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Ciencia & Saude Coletiva Mar 2020Electronic medical records have been touted as a solution to many of the shortcomings of health care systems. The aim of this essay is to review pertinent literature and... (Review)
Review
Electronic medical records have been touted as a solution to many of the shortcomings of health care systems. The aim of this essay is to review pertinent literature and present examples and recommendations from several decades of experience in the use of medical records in primary health care, in ways that can help primary care doctors to organize their work processes to improve patient care. Considerable problems have been noted to result from a lack of interoperability and standardization of interfaces among these systems, impairing the effective collaboration and information exchange in the care of complex patients. It is extremely important that regional and national health policies be established to assure standardization and interoperability of systems. Lack of interoperability contributes to the fragmentation of the information environment. The electronic medical record (EMR) is a disruptive technology that can revolutionize the way we care for patients. The EMR has been shown to improve quality and reliability in the delivery of healthcare services when appropriately implemented. Careful attention to the impact of the EMR on clinical workflows, in order to take full advantage of the potential of the EMR to improve patient care, is the key lesson from our experience in the deployment and use of these systems.
Topics: Communication; Electronic Health Records; Health Information Exchange; Humans; Medication Errors; National Health Programs; Patient Care Team; Quality Improvement; Quality of Health Care; Registries; United States
PubMed: 32267432
DOI: 10.1590/1413-81232020254.28922019 -
Journal of Medical Internet Research Dec 2021Electronic records could improve quality and efficiency of health care. National and international bodies propagate this belief worldwide. However, the evidence base... (Review)
Review
BACKGROUND
Electronic records could improve quality and efficiency of health care. National and international bodies propagate this belief worldwide. However, the evidence base concerning the effects and advantages of electronic records is questionable. The outcome of health care systems is influenced by many components, making assertions about specific types of interventions difficult. Moreover, electronic records itself constitute a complex intervention offering several functions with possibly positive as well as negative effects on the outcome of health care systems.
OBJECTIVE
The aim of this review is to summarize empirical studies about the value of electronic medical records (EMRs) for hospital care published between 2010 and spring 2019.
METHODS
The authors adopted their method from a series of literature reviews. The literature search was performed on MEDLINE with "Medical Record System, Computerized" as the essential keyword. The selection process comprised 2 phases looking for a consent of both authors. Starting with 1345 references, 23 were finally included in the review. The evaluation combined a scoring of the studies' quality, a description of data sources in case of secondary data analyses, and a qualitative assessment of the publications' conclusions concerning the medical record's impact on quality and efficiency of health care.
RESULTS
The majority of the studies stemmed from the United States (19/23, 83%). Mostly, the studies used publicly available data ("secondary data studies"; 17/23, 74%). A total of 18 studies analyzed the effect of an EMR on the quality of health care (78%), 16 the effect on the efficiency of health care (70%). The primary data studies achieved a mean score of 4.3 (SD 1.37; theoretical maximum 10); the secondary data studies a mean score of 7.1 (SD 1.26; theoretical maximum 9). From the primary data studies, 2 demonstrated a reduction of costs. There was not one study that failed to demonstrate a positive effect on the quality of health care. Overall, 9/16 respective studies showed a reduction of costs (56%); 14/18 studies showed an increase of health care quality (78%); the remaining 4 studies missed explicit information about the proposed positive effect.
CONCLUSIONS
This review revealed a clear evidence about the value of EMRs. In addition to an awesome majority of economic advantages, the review also showed improvements in quality of care by all respective studies. The use of secondary data studies has prevailed over primary data studies in the meantime. Future work could focus on specific aspects of electronic records to guide their implementation and operation.
Topics: Delivery of Health Care; Electronic Health Records; Health Services; Hospitals; Humans; Quality of Health Care
PubMed: 34941544
DOI: 10.2196/26323 -
The Journal of Allergy and Clinical... Feb 2020
Topics: Medical Records; Parenting; Reproductive Techniques, Assisted
PubMed: 32037113
DOI: 10.1016/j.jaip.2019.08.021 -
Journal of Korean Medical Science Sep 2019
Topics: Humans; Pregnancy; Insurance, Health; Medical Records; Quality of Health Care; Republic of Korea; Spondylitis, Ankylosing; Female
PubMed: 31559712
DOI: 10.3346/jkms.2019.34.e244 -
The Surgical Clinics of North America Apr 2023The electronic medical record has fundamentally altered the way surgeons participate and practice medicine. There is now a wealth of data, once hidden behind paper... (Review)
Review
The electronic medical record has fundamentally altered the way surgeons participate and practice medicine. There is now a wealth of data, once hidden behind paper records, that is, now available to surgeons to provide superior care to their patients. This article reviews the history of the electronic medical record, discusses use cases of additional data resources, and highlights the pitfalls of this relatively new technology.
Topics: Humans; Electronic Health Records; Medical Informatics; Medicine
PubMed: 36948716
DOI: 10.1016/j.suc.2022.11.005 -
Computers in Biology and Medicine Oct 2023Medical record images in EHR system are users' privacy and an asset, and there is an urgent need to protect this data. Image steganography can offer a potential...
