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.
Personal Health Record over Encrypted Data Using Cloud ServiceYogeshIJTSRD
CBPHR Cloud Based Personal Health Record systems are used for storage and management of patient records. Cloud computing provides real time health care data in a convenient and cost effective manner. Due to the lack of visibility in cloud platform, the users are always concerned with data privacy and security. This is the main obstacle in widely adopting CBPHR systems in health care sector. The paper is discussing a cloud based patient health record management scheme which is highly secured. In this approach, indexes are encrypted under different symmetric keys and also the encrypted data indexes from various data providers can be merge by cloud without knowing the index content. It also provides efficient and privacy preserving query processing using a single data query submitted by the data user. Encrypted data will be processed by cloud from all related data providers without knowing its query content. Dinesh Soni | Dr. Lakshmi JVN "Personal Health Record over Encrypted Data Using Cloud Service" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-4 , June 2021, URL: https://www.ijtsrd.compapers/ijtsrd41230.pdf Paper URL: https://www.ijtsrd.comcomputer-science/computer-security/41230/personal-health-record-over-encrypted-data-using-cloud-service/dinesh-soni
Legal and ethical considerations in nursing informaticsAHMED ZINHOM
This document outlines key concepts in nursing informatics related to information security, privacy, and ethics. It defines terms like privacy, confidentiality, consent and discusses threats to security like hackers. It also covers security measures to protect information like firewalls and passwords. Specific issues around internet technology, mobile devices and the impact on health information security are examined. Ten security principles related to accountability, consent and challenges to compliance are also overviewed.
Digital health is about electronically connecting up the points of healthcare so that health information can be shared securely.
This is the first step to understanding how digital health can help deliver safer, better and quality healthcare.
“My Health Record” is the new name of the digital health record system.
This document summarizes the design and development of a secure electronic health record (EHR) system that incorporates AES encryption. The system was designed using formal software engineering and database development methodologies. Key aspects of the design include defining entity relationships in an ER diagram, normalizing database tables, and implementing user authentication and encryption of sensitive data. The system provides role-based access and allows physicians, nurses and staff to securely view and update patient records.
AVAILABILITY, ACCESSIBILITY, PRIVACY AND SAFETY ISSUES FACING ELECTRONIC MEDI...ijsptm
Patient information recorded in electronic medical records is the most significant set of information of the healthcare system. It assists healthcare providers to introduce high quality care for patients. The aim of this study identifies the security threats associated with electronic medical records and gives
recommendations to keep them more secured. The study applied the qualitative research method through a case study. The study conducted seven interviews with medical staff and information technology technicians. The study results classified the issues that face electronic medical records into four main categories which were availability, accessibility, privacy, and safety of health information.
Speeding up Healthcare Application with HTTP/2CitiusTech
Healthcare data is being increasingly accessed over the public internet. With the rapid adoption of EHRs and patient portals, more and more healthcare technology providers are looking at providing the same features over the internet in a SaaS model to reduce feature to market time. As they embrace trends and begin supporting new use cases such as wearables, mobile health, AI and chat bots, more data gets transferred over the same public internet infrastructure
Secondly, there is a pressing need to optimize the time healthcare professionals spend on IT per patient instead of patient care. Hence, getting timely and accurate information is of utmost importance to ensure better patient care.
Patient engagement initiatives such as patient education, medication and visit reminder, positively impact patient outcomes and are a huge success if the applications built for the same provide seamless user experience. Internet based applications rely on HTTP. As web application became more prevalent, inefficiencies of HTTP need to be addressed. HTTP/2 (Hypertext Transfer Protocol Version 2) is the update to HTTP protocol that has been built with the aim of improving performance and reducing end user perceived latency, reducing network and server resource usage.This document introduces the features and benefits of HTTP/2 and how you can start using HTTP/2
This document discusses securing healthcare mobile applications in compliance with HIPAA regulations. It covers topics like common mobile security threats, weaknesses in mobile apps, best practices for securing apps, and HIPAA technical, administrative and physical safeguards for mobile devices. The document is intended to introduce measures to develop secure healthcare apps that protect electronic protected health information on mobile platforms.
The document discusses public health informatics standards and the Public Health Information Network (PHIN) framework. It outlines how PHIN aims to advance interoperability between public health organizations through selecting relevant data standards, describing minimum IT capabilities, and developing standardized software applications. It then summarizes Houston Department of Health and Human Services' (HDHHS) data systems integration project, which will develop a web portal integrating various applications using PHIN recommendations to facilitate data sharing.
Personal Health Record over Encrypted Data Using Cloud ServiceYogeshIJTSRD
CBPHR Cloud Based Personal Health Record systems are used for storage and management of patient records. Cloud computing provides real time health care data in a convenient and cost effective manner. Due to the lack of visibility in cloud platform, the users are always concerned with data privacy and security. This is the main obstacle in widely adopting CBPHR systems in health care sector. The paper is discussing a cloud based patient health record management scheme which is highly secured. In this approach, indexes are encrypted under different symmetric keys and also the encrypted data indexes from various data providers can be merge by cloud without knowing the index content. It also provides efficient and privacy preserving query processing using a single data query submitted by the data user. Encrypted data will be processed by cloud from all related data providers without knowing its query content. Dinesh Soni | Dr. Lakshmi JVN "Personal Health Record over Encrypted Data Using Cloud Service" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-5 | Issue-4 , June 2021, URL: https://www.ijtsrd.compapers/ijtsrd41230.pdf Paper URL: https://www.ijtsrd.comcomputer-science/computer-security/41230/personal-health-record-over-encrypted-data-using-cloud-service/dinesh-soni
Legal and ethical considerations in nursing informaticsAHMED ZINHOM
This document outlines key concepts in nursing informatics related to information security, privacy, and ethics. It defines terms like privacy, confidentiality, consent and discusses threats to security like hackers. It also covers security measures to protect information like firewalls and passwords. Specific issues around internet technology, mobile devices and the impact on health information security are examined. Ten security principles related to accountability, consent and challenges to compliance are also overviewed.
Digital health is about electronically connecting up the points of healthcare so that health information can be shared securely.
This is the first step to understanding how digital health can help deliver safer, better and quality healthcare.
“My Health Record” is the new name of the digital health record system.
This document summarizes the design and development of a secure electronic health record (EHR) system that incorporates AES encryption. The system was designed using formal software engineering and database development methodologies. Key aspects of the design include defining entity relationships in an ER diagram, normalizing database tables, and implementing user authentication and encryption of sensitive data. The system provides role-based access and allows physicians, nurses and staff to securely view and update patient records.
AVAILABILITY, ACCESSIBILITY, PRIVACY AND SAFETY ISSUES FACING ELECTRONIC MEDI...ijsptm
Patient information recorded in electronic medical records is the most significant set of information of the healthcare system. It assists healthcare providers to introduce high quality care for patients. The aim of this study identifies the security threats associated with electronic medical records and gives
recommendations to keep them more secured. The study applied the qualitative research method through a case study. The study conducted seven interviews with medical staff and information technology technicians. The study results classified the issues that face electronic medical records into four main categories which were availability, accessibility, privacy, and safety of health information.
Speeding up Healthcare Application with HTTP/2CitiusTech
Healthcare data is being increasingly accessed over the public internet. With the rapid adoption of EHRs and patient portals, more and more healthcare technology providers are looking at providing the same features over the internet in a SaaS model to reduce feature to market time. As they embrace trends and begin supporting new use cases such as wearables, mobile health, AI and chat bots, more data gets transferred over the same public internet infrastructure
Secondly, there is a pressing need to optimize the time healthcare professionals spend on IT per patient instead of patient care. Hence, getting timely and accurate information is of utmost importance to ensure better patient care.
