Electronic Healthcare

Commissioned by the Department of Health and Human Services, Key Capabilities of an Electronic Health Record System provides guidance on the most significant care delivery-related capabilities of electronic health record (EHR) systems. There is a great deal of interest in both the public and private sectors in encouraging all health care providers to migrate from paper-based health records to a system that stores health information electronically and employs computer-aided decision support systems. In part, this interest is due to a growing recognition that a stronger information technology infrastructure is integral to addressing national concerns such as the need to improve the safety and the quality of health care, rising health care costs, and matters of homeland security related to the health sector. Key Capabilities of an Electronic Health Record System provides a set of basic functionalities that an EHR system must employ to promote patient safety, including detailed patient data (e.g., diagnoses, allergies, laboratory results), as well as decision-support capabilities (e.g., the ability to alert providers to potential drug-drug interactions). The book examines care delivery functions, such as database management and the use of health care data standards to better advance the safety, quality, and efficiency of health care in the United States.

This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.

Hospitals, medical practices and healthcare organizations are implementing new technologies at breakneck speed. Yet privacy and security considerations are often an afterthought, putting healthcare organizations at risk of data security and privacy issues, fines, damage to their reputations, with serious potential consequences for the patients. Electronic Health Record systems (EHRs) consist of clinical notes, patient listings, lab results, imaging results and screening tests. EHRs are growing in complexity over time and requiring increasing amounts of data storage. With the development of the IoT, the Cloud and Smart Cities frameworks, new privacy and security methods are being pursued to secure healthcare-based systems and platforms. Presenting a detailed framework as well as comparative case studies for security protection, data integrity, privacy preservation, scalability, and healthcare legislation, this edited volume covers state of the art research and addresses privacy and security methods and technologies for EHRs.

How efficient is the Chinese healthcare system? Milcent examines the medication market in China against the global picture of healthcare organization, and how public healthcare insurance plans have been implemented in recent years, as well as reforms to tackle hospital inefficiency. Healthcare reforms, demographic changes and an increase in wealth inequity have altered healthcare preferences, which need to be addressed. Significantly, the patient–medical staff relationship is analysed, with new proposals for different lines of communication. Milcent puts forward digital healthcare in China as a tool to solve inefficiency and rising tensions, and generate profit. Where China is leading in the digitalization of healthcare, other countries can learn important lessons. Chinese social models are also put into context with respect to current reforms and experimentation.

This book discusses the current trends in nursing and healthcare in relation to the integration of information technological interventions across the care continuum. The use of such interventions in healthcare has increased rapidly in recent years, partly due to the rise in technological gadgets/applications used in daily routines (e.g. actigraphy bracelets, smartphones) and their unique properties that can be utilized in assessing, monitoring and managing a patient’s condition remotely. This book highlights the areas and the ways in which these interventions can facilitate patient assessment and monitoring and complement conventional treatments in the management of disease-induced or treatment-induced side effects. Furthermore, the book describes the development of such interventions and examines how they are designed to promote adherence and acceptance by the user. To this end, the book also discusses the need for personalizing the technological experience according to the user’s preferences and needs. Drawing on the latest studies in these areas, it not only provides suggestions for undertaking research in this context, but also offers insights into how these technologies impact patients’ clinical outcomes. Lastly, it addresses the challenges of utilizing such technologies and future directions. Providing multiple perspectives on the topic, the book appeals to a wide range of readers, including nurses, clinicians, researchers, technology experts and students, making them familiar with a broad selection of technological interventions and their application in clinical practice. Moreover, it highlights the factors that need to be considered in the development (and testing) of future interventions, in particular in nursing, and provides inspiration for future studies.

The adoption of Information and Communication Technologies (ICT) in healthcare is driven by the need to contain costs while maximizing quality and efficiency. However, ICT adoption for healthcare information management has brought far-reaching effects and implications on the spirit of the Hippocratic Oath, patient privacy and confidentiality. A wave of security breaches have led to pressing calls for opt-in and opt-out provisions where patients are free to choose to or not have their healthcare information collected and recorded within healthcare information systems. Such provisions have negative impact on cost, efficiency and quality of patient care. Thus determined efforts to gain patient trust is increasingly under consideration for enforcement through legislation, standards, national policy frameworks and implementation systems geared towards closing gaps in ICT security frameworks. The ever-increasing healthcare expenditure and pressing demand for improved quality and efficiency in patient care services are driving innovation in healthcare information management. Key among the main innovations is the introduction of new healthcare practice concepts such as shared care, evidence-based medicine, clinical practice guidelines and protocols, the cradle-to-grave health record and clinical workflow or careflow. Central to these organizational re-engineering innovations is the widespread adoption of Information and Communication Technologies (ICT) at national and regional levels, which has ushered in computer-based healthcare information management that is centred on the electronic healthcare record (EHR).

eHealth 2008, the First International Conference on Electronic healthcare for the twenty-first century, was held in City University, London, during September 8–9, 2008. The conference was organized as a meeting point for telecare product vendors, policy makers, government ministers, academics, clinicians and all those involved in electronic and mobile health, to examine and to share ideas contributing to the - vancement of electronic healthcare into the twenty-first century. The conference had a huge success with a large number of paper submissions. Ninety-seven papers were submitted, of which 32 were selected for presentation. Each paper was carefully reviewed blindly by a minimum of three referees from the resp- tive field. A special thanks should go to the Technical Program Committee for their hard and efficient work in the review process. In addition to the submitted contributions, the conference included a business pres- tation track with 12 invited talks by key people in the world of eHealth. The business presentation track was chaired by Sir Jonathan Michael (Deputy Director, BT Health). The success of this conference is to be credited to the contribution of many people.