New Zealand health sector has increasing demands in theageing population and ongoing inflation of medical costs. These demands are growing, and the importance of technology could optimise the healthcare sector performance. Advancement in technology drives Electronic Health Records
implementation to add substantial value to health delivery systems. The investment and promotion of health informationinfrastructure have positioned New Zealand as a world leader in the field of primary care sector. Factors such as organisation structure, culture, leadership and workflow design are important to achieving successful implementation of Electronic Health Records. This review intends to critically appraise the advantages of EHRs over paper-based records (PBRs). It outlines the measures introduced by Ministry of Health to implement EHRs across the health sector in New Zealand. Furthermore, the review will provide an international comparison in implementing EHRs with that of New Zealand.
When most patients visit physicians in a clinic or a hospital, they are asked about their medical history and related medical tests’ results which might not exist or might simply have been lost over time. In emergency situations, many patients suffer or sadly die because of lack of pertinent medical information. Patient’s Health information (PHI) saved by Electronic Medical Record (EMR) could be accessible only by a hospital using their EMR system. Furthermore, Personal Health Record (PHR) information cannot be solely relied on since it is controlled solely by patients. This paper introduces a novel framework for accessing, sharing, and controlling the medical records for patients and their physicians globally, while patients’ PHI are securely stored and their privacy is taken into consideration. Based on the framework, a proof of concept prototype is implemented. Preliminary performance evaluation results indicate the validity and viability of the proposed framework.
Barriers and Challenges to Telecardiology Adoption in Malaysia Context Yayah Zakaria
Mainly in infrastructure deficient communities, telecardiology is considered as a complement to insufficient cardiac care. Telecardiology can reduce travelling and waiting time, enables information sharing in shorter time and facilitate care in rural and remote areas. A qualitative study examined the perspectives of health care providers: cardiologist and general physician and
health care service receivers: patient and public towards telecardiology adoption. The barriers in telecardiology adoption were identified in this paper. It includes practicality of telecardiology, the need of education for staffs and administrators, ease of use, preferred face-to-face consultation,
cost and confidentiality. Improvements can be done by the implementers based on this study in order to promote telecardiology successfully in Malaysia.
When most patients visit physicians in a clinic or a hospital, they are asked about their medical history and related medical tests’ results which might not exist or might simply have been lost over time. In emergency situations, many patients suffer or sadly die because of lack of pertinent medical information. Patient’s Health information (PHI) saved by Electronic Medical Record (EMR) could be accessible only by a hospital using their EMR system. Furthermore, Personal Health Record (PHR) information cannot be solely relied on since it is controlled solely by patients. This paper introduces a novel framework for accessing, sharing, and controlling the medical records for patients and their physicians globally, while patients’ PHI are securely stored and their privacy is taken into consideration. Based on the framework, a proof of concept prototype is implemented. Preliminary performance evaluation results indicate the validity and viability of the proposed framework.
Barriers and Challenges to Telecardiology Adoption in Malaysia Context Yayah Zakaria
Mainly in infrastructure deficient communities, telecardiology is considered as a complement to insufficient cardiac care. Telecardiology can reduce travelling and waiting time, enables information sharing in shorter time and facilitate care in rural and remote areas. A qualitative study examined the perspectives of health care providers: cardiologist and general physician and
health care service receivers: patient and public towards telecardiology adoption. The barriers in telecardiology adoption were identified in this paper. It includes practicality of telecardiology, the need of education for staffs and administrators, ease of use, preferred face-to-face consultation,
cost and confidentiality. Improvements can be done by the implementers based on this study in order to promote telecardiology successfully in Malaysia.
Measuring prevailing practices of healthcare professional on electronic healt...journalBEEI
Paper based approach to clinical documentation such as handwritten notes among health care providers are cause of errors in medical field. Therefore, health record system needs to be replaced with electronic health record (EHR). Many health professionals in developing countries specifically in Iraq refuse to use the systems implemented for their benefits due to many reasons. Thus, the use of electronic services is important for successful electronic health implementations. Therefore, this study is intended to identify the main factors affecting the intention of use of the electronic health record in Iraq. Health professional staff who work in the main hospital in Dhi-Qar is chosen because this province is the first local province that implemented many electronic projects. The present study examined use of user acceptance of technology, based on the technology acceptance model (TAM). Moreover, the quantitative method approach for data collection using survey from staff who work in the main hospital in Dhi-Qar. Data was analyzed using Structural Equation Modeling using AMOS. The results indicated significant relationship between Ease of Use, Usefulness, Usefulness, Attitude, and Intention of use of EHR. These finding have implementation for decision makers in Iraq government to improve future implementation of e-health services.
Proposed Framework For Electronic Clinical Record Information Systemijcsa
This research paper is drawn from an ongoing, large-scale project of implementing Electronic Clinical Record (ECR). The overall aim in this study is to develop a deeper understanding of the socio-technical aspects of the complexities and challenges emerging from the implementation of the ECR, and in particular to study how to manage a gradual transition to digital record. We have proposed ECR conceptual mode. The end result of our research was a collection of ideas / surveys, and field work that clinical institutions and medical informatics must consider to ensure that patients and clinics do not lose long-term access to ECR and technology continually progress. Results of our study identified the need for more research in this particular area as no definitive solution to long-term access to electronic clinical records was revealed. Additionally, the research findings highlighted the fact that a few medical institutions may actually be concerned about long-term access to electronic records.
E-Health is alluded to as utilizing of information and communication technologies (ICT) in restorative field to control treatment of patients, research, and wellbeing training and checking of general wellbeing. The reason for this paper is thusly to investigate an institutionalized system for E-Health challenges confronted
by e-wellbeing A rundown of both e-wellbeing difficulties are given and a proposed structure is likewise accommodated E-Health and could give direction in the execution of e-wellbeing To understand the motivation behind the paper, an inductive substance examination procedure was taken after. The
fundamental outcomes were that in spite of the fact that the difficulties exceeds the advantages in the gave records, there is still trust that through appropriate ICT arrangements the advantages of e-wellbeing can develop all the more quickly. This can prompt to enhanced e-wellbeing administration conveyance and nationals in nations can all profit by this.
