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Dissertations / Theses on the topic 'Medical records Medical records Medical informatics'

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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

Kirkham, David Andrew. "Patient-held medical records : a thermodynamic perspective." Thesis, University of Cambridge, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.296769.

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3

Song, Lihong. "Medical concept embedding with ontological representations." HKBU Institutional Repository, 2019. https://repository.hkbu.edu.hk/etd_oa/703.

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Learning representations of medical concepts from the Electronic Health Records (EHRs) has been shown effective for predictive analytics in healthcare. The learned representations are expected to preserve the semantic meanings of different medical concepts, which can be treated as features and thus benefit a variety of applications. Medical ontologies have also been explored to be integrated with the EHR data to further enhance the accuracy of various prediction tasks in healthcare. Most of the existing works assume that medical concepts under the same ontological category should share similar representations, which however does not always hold. In particular, the categorizations in the categorical medical ontologies were established with various factors being considered. Medical concepts even under the same ontological category may not follow similar occurrence patterns in the EHR data, leading to contradicting objectives for the representation learning. In addition, these existing works merely utilize the categorical ontologies. Actually, it has been noticed that ontologies containing multiple types of relations are also available. However, studies rarely make use of the diverse types of medical ontologies. In this thesis research, we propose three novel representation learning models for integrating the EHR data and medical ontologies for predictive analytics. To improve the interpretability and alleviate the conflicting objective issue between the EHR data and medical ontologies, we propose techniques to learn medical concepts embeddings with multiple ontological representations. To reduce the reliance on labeled data, we treat the co-occurrence statistics of clinical events as additional training signals, which help us learn good representations even with few labeled data. To leverage the various domain knowledge, we also consider multiple medical ontologies (CCS, ATC and SNOMED-CT) and propose corresponding attention mechanisms so as to take the best advantage of the medical ontologies with better interpretability. Our proposed models can achieve the final medical concept representations which align better with the EHR data. We conduct extensive experiments, and our empirical results prove the effectiveness of the proposed methods. Keywords: Bio/Medicine, Healthcare-AI, Electronic Health Record, Representation Learning, Machine Learning Applications
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4

Pagano, Michael Pro. "Communicating healthcare information : an analysis of medical records /." Full-text version available from OU Domain via ProQuest Digital Dissertations, 1990.

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5

Sethi, Iccha. "Clinician Decision Support Dashboard: Extracting value from Electronic Medical Records." Thesis, Virginia Tech, 2012. http://hdl.handle.net/10919/41894.

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Medical records are rapidly being digitized to electronic medical records. Although Electronic Medical Records (EMRs) improve administration, billing, and logistics, an open research problem remains as to how doctors can leverage EMRs to enhance patient care. This thesis describes a system that analyzes a patientâ s evolving EMR in context with available biomedical knowledge and the accumulated experience recorded in various text sources including the EMRs of other patients. The aim of the Clinician Decision Support (CDS) Dashboard is to provide interactive, automated, actionable EMR text-mining tools that help improve both the patient and clinical care staff experience. The CDS Dashboard, in a secure network, helps physicians find de-identified electronic medical records similar to their patient's medical record thereby aiding them in diagnosis, treatment, prognosis and outcomes. It is of particular value in cases involving complex disorders, and also allows physicians to explore relevant medical literature, recent research findings, clinical trials and medical cases. A pilot study done with medical students at the Virginia Tech Carilion School of Medicine and Research Institute (VTC) showed that 89% of them found the CDS Dashboard to be useful in aiding patient care for doctors and 81% of them found it useful for aiding medical students pedagogically. Additionally, over 81% of the medical students found the tool user friendly. The CDS Dashboard is constructed using a multidisciplinary approach including: computer science, medicine, biomedical research, and human-machine interfacing. Our multidisciplinary approach combined with the high usability scores obtained from VTC indicated the CDS Dashboard has a high potential value to clinicians and medical students.
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6

Steiner, Bridget Anne. "Electronic medical record implementation in nursing practice a literature review of the factors of success /." Thesis, Montana State University, 2009. http://etd.lib.montana.edu/etd/2009/steiner/SteinerB0509.pdf.