Patient engagement initiatives such as patient education, medication and visit reminder, positively impact patient outcomes and are a huge success if the applications built for the same provide seamless user experience. Internet based applications rely on HTTP. As web application became more prevalent, inefficiencies of HTTP need to be addressed. HTTP/2 (Hypertext Transfer Protocol Version 2) is the update to HTTP protocol that has been built with the aim of improving performance and reducing end user perceived latency, reducing network and server resource usage.This document introduces the features and benefits of HTTP/2 and how you can start using HTTP/2
This document discusses securing healthcare mobile applications in compliance with HIPAA regulations. It covers topics like common mobile security threats, weaknesses in mobile apps, best practices for securing apps, and HIPAA technical, administrative and physical safeguards for mobile devices. The document is intended to introduce measures to develop secure healthcare apps that protect electronic protected health information on mobile platforms.
The document discusses public health informatics standards and the Public Health Information Network (PHIN) framework. It outlines how PHIN aims to advance interoperability between public health organizations through selecting relevant data standards, describing minimum IT capabilities, and developing standardized software applications. It then summarizes Houston Department of Health and Human Services' (HDHHS) data systems integration project, which will develop a web portal integrating various applications using PHIN recommendations to facilitate data sharing.
The document describes a proposed federated architecture for a National Digital Health Blueprint (NDHB) in India. A federated architecture allows decentralized management of health data while still enabling data sharing and interoperability. Key elements include:
- Health data is managed across national, state, and facility levels in a decentralized manner. Primary health records are maintained at the point of care.
- Citizens remain in control of their health data and how it is processed. Systems of Record hold primary data and other systems can only access it with applicable permissions and consent.
- The architecture proposes various "building blocks" including unique health identifiers, electronic health records, a health digilocker, and more to enable functionality while maintaining security
There are three key forms of health information exchange:
1) Directed exchange allows providers to electronically send and receive secure information like lab results between providers involved in a patient's care.
2) Query-based exchange allows providers to find and request information on a patient from other providers, often used for emergency care.
3) Consumer mediated exchange allows patients to aggregate and manage their health information online and help transfer it between providers.
Objective: to assess existing health information systems (HIS) tools, their scope, and performance to explore opportunities to integrate/link the tools and improve efficiency and reduce wastage of resources.
ELECTRONIC MEDICAL RECORD (EMR) SYSTEMS ARE BEING IMPLEMENTED INCREASINGLY WORLDWIDE. SAUDI
ARABIA IS ONE OF DEVELOPING COUNTRIES THAT COMMENCED IMPLEMENTING SUCH SYSTEMS IN 1988. WHILST
EMR UPTAKE HAS BEEN LOW IN SAUDI ARABIA UNTIL NOW, A NUMBER OF HOSPITALS HAVE IMPLEMENTED EMR
SYSTEMS SUCCESSFULLY. THIS PAPER ANALYSES AVAILABLE STUDIES (N=28) IN THE LITERATURE REGARDING EMR
IMPLEMENTATION IN SAUDI ARABIA TO IDENTIFY THE PROGRESS OF EMR IMPLEMENTATION TO DATE AND TO
IDENTIFY THE FACILITATORS AND BARRIERS TO IMPLEMENTATION.
The document discusses electronic claim objects to support India's health insurance sector. It proposes using standardized electronic objects based on FHIR resources to enable interoperable and automated claim processing. This would allow faster claims processing, reduced costs, and improved data for monitoring. The electronic objects would include minimum required coded data elements in a JSON format to represent claims, payments, and clinical summaries like discharge records.
Health Data Share Service System using RESTtheijes
The International Journal of Engineering & Science is aimed at providing a platform for researchers, engineers, scientists, or educators to publish their original research results, to exchange new ideas, to disseminate information in innovative designs, engineering experiences and technological skills. It is also the Journal's objective to promote engineering and technology education. All papers submitted to the Journal will be blind peer-reviewed. Only original articles will be published.
CLOUD-BASED DEVELOPMENT OF SMART AND CONNECTED DATA IN HEALTHCARE APPLICATIONijdpsjournal
There is a need of data integration in cloud – based system, we propose an Information Integration and Informatics framework for cloud – based healthcare application. The data collected by the Electronic Health Record System need to be smart and connected, so we use informatica for the connection of data
from different database. Traditional Electronic Health Record Systems are based on different technologies, languages and Electronic Health Record Standards. Electronic Health Record System stores data based on interaction between patient and provider. There are scalable cloud infrastructures, distributed and heterogeneous healthcare systems and there is a need to develop advanced healthcare application. This advance healthcare application will improve the integration of required data and helps in fast interaction between the patient and the service providers. Thus there is the development of smart
and connected data in healthcare application of cloud. The proposed system is developed by using cloud platform Aneka.
The document discusses the history and development of electronic health record systems (EHRs) in the United States. It describes how the US president called for widespread EHR adoption in 2004. It outlines the key components of EHRs and notes their benefits like improved patient care. It also discusses the roles of various government agencies and private organizations in initiatives to promote EHR adoption and interoperability through standards, funding, and public-private partnerships.
Challenges and Opportunities Around Integration of Clinical Trials DataCitiusTech
Conducting a Clinical Trial is a complex process, consisting of activities such as protocol preparation, site selection, approval of various authorities, meticulous collection and management of data, analysis and reporting of the data collected
Each activity is benefited from the development of point applications which ease the process of data collection, reporting and decision making. The recent advancements in mobile technologies and connectivity has enabled the generation and exchange of a lot more data than previously anticipated. However, the lack of interoperability and proper planning to leverage this data, still acts as a roadblock in allowing organizations truly harness their data assets. This document will help life sciences IT professionals and decision makers understand challenges and opportunities around clinical data integration
IRJET- A Framework for Disease Risk PredictionIRJET Journal
This document presents a framework for disease risk prediction using machine learning techniques. It proposes using a convolutional neural network model for disease prediction. The system architecture includes an admin module for dataset management and file conversion, and a disease risk prediction module for prediction. The admin module allows uploading medical data, converting files to a compatible format, and performing predictions. The disease risk prediction module takes a test set, generates compatible files, and uses those files and a convolutional neural network for prediction. The goal is to develop an automated disease prediction system to help predict disease and improve healthcare.
IRJET- An Information Forwarder for Healthcare Service and analysis using Big...IRJET Journal
This document proposes a system for collecting and analyzing healthcare big data using cloud computing. It discusses how healthcare data is growing rapidly in volume and variety due to data from various sources like sensors, and how traditional storage and processing may not be suitable. The proposed system has three layers - a data acquisition layer to collect data from sensors, a transmission layer to send the data to the cloud, and a computational layer in the cloud to analyze and classify the data using clustering and fuzzy rule-based classifiers. This would allow real-time remote healthcare by efficiently storing and processing the large amounts of heterogeneous healthcare data in the cloud. Evaluation metrics like response time, accuracy, cost and false positives are used to compare the proposed system to existing techniques.
The document discusses electronic health records (EHR) in long-term care facilities. It covers the goals of EHR which include improving care, sharing records efficiently, and using data to enhance care delivery. However, several issues need to be addressed such as standards development, costs, security, and usability. Nursing facilities can participate in local EHR initiatives and ensure their vendors plans support emerging requirements for interoperable health records. The vision is for an integrated healthcare system and strategies include incentivizing EHR adoption, reducing investment risks, and developing national and regional health information networks.
IRJET- MedBlock System for Securing Medical RecordsIRJET Journal
This document proposes a blockchain-based system called MedBlock to securely store and share medical records. The system aims to address limitations in current healthcare record systems related to privacy, security and data sharing. MedBlock uses blockchain technology and encryption to securely record medical transactions in an immutable ledger. It allows doctors to upload encrypted medical records and patients to access and share records through decryption keys. The system architecture includes modules for doctors and patients. If implemented, MedBlock could provide more secure, private and tamper-proof management of healthcare data compared to traditional electronic medical record systems.
The Electronic Health Record (EHR) is a longitudinal electronic record of patient health
information generated by one or more encounters in any care delivery setting. Included in this
information are patient demographics, progress notes, problems, medications, vital signs, past
medical history, immunizations, laboratory data, and radiology reports. The EHR automates and
streamlines the clinician's workflow. The EHR has the ability to generate a complete record of a
clinical patient encounter, as well as supporting other care-related activities directly or indirectly
via interface including evidence-based decision support, quality management, and outcomes
reporting.
