers' awareness and improve patient safety. Providers' involvement in every phase of an EMR system's implementation can improve the adoption rate. Champions play a critical role in successful adoption and implementation of EMR systems. Results of this study may assist health care leaders in implementing EMR systems to take advantage of federal incentive payments. Implications for positive social change include enhanced delivery of safe, high-quality health care.
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Ling, Meng-Chun. "Senior health care system." CSUSB ScholarWorks, 2005. https://scholarworks.lib.csusb.edu/etd-project/2785.

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Senior Health Care System (SHCS) is created for users to enter participants' conditions and store information in a central database. When users are ready for quarterly assessments the system generates a simple summary that can be reviewed, modified, and saved as part of the summary assessments, which are required by Federal and California law.
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Hardy, Jennifer Lynette. "Healthcare providers communication mechanisms using a case management model of care implications for information systems development, implementation & evaluation /." Access electronically, 2006. http://www.library.uow.edu.au/adt-NWU/public/adt-NWU20060731.120940/index.html.

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38

Jaishankar, Gayatri, Dina Alshunnaq, and Amanda Gutwein. "East Tennessee Asthma Quality Improvement Project: Can Electronic Records Help Improve Asthma Care in an Academic Practice?" Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/8879.

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39

Lundberg, Anna. "Care and Coercion : medical knowledge, social policy and patients with venereal disease in Sweden 1785-1903." Doctoral thesis, Umeå universitet, Demografiska databasen, 1999. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-15000.

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This study investigates the history of venereal diseases in Sweden in the period from 1785 to 1903. Medical and political perceptions of these diseases as well as the patients and their continued lives have been studied. Venereal diseases were considered a significant threat to the growth of the population throughout the period. They were recognised through the dramatic sores that they produced on the body of the patient, and were frequently cured with mercurial therapies. In the late nineteenth century, syphilis and gonorrhoea became the two most significant sexually transmitted diseases. They were believed to cause paralysis, mental illness, infant mortality and infertility. Sweden fought venereal diseases with a network of State-controlled health measures. County hospitals that contained special wards for patients diagnosed with venereal diseases were established in the late eighteenth century. These hospitals were financed by mandatory revenue after 1817. Medical care was mandatory and ministers, law officers and heads of households could inform the provincial physicians about the incidence of venereal disease. During the nineteenth century, the regulation of prostitution was enforced which implied that women were blamed for the spread of these diseases. Patients with venereal disease belonged to a cross section of contemporary Swedish society. Most of them were from the lower- or working-classes. They suffered higher age-specific mortality in the first half of the century, and high infant mortality throughout the period. It appears, however, that the constructed image of a patient with venereal disease had little impact upon their lives. Contemporary poverty and societal problems, such as unemployment and poor housing, probably played a larger part in their lives.
digitalisering@umu
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40

Kyazze, Michael. "A hybrid model for managing personal health records in South Africa." Thesis, Nelson Mandela Metropolitan University, 2014. http://hdl.handle.net/10948/3145.

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Doctors can experience difficulty in accessing medical information of new patients. One reason for this is that the management of medical records is mostly institution-centred. The lack of access to medical information may negatively affect patients in several ways. These include new medical tests that may need to be carried out at a cost to the patient and doctors prescribing drugs to which the patient is allergic. This research investigates how patients can play an active role in sharing their personal health records (PHRs) with doctors located in geographically separate areas. In order to achieve the goal of this research, existing literature concerning medical health records and standards was reviewed. A literature review of techniques that can be used to ensure privacy of health information was also undertaken. Interview studies were carried out with three medical practices in Port Elizabeth with the aim of contextualising the findings from the literature study. The Design Science Research methodology was used for this research. A Hybrid Model for Managing Personal Health Records in South Africa is proposed. This model allows patients to view their PHRs on their mobile phones and medical practitioners to manage the patients’ PHRs using a web-based application. The patients’ PHR information is stored both on a cloud server and on mobile devices hence the hybrid nature. Two prototypes were developed as a proof of concept; a mobile application for the patients and a web-based application for the medical practitioners. A field study was carried out with the NMMU health services department and 12 participants over a period of two weeks. The results of the field study were highly positive. The successful evaluation of the prototypes provides empirical evidence that the proposed model brings us closer to the realisation of ubiquitous access to PHRS in South Africa.
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41

Mansfield, Kathryn. "Identifying chronic widespread pain in primary care : a medical record database study." Thesis, Keele University, 2014. http://eprints.keele.ac.uk/629/.