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This is a review of the current literature to discern what factors need to be present in an electronic medical record (EMR) implementation in order for it to be successful for nurses. An extensive literature search was performed by using databases CINAHL, MEDLINE, and Health Reference Center for primary sources of research that specifically addressed EMR implementation and nursing. A coding scheme was developed and applied to each article for analysis. It was found that fit of the EMR with nurse functions, education, and positive nurse attitude were the three most common factors associated with successful EMR implementation for nurses. Lack of computer system quality, lack of fit of the EMR with nurse functions, and time requirements of its use were most commonly associated with lack of success.
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7

Win, Khin Than. "The application of the FMEA risk assessment technique to electronic health record systems." Access electronically, 2005. http://www.library.uow.edu.au/adt-NWU/public/adt-NWU20050822.093730/index.html.

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8

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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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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10

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

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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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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13

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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14

Chipfumbu, Colletor Tendeukai. "Engendering the meaningful use of electronic medical records: a South African perspective." Thesis, Nelson Mandela Metropolitan University, 2016. http://hdl.handle.net/10948/18420.

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Theoretically, the use of Electronic Medical Records (EMRs) holds promise of numerous benefits in healthcare provision, including improvement in continuity of care, quality of care and safety. However, in practice, there is evidence that the adoption of electronic medical records has been slow and where adopted, often lacks meaningful use. Thus there is a clear dichotomy between the ambitions for EMR use and the reality of EMR implementation. In the USA, a legislative approach was taken to turn around the situation. Other countries such as Canada and European countries have followed suit (in their own way) to address the adoption and meaningful use of electronic medical records. The South African e-Health strategy and the National Health Normative Standards Framework for Interoperability in eHealth in South Africa documents both recommend the adoption of EMRs. Much work has been done to establish a baseline for standards to ensure interoperability and data portability of healthcare applications and data. However, even with the increased focus on e-Health, South Africa remains excessively reliant on paper-based medical records. Where health information technologies have been adopted, there is lack of coordination between and within provinces, leading to a multitude of systems and vendors. Thus there is a lack of systematic adoption and meaningful use of EMRs in South Africa. The main objective of this research is to develop the components required to engender meaningful use of electronic medical records in the South African healthcare context. The main contributors are identified as EMR certification and consistent, proper use of certified EMRs. Literature review, a Delphi study and logical argumentation are used to develop the relevant components for the South African healthcare context. The benefits of EMRs can only be realized through systematic adoption and meaningful use of EMRs, thus this research contributes to providing a road map for engendering the meaningful use of EMRs with the ultimate aim of improving healthcare in the South African healthcare landscape.
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15

Ozurigbo, Evangeline C. "Leveraging Artificial Intelligence to Improve Provider Documentation in Patient Medical Records." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5398.

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Clinical documentation is at the center of a patient's medical record; this record contains all the information applicable to the care a patient receives in the hospital. The practice problem addressed in this project was the lack of clear, consistent, accurate, and complete patient medical records in a pediatric hospital. Although the occurrence of incomplete medical records has been a known issue for the project hospital, the issue was further intensified following the implementation of the 10th revision of International Classification of Diseases (ICD-10) standard for documentation, which resulted in gaps in provider documentation that needed to be filled. Based on this, the researcher recommended a quality improvement project and worked with a multidisciplinary team from the hospital to develop an evidence-based documentation guideline that incorporated ICD-10 standard for documenting pediatric diagnoses. Using data generated from the guideline, an artificial intelligence (AI) was developed in the form of best practice advisory alerts to engage providers at the point of documentation as well as augment provider efforts. Rosswurm and Larrabee's conceptual framework and Kotter's 8-step change model was used to develop the guideline and design the project. A descriptive data analysis using sample T-test significance indicated that financial reimbursement decreased by 25%, while case denials increased by 28% after ICD-10 implementation. This project promotes positive social change by improving safety, quality, and accountability at the project hospital.
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16

Abimbola, Isaiah Gbenga. "Assessing Value Added in the Use of Electronic Medical Records in Nigeria." Thesis, Walden University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3702058.