Recent research states that using new and emerging
technologies in the areas of telecommunications are widely
used in healthcare sector. The system Intelligent Electornic
Patient Record Management System (IEPRMS) is a
centralized database contains the in-patient record. It was
implemented using PHP & MYSQL combination. The
database record contains the patient personal info, department
lies-in, physician, tours, ,treatment and lab results. Since the
patient enters the hospital the workflow starts as the reception
user creates new record by entering the personal info and
sends the record to assigned department; at this stage the nurse
starts update the record by entering the physician comments,
required treatment, and sends lab test when it is required. The
procedure continues as long as the patient still in the hospital.
At last when the patient recovered or died the International
Classsification of Diseases(ICD) inserted to the record and out
or died date. In addition there are many supported tables that
can be updated manually through independent pages by IT
administrator. These tables like Physician names, medicines,
lab tests, users and ICDs. As the system consists of different
users and different user permissions. Also there are advance
search that can help to make statistical reports and researches
for the physicians. The system is considered time and cost
effective to healthcare.
This document provides an overview of the key learning objectives and content covered in Lecture e of an Introduction to Computer Science course on Security and Privacy. The lecture explains security and privacy concerns associated with Electronic Health Records (EHRs), describes security safeguards used for healthcare applications, and provides basics of ethical behavior online. References are also included that were cited in Lecture e.
SECURED FRAMEWORK FOR PERVASIVE HEALTHCARE MONITORING SYSTEMS ijscai
Pervasive Healthcare Monitoring System (PHMS)’ is one of the important pervasive computing
applications aimed at providing healthcare services to all the people through mobile communication
devices. Pervasive computing devices are resource constrained devices such as battery power, memory,
processing power and bandwidth. In pervasive environment data privacy is a key issue. In this
application a secured frame work is developed for receiving the patient’s medical data periodically,
updates automatically in Patient Record Database and generates a Checkup Reminder. In the present
work a light weight asymmetric algorithm proposed by the authors [26] is used for encrypting the data to
ensure data confidentiality for its users. Challenge response onetime password mechanism is applied for
authentication process
Personal health records (PHRs) have the potential to improve health outcomes but face challenges regarding interoperability, security, and privacy. PHRs could allow individuals to manage their own healthcare by communicating with providers and accessing health information. However, PHRs currently lack standardization and the ability to exchange information between different systems. Addressing issues such as determining security protocols, exchanging data between health information exchanges, and clarifying legal policies will help realize the full benefits of PHRs. Widespread adoption also requires resolving questions over who pays for and controls PHR data. Further research is needed to understand how to best design PHRs and incentivize their use.
The history of EHRs from the 1960s until 2021.
In modern health systems, the clinicians' digital experience is dominated by the Electronic Health Record system (EHR). These systems are a primary source of digital health information, and a key player in healthcare digital transformation.
For the full article A Brief History of EHRs https://mayaberlerner.medium.com/
This document provides an overview of electronic health record systems (EHRs). It discusses how EHRs are used by various healthcare professionals and departments to longitudinally collect and share patient health information. Key features of EHRs discussed include providing access to patient data, clinical decision support, supporting efficient healthcare processes, and enabling remote access to patient records. Several examples of early EHR systems developed by the VA, DoD, and IHS in the 1970s are provided. The role of government agencies and standards organizations in facilitating EHR adoption is also summarized.
Ehr by jessica austin, shaun baker, victoria blankenship and kayla borokayla_ann_30
This document provides an overview of electronic health records (EHR) including what they are, key components, considerations for implementation, and security and costs. It discusses that EHRs provide a centralized digital patient record accessible by healthcare providers. The eight essential components that must be included are things like health information, order entry, decision support, and administrative functions. Proper implementation requires input from various stakeholders like medical staff, IT, and leadership. Security and privacy are also important considerations, as are the financial costs of purchasing and maintaining an EHR system.
The document describes a proposed federated architecture for a National Digital Health Blueprint (NDHB) in India. A federated architecture allows decentralized management of health data while still enabling data sharing and interoperability. Key elements include:
- Health data is managed across national, state, and facility levels in a decentralized manner. Primary health records are maintained at the point of care.
- Citizens remain in control of their health data and how it is processed. Systems of Record hold primary data and other systems can only access it with applicable permissions and consent.
- The architecture proposes various "building blocks" including unique health identifiers, electronic health records, a health digilocker, and more to enable functionality while maintaining security
There are three key forms of health information exchange:
1) Directed exchange allows providers to electronically send and receive secure information like lab results between providers involved in a patient's care.
2) Query-based exchange allows providers to find and request information on a patient from other providers, often used for emergency care.
3) Consumer mediated exchange allows patients to aggregate and manage their health information online and help transfer it between providers.
Objective: to assess existing health information systems (HIS) tools, their scope, and performance to explore opportunities to integrate/link the tools and improve efficiency and reduce wastage of resources.
ELECTRONIC MEDICAL RECORD (EMR) SYSTEMS ARE BEING IMPLEMENTED INCREASINGLY WORLDWIDE. SAUDI
ARABIA IS ONE OF DEVELOPING COUNTRIES THAT COMMENCED IMPLEMENTING SUCH SYSTEMS IN 1988. WHILST
EMR UPTAKE HAS BEEN LOW IN SAUDI ARABIA UNTIL NOW, A NUMBER OF HOSPITALS HAVE IMPLEMENTED EMR
SYSTEMS SUCCESSFULLY. THIS PAPER ANALYSES AVAILABLE STUDIES (N=28) IN THE LITERATURE REGARDING EMR
IMPLEMENTATION IN SAUDI ARABIA TO IDENTIFY THE PROGRESS OF EMR IMPLEMENTATION TO DATE AND TO
IDENTIFY THE FACILITATORS AND BARRIERS TO IMPLEMENTATION.
The document discusses electronic claim objects to support India's health insurance sector. It proposes using standardized electronic objects based on FHIR resources to enable interoperable and automated claim processing. This would allow faster claims processing, reduced costs, and improved data for monitoring. The electronic objects would include minimum required coded data elements in a JSON format to represent claims, payments, and clinical summaries like discharge records.
Health Data Share Service System using RESTtheijes
The International Journal of Engineering & Science is aimed at providing a platform for researchers, engineers, scientists, or educators to publish their original research results, to exchange new ideas, to disseminate information in innovative designs, engineering experiences and technological skills. It is also the Journal's objective to promote engineering and technology education. All papers submitted to the Journal will be blind peer-reviewed. Only original articles will be published.
CLOUD-BASED DEVELOPMENT OF SMART AND CONNECTED DATA IN HEALTHCARE APPLICATIONijdpsjournal
There is a need of data integration in cloud – based system, we propose an Information Integration and Informatics framework for cloud – based healthcare application. The data collected by the Electronic Health Record System need to be smart and connected, so we use informatica for the connection of data
from different database. Traditional Electronic Health Record Systems are based on different technologies, languages and Electronic Health Record Standards. Electronic Health Record System stores data based on interaction between patient and provider. There are scalable cloud infrastructures, distributed and heterogeneous healthcare systems and there is a need to develop advanced healthcare application. This advance healthcare application will improve the integration of required data and helps in fast interaction between the patient and the service providers. Thus there is the development of smart
and connected data in healthcare application of cloud. The proposed system is developed by using cloud platform Aneka.
The document discusses the history and development of electronic health record systems (EHRs) in the United States. It describes how the US president called for widespread EHR adoption in 2004. It outlines the key components of EHRs and notes their benefits like improved patient care. It also discusses the roles of various government agencies and private organizations in initiatives to promote EHR adoption and interoperability through standards, funding, and public-private partnerships.