Big Data Analytics using in Healthcare Management Systemijtsrd
Big data is the new technology for healthcare management system. Present day's big data analytics are using in everywhere because of its good data management and its large storage capacity. In hospital managements the patients and doctors record keeping safe is the important role in healthcare system. In worldwide the big data method is extended use in the area of medicine and healthcare system. In this sector so many problems are there in implementing big data in healthcare system especially in relation to securities, privacy matters, standard records, good governance, managing of data, data storing and maintenance, etc. It is critical that these challenges to overcome before big data can be implemented successfully in healthcare. The amount of data being digitally collected and stored safely in big data Hadoop clusters. This paper introduces healthcare data, big data in healthcare systems, applications, advantages, issues of Big Data analytics in healthcare sector. Gagana H. S | Bhavani B. T | Gouthami H. S "Big Data Analytics using in Healthcare Management System" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-4 , June 2020, URL: https://www.ijtsrd.com/papers/ijtsrd31014.pdf Paper Url :https://www.ijtsrd.com/computer-science/other/31014/big-data-analytics-using-in-healthcare-management-system/gagana-h-s
Describes Indian Council of Medical Research, ICMR Institutes, importance of IT in health care, Health Information System and Mobile based Surveillance Quest using IT. For more information visit: http://www.transformhealth-it.org/
A risk assessment is nothing more than a careful examination of what, in your work or activities, could cause harm to people, so that you can weigh up whether you have taken enough precautions or should do more to prevent harm. The aim is to make sure that no one gets hurt or becomes ill. Accidents and ill health can ruin lives, and affect your business too. See more at http://greenwgroup.ae/
Measuring prevailing practices of healthcare professional on electronic healt...journalBEEI
Paper based approach to clinical documentation such as handwritten notes among health care providers are cause of errors in medical field. Therefore, health record system needs to be replaced with electronic health record (EHR). Many health professionals in developing countries specifically in Iraq refuse to use the systems implemented for their benefits due to many reasons. Thus, the use of electronic services is important for successful electronic health implementations. Therefore, this study is intended to identify the main factors affecting the intention of use of the electronic health record in Iraq. Health professional staff who work in the main hospital in Dhi-Qar is chosen because this province is the first local province that implemented many electronic projects. The present study examined use of user acceptance of technology, based on the technology acceptance model (TAM). Moreover, the quantitative method approach for data collection using survey from staff who work in the main hospital in Dhi-Qar. Data was analyzed using Structural Equation Modeling using AMOS. The results indicated significant relationship between Ease of Use, Usefulness, Usefulness, Attitude, and Intention of use of EHR. These finding have implementation for decision makers in Iraq government to improve future implementation of e-health services.
Proposed Framework For Electronic Clinical Record Information Systemijcsa
This research paper is drawn from an ongoing, large-scale project of implementing Electronic Clinical Record (ECR). The overall aim in this study is to develop a deeper understanding of the socio-technical aspects of the complexities and challenges emerging from the implementation of the ECR, and in particular to study how to manage a gradual transition to digital record. We have proposed ECR conceptual mode. The end result of our research was a collection of ideas / surveys, and field work that clinical institutions and medical informatics must consider to ensure that patients and clinics do not lose long-term access to ECR and technology continually progress. Results of our study identified the need for more research in this particular area as no definitive solution to long-term access to electronic clinical records was revealed. Additionally, the research findings highlighted the fact that a few medical institutions may actually be concerned about long-term access to electronic records.
E-Health is alluded to as utilizing of information and communication technologies (ICT) in restorative field to control treatment of patients, research, and wellbeing training and checking of general wellbeing. The reason for this paper is thusly to investigate an institutionalized system for E-Health challenges confronted
by e-wellbeing A rundown of both e-wellbeing difficulties are given and a proposed structure is likewise accommodated E-Health and could give direction in the execution of e-wellbeing To understand the motivation behind the paper, an inductive substance examination procedure was taken after. The
fundamental outcomes were that in spite of the fact that the difficulties exceeds the advantages in the gave records, there is still trust that through appropriate ICT arrangements the advantages of e-wellbeing can develop all the more quickly. This can prompt to enhanced e-wellbeing administration conveyance and nationals in nations can all profit by this.
Big Data Analytics using in Healthcare Management Systemijtsrd
Big data is the new technology for healthcare management system. Present day's big data analytics are using in everywhere because of its good data management and its large storage capacity. In hospital managements the patients and doctors record keeping safe is the important role in healthcare system. In worldwide the big data method is extended use in the area of medicine and healthcare system. In this sector so many problems are there in implementing big data in healthcare system especially in relation to securities, privacy matters, standard records, good governance, managing of data, data storing and maintenance, etc. It is critical that these challenges to overcome before big data can be implemented successfully in healthcare. The amount of data being digitally collected and stored safely in big data Hadoop clusters. This paper introduces healthcare data, big data in healthcare systems, applications, advantages, issues of Big Data analytics in healthcare sector. Gagana H. S | Bhavani B. T | Gouthami H. S "Big Data Analytics using in Healthcare Management System" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-4 , June 2020, URL: https://www.ijtsrd.com/papers/ijtsrd31014.pdf Paper Url :https://www.ijtsrd.com/computer-science/other/31014/big-data-analytics-using-in-healthcare-management-system/gagana-h-s
Describes Indian Council of Medical Research, ICMR Institutes, importance of IT in health care, Health Information System and Mobile based Surveillance Quest using IT. For more information visit: http://www.transformhealth-it.org/
A risk assessment is nothing more than a careful examination of what, in your work or activities, could cause harm to people, so that you can weigh up whether you have taken enough precautions or should do more to prevent harm. The aim is to make sure that no one gets hurt or becomes ill. Accidents and ill health can ruin lives, and affect your business too. See more at http://greenwgroup.ae/
A FRAMEWORK FOR EXTRACTING AND MODELING HIPAA PRIVACY RULES FOR HEALTHCARE AP...hiij
Some organizations use software applications to manage their customers’ personal, medical, or financial
information. In the United States, those software applications are obligated to preserve users’ privacy and
to comply with the United States federal privacy laws and regulations. To formally guarantee compliance
with those regulations, it is essential to extract and model the privacy rules from the text of the law using a
formal framework. In this work we propose a goal-oriented framework for modeling and extracting the
privacy requirements from regulatory text using natural language processing techniques.
But every organisation needs to make sure that it follows good health, safety and environmental practices.
Auditing is a structured comprehensive process used for verifying the efficiency, effectiveness and reliability of an organisation's occupational health, safety and environmental management system.
Green World Group in association BSCIC trains OHSAS 18001 Auditor courses. For further details Please visit http://greenwgroup.ae/
Survey of open source health information systemshiij
Due to the Health Information Technology for Economic and Clinical Health Act (HITECH), the US
medical industry has been given a directive to transition to electronic health records. Electronic Health
Records will enhance efficiency and quality of patient care. In this paper, open-source health information
systems are surveyed.These systems include electronic medical records, electronic health records and
personal health record systems. Their functionality, implementation technologies used, and security
features are discussed.
The ECG signals captured from the body of the patient using three electrode model is processed and
conditioned by the analog front end device is finally sent to the data acquisition unit. The data acquisition
unit used is the user pc/ laptop with MATLAB. Using very specific image processing techniques the critical
intelligence from the captured image is extracted. From this processed image any sort of abnormal
conditions is determined which is informed to the corresponding doctor via text message. Simultaneously
the processed image is sent to the doctor mail by using specific TCP/IP protocol.