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Electronic medical records (EMRs) or electronic health records have been in use for years in hospitals around the world as a time-saving system for patient record keeping. Despite its widespread use, some physicians disagree with the assertion that EMRs save time. The purpose of this study was to explore whether any time saved with the use of the EMR system was actually devoted by doctors to patient-care and thereby to improved patient-care efficiency. The conceptual support for this study was predicated employing the task-technology fit theory. Task-technology theorists argue that information technology is likely to have a positive impact in individual performance and production timeliness if its capabilities match the task that the user must perform. The research questions addressed the use of an EMR system as a time-saving device, its impact on the quality of patient-care, and how it has influenced patients? access to healthcare in Nigeria. In this research, a comparative qualitative case study was conducted involving 2 hospitals in Nigeria, one using EMRs and another using paper-based manual entry. A purposeful sample of 12 patients and 12 physicians from each hospital was interviewed. Data were compiled and organized using Nvivo 10 software for content analysis. Categories and recurring themes were identified from the data. The findings revealed that reduced patients? registration processing time gave EMR-using doctors more time with their patients, resulting in better patient care. These experiences were in stark contrast to the experiences of doctors who used paper-based manual entry. This study supports positive social change by informing decision makers that time saved by implementing EMR keeping may encourage doctors to spend more time with their patients, thus improving the general quality of healthcare in Nigeria.

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Dunphy, Gerard Michael. "Requirements analysis of a multimedia patient information system in telemedicine applications." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape8/PQDD_0029/MQ47447.pdf.

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18

Rios, Anthony. "Deep Neural Networks for Multi-Label Text Classification: Application to Coding Electronic Medical Records." UKnowledge, 2018. https://uknowledge.uky.edu/cs_etds/71.

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Coding Electronic Medical Records (EMRs) with diagnosis and procedure codes is an essential task for billing, secondary data analyses, and monitoring health trends. Both speed and accuracy of coding are critical. While coding errors could lead to more patient-side financial burden and misinterpretation of a patient’s well-being, timely coding is also needed to avoid backlogs and additional costs for the healthcare facility. Therefore, it is necessary to develop automated diagnosis and procedure code recommendation methods that can be used by professional medical coders. The main difficulty with developing automated EMR coding methods is the nature of the label space. The standardized vocabularies used for medical coding contain over 10 thousand codes. The label space is large, and the label distribution is extremely unbalanced - most codes occur very infrequently, with a few codes occurring several orders of magnitude more than others. A few codes never occur in training dataset at all. In this work, we present three methods to handle the large unbalanced label space. First, we study how to augment EMR training data with biomedical data (research articles indexed on PubMed) to improve the performance of standard neural networks for text classification. PubMed indexes more than 23 million citations. Many of the indexed articles contain relevant information about diagnosis and procedure codes. Therefore, we present a novel method of incorporating this unstructured data in PubMed using transfer learning. Second, we combine ideas from metric learning with recent advances in neural networks to form a novel neural architecture that better handles infrequent codes. And third, we present new methods to predict codes that have never appeared in the training dataset. Overall, our contributions constitute advances in neural multi-label text classification with potential consequences for improving EMR coding.
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Jalal-Karim, Akram. "Sharing and viewing segments of electronic patient records service (SVSEPRS) using multidimensional database model." Thesis, Brunel University, 2008. http://bura.brunel.ac.uk/handle/2438/2982.