Challenges and Opportunities Around Integration of Clinical Trials DataCitiusTech
Conducting a Clinical Trial is a complex process, consisting of activities such as protocol preparation, site selection, approval of various authorities, meticulous collection and management of data, analysis and reporting of the data collected
Each activity is benefited from the development of point applications which ease the process of data collection, reporting and decision making. The recent advancements in mobile technologies and connectivity has enabled the generation and exchange of a lot more data than previously anticipated. However, the lack of interoperability and proper planning to leverage this data, still acts as a roadblock in allowing organizations truly harness their data assets. This document will help life sciences IT professionals and decision makers understand challenges and opportunities around clinical data integration
IRJET- A Framework for Disease Risk PredictionIRJET Journal
This document presents a framework for disease risk prediction using machine learning techniques. It proposes using a convolutional neural network model for disease prediction. The system architecture includes an admin module for dataset management and file conversion, and a disease risk prediction module for prediction. The admin module allows uploading medical data, converting files to a compatible format, and performing predictions. The disease risk prediction module takes a test set, generates compatible files, and uses those files and a convolutional neural network for prediction. The goal is to develop an automated disease prediction system to help predict disease and improve healthcare.
IRJET- An Information Forwarder for Healthcare Service and analysis using Big...IRJET Journal
This document proposes a system for collecting and analyzing healthcare big data using cloud computing. It discusses how healthcare data is growing rapidly in volume and variety due to data from various sources like sensors, and how traditional storage and processing may not be suitable. The proposed system has three layers - a data acquisition layer to collect data from sensors, a transmission layer to send the data to the cloud, and a computational layer in the cloud to analyze and classify the data using clustering and fuzzy rule-based classifiers. This would allow real-time remote healthcare by efficiently storing and processing the large amounts of heterogeneous healthcare data in the cloud. Evaluation metrics like response time, accuracy, cost and false positives are used to compare the proposed system to existing techniques.
The document discusses electronic health records (EHR) in long-term care facilities. It covers the goals of EHR which include improving care, sharing records efficiently, and using data to enhance care delivery. However, several issues need to be addressed such as standards development, costs, security, and usability. Nursing facilities can participate in local EHR initiatives and ensure their vendors plans support emerging requirements for interoperable health records. The vision is for an integrated healthcare system and strategies include incentivizing EHR adoption, reducing investment risks, and developing national and regional health information networks.
IRJET- MedBlock System for Securing Medical RecordsIRJET Journal
This document proposes a blockchain-based system called MedBlock to securely store and share medical records. The system aims to address limitations in current healthcare record systems related to privacy, security and data sharing. MedBlock uses blockchain technology and encryption to securely record medical transactions in an immutable ledger. It allows doctors to upload encrypted medical records and patients to access and share records through decryption keys. The system architecture includes modules for doctors and patients. If implemented, MedBlock could provide more secure, private and tamper-proof management of healthcare data compared to traditional electronic medical record systems.
The Electronic Health Record (EHR) is a longitudinal electronic record of patient health
information generated by one or more encounters in any care delivery setting. Included in this
information are patient demographics, progress notes, problems, medications, vital signs, past
medical history, immunizations, laboratory data, and radiology reports. The EHR automates and
streamlines the clinician's workflow. The EHR has the ability to generate a complete record of a
clinical patient encounter, as well as supporting other care-related activities directly or indirectly
via interface including evidence-based decision support, quality management, and outcomes
reporting.
Recent research states that using new and emerging
technologies in the areas of telecommunications are widely
used in healthcare sector. The system Intelligent Electornic
Patient Record Management System (IEPRMS) is a
centralized database contains the in-patient record. It was
implemented using PHP & MYSQL combination. The
database record contains the patient personal info, department
lies-in, physician, tours, ,treatment and lab results. Since the
patient enters the hospital the workflow starts as the reception
user creates new record by entering the personal info and
sends the record to assigned department; at this stage the nurse
starts update the record by entering the physician comments,
required treatment, and sends lab test when it is required. The
procedure continues as long as the patient still in the hospital.
At last when the patient recovered or died the International
Classsification of Diseases(ICD) inserted to the record and out
or died date. In addition there are many supported tables that
can be updated manually through independent pages by IT
administrator. These tables like Physician names, medicines,
lab tests, users and ICDs. As the system consists of different
users and different user permissions. Also there are advance
search that can help to make statistical reports and researches
for the physicians. The system is considered time and cost
effective to healthcare.
This document provides an overview of the key learning objectives and content covered in Lecture e of an Introduction to Computer Science course on Security and Privacy. The lecture explains security and privacy concerns associated with Electronic Health Records (EHRs), describes security safeguards used for healthcare applications, and provides basics of ethical behavior online. References are also included that were cited in Lecture e.
SECURED FRAMEWORK FOR PERVASIVE HEALTHCARE MONITORING SYSTEMS ijscai
Pervasive Healthcare Monitoring System (PHMS)’ is one of the important pervasive computing
applications aimed at providing healthcare services to all the people through mobile communication
devices. Pervasive computing devices are resource constrained devices such as battery power, memory,
processing power and bandwidth. In pervasive environment data privacy is a key issue. In this
application a secured frame work is developed for receiving the patient’s medical data periodically,
updates automatically in Patient Record Database and generates a Checkup Reminder. In the present
work a light weight asymmetric algorithm proposed by the authors [26] is used for encrypting the data to
ensure data confidentiality for its users. Challenge response onetime password mechanism is applied for
authentication process
Personal health records (PHRs) have the potential to improve health outcomes but face challenges regarding interoperability, security, and privacy. PHRs could allow individuals to manage their own healthcare by communicating with providers and accessing health information. However, PHRs currently lack standardization and the ability to exchange information between different systems. Addressing issues such as determining security protocols, exchanging data between health information exchanges, and clarifying legal policies will help realize the full benefits of PHRs. Widespread adoption also requires resolving questions over who pays for and controls PHR data. Further research is needed to understand how to best design PHRs and incentivize their use.
The history of EHRs from the 1960s until 2021.
In modern health systems, the clinicians' digital experience is dominated by the Electronic Health Record system (EHR). These systems are a primary source of digital health information, and a key player in healthcare digital transformation.
For the full article A Brief History of EHRs https://mayaberlerner.medium.com/
This document provides an overview of electronic health record systems (EHRs). It discusses how EHRs are used by various healthcare professionals and departments to longitudinally collect and share patient health information. Key features of EHRs discussed include providing access to patient data, clinical decision support, supporting efficient healthcare processes, and enabling remote access to patient records. Several examples of early EHR systems developed by the VA, DoD, and IHS in the 1970s are provided. The role of government agencies and standards organizations in facilitating EHR adoption is also summarized.
Ehr by jessica austin, shaun baker, victoria blankenship and kayla borokayla_ann_30
This document provides an overview of electronic health records (EHR) including what they are, key components, considerations for implementation, and security and costs. It discusses that EHRs provide a centralized digital patient record accessible by healthcare providers. The eight essential components that must be included are things like health information, order entry, decision support, and administrative functions. Proper implementation requires input from various stakeholders like medical staff, IT, and leadership. Security and privacy are also important considerations, as are the financial costs of purchasing and maintaining an EHR system.
Streamline Your Practice with Top Healthcare Software.pdfSeasiaInfotech2
Healthcare providers can choose from various software solutions such as Patient Management Systems, Electronic Health Records, Medical Robotics Software, Telehealth platforms, and more to support their work depending upon their unique business requirements.
The document discusses Kareo, a healthcare IT company that offers electronic health record (EHR) software. It began as a medical billing software company and now offers a free, web-based EHR product. Kareo's EHR operates on a "freemium" model where the software is free but additional premium products can be purchased. It discusses Kareo's services, investors, areas of focus like interoperability, and usage trends. Open standards are important to enable data sharing and interoperability between different healthcare IT systems.
Evaluation of a clinical information system (cis)nikita024
This power point presentation provides an overview of a clinical information system (CIS). It discusses what a CIS is, how CIS have evolved, and the key players involved in designing CIS. It also examines the electronic health record component of a CIS and discusses the eight basic components that make up an EHR. Additional topics covered include clinical decision making systems, safety, costs, and education regarding CIS. The presentation was created by four students with each student covering specific slides and aspects of the topic.
This document discusses factors to consider when evaluating a clinical information system (CIS), including:
- Who is involved in choosing, implementing, and revising a CIS
- Factors to consider before implementing a CIS such as costs and failure rates
- How a CIS should be structured and updated
- Companies that design clinical decision support systems
- Security, access controls, and costs including implementation, support personnel, and purchasing options.