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Chronic widespread pain (CWP) is common and associated with poor health. In general practice no morbidity code for CWP exists. By identifying patients in medical records consulting regularly over five years with multiple individual regional (axial, upper limb, lower limb) problems, a previous study identified patients in one practice with features consistent with CWP. This suggests patients regularly consult for regional pains without being recognised, or managed, as having a generalised condition. The original criteria for identifying these recurrent regional consulters (RRCs) had limitations including a restricted set of musculoskeletal morbidity codes. This thesis aimed to develop the existing RRC definition, determine characteristics of RRCs, and assess the extent of unrecognised CWP in primary care. The study was set in: i) a general practice database; ii) a cohort with linked self-reported health and medical records. RRCs were identified using different code lists, over altered timeframes, and with a varied number of recorded body regions. Three-quarters of RRCs were not recorded with a generalised pain code related to CWP (e.g. fibromyalgia) and are therefore potentially unrecognised as having a generalised pain condition. Recorded prevalence of recognised CWP was lower than community CWP prevalence, suggesting CWP is under-recognised in primary care. The new approach to identifying RRCs, using all regional musculoskeletal Read codes and identifying patients prospectively between three and five years from an index musculoskeletal consultation, identified more patients earlier, and returned patients with features consistent with self-reporting of CWP (e.g. increased somatic symptoms, frequent consultation, worse general health). However, RRC prevalence overestimated CWP prevalence and not all RRCs self-reported CWP, suggesting the RRC criteria identified a heterogeneous group of frequent consulters sharing features with CWP, including those less severely affected who do not necessarily fit established CWP criteria. They nonetheless lie on the spectrum of polysymptomatic distress characteristic of CWP.
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42

Ueda, Kayo. "Applicability of care quality indicators for women with low-risk pregnancies planning hospital birth: a retrospective study of medical records." Doctoral thesis, Kyoto University, 2021. http://hdl.handle.net/2433/264665.

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京都大学
新制・課程博士
博士(社会健康医学)
甲第23384号
社医博第117号
新制||社医||11(附属図書館)
京都大学大学院医学研究科社会健康医学系専攻
(主査)教授 佐藤 俊哉, 教授 滝田 順子, 教授 万代 昌紀
学位規則第4条第1項該当
Doctor of Public Health
Kyoto University
DFAM
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43

May, Joy L. "The study of Electronic Medical Record adoption in a Medicare certified home health agency using a grounded theory approach." Thesis, Capella University, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3605534.

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The purpose of this qualitative grounded theory study was to examine the experiences of clinicians in the adoption of Electronic Medical Records in a Medicare certified Home Health Agency. An additional goal for this study was to triangulate qualitative research between describing, explaining, and exploring technology acceptance. The experiences were studied through an anonymous survey using a third party vendor. The data revealed that in spite of Internet and connectivity issues, clinicians at XYZ Home Care overlooked these issues because of the benefits in utilizing an electronic medical record system. These benefits include quick access to patient medical records and saving time. The data allowed for triangulation between describing, explaining, and exploring technology acceptance.

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44

Wong, Oi-ling Irene. "Medical ecology of inpatient service utilization in Hong Kong a population survey /." Click to view the E-thesis via HKUTO, 2003. http://sunzi.lib.hku.hk/hkuto/record/B31971337.

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45

Alvin, Pleil. "Evaluation and assessment of a generic computerized patient record system utilized by physical therapists in a primary care setting." Thesis, University of Skövde, School of Humanities and Informatics, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-896.

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Within the field of medical informatics, patient medical records are the sole source of information for dealing with clinical activities concerning the documentation, care, progression, and ongoing interactions between the patient and clinicians. Electronic or computer-based patient records (CPRs) have had a presence within health care in some form and magnitude for the past thirty years yet only recently have been incorporated in health care to a larger extent. Due to the wide variation of professions in health care, there is a problem of CPRs not being able to fulfill all the possibilities and demands the individual professionals need, since many CPRs are designed as a generic system, to be used across multiple professions.

The focus of this report is on the utilization of a generic CPR in a specialist clinical setting, i.e., a physical therapy clinic, and to analyze how the therapists utilize the different components and features in a generic CPR. The purpose of the evaluation was to investigate how viable the CPR was as a documentation tool and to which extent it supported the therapists in their clinical, documentation and delivery of care activities. In this study, a total of seven physical therapists participated in a post-usage evaluation of an existing CPR. The evaluation was achieved by interpretative research with open-ended interviews and observations. The results of the study showed that despite some shortcomings, the generic CPR was an effective tool for the clinicians, not only as a documenting aid, but also enabling them to quickly research the patients' prior diagnosis and treatment history, plan for future care, support decision-making and to communicate with other professionals so as to coordinate treatment and planning.