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The concentration on healthcare information technology has never been determined than it is today. This awareness arises from the efforts to accomplish the extreme utilization of Electronic Health Record (EHR). Due to the greater mobility of the population, EHR will be constructed and continuously updated from the contribution of one or many EPRs that are created and stored at different healthcare locations such as acute Hospitals, community services, Mental Health and Social Services. The challenge is to provide healthcare professionals, remotely among heterogeneous interoperable systems, with a complete view of the selective relevant and vital EPRs fragments of each patient during their care. Obtaining extensive EPRs at the point of delivery, together with ability to search for and view vital, valuable, accurate and relevant EPRs fragments can be still challenging. It is needed to reduce redundancy, enhance the quality of medical decision making, decrease the time needed to navigate through very high number of EPRs, which consequently promote the workflow and ease the extra work needed by clinicians. These demands was evaluated through introducing a system model named SVSEPRS (Searching and Viewing Segments of Electronic Patient Records Service) to enable healthcare providers supply high quality and more efficient services, redundant clinical diagnostic tests. Also inappropriate medical decision making process should be avoided via allowing all patients‟ previous clinical tests and healthcare information to be shared between various healthcare organizations. Multidimensional data model, which lie at the core of On-Line Analytical Processing (OLAP) systems can handle the duplication of healthcare services. This is done by allowing quick search and access to vital and relevant fragments from scattered EPRs to view more comprehensive picture and promote advances in the diagnosis and treatment of illnesses. SVSEPRS is a web based system model that helps participant to search for and view virtual EPR segments, using an endowed and well structured Centralised Multidimensional Search Mapping (CMDSM). This defines different quantitative values (measures), and descriptive categories (dimensions) allows clinicians to slice and dice or drill down to more detailed levels or roll up to higher levels to meet clinicians required fragment.
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Richardson, Tony Andrew. "Meeting Meaningful-Use Requirements With Electronic Medical Records in a Community Health Clinic." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2872.

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Small nonprofit medical practices lack the technical expertise to implement electronic medical records (EMRs) that are consistent with federal meaningful-use requirements. Failure to comply with meaningful-use EMR requirements affects nonprofit community health care leaders' ability to receive reimbursement for care. Complexity theory was the conceptual framework used in this exploratory single case study. The purpose of the study was to explore the strategies nonprofit community health care leaders in Washington, DC used to implement EMRs in order to comply with the meaningful-use requirements. Data were collected via in-depth interviews with 7 purposively-selected health care leaders in a nonprofit clinic and were supplemented with archival records from the organization's policies and legislated mandates. Participants' responses were coded into invariant constituents, single concepts, and ideas to develop theme clusters. Member checking was used to validate the transcribed data which was subsequently coded into 4 themes that included: access to information, quality of care, training, and reporting implications. Recommendations include increased effectiveness of training provided to health care leaders or the perceptions of the patients as stakeholders in EMR implementation. By using strategies that facilitate seamless movement of information within a digital health care infrastructure, business leaders could benefit from improved reimbursement for services. Implications for social change include progress and transformation in the way health care access is provided.
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Lee, Koon-hung. "Communicating patients' medical information by online electronic health record system physicians and dentists' perception /." Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B31971933.

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22

Harmse, Magda Susanna. "Physicians' perspectives on personal health records: a descriptive study." Thesis, Nelson Mandela Metropolitan University, 2016. http://hdl.handle.net/10948/6876.

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A Personal Health Record (PHR) is an electronic record of a patient’s health-related information that is managed by the patient. The patient can give access to other parties, such as healthcare providers and family members, as they see fit. These parties can use the information in emergency situations, in order to help improve the patient’s healthcare. PHRs have an important role to play in ensuring that a patient’s complete health history is available to his healthcare providers at the point of care. This is especially true in South Africa, where the majority of healthcare organizations still rely on paper-based methods of record-keeping. Research indicates that physicians play an important role in encouraging the adoption of PHRs amongst patients. Whilst various studies have focused on the perceptions of South African citizens towards PHRs, to date no research has focused on the perceptions of South African physicians. Considering the importance of physicians in encouraging the adoption of PHRs, the problem being addressed by this research project thus relates to the lack of information relating to the perceptions of South African physicians of PHRs. Physicians with private practices at private hospitals in Port Elizabeth, South Africa were surveyed in order to determine their perceptions towards PHRs. Results indicate perceptions regarding benefits to the physician and the patient, as well as concerns to the physician and the patient. The levels of trust in various potential PHR providers and the potential uses of a PHR for the physician were also explored. The results of the survey were compared with the results of relevant international literature in order to describe the perceptions of physicians towards PHRs.
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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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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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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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Abdullah, Foziyah H. "Electronic patient records system in Hamad Medical Corporation, Qatar : perspectives and potential use." Thesis, Loughborough University, 2007. https://dspace.lboro.ac.uk/2134/8096.