- How users should be educated on a system and updates through various learning methods.
Design and Implementation of Hospital Management System Using JavaIOSR Journals
This document describes the design and implementation of a Hospital Management System (HMS) using Java. The HMS was developed to address challenges with manual hospital management processes and provide benefits like streamlined operations and enhanced patient care. It includes modules for patient management, services management, appointments, the pharmacy, admissions and accounting. The system uses a database to store patient and medical records and allows users to view records, diagnoses and drug prescriptions. Test results showed the HMS met user requirements and provided functionality like registering patients, viewing inpatient data and the drug database. It was concluded the HMS can help hospitals enhance patient care and increase organizational profitability by improving operational control and streamlining processes.
Lecture 3 softwares used in health care (2)Munef Almadhi
This document summarizes major open source software used in healthcare, categorizing them into public health and bio surveillance, dental management, electronic health records, medical practice management, health system management, imaging/visualization, medical information systems, and research. Key software described include Epi Info for public health surveillance, Open Dental for dental records, CommuniMed and OpenEMR for electronic health records, ClearHealth for practice management, DHIS for health systems, Drishti for imaging, Caisis for medical information, and LabKey Server and Open Clinica for research.
This document provides an introduction to information, information science, and information systems. It defines key terms like data, information, knowledge, information science, and information systems. Information science is described as the science of studying how information and knowledge are used in organizations and how people, organizations, and information systems interact. The document outlines how data is acquired and processed to become valuable information.
This document discusses electronic health records (EHR) and the federal initiatives to promote their adoption in the United States. It describes how different government departments and agencies have implemented and supported EHR systems, including the Veterans Health Administration, Department of Defense, Indian Health Service, Office of the National Coordinator for Health Information Technology, and Center for Medicare and Medicaid Services. It also outlines the goals and strategies of the federal government's strategic framework for health information technology development.
This document discusses hospital information systems (HIS). It begins by defining HIS and explaining their importance in managing clinical, administrative, and financial aspects of hospitals. It then outlines the objectives and components of HIS, including clinical information systems, financial systems, and more. Examples of specific HIS are provided, like electronic medical records and remote patient monitoring. Advantages of HIS include improved data access and efficiency. Challenges to implementation include user acceptance and costs. The document concludes by discussing the life cycle and training involved with HIS.
Accenture-Singapore-Journey-to-Build-National-Electronic-Health-Record-SystemDr.Nilesh Sudam B
Singapore has embarked on a journey to build a National Electronic Health Record (NEHR) system to provide common access to medical information for its population. The NEHR project focused initially on "Continuity of Care" by developing a view-only system with clinical events, reports, alerts and records. The project addressed challenges like managing data from diverse sources and engaging clinicians. It took a disciplined approach to governance, operations, and a simple initial phase to lay the groundwork for more advanced capabilities in the future.
Standards and Best Practices for Confidentiality of Electronic Health RecordsMEASURE Evaluation
This document summarizes standards and best practices for ensuring confidentiality of electronic health records. It discusses key concepts like privacy, security and confidentiality in the context of electronic health records. It outlines the situation in lower and middle income countries, where expertise and legal frameworks around eHealth privacy and security is often lacking. The document reviews global standards set by organizations like ISO, and emphasizes that while standards are important, non-technical factors like policy, processes and compliance are also critical to protecting health information privacy and security.
The document discusses questions regarding a healthcare system's vendor selection process for an IT project. It recommends the types of information an organization should provide to vendors in a Request for Information (RFI) and gather from vendors in the early planning stages. This includes vendor background, technical requirements, functionality, implementation processes, and training. An RFP with more specific details is issued to a select few vendors.
Electronic Health Records Protecting Assets With A Solid Security Plan Wp101207Erik Ginalick
EHR systems provide significant benefits but also require proper security plans to protect patient data. A solid security plan includes:
1) Conducting a risk analysis to identify vulnerabilities and ensure compliance with HIPAA security rules.
2) Implementing administrative safeguards like security policies, employee training, and systems to monitor threats.
3) Using technical security like firewalls, encryption, and authentication controls to restrict access and protect hardware and software.
This will allow organizations to maximize the benefits of EHR while safeguarding protected health information.
A framework for secure healthcare systems based on big data analytics in mobi...ijasa
In this paper we introduce a framework for Healthcare Information Systems (HISs) based on big data
analytics in mobile cloud computing environments. This framework provides a high level of integration,
interoperability, availability and sharing of healthcare data among healthcare providers, patients, and
practitioners. Electronic Medical Records (EMRs) of patients dispersed among different Care Delivery
Organizations (CDOs) are integrated and stored in the Cloud storage area, this creates an Electronic
Health Records (EHRs) for each patient. Mobile Cloud allows fast Internet access and provision of EHRs
from anywhere and at any time via different platforms. Due to the massive size of healthcare data, the
exponential increase in the speed in which this data is generated and the complexity of healthcare data
type, the proposed framework employs big data analytics to find useful insights that help practitioners take
critical decisions in the right time. In addition, our proposed framework applies a set of security
constraints and access control that guarantee integrity, confidentiality, and privacy of medical information.
We believe that the proposed framework paves the way for a new generation of lower cost, more efficient
healthcare systems.
The document discusses the development and importance of Nursing Minimum Data Sets (NMDS) systems. It notes that the identification of NMDS in the 1980s spurred the development of similar nursing data sets around the world. The chapter provides a historical overview and synthesis of NMDS systems, and discusses how they can increase nursing data and information capacity to support knowledge building for the nursing discipline and profession. This data can help inform the development of electronic health record systems.
The document discusses key components of a Clinical Information System (CIS) including the Electronic Health Record (EHR). It describes the 8 components of an EHR, how clinical decision making systems work, considerations for safety, cost, and education. Clinical decision making systems use evidence-based practices and hierarchical approaches to determine diagnoses and treatment plans. Safety involves backing up data, protecting files from threats, and complying with privacy laws like HIPAA. Costs include purchasing, maintenance, training staff, and ongoing security and upgrades. Education of staff is important both initially and continuously as systems evolve.
1. The document discusses the advantages and disadvantages of implementing an electronic health record (EHR) system to replace a paper-based system.
2. A key disadvantage is the high cost of implementation, with the cost of Alberta's new clinical information system estimated at $1.6 billion over 10 years.
3. Another disadvantage is a lack of interoperability between existing EHR systems, which prevents patient information from being shared and understood across health settings.
Similar to SURVEY OF OPEN SOURCE HEALTH INFORMATION SYSTEMS (20)
A PRACTICAL APPROACH TO PREDICTING DEPRESSION: VERBAL AND NON-VERBAL INSIGHTS...hiij
While global standards have been established for diagnosing depression, the reliance on expert judgement
and observation remains a challenge. This study delves into a potential approach of efficient data
collection to increase the practicability of machine learning models in accurately predicting depression
based on a comprehensive analysis of verbal and non-verbal cues exhibited by individuals.
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 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
The document summarizes a systematic literature review on factors influencing adoption of eHealth technologies in developing countries. The review analyzed 29 papers published between 2009-2021. Key findings included:
- Widely used frameworks for eHealth adoption in developing countries were TAM, UTAUT, and TOE, but these did not fully capture all relevant factors.
- Additional factors identified included socio-demographic, technological, information, socio-cultural, organizational, governance, ethical/legal, and financial dimensions.
- The review proposed a novel, context-specific eHealth adoption framework for developing countries with eight dimensions addressing the above factors.
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
Debunking Nutrition Myths: Separating Fact from Fiction"AlexandraDiaz101
In a world overflowing with diet trends and conflicting nutrition advice, it’s easy to get lost in misinformation. This article cuts through the noise to debunk common nutrition myths that may be sabotaging your health goals. From the truth about carbohydrates and fats to the real effects of sugar and artificial sweeteners, we break down what science actually says. Equip yourself with knowledge to make informed decisions about your diet, and learn how to navigate the complexities of modern nutrition with confidence. Say goodbye to food confusion and hello to a healthier you!
Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
How to Control Your Asthma Tips by gokuldas hospital.Gokuldas Hospital
Respiratory issues like asthma are the most sensitive issue that is affecting millions worldwide. It hampers the daily activities leaving the body tired and breathless.