Modern Era of Medical Field : E-HealthFull Text ijbbjournal
E-Health is alluded to as utilizing of information and communication technologies (ICT) in restorative field
to control treatment of patients, research, and wellbeing training and checking of general wellbeing. The
reason for this paper is thusly to investigate an institutionalized system for E-Health challenges confronted
by e-wellbeing A rundown of both e-wellbeing difficulties are given and a proposed structure is likewise
accommodated E-Health and could give direction in the execution of e-wellbeing To understand the
motivation behind the paper, an inductive substance examination procedure was taken after. The
fundamental outcomes were that in spite of the fact that the difficulties exceeds the advantages in the gave
records, there is still trust that through appropriate ICT arrangements the advantages of e-wellbeing can
develop all the more quickly. This can prompt to enhanced e-wellbeing administration conveyance and
nationals in nations can all profit by this
Electronic Health Records EHRs and Electronic Medical Records EMRs and Their ...ijtsrd
This review explores the profound impact of Electronic Health Records EHRs and Electronic Medical Records EMRs on modern healthcare practices. Beginning with a historical perspective, the article delves into the key components, advantages, and challenges associated with these digital records. Patient demographics, medical history, medication lists, and allergies are seamlessly integrated, enhancing accessibility and improving patient safety. The digital transformation facilitates streamlined communication and care coordination, breaking down traditional barriers among healthcare providers. The incorporation of telehealth and remote monitoring enriches patient engagement and extends healthcare beyond traditional settings. Furthermore, the review highlights the role of EHRs and EMRs in supporting evidence based medicine, fostering a culture of continuous improvement and innovation. The synergy between these records and data analytics enhances population health management, contributing to evidence based practices and informed decision making. In conclusion, the integration of EHRs and EMRs marks a transformative era in healthcare, promoting patient centered, data driven, and efficient healthcare delivery. Sandeep Bairi | Mohd Shoaib | P. Rithika Rashmi "Electronic Health Records (EHRs) and Electronic Medical Records (EMRs) and Their Significance" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd63454.pdf Paper Url: https://www.ijtsrd.com/pharmacy/other/63454/electronic-health-records-ehrs-and-electronic-medical-records-emrs-and-their-significance/sandeep-bairi
CONCEPTUAL MODEL FOR ELECTRONIC CLINICAL RECORD INFORMATION SYSTEMijistjournal
This study is drawn from an ongoing, large-scale project of implementing Electronic Clinical Record (ECR). The overall aim in this study is to develop a deeper understanding of the socio-technical aspects of the complexities and challenges emerging from the implementation of the ECR, and in particular to study how to manage a gradual transition to digital record. We have proposed ECR conceptual model. The end result of our research was a collection of ideas / surveys, and field work that clinical institutions and medical informatics must consider to ensure that patients and clinics do not lose long-term access to ECR and technology continually progress. Results of our study identified the need for more research in this particular area as no definitive solution to long-term access to electronic clinical records was revealed. Additionally, the research findings highlighted the fact that a few medical institutions may actually be concerned about long-term access to electronic records.
CONCEPTUAL MODEL FOR ELECTRONIC CLINICAL RECORD INFORMATION SYSTEMijistjournal
This study is drawn from an ongoing, large-scale project of implementing Electronic Clinical Record (ECR). The overall aim in this study is to develop a deeper understanding of the socio-technical aspects of the complexities and challenges emerging from the implementation of the ECR, and in particular to study how to manage a gradual transition to digital record. We have proposed ECR conceptual model. The end result of our research was a collection of ideas / surveys, and field work that clinical institutions and medical informatics must consider to ensure that patients and clinics do not lose long-term access to ECR and technology continually progress. Results of our study identified the need for more research in this particular area as no definitive solution to long-term access to electronic clinical records was revealed. Additionally, the research findings highlighted the fact that a few medical institutions may actually be concerned about long-term access to electronic records.
Pg2 Beginning in 1991, the IOM (which stands for the Institute o.docxrandymartin91030
Pg2 Beginning in 1991, the IOM (which stands for the Institute of Medicine of the National Academies) sponsored studies and created reports that led the way toward the concepts we have in place today for electronic health records. Originally, the IOM called them computer-based patient records.1 During their evolution, the EHR have had many other names, including electronic medical records, computerized medical records, longitudinal patient records, and electronic charts. All of these names referred to essentially the same thing, which in 2003, the IOM renamed as the electronic health records, or EHR.
Note: EHR
The acronym EHR is commonly used as shorthand for Electronic Health Records, and will be used in the remainder of this book.
Institute of Medicine (IOM)
The IOM report2 put forth a set of eight core functions that an EHR should be capable of performing:
Health information and data
This function provides a defined data set that includes such items as medical and nursing diagnoses, a medication list, allergies, demographics, clinical narratives, and laboratory test results. Further, it provides improved access to information needed by care providers when they need it.
Result management
Computerized results can be accessed more easily (than paper reports) by the provider at the time and place they are needed.
· Reduced lag time allows for quicker recognition and treatment of medical problems.
· The automated display of previous test results makes it possible to reduce redundant and additional testing.
· Having electronic results can allow for better interpretation and for easier detection of abnormalities, thereby ensuring appropriate follow-up.
· Access to electronic consults and patient consents can establish critical links and improve care coordination among multiple providers, as well as between provider and patient
Order management
Computerized provider order entry (CPOE) systems can improve workflow processes by eliminating lost orders and ambiguities caused by illegible handwriting, generating related orders automatically, monitoring for duplicate orders, and reducing the time required to fill orders.
· CPOE systems for medications reduce the number of errors in medication dose and frequency, drug allergies, and drug–drug interactions.
· The use of CPOE, in conjunction with an EHR, also improves clinician productivity.
Decision Support
Computerized decision support systems include prevention, prescribing of drugs, diagnosis and management, and detection of adverse events and disease outbreaks.
· Computer reminders and prompts improve preventive practices in areas such as vaccinations, breast cancer screening, colorectal screening, and cardiovascular risk reduction.
Electronic communication and connectivity
Electronic communication among care partners can enhance patient safety and quality of care, especially for patients who have multiple providers in multiple settings that must coordinate care plans.
· Electronic co.
Running head MEDICAL TECHNOLOGY 1MEDICA.docxcowinhelen
Running head: MEDICAL TECHNOLOGY 1
MEDICAL TECHNOLOGY 6
Medical Technology
Felicia Jones
04/26/2017
Introduction
Health Information Technology (HIT) involves the use of a digital format to store, distribute, and analyze health information. HIT is used between doctor-patient communications to improve the patient’s care. The IT professionals working in the HIT are involved in the technical side of managing health information using software and hardware to manage patients’ data. The professionals provide support to the Electronic Health Records (EHRs) management and other professionals to ascertain accurate dissemination of medical records adhering to HIPAA and HITECH rules and regulations (McInnes, 2016).
Health and financial benefits of implementing EHR
Improved health care and convenience
Access to the patients’ records is easy even in remote locations which ease the quality of care in the case of emergencies. Having all the information located at a central place makes decision making easy. Use of EHRs helps different hospitals and laboratories to access a patient’s medical history
Improved Patient participation
EHRs makes it possible for health professionals to give the patients all their medical evaluations. The providers can provide follow-up information such as web resources and self-care instructions which aid in improving the quality of health care.
Improved diagnostics and patient outcomes
With an accurate medical history of a patient, the medical professionals can check for any allergies, prior treatments which help during the treatment process. The frequency of medical errors during diagnosis. Qualified EHR checks for problems when a new medication is given to the patient and alerting the doctor in advance in the case of any potential threats. In regard to national disasters where casualties forget their medical history, EHR helps quick retrieval of their history and aid in saving their lives.
Time and cost savings
Use of EHRs assists in reducing duplication of testing which saves on the cost of conducting laboratory tests. Moreover, the administrative expenses as a result of filling of numerous patients paperwork. As a consequence of the use of EHRs, there is reduced transcription, storage, and chart-pull costs. The use of electronic prescribing reduces medical errors (Goldberg, & Feng, 2012).
Cost of implementing and maintaining EHR
Setting up an EHR system up and running is quite expensive. Some of the expenses associated with establishing the system are the required hardware and software, installation, training of the IT professionals and ongoing maintenance. There are other costs such as over-time-pay for the providers. Taking a primary care facility with five physicians, the cost of setting up an EHR system is $162,000 and maintenance cost of $ 85,500 within the first year. The IT professionals operating the EHRs needed 611 hours of training whereas each physician require ...