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Since the 1990 the use of Electronic Patient Records (EPR) in health services has become increasingly prevalent world wide. EPR has become an important aspect of the continuous improvement of patient care. Transferring all patient records from paper based to electronic is now a priority for many health services. The research reported in this thesis is sponsored by Hamad Medical Corporation (HMC) to provide opportunity to explore the potential role for EPR in the Medical Records Department. The study has been designed to gain better understanding of the users perspectives with regard to the use of patient records. In order to analyse and understand the complex dynamic involved in the management and use of patient records, it was recognised that systems thinking offered an appropriate framework for this research. Soft System Methodology (SSM) was therefore applied to the analysis of the data and used to inform the development of a conceptual model. Using SSM in combination with the structured questionnaire survey and telephone semi-structured interview, triangulation of methods was achieved. Use of these generated rich data revealing for example the general dissatisfaction expressed with the existing manual patient records system, the lack of confidentiality, poor legibility, shortage of space and the frequent misfiling of records. The need to address these problems has informed the strategic plan for the development and implementation of EPR for HMC. The research has successfully addressed the stated aims and research questions and guided the formulation of proposals for improvements.
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Long, Trisha L. "Medication Information Management Practices of Older Americans." Master's thesis, School of Information and Library Science, 2007. http://hdl.handle.net/1901/391.

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This paper presents the results of a survey of 30 adults aged 55 and older, who had taken multiple prescription medications in the past two years. The purpose of the study was to determine how older adults manage their medication information currently, what information they save and share, and how they wish to manage medication information in an electronic environment, such as a personal health record. Adults in the survey shared information most frequently with their doctors, and with friends and family. They usually shared basic information about a medication, including its name, dose, and the frequency with which it is taken. Nearly half used an artifact, such as a list, to keep track of and share their information. Nearly a third of participants desired to keep an electronic record, suggesting that a percentage of the older adult population would be open to using electronic records to manage medication information.
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Ho, Lai-ming. "Evaluation of the development and impact of clinical information systems /." Hong Kong : University of Hong Kong, 1998. http://sunzi.lib.hku.hk/hkuto/record.jsp?B19657857.

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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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30

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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Chava, Nalini. "Administrative reporting for a hospital document scanning system." Virtual Press, 1996. http://liblink.bsu.edu/uhtbin/catkey/1014839.

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This thesis will examine the manual hospital document retrieval system and electronic document scanning system. From this examination, requirements will be listed for the Administrative Reporting for the Hospital Document Scanning System which will provide better service and reliability than the previous systems. To assure that the requirements can be met, this will be developed into a working system which is named as the Administrative Reporting for the Hospital Document Scanning System(ARHDSS).
Department of Computer Science
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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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Ferreira, Dácio Miranda [UNIFESP]. "Comparação dos tempos de geração e digitação de laudos radiológicos entre um sistema eletrônico baseado em voz sobre IP(VOIP) e um sistema tradicional baseado em papel." Universidade Federal de São Paulo (UNIFESP), 2009. http://repositorio.unifesp.br/handle/11600/9216.

