Electronic Records Management Research Articles

Electronic Medical Records Management and Administration: Current Trends, Issues, Solutions, and Future Directions

Electronic Medical Records Management and Administration: Current Trends, Issues, Solutions, and Future Directions

IoT-based eHealth using blockchain technology: a survey

AbstractThe eHealth sector has witnessed significant growth due to technological advancements, facilitating care delivery in patients' homes and moving away from traditional hospital settings. Blockchain and the Internet of Things (IoT) play pivotal roles in enhancing healthcare services, offering features such as remote patient monitoring, streamlined electronic medical record (EMR) management, drug traceability, and effective disease control, particularly during events like the COVID-19 pandemic. The growing utilization of IoT devices brings about security challenges, including concerns related to data integrity and device authentication. This paper proposes the integration of blockchain technology as a robust solution. Leveraging its decentralized and tamper-resistant features, blockchain establishes trust among diverse IoT devices, ensuring the integrity of IoT data. Additionally, smart contracts enhance device authentication, fortifying overall security by addressing vulnerabilities associated with centralization. Regarding the management of eHealth, this survey begins with an overview of the industry, highlighting IoT-related challenges in healthcare. It explores various IoT applications in eHealth and discusses how blockchain can effectively address obstacles in healthcare management through IoT. Notably, the paper provides insights into examining consensus algorithm parameters within blockchain systems, clarifying the methodology used to assess and optimize these critical components. The survey extends to a thorough review of existing research on integrating blockchain-based IoT in eHealth. Finally, it presents an overview of challenges and potential solutions for implementing blockchain-based IoT in the eHealth sector. This comprehensive survey aims to empower stakeholders by providing insights to enhance patient care in this dynamic and evolving field.

Electronic Alerts to Improve Management of Heparin-Induced Thrombocytopenia

IntroductionHeparin-induced thrombocytopenia (HIT) is a difficult clinicopathologic diagnosis to make and to treat. Delays in identification and appropriate treatment can lead to increased morbidity and mortality. MethodsThis quality improvement initiative developed three electronic health record-based interventions at our 750-bed academic medical center to improve the initial management of suspected HIT between 2018-2021: 1. an interruptive alert to recommend discontinuation of active heparin products when signing a heparin-platelet factor 4 test (PF4) order, 2. integrated 4T score calculation in the heparin-PF4 test order, and 3. interruptive alert suggesting not to order heparin-PF4 tests when the 4T score was < 4. Changes in practice were assessed over a defined time periods pre and post each intervention. ResultsIntervention 1 resulted in heparin discontinuation in more patients, with 65% (191 heparin orders/293 heparin-PF4 ELISA tests) of cases continuing heparin pre-alert and only 54% (127 heparin orders/235 heparin-PF4 ELISA tests) post-interruptive alert (p = 0.015). Intervention 2 increased appropriate heparin-PF4 test ordering from 40.4% (110/272) pre-intervention to 79.1% (246/311) (p< 0.00001), with inappropriate heparin-PF4 ordering defined as testing when 4T score < 4. Intervention 3 did not lead to reduction in heparin-PF4 testing in the control group (96 inappropriate orders/ 402 total orders, 24%) compared to the randomized alert group (56 inappropriate orders/ 298 total orders, 19%) (p=0.13). ConclusionImplementation of unique electronic health record interventions, including both diagnostic and management interventions, led to improved guideline-based, accurate care delivery with 4T score calculation and cessation of heparin for patients with suspected HIT.

E2EE enhanced patient-centric blockchain-based system for EHR management.