The key to a good grip on asthma is proper knowledge and management strategies. Understanding the patient-specific symptoms and carving out an effective treatment likewise is the best way to keep asthma under control.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
1. Health Informatics- An International Journal (HIIJ) Vol.3, No.1, February 2014
DOI: 10.5121/hiij.2014.3102 23
SURVEY OF OPEN SOURCE HEALTH
INFORMATION SYSTEMS
Bilan Jones, Xiaohong Yuan, Emmanuel Nuakoh, and Khadija Ibrahim
Department of Computer Science, North Carolina A&T State University, Greensboro,
NC
ABSTRACT
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.
KEYWORDS
Electronic Health Records, Health information systems, Electronic medical records, Personal health
records
1. INTRODUCTION
In 2009, President Obama signed into law, the American Recovery and Reinvestment Act
(ARRA). This was a $787 billion stimulus package that was designed to create new jobs while
saving existing ones and to spur economic activity. Within the stimulus package was the HITECH
(Health Information Technology for Economic and Clinical Health) Act. It was designed to meet
the goal made by President Obama to computerize all of America’s medical records by 2014.
According to the president, this will improve the quality of our health care while lowering its
costs. It will also cut waste, eliminate red tape, and reduce the need to repeat expensive medical
tests. Though it just won’t save billions of dollars and thousands of jobs, it will save lives by
reducing the deadly but preventable medical errors that pervade our health care system[1].”
Electronic health records (EHR) can be defined as a longitudinal collection of electronic health
information about individual patients and populations [2]. It includes such data as contact
information, medical history and insurance information, family history, records of
hospitalizations, list of medications taken or currently prescribed, and allergies which can all be
shared with various hospitals or doctors’ offices if necessary. Because EHRs are designed to
make it easier to share and use a patient’s health care record, it will be easier for providers to be
better at managing a patient’s care. Furthermore, benefits of EHR systems that have been
identified include reducing medical errors, improving quality of care, conserving physician time,
sharing patient information among healthcare practitioners, and workflow efficiency [3].
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Health Information Systems are systems for the collection and processing of data from various
sources, and using the information for policy making and management of health services. Health
information systems can be categorized into three different groups—electronic medical records,
electronic health records, and personal health records. Currently, there are many types of open
source health information systems in use. Open source health information systems give many
health care providers the opportunity to use electronic health records without having to incur
large costs. Also, they are able to make modifications to the software in order to suit their needs.
An electronic medical record is an electronic record of a patient’s health information that can be
created, gathered, and managed by doctors and their staff within one healthcare organization
whereas an electronic health record is an electronic record of a patient’s health information that
adheres to national standards. It can also be created and managed by doctors and their staff across
more than one health care organization.A personal health record is an electronic record of an
individual's health information that, in similarity with the electronic health record has to conform
to national standards but is controlled by that individual [4]. In this paper,some existing open
source health information systems will be surveyed and analyzed in terms of their functionality,
implementation technology used and also whether or not they have security features in place
which would satisfy the HIPAA security rule.
2.ELECTRONIC MEDICAL RECORDS
In this section, six electronic medical records will be discussed.
2.1 ClearHealth
ClearHealth was developed in 2003 by David Ulhman. It is a web-based open-source practice
management and electronic medical records (EMR) system written in the PHP programming
language. Its design is basedon VISTA (Veterans Health Information Systems and Technology
Architecture) which is the Department of Veterans affairs Health Information Technology (IT)
system.
ClearHealth offers three products with the base product being the only open source product
offered. It is intended for individuals and small practices to set up by themselves. The base
product uses the same codebase as all the other options that are available but it is set up with
different configuration options. The software from ClearHealth is offered under the GNU GPL
(General Public License). The features of ClearHealth include Electronic Medical Records
(EMR), medical billing, medical accounts receivable, scheduling, and access control functions.
ClearHealth was designed with HIPAA compliant security features in place. The security was
implemented using the PHPGacl (PHP General Access Control Lists) toolkit[5]. The PHPGacl is
a PHP based access control list script that allows powerful permission to be added to software
applications. Through the use of the toolkit role based access control can be implemented. Some
security features include the fact that the admin section will often not be displayed. The admin
section allows you to configure it so that it can be customized to meet the needs of your office or
practice. Also each user, once created in ClearHealth, is assigned a security role. The roles
determine what menu or sections that particular user has access to. There is also a timer which
allows for automatic logoff which is also a security feature[6].
2.2 Caisis
Caisis is a web-based cancer data management system that was designed to bridge the gap
between research and clinical practice (FAQ). It is an open source system which is primarily used
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by researchers as a tool to manage their patient data. Its functionality allows for the integration of
customized electronic medical records.The project began in 2002 to serve as a replacement for an
outdated research database at Memorial Sloan-Kettering Cancer Center (MSKCC). As the
number of people using the database and the requirements needed expanded, a search was held to
find a commercially available database that would meet their requirements. Since a number of
systems were reviewed and none could meet some of their most basic requirements: cost
effectiveness in terms of both ownership and maintenance, straightforward administration by a
small group, and the flexibility and expandability to meet the evolving needs of a fast-paced,
research oriented hospital, a team from the hospital was created and became in charge of
developing the open source system[7]. Today, the system is free to download and install under the
GPL.
Caisis is currently in use by institutions throughout various countries. Countries include Canada,
United States, Brazil, Spain, Norway, Saudi Arabia, India, and Sweden. In order to have a
successful installation, Caisis requires that the web server that will host the software have
Windows Server 2000 and above, Internet Information Service 6 and above, and Microsoft .NET
Framework 3.5/4.0. The database requires a Microsoft SQL server 2008++. Since Caisis is web-
based it can be ran on Internet Explorer 7+, Firefox, Safari 3+, and Chrome 12+.
The Caisis security system strictly adheres to the guidelines set forth by HIPAA. Steps have been
taken to limit unauthorized access to patient data or other security and confidentiality breaches.
Once logged into the system, users can prevent unapproved access to entire sections of data [8].
2.3 OpenMRS
OpenMRS (Open Medical Record System), an open source medical record system platform was
created in 2004 by Regenstrief Institute and Partners in Health. It is a software platform used by
many countries around the world such as South Africa, Kenya, Rwanda, Lesotho, Zimbabwe,
Mozambique, Uganda, Tanzania, Haiti, India, China, United States, Pakistan, and the Philippines.
It was designed to be used for any individuals who need to establish a medical record system.
Currently, there is only a portal for medical providers but the developers of OpenMRS are
working to establish a personally controlled health record portal that will allow individuals to be
in charge of their personal health record. It would be owned and available to be managed by the
patient.
OpenMRS is programmed in Java and the core application works through a web-browser. It can
run on UNIX, Microsoft and Mac operating systems platforms [9]. An added benefit of
OpenMRS is that, the medical records system can be customized without having a vast
programming background. A conceptual database structure is the basis of the system but is not
dependent on the actual types of medical information required to be collected or on particular data
collection forms, so it can be customized for different uses [10]. Information that is stored in
OpenMRS is easy to summarize and analyze. It has the ability to store all diagnosis, tests,
procedures, drugs and other general questions and potential answers. Since it is a client-server
application, it can work in an environment where multipleclient computers are used to access the
same information on a server[10].
Several layers contribute to the design of OpenMRS. They include the data model, the application
programming interface (API), and the web application. The data model borrows form the
Regenstrief model, which is based on a concept dictionary [11]. The API’s design, which
provides a “wrapper” around the data model, allows any developer to invoke method calls
without having to understand the details of the data model. Web front-ends and modules that
extend the core functions are included in the web application. An example of a module whose
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core function can be extended is the usage statistics module. It can be used to keep track of the
usage of patient records by OpenMRS users[12].
Features of OpenMRS include the central concept dictionary, security, privilege-based access and
a patient repository. The central concept dictionary provides definitions of all data thatare defined
in a centralized dictionary. The security features of the application are based on user
authentication. User roles and permission systems are based on what privileges a user is given
access to. The patient repository allows for the creation and maintenance of patient data which
includes the demographics of each patient, encounter data, and orders.