Challenges of the Healthcare Industry in Indiadrparul6375
he healthcare industry in India faces several challenges, ranging from infrastructure and access to healthcare services to regulatory issues and affordability. Some of the key challenges include:
Infrastructure and Resource Constraints: India's healthcare infrastructure is often inadequate, especially in rural areas. There is a shortage of hospitals, clinics, beds, medical professionals, and essential medical equipment. This imbalance between demand and supply leads to overcrowding in healthcare facilities and compromises the quality of care.
Accessibility and Geographic Disparities: Accessibility to healthcare services varies significantly across different regions of India. Rural areas often lack basic healthcare facilities, forcing people to travel long distances for treatment. This geographic disparity exacerbates healthcare inequalities, with urban populations having better access to healthcare compared to rural populations.
Affordability and Financial Barriers: Healthcare costs in India can be prohibitively expensive for many people, particularly those from low-income backgrounds. Out-of-pocket expenditure on healthcare is high, pushing many families into poverty. Lack of comprehensive health insurance coverage further exacerbates financial barriers to accessing quality healthcare services.
Electronic health record (EHR) is a computerized patient-centric history of an individual’s health
care record that includes data from the multiple sources of care that the patient has used.
Running Head THE HEALTH INFORMATION EXCHANGE (HIE) IN U.S 1.docxtodd521
Running Head: THE HEALTH INFORMATION EXCHANGE (HIE) IN U.S 1
THE HEALTH INFORMATION EXCHANGE (HIE) IN U.S 9
The Health Information Exchange (HIE) in U.S
Yehyun Park
Purdue University
01/02/2019
The impetus of Health Information Exchange in U.S
Health Information Exchange (HIE) is an information system that promotes a secure sharing of critical information as well the inclusive access critical medical information about a patient electronically (Abdelhak et al, 2014). One merit of the use of such electronic systems in the U.S is that they occur in different verities. The HIE also offer different types of services. Evidently, a recent development has enabled the HIE systems to promote the Marketplace and regional institutional services concerning the health sector. The merit of HIE applications included the improvement of speed, Quality, safety and reduced relative prices of charge per patient for care. This is made possible by the quick sharing of critical information among the doctors, pharmacists, nurses among all the relevant health personnel. The HGIE systems are such that, they are technically enabled to provide quick response to information demand with the relevant urgency and thus aids in the making of vital patient’s data and medical progress devoid of medical errors, readmissions, and duplicate testing. The resulting system has a generally improved diagnosis.
HIE enables three line of services in general: directed exchange, Query-based Exchange a consumer-mediated exchange services. Direct Exchange is the sending or receiving data electronically in the aid of coordination by caregivers. Whenever heath care provider wants to consult with other providers about a planned care, they employ the Query-based exchange while consumer-mediated Exchange enables patients to manage through control of the use of their personal information (Abdelhak et al, 2014). The availability of the three forms of health information Exchange makes the strong point of HIE since their integration in use is guided by some predetermined policies, technology, principles, and policies provision which have already been piloted before. The three forms are completely available throughout. With the Consumer-mediated Exchange system, the patient can be able to monitor the use of his personal medical information by their care provider. The patients can make a participation in their care enhancing through providing alternative providers with their heath condition, describe their heath information give the health missing or incorrect information, track and manage their own health.
Describe basic HIE organizational structures, architectures, and services
The commonly known architecture types of HIE includes the centralized hybrid and the federated models of HIE. The centralized HIE model is enabled with one Clinical Data Repository (CDR). The CDR is managed by HIE authority that is under the governance of the representatives from the relevant hospitals (Abdelhak .
Healthcare Informatics is defined as the integration of health-ca.docxpooleavelina
Healthcare Informatics is defined as "the integration of health-care sciences, computer science, information science, and cognitive science to assist in the management of healthcare information" (Saba & McCormick, 2015, p. 232). Nursing Informatics is a subset of informatics, specific to the field and the role of the nurse in the healthcare setting. The American Nurses Association (ANA) identified nursing informatics as "a specialty that integrates nursing, science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice" (ANA, 2001, p.17). Healthcare and nursing informatics are both vastly growing fields within the medical field and are continuously incorporating new and evolving technology. Both have been around for the past three decades, at least. The technology boom at the turn of the century has helped informatics and information systems further evolve. Enhanced delivery of care, improved health outcomes, and advanced patient education are just a few aspects that have improved. With any new technology or innovation there are implications, some foreseeable and some that come to light after the unveiling of the new process or product: some impacts that are most notable are clinical, managerial, and policy implications. This paper explores the implications, (both constructive and adverse), that are the most notable in today's healthcare world within the healthcare and nursing informatics fields.
Citation
Sweeney, J. (Feb, 2017). Healthcare Informatics. Online Journal of Nursing Informatics (OJNI), 21( 1), Available at http://www.himss.org/ojni
Introduction
Healthcare Informatics is defined as "the integration of health-care sciences, computer science, information science, and cognitive science to assist in the management of healthcare information" (Saba & McCormick, 2015, Pg. 232). Nursing Informatics is a subset of informatics, specific to the field and the roll of the nurse in the healthcare setting. The American Nurses Association (ANA) identified nursing informatics as "a specialty that integrates nursing, science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice" (ANA, 2001, Pg.17). Healthcare and nursing informatics are both vastly growing fields within the medical field and are continuously incorporating new and evolving technology. Both have been around for the past three decades, at least. The technology boom at the turn of the century has helped informatics and information systems further evolve. Enhanced delivery of care, improved health outcomes, and advanced patient education are just a few aspects that have improved. With any new technology or innovation there are implications, some foreseeable and some that come to light after the unveiling of the new process or product. Some impacts that are most notable are clinical, managerial, and policy implications. This paper will explore the impli ...
MANAGING THE INFORMATION SECURITY ISSUES OF ELECTRONIC MEDICAL RECORDSijsptm
All healthcare providers should have enough knowledge and sufficient information to understand the potential risk, which can lead to a breach in the Jordanian health information system (Hakeem program). This study aims to emphasise the importance of sharing sensitive health information among healthcare providers, create laws and regulations to keep the electronic medical records secure, and increase the
awareness about health information security among healthcare providers. The study conducted seven interviews with medical staff and an information technology technician. The study results showed that sharing sensitive information in a secure environment, creating laws and regulations, and increasing the
awareness about health information security render the electronic medical records of patients more secure and safe
Similar to IMPLEMENTING ELECTRONIC HEALTH RECORDS IN NEW ZEALAND: A CRITICAL APPRAISAL OF LITERATURE (20)
Health Informatics - An International Journal (HIIJ)hiij
Healthcare Informatics: An International Journal is a quarterly open access peer-reviewed journal that Publishes articles which contribute new results in all areas of the health care.
The journal focuses on all of aspect in theory, practices, and applications of Digital Health Records, Knowledge Engineering in Health, E-Health Information, and Information Management in healthcare, Bio-Medical Expert Systems, ICT in health promotion and related topics. Original contributions are solicited on topics covered under the broad areas such as (but not limited to) listed below:
Health Informatics - An International Journal (HIIJ)hiij
Healthcare Informatics: An International Journal is a quarterly open access peer-reviewed journal that Publishes articles which contribute new results in all areas of the health care.