To secure sensitive medical records in the healthcare clouds, this paper proposes an End-to-End Encryption (E2EE) to enhance a patient-centric blockchain-based system for electronic health record (EHR) management. The suggested system with a focus on the patient enables individuals to oversee their medical records within various involved parties by authorizing or withdrawing permission for access to their records. Utilizing the inter-planetary file system (IPFS) for record storage is chosen due to its decentralized nature and its ability to guarantee the unchangeability of records. Then an E2EE enhancement maintains the medical data integrity using dual level-Hybrid encryption: symmetric Advanced Encryption Standard (AES) and asymmetric Elliptic Curve Cryptography (ECC) cryptographic techniques. The proposed system is implemented using the Ethereum blockchain system for EHR data sharing and integration utilizing a web-based interface for the patient and all users to initiate the EHR sharing transactions over the IPFS cloud. The proposed system performance is evaluated in a working system prototype. For different file sizes between 512 KB to 100 MB, the performance metrics used to evaluate the proposed system were the time consumed for generating key, encryption, and decryption. The results demonstrate the proposed system's superiority over other cutting-edge systems and its practical ability to share secure health data in cloud environments.

Exploring the Impact of Artificial Intelligence in Healthcare

The integration of artificial intelligence (AI) applications has revolutionized healthcare. This study conducts a comprehensive literature review to elucidate the multifaceted role of AI in healthcare, focusing on key aspects including medical imaging and diagnostics, virtual patient care, medical research and drug discovery, patient engagement and compliance, rehabilitation, and administrative applications. AI's impact is observed across various domains, including detecting clinical conditions in medical imaging, early diagnosis of coronavirus disease 2019 (COVID-19), virtual patient care utilizing AI-powered tools, electronic health record management, enhancing patient engagement and treatment compliance, reducing administrative burdens for healthcare professionals (HCPs), drug and vaccine discovery, identification of medical prescription errors, extensive data storage and analysis, and technology-assisted rehabilitation. However, the integration of AI in healthcare encounters several technical, ethical, and social challenges, such as privacy concerns, safety issues, autonomy and consent, cost considerations, information transparency, access disparities, and efficacy uncertainties. Effective governance of AI applications is imperative to ensure patient safety, accountability, and to bolster HCPs' confidence, thus fostering acceptance and yielding significant health benefits. Precise governance is essential to address regulatory, ethical, and trust concerns while advancing the adoption and implementation of AI in healthcare. With the onset of the COVID-19 pandemic, AI has sparked a healthcare revolution, signaling a promising leap forward to meet future healthcare demands.

Exploring the Impact of Artificial Intelligence in Healthcare

The integration of artificial intelligence (AI) applications has revolutionized healthcare. This study conducts a comprehensive literature review to elucidate the multifaceted role of AI in healthcare, focusing on key aspects including medical imaging and diagnostics, virtual patient care, medical research and drug discovery, patient engagement and compliance, rehabilitation, and administrative applications. AI's impact is observed across various domains, including detecting clinical conditions in medical imaging, early diagnosis of coronavirus disease 2019 (COVID-19), virtual patient care utilizing AI-powered tools, electronic health record management, enhancing patient engagement and treatment compliance, reducing administrative burdens for healthcare professionals (HCPs), drug and vaccine discovery, identification of medical prescription errors, extensive data storage and analysis, and technology-assisted rehabilitation. However, the integration of AI in healthcare encounters several technical, ethical, and social challenges, such as privacy concerns, safety issues, autonomy and consent, cost considerations, information transparency, access disparities, and efficacy uncertainties. Effective governance of AI applications is imperative to ensure patient safety, accountability, and to bolster HCPs' confidence, thus fostering acceptance and yielding significant health benefits. Precise governance is essential to address regulatory, ethical, and trust concerns while advancing the adoption and implementation of AI in healthcare. With the onset of the COVID-19 pandemic, AI has sparked a healthcare revolution, signaling a promising leap forward to meet future healthcare demands.