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Made available in DSpace on 2015-07-22T20:49:44Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-04-29. Added 1 bitstream(s) on 2015-08-11T03:25:40Z : No. of bitstreams: 1 Publico-058.pdf: 1174030 bytes, checksum: 6102ccff4fb9134a645e0915a421a08f (MD5)
O registro de informações do paciente é um instrumento de grande importância na área médica. O processo de geração de laudos em radiologia pode ser dinamizado e melhorado com a utilização de sistemas eletrônicos baseados em tecnologias de informação e comunicação que podem trazer benefícios como o aumento de produtividade e redução de tempo e custo. Esta pesquisa comparou tempos de geração e digitação de laudos entre um sistema eletrônico, que possibilitou ao médico radiologista gravar seus laudos gerados por voz em formato digital e o sistema tradicional no qual o radiologista escreve o laudo a mão. Para realização da pesquisa foi necessário modelar e construir o sistema eletrônico proposto para fins de comparação com o tradicional já existente. Por meio de formulários, radiologistas e digitadores anotaram os tempos de geração e digitação dos laudos nos dois sistemas. Comparadas as médias entre eles, o sistema eletrônico apresentou redução de 20% (p=0,0410) do tempo médio de geração do laudo em comparação com o sistema tradicional. Por outro lado, o sistema tradicional foi mais eficiente em relação ao tempo de digitação já que a média de tempo do sistema eletrônico foi três vezes maior (p<0,0001).
The patient medical record is extremely important in medicine. The radiology report generation process can be improved using electronic models based in communication and information technologies that can improve productivity, reduce time and cost. This research compares generation and transcription times of the radiology report between a radiology information system where the radiologist can record radiology reports by voice in digital format and the traditional system in which the radiologist writes the radiology reoport by hands. To conduct the study was necessary to model and construct the electronic system for comparison with the existing traditional system. Using forms, radiologists and transcriptionists register the generation and transcription times in both systems. Comparign the averages, the electronic system reduced 20% (p=0,0410) the generation average time of radiology report compared with traditional system. Moreover, the traditional system was more efficient in relation to transcription time whereas the average time of eletronic system was three times bigger (p<0,0001).
TEDE
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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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Sukhija, Ruchi. "Document imaging application." CSUSB ScholarWorks, 2007. https://scholarworks.lib.csusb.edu/etd-project/3217.

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The purpose of this project was to develop a document imaging application. By scanning the documents into an electronic repository, medical staff will be able to more easily store and locate these records. To make the application user friendly and facilitate staff access to patient medical records, the application is wed-based and uses the Oracle Application Server to implement a multitiered model.
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Adu, Ebenezer Siaw. "Organizational Complexity and Hospitals' Adoption of Electronic Medical Records for Closed-loop Medication Therapy Management." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/3652.

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Over 700,000 adverse drug events (ADEs) result in emergency hospital visits annually, and many of these ADEs are preventable through the use of health information technology in hospitals. However, only 12.6% of U.S. hospitals have developed the capacity to adopt closed-loop electronic medical records (EMR). Organizational complexity may be a major factor influencing hospitals' adoption of closed-loop EMR. This quantitative study explored how organizational complexity influenced hospitals' adoption of closed-loop EMR. Diffusion of innovation theory was the foundation for this study. Logistic regression was used to establish possible relationships between organizational complexity and hospitals' adoption of EMR for closed-loop medication therapy management. Secondary data from Health Information and Management Systems Society were examined to explore the relationship between organization complexity and hospitals' adoption of EMR for closed-loop medication therapy. The research questions explored whether vendor selection strategy, structural complexity, and management structure influence hospitals' adoption of EMR for closed-loop medication therapy management. The results indicated that all three variables, vendor selection strategy, structural complexity, and management structure, are statistically significant predictors of hospitals' adoption of EMR for closed-loop medication therapy management. Results from this study may promote positive social change by enhancing hospitals' adoption of EMR for closed-loop medication therapy management, which may therefore help improve the quality, efficiency, and safety of health care delivery in U.S. hospitals.
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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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Mhembere, Taurai Brian. "Lack of adoption of electronic Medical Records Systems in developing countries. A case study of Zimbabwe." Master's thesis, Faculty of Commerce, 2019. http://hdl.handle.net/11427/31093.