The journal focuses on all of aspect in theory, practices, and applications of Digital Health Records, Knowledge Engineering in Health, E-Health Information, and Information Management in healthcare, Bio-Medical Expert Systems, ICT in health promotion and related topics. Original contributions are solicited on topics covered under the broad areas such as (but not limited to) listed below:
HEALTH DISPARITIES: DIFFERENCES IN VETERAN AND NON-VETERAN POPULATIONS USING ...hiij
Introduction: This study investigated self-reported health status, health screenings, vision problems, and
vaccination rates among veteran and non-veteran groups to uncover health disparities that are critical for
informed health system planning for veteran populations.
Methods: Using public-use data from the National Health Interview Survey (2015-2018), this study adopts
an ecologic cross-sectional approach to conduct an in-depth analysis and visualization of the data assisted
by Generative AI, specifically ChatGPT-4. This integration of advanced AI tools with traditional
epidemiological principles enables systematic data management, analysis, and visualization, offering a
nuanced understanding of health dynamics across demographic segments and highlighting disparities
essential for veteran health system planning.
Findings: Disparities in self-reports of health outcomes, health screenings, vision problems, and
vaccination rates were identified, emphasizing the need for targeted interventions and policy adjustments.
Conclusion: Insights from this study could inform health system planning, using epidemiological data
assessment to suggest enhancements for veteran healthcare delivery. These findings highlight the value of
integrating Generative AI with epidemiological analysis in shaping public health policy and health
planning.
Health Informatics - An International Journal (HIIJ)hiij
Healthcare Informatics: An International Journal is a quarterly open access peer-reviewed journal that Publishes articles which contribute new results in all areas of the health care.
The journal focuses on all of aspect in theory, practices, and applications of Digital Health Records, Knowledge Engineering in Health, E-Health Information, and Information Management in healthcare, Bio-Medical Expert Systems, ICT in health promotion and related topics. Original contributions are solicited on topics covered under the broad areas such as (but not limited to) listed below:
Health Informatics - An International Journal (HIIJ)hiij
Healthcare Informatics: An International Journal is a quarterly open access peer-reviewed journal that Publishes articles which contribute new results in all areas of the health care.
The journal focuses on all of aspect in theory, practices, and applications of Digital Health Records, Knowledge Engineering in Health, E-Health Information, and Information Management in healthcare, Bio-Medical Expert Systems, ICT in health promotion and related topics. Original contributions are solicited on topics covered under the broad areas such as (but not limited to) listed below:
Health Informatics - An International Journal (HIIJ)hiij
Healthcare Informatics: An International Journal is a quarterly open access peer-reviewed journal that Publishes articles which contribute new results in all areas of the health care.
The journal focuses on all of aspect in theory, practices, and applications of Digital Health Records, Knowledge Engineering in Health, E-Health Information, and Information Management in healthcare, Bio-Medical Expert Systems, ICT in health promotion and related topics. Original contributions are solicited on topics covered under the broad areas such as (but not limited to) listed below:
Health Informatics - An International Journal (HIIJ)hiij
Healthcare Informatics: An International Journal is a quarterly open access peer-reviewed journal that Publishes articles which contribute new results in all areas of the health care.
The journal focuses on all of aspect in theory, practices, and applications of Digital Health Records, Knowledge Engineering in Health, E-Health Information, and Information Management in healthcare, Bio-Medical Expert Systems, ICT in health promotion and related topics. Original contributions are solicited on topics covered under the broad areas such as (but not limited to) listed below:
Health Informatics - An International Journal (HIIJ)hiij
Healthcare Informatics: An International Journal is a quarterly open access peer-reviewed journal that Publishes articles which contribute new results in all areas of the health care.
The journal focuses on all of aspect in theory, practices, and applications of Digital Health Records, Knowledge Engineering in Health, E-Health Information, and Information Management in healthcare, Bio-Medical Expert Systems, ICT in health promotion and related topics. Original contributions are solicited on topics covered under the broad areas such as (but not limited to) listed below:
BRIEF COMMENTARY: USING A LOGIC MODEL TO INTEGRATE PUBLIC HEALTH INFORMATICS ...hiij
The COVID-19 pandemic has been a watershed moment in public health surveillance, highlighting the
crucial role of data-driven insights in informing health actions and policies. Revisiting key concepts—
public health, epidemiology in public health practice, public health surveillance, and public health
informatics—lays the foundation for understanding how these elements converge to create a robust public
health surveillance system framework. Especially during the COVID-19 pandemic, this integration was
exemplified by the WHO efforts in data dissemination and the subsequent global response. The role of
public health informatics emerged as instrumental in this context, enhancing data collection, management,
analysis, interpretation, and dissemination processes. A logic model for public health surveillance systems
encapsulates the integration of these concepts. It outlines the inputs and outcomes and emphasizes the
crucial actions and resources for effective system operation, including the imperative of training and
capacity development.
Health Informatics - An International Journal (HIIJ)hiij
Healthcare Informatics: An International Journal is a quarterly open access peer-reviewed journal that Publishes articles which contribute new results in all areas of the health care.
The journal focuses on all of aspect in theory, practices, and applications of Digital Health Records, Knowledge Engineering in Health, E-Health Information, and Information Management in healthcare, Bio-Medical Expert Systems, ICT in health promotion and related topics. Original contributions are solicited on topics covered under the broad areas such as (but not limited to) listed below:
AUTOMATIC AND NON-INVASIVE CONTINUOUS GLUCOSE MONITORING IN PAEDIATRIC PATIENTShiij
Glycated haemoglobin does not allow you to highlight the effects that food choices, physical activity and
medications have on your glycaemic control day by day. The best way to monitor and keep track of the
immediate effects that these have on your blood sugar levels is self-monitoring, therefore the use of a
glucometer. Thanks to this tool you have the possibility to promptly receive information that helps you to
intervene in the most appropriate way, bringing or keeping your blood sugar levels as close as possible to
the reference values indicated by your doctor. Currently, blood glucose meters are used to measure and
control blood glucose. Diabetes is a fairly complex disease and it is important for those who suffer from it
to check their blood sugar (blood sugar) periodically throughout the day to prevent dangerous
complications. Many children newly diagnosed with diabetes and their families may face unique challenges
when dealing with the everyday management of diabetes, including treatments, adapting to dietary
changes, and the routine monitoring of blood glucose. Many questions may also arise when selecting a
blood glucose meter for paediatric patients. With current blood glucose meters, even with multiple daily
self-tests, high and low blood glucose levels may not be detected. Key factors that may be considered when
selecting a meter include accuracy of the meter; size of the meter; small sample size required for testing;
ease of use and easy-to-follow testing procedure; ability for alternate testing sites; quick testing time and
availability of results; ease of portability to allow testing at school and during leisure time; easyto- read
numbers on display; memory options; cost of meter and supplies. In this study we will show a new
automatic portable, non-invasive device and painless for the daily continuous monitoring (24 hours a day)
of blood glucose in paediatric patients.