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46

Ng, Suk-han Christina. "The health policy network and policy community in Hong Kong : from concertation to pressure pluralism /." View the Table of Contents & Abstract, 1998. http://sunzi.lib.hku.hk/hkuto/record/B36628979.

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47

Van, der Watt Cecil Clifford. "Design considerations of a semantic metadata repository in home-based healthcare." Thesis, Cape Peninsula University of Technology, 2011. http://hdl.handle.net/20.500.11838/2300.

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Thesis (MTech (Information Technology))--Cape Peninsula University of Technology, 2011.
The research was conducted as part of a socio-tech initiative undertaken at the Cape Peninsula University of Technology. The socio-tech initiative overall focus was on addressing issues faced by rural and under-resourced communities in South Africa, specifically looking at Home-Based Healthcare (HBHC) primarily in the Western Cape. As research into the HBHC context in rural and under-resourced communities continued numerous issues around data and data-elements came to light. These data issues were especially prevalent in relation to the various paper forms being used by the HBHC initiatives that attempt to deliver care in these communities. The communities have the tendency to suffer from poor access to formal healthcare services and healthcare facilities. The data issues were primarily in terms of how data was defines and used within the HBHC initiatives. Within the HBHC initiatives that cater for rural and under-resourced communities there was a clear prevalence of paper-based systems, and a very low penetration of IT-based solution. Because similar and related data-elements are used throughout the paper forms and within different context these data-elements are inconsistently used and presented. The paper forms further obfuscate these inconsistencies as the paper forms regularly change due to internal and external factors. When these paper forms are changed date elements are added or removed without the changes to the underlying ontologies being considered.
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48

Kabaso, Boniface. "Health information systems interoperability in Africa: service oriented architectural model for interoperability in African context." Thesis, Cape Peninsula University of Technology, 2014. http://hdl.handle.net/20.500.11838/1413.

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Africa has been seeing a steady increase in the Information and Communication Technology (ICT) systems deployed in health care institutions. This is evidenced by the funding that has been going into health information systems from both the government and the donor organisations. Large numbers of national and international agencies, research organisations, Non- Governmental Organisations(NGOs) etc continue to carry out studies and develop systems and procedures to exploit the power of Information and Communication Technology (ICT) in public and private health institutions. This uncoordinated mass migration to electronic medical record systems in Africa has created a heterogeneous and complex computing environment in health care institutions, where most of the deployed systems have technologies that are local, proprietary and insular. Furthermore, the electronic infrastructure in Africa meant to facilitate the electronic exchange of information has a number of constraints. The infrastructure connectivity on which ICT applications run, is still segmented. Most parts of Africa lack the availability of a reliable connectivity infrastructure. In some cases, there is no connectivity at all. This work aims at using Service Oriented Architectures (SOA) to address the problems of interoperability of systems deployed in Africa and suggest design architectures that are able to deal with the state of poor connectivity. SOA offers to bring better interoperability of systems deployed and re-usability of existing IT assets, including those using different electronic health standards in a resource constrained environment like Africa.
Thesis submitted in fulfilment of the requirements for the degree Doctor of Technology: Information Technology in the Faculty of Informatics And Design at the Cape Peninsula University of Technology 2014
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49

Ngai, Wing William. "Review on health care financing options for Hong Kong." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B42997653.

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50

Mashima, Daisuke. "Safeguarding health data with enhanced accountability and patient awareness." Diss., Georgia Institute of Technology, 2012. http://hdl.handle.net/1853/45775.

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Several factors are driving the transition from paper-based health records to electronic health record systems. In the United States, the adoption rate of electronic health record systems significantly increased after "Meaningful Use" incentive program was started in 2009. While increased use of electronic health record systems could improve the efficiency and quality of healthcare services, it can also lead to a number of security and privacy issues, such as identity theft and healthcare fraud. Such incidents could have negative impact on trustworthiness of electronic health record technology itself and thereby could limit its benefits. In this dissertation, we tackle three challenges that we believe are important to improve the security and privacy in electronic health record systems. Our approach is based on an analysis of real-world incidents, namely theft and misuse of patient identity, unauthorized usage and update of electronic health records, and threats from insiders in healthcare organizations. Our contributions include design and development of a user-centric monitoring agent system that works on behalf of a patient (i.e., an end user) and securely monitors usage of the patient's identity credentials as well as access to her electronic health records. Such a monitoring agent can enhance patient's awareness and control and improve accountability for health records even in a distributed, multi-domain environment, which is typical in an e-healthcare setting. This will reduce the risk and loss caused by misuse of stolen data. In addition to the solution from a patient's perspective, we also propose a secure system architecture that can be used in healthcare organizations to enable robust auditing and management over client devices. This helps us further enhance patients' confidence in secure use of their health data.
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