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This study explored the phenomenon of electronic medical records systems in Zimbabwean primary healthcare institutions. The goal of the study was to investigate the lack of adoption of electronic medical records systems by primary healthcare institutions in developing countries using an interpretative case study approach focusing on the Zimbabwean context. Despite the positive benefits that are associated with EMRs, developing countries have been reluctant in implementing this technology within their primary healthcare institutions. A number of studies have been conducted on EMR systems but only a few have investigated the reasons for the limited use of EMR technology in developing countries particularly within the Zimbabwean context. This study primarily adopted a case study approach and was qualitative in nature. The study made use of in-depth interviews to obtain its data, and purposive sampling method was used to identify participants for the study. The study made use of a sample size of fourteen respondents who were identified based on their knowledge and could assist explore this particular topic relevant to the research. The targeted population for this research were key staff members privy to patients’ medical records management within the primary healthcare facilities. The data collected was analysed using thematic analysis soon after the transcription process. The results of the study show that EMRs technology in Zimbabwe has been implemented on a limited scale within its public hospitals. The technology is being used mostly in HIV/AIDS management or in particular departments. The study reveals that although healthcare institutions in Zimbabwe have adopted EMRs technology, most of the information is still being archived on the paper based system. The findings of the study show that Zimbabwe hasn’t adopted EMRs due to challenges such as lack of proper infrastructures, resistance in the use of EMRs, remoteness, shortages in skilled labour and concerns of confidentiality and privacy. Furthermore, the study shows that though the application of the EMR system is limited in Zimbabwean hospitals, the study found that its benefits have been noticeable. EMR technology has made it easy to access information, averted redundant expenditure and has made time improvements. However, the study revealed that EMR systems come with their own shortcomings such as lack of access to patient documents due to network faults and the need for familiarity with computer systems.
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Ducrou, Amanda Joanne. "Complete interoperability in healthcare technical, semantic and process interoperability through ontology mapping and distributed enterprise integration techniques /." Access electronically, 2009. http://ro.uow.edu.au/theses/3048.

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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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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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42

Bickram-Shrestha, Ravi. "The patient information folder : an approach to the Electronic Patient Record." Thesis, Imperial College London, 1999. http://hdl.handle.net/10044/1/7473.

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43

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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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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Johansson, Axel. "Patient Empowerment and Accessibilityin e-Health Services : Accessibility Evaluation of a Mobile WebSite for Medical Records Online." Thesis, Uppsala universitet, Avdelningen för visuell information och interaktion, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-262241.

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This thesis evaluates a DEMO version of the mobile web site for medical recordsonline, m.minavardkontakter.se, from a web accessibility point of view. The evaluationis an expert evaluation based on the ISO standard for web accessibility, Web ContentAccessibility Guidelines (WCAG) 2.0 that is complemented with an evaluation basedon fictitious characters, so called personas. The personas were used to representthree groups of people with different kinds of disabilities; perceptual impairment(aniridia), physical impairment (rheumatism) and cognitive impairment (aphasia). Bycombining and comparing these two methods of evaluation, the thesis also evaluatesthe methods themselves. It was seen from both evaluations that the mobile web sitedoes not entirely fulfill the requirements (success criteria) for web accessibility.WCAG 2.0 found more problems in accessibility than did the personas. However, thepersonas found some problems that were overseen by WCAG 2.0, especially whenthe mobile web site was explored using voice synthesis. The results from the twoevaluations were combined in a set of recommendations for improvement, ranked inorder of importance according to the author. The results conclude that WCAG 2.0 isa good tool for evaluating web accessibility but it is recommended to continue to usethe personas in the future development of the mobile web site.
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Bazile, Emmanuel Patrick. "Electronic Medical Records (EMR): An Empirical Testing of Factors Contributing to Healthcare Professionals’ Resistance to Use EMR Systems." NSUWorks, 2016. http://nsuworks.nova.edu/gscis_etd/964.