INTEGRATING MACHINE LEARNING IN CLINICAL DECISION SUPPORT SYSTEMShiij
This review article examines the role of machine learning (ML) in enhancing Clinical Decision Support
Systems (CDSSs) within the modern healthcare landscape. Focusing on the integration of various ML
algorithms, such as regression, random forest, and neural networks, the review aims to showcase their
potential in advancing patient care. A rapid review methodology was utilized, involving a survey of recent
articles from PubMed and Google Scholar on ML applications in healthcare. Key findings include the
demonstration of ML's predictive power in patient outcomes, its ability to augment clinician knowledge,
and the effectiveness of ensemble algorithmic approaches. The review highlights specific applications of
diverse ML models, including moment kernel machines in predicting surgical outcomes, k-means clustering
in simplifying disease phenotypes, and extreme gradient boosting in estimating injury risk. Emphasizing
the potential of ML to tackle current healthcare challenges, the article highlights the critical role of ML in
evolving CDSSs for improved clinical decision-making and patient care. This comprehensive review also
addresses the challenges and limitations of integrating ML into healthcare systems, advocating for a
collaborative approach to refine these systems for safety, efficacy, and equity.
BRIEF COMMENTARY: USING A LOGIC MODEL TO INTEGRATE PUBLIC HEALTH INFORMATICS ...hiij
The COVID-19 pandemic has been a watershed moment in public health surveillance, highlighting the
crucial role of data-driven insights in informing health actions and policies. Revisiting key concepts—
public health, epidemiology in public health practice, public health surveillance, and public health
informatics—lays the foundation for understanding how these elements converge to create a robust public
health surveillance system framework. Especially during the COVID-19 pandemic, this integration was
exemplified by the WHO efforts in data dissemination and the subsequent global response. The role of
public health informatics emerged as instrumental in this context, enhancing data collection, management,
analysis, interpretation, and dissemination processes. A logic model for public health surveillance systems
encapsulates the integration of these concepts. It outlines the inputs and outcomes and emphasizes the
crucial actions and resources for effective system operation, including the imperative of training and
capacity development.
INTEGRATING MACHINE LEARNING IN CLINICAL DECISION SUPPORT SYSTEMShiij
This review article examines the role of machine learning (ML) in enhancing Clinical Decision Support
Systems (CDSSs) within the modern healthcare landscape. Focusing on the integration of various ML
algorithms, such as regression, random forest, and neural networks, the review aims to showcase their
potential in advancing patient care. A rapid review methodology was utilized, involving a survey of recent
articles from PubMed and Google Scholar on ML applications in healthcare. Key findings include the
demonstration of ML's predictive power in patient outcomes, its ability to augment clinician knowledge,
and the effectiveness of ensemble algorithmic approaches. The review highlights specific applications of
diverse ML models, including moment kernel machines in predicting surgical outcomes, k-means clustering
in simplifying disease phenotypes, and extreme gradient boosting in estimating injury risk. Emphasizing
the potential of ML to tackle current healthcare challenges, the article highlights the critical role of ML in
evolving CDSSs for improved clinical decision-making and patient care. This comprehensive review also
addresses the challenges and limitations of integrating ML into healthcare systems, advocating for a
collaborative approach to refine these systems for safety, efficacy, and equity.
Health Informatics - An International Journal (HIIJ)hiij
Healthcare Informatics: An International Journal is a quarterly open access peer-reviewed journal that Publishes articles which contribute new results in all areas of the health care.
The journal focuses on all of aspect in theory, practices, and applications of Digital Health Records, Knowledge Engineering in Health, E-Health Information, and Information Management in healthcare, Bio-Medical Expert Systems, ICT in health promotion and related topics. Original contributions are solicited on topics covered under the broad areas such as (but not limited to) listed below:
The Proposed Guidelines for Cloud Computing Migration for South African Rural...hiij
It is now overdue for the hospitals in South African rural areas to implement cloud computing technologies in order to access patient data quickly in an emergency. Sometimes medical practitioners take time to attend patients due to the unavailability of kept records, leading to either a loss of time or the reassembling of processes to recapture lost patient files. However, there are few studies that highlight challenges faced by rural hospitals but they do not recommend strategies on how they can migrate to cloud computing. The purpose of this paper was to review recent papers about the critical factors that influence South African hospitals in adopting cloud computing. The contribution of the study is to lay out the importance of cloud computing in the health sectors and to suggest guidelines that South African rural hospitals can follow in order to successfully relocate into cloud computing.The existing literature revealed that Hospitals may enhance their record-keeping procedures and conduct business more effectively with the help of the cloud computing. In conclusion, if hospitals in South African rural areas is to fully benefit from cloud-based records management systems, challenges relating to data storage, privacy, security, and the digital divide must be overcome.
SUPPORTING LARGE-SCALE NUTRITION ANALYSIS BASED ON DIETARY SURVEY DATAhiij
While online survey systems facilitate the collection on copious records on diet, exercise and other healthrelated data, scientists and other public health experts typically must download data from those systems
into external tools for conducting statistical analyses. A more convenient approach would enable
researchers to perform analyses online, without the need to coordinate additional analysis tools. This
paper presents a system illustrating such an approach, using as a testbed the WAVE project, which is a 5-
year childhood obesity prevention initiative being conducted at Oregon State University by health scientists
utilizing a web application called WavePipe. This web application has enabled health scientists to create
studies, enrol subjects, collect physical activity data, and collect nutritional data through online surveys.
This paper presents a new sub-system that enables health scientists to analyse and visualize nutritional
profiles based on large quantities of 24-hour dietary recall records for sub-groups of study subjects over
any desired period of time. In addition, the sub-system enables scientists to enter new food information
from food composition databases to build a comprehensive food profile. Interview feedback from novice
health science researchers using the new functionality indicated that it provided a usable interface and
generated high receptiveness to using the system in practice.
AN EHEALTH ADOPTION FRAMEWORK FOR DEVELOPING COUNTRIES: A SYSTEMATIC REVIEWhiij
#Health #clinic #education #StaySafe #pharmacy #healthylifestyle
call for papers..!
-----------------------------
Health Informatics: An International Journal (HIIJ)
ISSN : 2319 - 2046 (Online); 2319 - 3190 (Print)
Here's where you can reach us : hiij@aircconline.com
visit us on : https://airccse.org/journal/hiij/index.html
**************
published articles..!
AN EHEALTH ADOPTION FRAMEWORK FOR
DEVELOPING COUNTRIES: A SYSTEMATIC REVIEW
https://aircconline.com/hiij/V10N3/10321hiij01.pdf
GENDER DISPARITYOF TUBERCULOSISBURDENIN LOW-AND MIDDLE-INCOME COUNTRIES: A SY...hiij
The tuberculosis burden is higher in the population from low- and middle-income countries (LMICs) and
differently affects gender. This review explored risk factors that determine gender disparity in tuberculosis
in LMICs. The research design was a systematic review. Three databases; Google Scholar, PubMed, and
HINARI provided 69 eligible papers.The synthesized data were coded, grouped and written in a descriptive
narrative style. HIV-TB co-infected women had a higher risk of mortality than TB-HIV-infected men. The
risk of Vitamin-D deficiency-induced tuberculosis was higher in women than in men. Lymph node TB,
breast TB, and cutaneous and abdominal TB occurred commonly in women whereas pleuritis, miliary TB,
meningeal TB, pleural TB and bone and joint TB were common in men. Employed men had higher contact
with tuberculosis patients and an increased chance of getting the disease. Migrant women were more likely
to develop tuberculosis than migrant men. The TB programmers and policymakers should balance the
different gaps of gender in TB-related activities and consider more appropriate approaches to be genderbased and have equal access to every TB-associated healthcare.