According to[9],OpenMRS provides the ability to create a super user role that is all-powerful
leaving it vulnerable to an insider threat. A user with the administrator role can create any number
of permissions and roles. Roles can be comprised of any number of permissions and built up from
other defined roles. According to [11], some vulnerabilities were found within OpenMRS. Using
the free edition of the tool, Acunetix, 22 alerts for cross-site scripting vulnerabilities were found.
Other vulnerabilities found include J2EE Misconfiguration, and system information leak.
2.4 VistA
VistA (Veterans Health Information Systems and Technology Architecture) is the US Department
of Veteran Affairs Health Electronic Health Record System. It was introduced in 1996 by the
Chief Information Office to serve as an electronic health record for the VA[13]. It is built on a
client-server architecture, which ties together workstations and personal computers with graphical
user interfaces at Veterans Health Administration (VHA) facilities, as well as software developed
by local medical facility staff. VistA also includes the links that allow commercial off-the-shelf
software and products to be used with existing and future technologies. The VistA software is
available to the public under a law called the Freedom of Information Act (FOIA).
Two main components, VA FileMan and Kernel make up the primary infrastructure of VistA. VA
FileMan is a database management system that organizes the medical data, storing it in fields,
records and files [14]. The Kernel provides the portability layer on top of the operating system, as
well as management tools and shared services such as sign-on and security service, menu
management, and error processing [14]. The structure of the VistA system enablesit to be
integrated on a database level and all data between applications can be consistently shared.
2.5 WorldVistA
WorldVistA is an open source, GPL licensed, electronic record that is based on the VistA system,
used by the US Department of Veterans Affairs (VA). It was established to further improve,
through collaboration, the VistA electronic health record system. Byestablishing WorldVistA,
thecreators wanted it to benefit patients throughout the U.S., not just the patients of the VA
system.
The WorldVistA system usesthe same architecture as VistA. Even though they share the same
architecture, there have been some changes to the WorldVistA system. One such change was the
addition of pediatric and obstetric functionality. This feature utilizes pediatric growth charts that
also use open source software called PHP Growth Charts. WorldVistA was also designed with a
wide array of modules. They include patient registration and management, order entry with
reporting, a documentation library, and supplies/assets management.
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2.6 OSCAR
OSCAR (Open Source Clinical Application Resource) is an open source electronic medical
record software programthat was designed by doctors and is licensed under the General Public
License. Its features include full billing capabilities, chronic disease management tools, and
prescription features. You have the option of running OSCAR locally in an office setting or it can
be reached using the internet. Since OSCAR is web-based it can run on any Windows, Linux, or
Mac operating system. OSCAR also has a personal health record, called MyOSCAR which
enables patient to have access to and manage their health records. They can also communicate
with doctors, make requests for copies of their lab results, manage prescription renewals, and
request or cancel appointments.
OSCAR is primarily written in JavaServer Pages (JSP) and served via the Apache Tomcat servlet
container. The backend storage is a MySQL database, and the interface layer between Java and
MySQL is Hibernate [15]. As a Tomcat web application, OSCAR generally follows the typical
model-view-controller design pattern. This means that the model code (Data Access Objects, or
DAOs) is separate from the controller code (servlets) and those are separated from the views
(Java Server Pages, or JSPs) [15].
Transport layer security is used by OSCAR to encrypt the information flowing between the server
and the browsers/clients or workstations connected to it[16]. When the communication is
encrypted between the server and the workstations, the users are protected against those who
would like to listen in on this communication. It is the same technology used by banks to secure
their online banking sessions. To secure the workstation itself, OSCAR requires a double
password in order for users to log in. The user sets up one password, while the other is set by the
administrator of the OSCAR system.
3. ELECTRONIC HEALTH RECORDS
In this section two examples of electronic health records will be discussed. They are OpenEMR
and Tolven.
3.1 OpenEMR
OpenEMR is an electronic health records and medical practice management application that can
run on Windows, Linux, Mac OS X, as well as many other platforms. It was started in 1998 by a
group of friends who wanted to create an EMR system for a friend’s mother who was a physician.
They thought they could give the software away for free and charge for support. Initially, they
decided to call it Medical Practice Professional. Eventually the name of the project became
OpenEMR and a company named Synitech was formed around it. Synitech continued developing
OpenEMR until version 2.0. In 2001 Synitech, turned the OpenEMR project development and
leadership over to Walt Pennington and Penn Firm in San Diego, California. Once the developers
decided to pursue other interests, the source files of OpenEMR were transferred to SourceForge.
In 2011, OpenEMR was deemed Meaningful Use Certified for use in the United States by ICSA
(International Computer Security Association) Labs which is an Independent Division of Verizon
Business [17]. OpenEMR is now licensed under the General Public License (GPL), and can be
considered a valid open source alternative for electronic health records and practice management
software.
Features of OpenEMR include patient demographics and scheduling, electronic medical records,
medical billing, and security. OpenEMR allows information such as the name, date of birth, sex,
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and primary provider to be tracked for each patient. These demographics help to distinguish each
patient from the next as a form of identification. The patient scheduling feature of OpenEMR
allows for a patient’s scheduling data, as well as their patient and physician data to be shared
among different practices and facilities. This feature also provides patients with notifications
about their appointments through email and sms text messages. Electronic medical records
provide an electronic record of a patient’s medical history. Through the use of this feature a
patient’s medical history can be stored, retrieved and modified. OpenEMR, through its medical
billing feature, support paper claims, insurance eligibility queries, insurance tracking, and
accounts receivable. It is customizable to work with a clearing house using Electronic Remittance
Advice (ERA), or HIPAA 835, an electronic transaction which provides claim payment
information in the HIPAA mandated ACSX12 005010X221A format [17]. The ability to encrypt
medical documents is part of the security features of OpenEMR. This is achieved through the use
of the PHP mcrypt library [18]. Another feature of OpenEMR is its support of fine-grained per-
user access controls which allows you to specify what each user has access to. Also the software
can be remotely accessed from any web browser that has a valid security certificate installed.
Furthermore, OpenEMR allows multi-language support which enables it to be used by different
countries throughout the world. It supports languages such as Arabic, Chinese, Portuguese,
Russian, Turkish, Ukrainian, and Vietnamese.Two choices are available if you want to include a
patient portal within your version of OpenEMR. One option is a patient portal that is built within
OpenEMR. The other option is to use a portal that was designed by a third party. It uses a set of
application programming interfaces that are included within OpenEMR.
Even though OpenEMR is a great example of open source practice management software, it still
is subject to vulnerabilities. Through the use of a source code analysis tool, Fortify 360 v5, and
IBM Rational Appscan v7.8 scripting vulnerabilities as well as implementation flaws were found
[17]. Some of the authentication vulnerabilities in OpenEMR 4.1.1 are reported in [18]. For
example, there is no forgotten password function to help users recover their passwords if they
forgot it. The only way they will be able to access the account is for the user to call the
administrator for a new password. It does not have an account lockout after a certain number of
failed attempts.This feature can prevent hackers from attempting to guess user passwords [18].
3.2 Tolven
Tolven is an open source electronic record that utilizes the GNU-LPGL license. It is web-based
and the Web browser is its primary tool for user interaction. The installation of Tolven is
composed of three components. It is made up of a database, LDAP (Lightweight Directory
Access Protocol) server, and the Tolven application server. PostgreSQL is the database used by
Tolven which is also an open source product; the LDAP server is what Tolven users to hold
identifying and demographical information about the user. The application server uses the LDAP
server to authenticate users. Tolven is equipped with two user interfaces. The eCHR, electronic
clinical health record is for physicians and other healthcare providers. It allows them to securely
access healthcare information relating to an individual patient in a structured and easily accessible
way [20]. The ePHR, electronic personal health record, allows patients to share personal health
information regarding themselves and their loved ones in a protectedway.
The Tolven software uses some standard technologies such as Java, Enterprise Java Beans
(EJB3), AJAX (Asynchronous JavaScript), and relational database [20]. It supports various data
formats and Tolven’s architecture is plug-in based.