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The benefits of using electronic medical records (EMRs) have been well documented; however, despite numerous financial benefits and cost reductions being offered by the federal government, some healthcare professionals have been reluctant to implement EMR systems. In fact, prior research provides evidence of failed EMR implementations due to resistance on the part of physicians, nurses, and clinical administrators. In 2010, only 25% of office-based physicians have basic EMR systems and only 10% have fully functional systems. One of the hindrances believed to be responsible for the slow implementation rates of EMR systems is resistance from healthcare professionals not truly convinced that the system could be of substantive use to them. This study used quantitative methods to measure the relationships between six constructs, namely computer self-efficacy (CSE), perceived complexity (PC), attitude toward EMR (ATE), peer pressure (PP), anxiety (AXY), and resistance to use of technology (RES), are predominantly found in the literature with mixed results. Moreover, they may play a significant role in exposing the source of resistance that exists amongst American healthcare professionals when using Electronic Medical Records (EMR) Systems. This study also measured four covariates: age, role in healthcare, years in healthcare, gender, and years of computer use. This study used Structural Equation Modeling (SEM) and an analysis of covariance (ANCOVA) to address the research hypotheses proposed. The survey instrument was based on existing construct measures that have been previously validated in literature, however, not in a single model. Thus, construct validity and reliability was done with the help of subject matter experts (SMEs) using the Delphi method. Moreover, a pilot study of 20 participants was conducted before the full data collection was done, where some minor adjustments to the instrument were made. The analysis consisted of SEM using the R software and programming language. A Web-based survey instrument consisting of 45 items was used to assess the six constructs and demographics data. The data was collected from healthcare professionals across the United States. After data cleaning, 258 responses were found to be viable for further analysis. Resistance to EMR Systems amongst healthcare professionals was examined through the utilization of a quantitative methodology and a cross-sectional research measuring the self-report survey responses of medical professionals. The analysis found that the overall R2 after the SEM was performed, the model had an overall R2 of 0.78, which indicated that 78% variability in RES could be accounted by CSE, PC, ATE, PP, and AXY. The SEM analysis of AXY and RES illustrated a path that was highly significant (β= 0.87, p < .001), while the other constructs impact on RES were not significant. No covariates, besides years of computer use, were found to show any significance differences. This research study has numerous implications for practice and research. The identification of significant predictors of resistance can assist healthcare administrators and EMR system vendors to develop ways to improve the design of the system. This study results also help identify other aspects of EMR system implementation and use that will reduce resistance by healthcare professionals. From a research perspective, the identification of specific attitudinal, demographic, professional, or knowledge-related predictors of reference through the SEM and ANCOVA could provide future researchers with an indication of where to focus additional research attention in order to obtain more precise knowledge about the roots of physician resistance to using EMR systems.
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Lee, Koon-hung, and 勵冠雄. "Communicating patients' medical information by online electronic health record system: physicians anddentists' perception." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B31971933.

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48

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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Chen, Rong. "Towards interoperable and knowledge-based electronic health records using archetype methodology /." Linköping : Department of Biomedical Engineering, Linköpings universitet, 2009. http://www.bibl.liu.se/liupubl/disp/disp2009/tek1280s.htm.

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Sharma, Urvashi. "Understanding the processes of information systems deployment and evaluation : the challenges facing e-health." Thesis, Brunel University, 2011. http://bura.brunel.ac.uk/handle/2438/6096.

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Information Systems (IS) innovations in healthcare sector are seen as panacea to control burgeoning demand on healthcare resources and lack of streamlining in care delivery. Two particular manifestations of such innovations are telehealth and electronic records in its two forms: the electronic medical records and the electronic health records. Deployment efforts concerning both of these IS-innovations have encountered a rough terrain and have been slow. Problems are also faced while evaluating the effectiveness of innovations on health and care delivery outcomes through strategies such as randomised controlled trials- particularly in case of telehealth. By taking these issues into account, this research investigates the issues that affect IS innovation deployment and its evaluation. The strategy adopted in this research was informed by recursive philosophy and theoretical perspectives within IS that strived to expound this recursive relationship. It involved conducting two longitudinal case studies that are qualitative in nature. The first study involved telehealth deployment and its evaluation in the UK, while the second case study involved the deployment of electronic medical/health records in the US. Data was collected through focus group discussions, interviews and online discussion threads; and was analysed thematically. The results of this research indicate that there are nine issues that arise and affect the deployment and evaluation of IS innovation in healthcare; and these are design, efficiency and effectiveness, optimality and equity, legitimacy, acceptance, demand and efficacy, expertise, new interaction patterns, and trust. These issues are attributes of relationships between the IS innovation, context of healthcare and the user. The significance of these attributes varies during the deployment and evaluation process, and due to iterative nature of IS innovation. This research further indicates that all the attributes have either direct or indirect impact on work practices of the user.
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