BRIEF COMMUNICATIONS DATA HYGIENE: IMPORTANT STEP IN DECISIONMAKING WITH IMPL...hiij
Medical and health data that have been entered into an electronic data system in real-time cannot be
assumed to be accurate and of high quality without verification. The adoption of the electronic health
record (EHR) by many countries to the support care and treatment of patients illustrates the importance of
high quality data that can be shared for efficient patient care and the operation of healthcare systems.
This brief communication provides a high-level overview of an EHR system and practices related to high
data quality and data hygiene that could contribute to the analysis and interpretation of EHR data for use
in patient care and healthcare system administration.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
Instructions for Submissions thorugh G- Classroom.pptx
IMPLEMENTING ELECTRONIC HEALTH RECORDS IN NEW ZEALAND: A CRITICAL APPRAISAL OF LITERATURE
1. Health Informatics - An International Journal (HIIJ) Vol.5, No.4, November 2016
DOI: 10.5121/hiij.2016.5401 1
IMPLEMENTING ELECTRONIC HEALTH RECORDS
IN NEW ZEALAND: A CRITICAL APPRAISAL OF
LITERATURE
Arun Sam Singh Selwyn Jebaraj
School of Health Sciences, University of Canterbury, Christchurch, New Zealand
ABSTRACT
New Zealand health sector has increasing demands in theageing population and ongoing inflation of
medical costs. These demands are growing, and the importance of technology could optimise the
healthcare sector performance. Advancement in technology drives Electronic Health Records
implementation to add substantial value to health delivery systems. The investment and promotion of
health informationinfrastructure have positioned New Zealand as a world leader in the field of primary
care sector. Factors such as organisation structure, culture, leadership and workflow design are
important to achieving successful implementation of Electronic Health Records. This review intends to
critically appraise the advantages of EHRs over paper-based records (PBRs). It outlines the measures
introduced by Ministry of Health to implement EHRs across the health sector in New Zealand.
Furthermore, the review will provide an international comparison in implementing EHRs with that of
New Zealand.
KEYWORDS
Electronic Health Records, Paper Based Records, Health Records
1. INTRODUCTION
New Zealand health sector faces challenges due to escalating medical costs. This trend is likely
to continue with the increasing demands from the ageing population and ongoing inflation of
medical costs. The health demands are growing due to increasing shortage of health workforce
and a declining labour productivity in the health sector (1).Technology could be an important
determinant to optimise the healthcare sector performance.
Advancement in technology is a key driver for New Zealand to introduce Electronic Health
Records (EHRs). Seamless integration of primary and secondary care health information is
necessary to ensure high productivity of EHRs. Factors such as organisation structure, culture,
leadership and workflow design are important to achieving successful implementation of EHRs.
Therefore EHR implementation in health sector could add substantial value to the New Zealand
healthcare delivery system (1).
2. HEALTH RECORDS
Records relate to any information and documents that are arranged in a systematic way, acting
for the purpose of accountability and as a means of communication (2, 3). The origin of first
known records in the health sector was reported by Hippocrates in Fifth century (4). Medical
records relate to a systemic way of collecting, sorting and storing the required data, with the
objective of reporting the information easily when required. For years, medical records were
handwritten in papers, kept in files and maintained as patient-based records (3).
2. Health Informatics - An International Journal (HIIJ) Vol.5, No.4, November 2016
2
Paper-Based Records (PBRs) are described as, “An account of a patient’s health and disease
after he or she has sought medical help. This record usually contains findings, considerations,
test results and treatment information related to the disease process”(4). Paper records are used
to collect the primary information from patients and then input the information into computers.
These records are significant to any treatment, and should be stored safely and free from privacy
risks (5). Factors including physician’s handwriting, retrieval mechanical destruction of papers
and retrieval time influenced PBRs could not be helpful for future and to a larger extent (3, 6).
Uncertainty, fragmentation of information, and storage issues associated with bulky paper
records are some of the cited barriers associated with paper records which lead to the
introduction of EHRs (7).
3. DEFINITION OF ELECTRONIC HEALTH RECORDS (EHRS)
The concept of EHR is also named as Electronic Patient Record (EPR), Electronic Medical
Record (EMR) and Computerized Patient Record (CPR), National Health Record (NHR) (1).
Health Information Management Systems Society (HIMSS) defined EHRs as, “a longitudinal
electronic record of patient health information generated by one or more encounters in any care
delivery setting” (8).
4. BENEFITS OF USING EHRS
Implementation of EHRs provides wider benefits to clinicians, patients, and healthcare
managers as well as enhance healthcare delivery systems (3). Benefits of EHRs could be
classified into clinical, organisational and societal outcomes. Improved quality of care and
patient safety are the key clinical outcomes associated with using EHRs. Some reported
advantages of EHRs include: a) improved legibility of clinical notes, b) accessible information,
c) computerized reminders to physicians (9, 10), d) standardised care (11), e) reduced clinical
investigations(12), f) reduced medication errors, and g) low mortality rates associated with
reduced medical complications (13). Ultimately, this has been shown to improve the quality and
patient safety (14-16).
EHRs organisational outcomes relate to revenue enhancement, by reducing inaccurate coding,
the costs associated with paper charts, and documentation procedures. It also enhances data
security and patient confidentiality (17-19). EHRs societal benefits facilitate the ability to
conduct research with patient data and identifies evidence-based clinical practices(20, 21).
Several healthcare institutions use PBRs to collect the primary patient information and then
subsequently fed them into computers, and thereby use both PBRs and EHRs (22).
4.1. Advantages of using EHRs over PBRs
Patient-based records provide significant attributes as physical and information systems and are
easy to carry, but these are overcome by small portable tablets. PBRs need no special training
when compared to use EHRs by existing healthcare professional. The need to overcome such
disadvantages has led to the development of EHRs (4).
The structured text and controlled vocabulary of EHRs (22), allows faster retrieval of
information. It does not require a person to pull the records when needed and could integrate,
share information to improve the documentation as compared to standalone PBRs (14, 23-26).
PBRs limit the access of health information to a geographic location, but EHRs could help to
identify the inappropriate access of health information (27). Integration of information, medical
3. Health Informatics - An International Journal (HIIJ) Vol.5, No.4, November 2016
3
advancements, upcoming retrospective research significantly contribute organisations to the use
of EHRS over PBRs (28).
The availability of integrated health information and the ease of access facilitate benefits, but
also pose challenges in implementing EHRs. The cost associated with implementation,
converting paper charts to electronic one, and the maintenance work associated with software
up-gradation, ongoing training support needs are the reported barriers to successfully implement
EHRs (29-31). Furthermore, disruption of the normal workflow, temporary loss of productivity
and increased the risk of patient privacy violations, lack of interoperability standards between
EHRs also poses the challenge to successfully implement EHRs (15, 32, 33). The emergence of
new standards for exchanging, integrating, sharing and retrieving information has facilitated
implementing EHRs globally including New Zealand.
5. IMPLEMENTATION OF EHRS IN NEW ZEALAND
In New Zealand, General Practitioners (GPs) were the first to use computers in the early
1980s(27). In 1992 Ministry of Health introduced National Health Identifier (NHI). It is a
unique identifier assigned to every person who uses health and disability support services in
New Zealand to make an error- free identification (4, 27, 34). This NHI is associated to Medical
warnings System (MWS), that warns health professional about any risk factors when making a
clinical decision with an individual patient (34, 35). Every health provider is uniquely identified
by Health Provider Index (HPI) to enable secure ways to access and transfer health information
(36).
