International journal of medical informatics
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Physician-patient communication is essential in the physician-patient relationship. Concerns were raised about the impact of the computer on this relationship with the increase in use of electronic medical records (EMR). Most studies addressed the physician's perspective and only few explored the patient's perspective. ⋯ Physician-patient communication was not negatively affected by the physician use of the computer as rated by patients. An ongoing relationship with the physician remains a significant predictor of better physician-patient communication even in the presence of the computer.
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The emergence of online health communities broadens and diversifies channels for patient-doctor interaction. Given limited medical resources, online health communities aim to provide better treatment by decreasing medical costs, making full use of available resources and providing more diverse channels for patients. ⋯ This study contributes to both knowledge and practice. This study shows that there is channel effect in healthcare, websites' managers can encourage physicians to provide online services, especially for these physicians who do not have enough patients.
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Recent U.S. government regulations incentivize implementation of an electronic health record (EHR) with computerized order entry and structured results display. Many institutions have also chosen to interface their EHR to their laboratory information system (LIS). Reported long-term benefits include increased efficiency and improved quality and safety. In order to successfully implement an interfaced EHR-LIS, institutions must plan years in advance and anticipate the impact of an integrated system. It can be challenging to fully understand the technical, workflow and resource aspects and adequately prepare for a potentially protracted system implementation and the subsequent stabilization. ⋯ EHR-LIS implementations have many challenges requiring institutions to adapt and develop new infrastructures. This article should be helpful to other institutions facing or undergoing a similar endeavor.
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Since the 1990s many hospitals in the OECD countries have introduced electronic health record (EHR) systems. A number of studies have examined the factors impinging on EHR implementation. Others have studied the clinical efficacy of EHR. However, only few studies have explored the (intermediary) factors that make EHR systems conducive to quality management (QM). ⋯ The findings resonates well with previous reviews, though two factors making EHR support QM seem new, namely: political goals and strategies, and integration of guidelines for clinical conduct. Lacking EHR type specification and diversity in study method imply that there is a strong need for further research on the factors that may make EHR may support QM.
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An electronic healthcare record (EHR) system, when used by healthcare providers, improves the quality of care for patients and helps to lower costs. Information collected from manual or electronic health records can also be used for purposes not directly related to patient care delivery, in which case it is termed secondary use. EHR systems facilitate the collection of this secondary use data, which can be used for research purposes like observational studies, taking advantage of improvement in the structuring and retrieval of patient information. However, some of the following problems are common when conducting a research using this kind of data: (i) Over time, systems and data storage methods become obsolete; (ii) Data concerns arise since the data is being used in a context removed from its original intention; (iii) There are privacy concerns when sharing data about individual subjects; (iv) The partial availability of standard medical vocabularies and natural language processing tools for non-English language limits information extraction from structured and unstructured data in the EHR systems. A systematic approach is therefore needed to overcome these, where local data processing is performed prior to data sharing. ⋯ This method guarantees a reproducible cohort extraction for use of secondary data in observational studies with enough parameterization to support different study designs and can be used on diverse data sources. Moreover it allows observational electronic health record cohort research to be performed in a non-English language with limited international recognized medical vocabulary.