The creators of Tolven have taken measures to ensure that Tolven is safe from some of the most
critical vulnerabilities for Java applications. For example, to prevent SQL injections, queries in
Tolven never add user input directly into the query string. All queries use strongly-type query
parameters. In addition, all applicable queries are qualified by account [21].
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4. PERSONAL HEALTH RECORDS
We earlier saw that OSCAR, OpenEMR, and OpenMRS have personal health records as part of
their functionality. In this section, we will discuss a health information system that is completely
apersonal health record.
4.1 Indivo
Indivo is a type of personally controlled health record that is open source and web based. It
allows the patient to own and manage all their medical records that pertain to their medical
history, essentially creating their own personal health record. The patients in turn, are able to
provide their doctors with all pertinent medical information regarding their health quite easily.
Indivo is a three-tier system with a data storage tier, a business logic tier, and a user interface
[22]. The central feature of Indivo is the Indivo API. The Indivo API allows the system to collect
health records from various data sources and share those records with third parties. The business
logic tier is comprised of the Indivo Server, which manages the documents that make up a
personally controlled health record. Documents are made available to client applications using the
Indivo Server through the Indivo API. The server also determines which documents are available
to which users. The Indivo Server has two classes of security policies. One is server-based and
explicitly type-permits or denies certain actions. The second policy type is user-based. It gives the
patient the opportunity to indicate what privileges on specific portions of their health records
other users have access to. The dual-class (server and individual) approach to access policies is a
defining feature of the Indivo system [22].The data storage tier of Indivo is used to store the
documents that make up a user’s PHR. This tier is encrypted to protect users in case of theft or
hardware loss. A separate physical server hosts the encryption keys to prevent decryption of
patient data in the case that the storage machine is compromised. Also, each record stored in the
system is fractured into loosely-related, encrypted data packets to mask the size of an individual
record [22]. The graphical user interface (GUI) is responsible forensuring that the data contained
in a patient’s record is presented in a useful and understandable way. Since the GUI gets all the
data for the health record from the Indivo Server, all the security policies are applied
automatically as well. A single Indivo Server can support multiple user interfaces because the
interfaces interact with the server as clients using a standard API.
5. CONCLUSION
There are several types of open source health information systems that are available for use by
physicians and hospitals. While all the systems discussed in this paper are open source, every
open source system is different even though they may share similarities. Both ClearHealth and
WorldVistA are designed based on the VISTA system architecture. Most of the health
information systems are web-based. They are ClearHealth, Caisis, OpenEMR, Indivo, OSCAR,
and Tolven. ClearHealth, OpenEMR, and OSCAR include features that would be essential to a
doctor’s office. These features include medical billing, scheduling, electronic medical records,
and security features designed to ensure HIPAA compliance. Tolven, OSCAR, and OpenEMR
have designed features within their systems that would give administrators the option of allowing
patients to be in charge of their own medical records. Furthermore, OpenMRS is in the process of
establishing a patient portal that will also allow patients to control their medical records. Indivo
gives patients total control of their medical records by allowing them to control who has access to
their records. Each on the systems reviewed have security features in place. The features include
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access controls, encryption, and one systemOSCAR boasts security technology that isutilized by
the banking industry.
ACKNOWLEDGEMENTS
This work is partially supported by NSF under the grant HRD-1137516 and Department of
Education under grant P120A090049. Any opinions, findings, and conclusions or
recommendations expressed in this material are those of the author(s) and do not necessarily
reflect the views of NSF and the Department of Education.
REFERENCES
[1] Obama, Barack. George Mason University, Fairfax. 08 Jan 2009. Speech
[2] Wan, Yina, “Application of HER in Health Care,”Multimedia and Information Technology (MMIT),
2010 Second International Conference on, vol. 1, no., pp.60,63, 24-25 April 2010
[3] Thakkar, Minal, and Diane C. Davis. "Risks, barriers, and benefits of EHR systems: a comparative
study based on size of hospital." Perspectives in Health Information Management/AHIMA,
American Health Information Management Association 3 (2006).
[4] Wager, Karen A., Frances W. Lee, and John P. Glaser. "Types of Health Care Information." Health
Care Information Systems: A Practical Approach for Health Care Management. United States: Jossey-
Bass, 2009. 5. Print.
[5] "Introduction to ClearHealth." Osnews,[online] June 2005, http://www.osnews.com/story/10740
(Accessed: 11 August 2013).
[6] Cleland-Huang, J.; Czauderna, A.; Gibiec, M.; Emenecker, J., "A machine learning approach for
tracing regulatory codes to product specific requirements," Software Engineering, 2010 ACM/IEEE
32nd International Conference on , vol.1, no., pp.155,164, 2-8 May 2010
[7] "Caisis Cancer Data Management System : FAQ." Caisis, [online] 2013,
http://www.caisis.org/faq.html# (Accessed: 22 April. 2013).
[8] Fearn, Paul A., Kevin Regan, Frank Sculli, Jason Fajardo, Brandon Smith, and Paul Alli. "Lessons
Learned from Caisis: An Open Source, Web-Based System for Integrating Clinical Practice and
Research." (2007): Print.
[9] Eric Helms and Laurie Williams. 2011. “Evaluating access control of open source electronic health
record systems”. In Proceedings of the 3rd Workshop on Software Engineering in Health Care
(SEHC '11). ACM, New York, NY, USA, 63-70.
[10] “About OpenMRS”,.OpenMRS,[online] 2004, http://www.openmrs.org/about (Accessed: 4 June
2013).
[11] Dukes, L.; Xiaohong Yuan; Akowuah, F., "A case study on web application security testing with
tools and manual testing," Southeastcon, 2013 Proceedings of IEEE , vol., no., pp.1,6, 4-7 April
2013
[12] "Usage Statistics Module,." OpenMRS Community Wiki, [online] 2013,
https://wiki.openmrs.org/display/docs/Usage+Statistics+Module (Accessed: 22 June 2012).
[13] United States Department of Veteran Affairs .”VistA Monograph”.United States Department of
Veteran Affairs, 25 Nov. 2013. Web. 30 Nov.
2013<http://www.ehealth.va.gov/VistA_Monograph.asp>.
[14] Herbsleb, James, Claudia MüllerBirn, and W. Ben Towne. "The VistA Ecosystem: Current Status and
Future Directions." Pittsburgh, PA: Institute for Software Research (2010).
[15] Rattan, Jennifer. "OSCAR." The Architecture of Open Source Applications, Volume II. 2012.
OSCAR. Web. 5 Oct. 2013. <http://aosabook.org/en/oscar.html>.
[16] "About OSCAR.," Oscar Canada Users Society, [online] 2013, http://oscarcanada.org/about-
oscar/brief-overview/index_html#security (Accessed: 15 March 2013).
[17] Austin, A., Smith, B., and Williams, L., “Towards Improved Security Criteria for Certification of
Electronic Health Record Systems”, 2nd Workshop on Software Engineering in Healthcare at the
International Conference on Software Engineering (ICSE) 2010, Cape Town, South Africa, electronic
proceedings.
9. Health Informatics- An International Journal (HIIJ) Vol.3, No.1, February 2014
31
[18] Lake, Jerissa. “Authentication Vulnerabilities in OpenEMR”, The 2013 symposium on Computing at
Minority Institutions, Association of Computer and Information Science/Engineering Departments at
Minority Institutions, April 2013, Virginia Beach, VA, Unpublished conference paper, 2013.
[19] "Encryption and Decryption of Documents.," OpenEMR Wiki, [online] 2013, http://www.open-
emr.org/wiki/index.php/Encryption_and_Decryption_of_Documents (Accessed: July & Aug.
2013).
[20] “Open Source Solutions.,” Tolven, [online] 2013, http://home.tolven.org/ (Accessed: 10 September
2013).
[21] “Web Security.,” Tolven, [online] 2013, http://home.tolven.org/?page_id=151 (Accessed: 10
September 2013)
[22] Mandl, Kenneth D., et al. "Indivo: a personally controlled health record for health information
exchange and communication." BMC medical informatics and decision making 7.1 (2007): 2