Transferring and storing health information electronically was introduced by Health Link in
1993 (37). This is a health-system integrator that enables medical practitioners to communicate
electronically with other health systems. (37, 38). This enabled GPs to exchange electronic
information using the point-2- point communication and computerized nearly 100% of primary
care in New Zealand (1, 38). The rules to collect, use and disclose this information is governed
by Health Information Privacy Code 1994 (39). The clear importance of this technology was
established by the formation of Information Health Strategy in 1991, and Health Information
Strategy in 2000 (4). In 2003, Child Health Information strategy (CHIS) plan was developed to
collect and use the health information of children and young people (40).
This technology importance was further enhanced by the establishment of the National Health
Information Standards Organisation (HISO) in 2003. HISO supports to develop and manage
technology standards such as Health Level seven (HL7), to enable an integrated healthcare in
New Zealand (41). Systematized Nomenclature of Medicine- Clinical terms (SNOMED CT) an
essential clinical terminology standard had been endorsed by HISO to be used across the health
and disability sector in New Zealand (38, 42).
Initiatives such as NHI, HPI, MWS, a National clinical terminology, early adoption of HL7, and
the National health information privacy code provided the building blocks for the National EHR
implementation (43). EHR architecture shares information, either on a need-to-know basis or
limits data access to providers within the “circle of care” (41, 44). Some of the well-functioning
regional EHRs are Primary Information Systems Management (PRISM) implemented by West
Coast District Health Board (DHB) and TesSafe project implemented between Auckland DHBs
of Waitemata, Auckland, and Counties Manukau(45). Nigel Murray, CEO of Waikato DHB,
highlighted consumer as the key to designing the single National EHR to turn data into
meaningful information (46). This single EHR could consolidate information to improve
decision support and patient care coordination for patients with chronic health conditions (47).
4. Health Informatics - An International Journal (HIIJ) Vol.5, No.4, November 2016
4
6. CHALLENGES ACROSS OTHER COUNTRIES
Countries such as the United Kingdom (UK), Australia, Canada have invested heavily,
however, they are yet to successfully achieve National Health IT solutions for their people (48).
The United States of America (USA), uses an incentive program named “Meaningful use of
electronic record” to implement EHRs. To receive this financial incentive, organisations need to
demonstrate that EHRs implementation improves the health outcomes and quality of care (27).
In 1998 New Zealand government provided a one-time grant to GPs to purchase computers and
make electronic claims. This grant helped 98% of GPs to use computerized billing systems (1).
The United Kingdom identifies a unique patient master index as a national requirement for
implementing EHRs (49). This unique identifier number was resisted by the United States of
America as it compromises on patient privacy. These concerns were not foreseen in New
Zealand and created a strong capability for integrating different information platforms by
developing unique identifiers like NHI and HPI (1, 27).
Effective implementation of EHRs needs vocabulary, messaging and security standards to
exchange information seamlessly. Many countries have adopted standards such as International
Standards Organisation (ISO), HL7, to enable interoperability in exchanging information. In
New Zealand, these standards are based on ISO models in exchanging information. Canada
Health Infoway programme used the Picture Archiving Communication System (PACS) for
capturing and transmitting images electronically and showed improved efficiency in clinical
decision making (1). In New Zealand, all DHBs have adopted filmless radiology department,
either by implementing radiology PACS or receive and secure electronic radiology images from
a third party vendor within their electronic medical records (50).
Moving towards a single EHR system, Singapore’s National Electronic Health Record (NEHR)
relates to the goal of “One Singaporean, One Health Record” for its 5.1million citizens
(Deloitte, 2015). In New Zealand, Health Minister Jonathan Coleman stated, the single National
EHR would provide information via patient portals and enable clinicians to get comprehensive
patient information in one place. It would also enable the government to make better investment
decisions, target and monitor the effectiveness of public health programmes (Scoop media, 2016
June 21).
Protection and sharing of this electronic medical information in the USA are directed by Health
Insurance Portability and Accountability Act (HIPAA). In New Zealand, the Privacy act 1993
and Health Information Privacy code 1994, governs the collection, usage, and disclosure of
medical information (27). The National Health IT Board established Connected Health
Programmes, to share secure health information between health professionals (27).
The DHBs in New Zealand have their decisions in IT investments. The focus on IT
infrastructure and legacy systems maintenance contributes to 40 to 60 % of the total IT spending
(Deloitte, 2015). The “Working to Add Value of E- information (WAVE) reported the
investment and promotion of health information infrastructure have positioned New Zealand as
a world leader in the field of primary care sector (43). Consistent, multi- year level funding
needs to address IT investment into strategic assets, rather than subject to short-term constraint
(51). The Thirty year New Zealand Infrastructure Plan 2015 provides, a better approach to use
the existing infrastructure and allocating resources for new investment (52). There is also a need
for DHBs to use structured templates for documentation, implementing nursing documentation
systems and support to implement medication safety management to move up current
Electronic Medical Record Adoption Model (EMRAM) score of 2.8(50).
5. Health Informatics - An International Journal (HIIJ) Vol.5, No.4, November 2016
5
7. CONCLUSION
The investment and promotion of health information infrastructure have positioned New
Zealand as a world leader in the field of primary care sector. But a system-wide approach to
managing the electronic health information across the health sector is currently in early stages in
New Zealand. Despite having unique identifiers such as NHI and HPI, it remains a challenge to
merge data from different systems and aggregate into useful information. This relates to poor
data quality and reduced patient outcomes as it lacks management, reporting, and analytical
capabilities. Some of the regional and national initiatives that consolidate the information offers
a promising prospect for further consolidating the information. This could progress the ability to
integrate the health information to implement the single EHR system at New Zealand. The well-
developed electronic medical record foundation in New Zealand puts it on par with the majority
of the countries across the world. Leadership and the governance models could standardise the
clinical workflow and would contribute towards a successful implementation of single national
EHR. Such an implementation could improve decision support and foster patient care
coordination for the health and wellbeing of citizens in New Zealand.
8. REFERENCES
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[Available from:http://www.nzdoctor.co.nz/media/6000178/independent-review-new-zealand-
electronic-health-records-strategy-oct15.pdf.
[2] Ivanova M, Ivanov S, Magnini VP. The Routledge Handbook of Hotel Chain Management:
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[3] Alsahafi YA. Studies of EHR implementation and operation in different countries with particular
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[4] Mharakurwa Hwata E. The Attitudes that New Zealand Chinese and Korean people have toward
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Pediatrics Roukema J, Los RK, Bleeker SE, et al (Sophia Children's Hosp, Rotterdam, The
Netherlands) Pediatrics 117: 15-21, 2006. Year Book of Pediatrics. 2007;2007:302-3.
[8] HIMSS. Electronic Health Records [Available from: http://www.himss.org/library/ehr/.
[9] Demakis JG, Beauchamp C, Cull WL, Denwood R, Eisen SA, Lofgren R, et al. Improving
residents' compliance with standards of ambulatory care: results from the VA Cooperative Study
on Computerized Reminders. Jama. 2000;284(11):1411-6.
[10] McDonald C, Hui SL, Tierney WM. Effects of computer reminders for influenza vaccination on
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Author
Short Biography
Arun Sam Singh Selwyn Jebaraj. BPT, MBA- Hospital and Health Systems Management, PG Diploma
Health Information Management. 8 years of Experience into Hospital Operations Management, Quality
and Information Management. Lean Six Sigma Green Belt Certified Professional.