Medical record images in EHR system are users' privacy and an asset, and there is an urgent need to protect this data. Image steganography can offer a potential solution. A steganographic model for medical record images is therefore developed based on StegaStamp. In contrast to natural images, medical record images are document images, which can be very vulnerable to image cropping attacks. Therefore, we use text region segmentation and watermark region localization to combat the image cropping attack. The distortion network has been designed to take into account the distortion that can occur during the transmission of medical record images, making the model robust against communication induced distortions. In addition, based on StegaStamp, we innovatively introduced FISM as part of the loss function to reduce the ripple texture in the steganographic image. The experimental results show that the designed distortion network and the FISM loss function term can be well suited for the steganographic task of medical record images from the perspective of decoding accuracy and image quality.
Topics: Medical Records; Confidentiality; Medical Informatics
PubMed: 37603961
DOI: 10.1016/j.compbiomed.2023.107344 -
The Journal of Foot and Ankle Surgery :... 2020
Topics: Electronic Health Records; Humans; Medical Records; Time Factors; Workload
PubMed: 31882131
DOI: 10.1053/j.jfas.2019.11.001 -
Critical Care Clinics Oct 2023Electronic medical records (EMRs) constitute the electronic version of all medical information included in a patient's paper chart. The electronic health record (EHR)... (Review)
Review
Electronic medical records (EMRs) constitute the electronic version of all medical information included in a patient's paper chart. The electronic health record (EHR) technology has witnessed massive expansion in developed countries and to a lesser extent in underresourced countries during the last 2 decades. We will review factors leading to this expansion, how the emergence of EHRs is affecting several health-care stakeholders; some of the growing pains associated with EHRs with a particular emphasis on the delivery of care to the critically ill; and ongoing developments on the path to improve the quality of research, health-care delivery, and stakeholder satisfaction.
Topics: Humans; Electronic Health Records
PubMed: 37704334
DOI: 10.1016/j.ccc.2023.03.004 -
Annual International Conference of the... Jul 2023To solve the difficulty of medical data sharing in traditional medical information systems, we proposed an electronic medical record secure-sharing scheme based on the...
To solve the difficulty of medical data sharing in traditional medical information systems, we proposed an electronic medical record secure-sharing scheme based on the Blockchain technique. The encrypted text of the patient's electronic medical record is stored in the cloud server while the metadata of the medical record and access strategy is stored in the blockchain system. We employed smart contracts in the blockchain system to achieve user rights management. We used the decentralized, tamper-proof, and traceable features of the blockchain to realize the safe sharing of electronic medical records. The experimental results of security analysis show that the method can defend against potential network attacks while satisfying patient privacy protection and confidentiality. This study verifies the feasibility and great operating efficiency of the blockchain-based electronic medical record security sharing scheme.Clinical relevance- Our proposed blockchain-based electronic medical record-sharing scheme has great potential for the safe access of third-party users to patient data.
Topics: Humans; Electronic Health Records; Blockchain; Computer Security; Confidentiality; Text Messaging
PubMed: 38083057
DOI: 10.1109/EMBC40787.2023.10340218 -
Journal of Medical Internet Research Dec 2022Personal electronic health records (PEHRs) allow patients to view, generate, and manage their personal and medical data that are relevant across illness episodes, such... (Review)
Review
BACKGROUND
Personal electronic health records (PEHRs) allow patients to view, generate, and manage their personal and medical data that are relevant across illness episodes, such as their medications, allergies, immunizations, and their medical, social, and family health history. Thus, patients can actively participate in the management of their health care by ensuring that their health care providers have an updated and accurate overview of the patients' medical records. However, the uptake of PEHRs remains low, especially in terms of patients entering and managing their personal and medical data in their PEHR.
OBJECTIVE
This scoping review aimed to explore the barriers and facilitators that patients face when deciding to review, enter, update, or modify their personal and medical data in their PEHR. This review also explores the extent to which patient-generated and -managed data affect the quality and safety of care, patient engagement, patient satisfaction, and patients' health and health care services.
METHODS
We searched the MEDLINE, Embase, CINAHL, PsycINFO, Cochrane Library, Web of Science, and Google Scholar web-based databases, as well as reference lists of all primary and review articles using a predefined search query.
RESULTS
Of the 182 eligible papers, 37 (20%) provided sufficient information about patients' data management activities. The results showed that patients tend to use their PEHRs passively rather than actively. Patients refrain from generating and managing their medical data in a PEHR, especially when these data are complex and sensitive. The reasons for patients' passive data management behavior were related to their concerns about the validity, applicability, and confidentiality of patient-generated data. Our synthesis also showed that patient-generated and -managed health data ensures that the medical record is complete and up to date and is positively associated with patient engagement and patient satisfaction.
CONCLUSIONS
The findings of this study suggest recommendations for implementing design features within the PEHR and the construal of a dedicated policy to inform both clinical staff and patients about the added value of patient-generated data. Moreover, clinicians should be involved as important ambassadors in informing, reminding, and encouraging patients to manage the data in their PEHR.
Topics: Humans; Electronic Health Records; Health Records, Personal; Patients; Patient Participation; Health Personnel
PubMed: 36574275
DOI: 10.2196/37783