A systematic study on integrating blockchain in healthcare for electronic health record management and tracking medical supplies

In the current landscape of swiftly evolving technology, security remains a paramount concern. Motivated by the challenges presented during pandemics such as COVID-19, this article aims to enhance healthcare transparency and expedite treatment processes. The existing centralized medical data management system scatters patient records across disparate hospitals and pharmacies, prompting the necessity for a patient-centric data repository. The integration of blockchain emerges as a viable solution, giving patients control over their information and facilitating seamless sharing with relevant institutions—be it hospitals, pharmacies, or insurance firms. This article outlines a strategic framework for securing medical data based on comprehensive literature review and proposes measures derived from previous studies. Furthermore, the study explores blockchain's application in tracing medicinal supplies, crucial for detecting counterfeit medications within the supply chain. Detailed elucidation of IBM Research's proposed model highlights the potential of blockchain in this domain. Additionally, an extensive comparative analysis of existing models underscores their strengths and limitations in these healthcare applications. Challenges persist in deploying blockchain in developing countries, primarily due to resource limitations, signalling the need for tailored solutions conducive to such environments. This study serves as an exploration, emphasising the need for continued research and innovation in harnessing blockchain's potential for healthcare transformation.

Determining the feasibility of calculating pancreatic cancer risk scores for people with new-onset diabetes in primary care (DEFEND PRIME): study protocol

IntroductionWorldwide, pancreatic cancer has a poor prognosis. Early diagnosis may improve survival by enabling curative treatment. Statistical and machine learning diagnostic prediction models using risk factors such as patient demographics...

Professional Ethics, Challenges and Opportunities for Blockchain Technology in Healthcare Sector: A Systematic Review

Background:: The healthcare sector faces numerous issues, such as insurance fraud, electronic medical record management, interoperability, insecure dissemination of information, etc. The novel Blockchain technology holds tremendous potential to transform the healthcare sector by addressing these rising challenges in the industry. It provides a secure platform for storing, disseminating, and retrieving sensitive patient data and health records while preserving the ethical principles of the healthcare sector. Method:: In this study, we systematically reviewed the literature on blockchain technology in healthcare using PRISMA and highlighted how blockchain technology might promote innovation and deliver major improvements in the healthcare sector. Result:: Our goal is to examine the present status of this discipline, focusing on limits and potential advances. Queries were used to gather Scopus, PubMed, SpringerLink, IEEE Xplore, and Web of Science publications that met the criteria for the selection of papers. Conclusion:: This article, thus, analyses the potential for blockchain in the healthcare industry and outlines blockchain-based products in healthcare. Our study enhances and complements prior healthcare blockchain research.

S3EF-HBCAs: Secure and Sustainable Software Engineering Framework for Healthcare Blockchain Applications.

Blockchain applications in healthcare have grown rapidly. They include record-keeping, clinical trials, medical supply chains, patient monitoring, etc., where blockchain characteristics are needed to improve safety, privacy, and security. Blockchain technology is one of the most significant disruptive technologies today. However, Porru et al.1 reported that it lacks processes, tools, and techniques. Therefore, this paper provides a systematic framework for a secure and sustainable software engineering framework for healthcare blockchain applications (S3EF-HBCA). S3EF-HBCA is a significant contribution that includes requirements engineering for healthcare, business process modeling for healthcare, domain modeling for healthcare, a reference architecture for healthcare, and validation by a case study on electronic healthcare record management system (EHR), and simulation with business process modeling notation (BPMN) tools. The simulation shows it has taken 10.45 min to process 100 instances of real-time data and service requests. The overall result shows encouragement regarding process, tools, standards, and testing.

Parallel-Based Corpus Annotation for Malay Health Documents

Named entity recognition (NER) is a crucial component of various natural language processing (NLP) applications, particularly in healthcare. It involves accurately identifying and extracting named entities such as medical terms, diseases, and drug names, and healthcare professionals are essential for tasks like clinical text analysis, electronic health record management, and medical research. However, healthcare NER faces challenges, especially in Malay, in which specialized corpora are limited, and no general corpus is available yet. To address this, the paper proposes a method for constructing an annotated corpus of Malay health documents. The researchers leverage a parallel source that contains annotated entities in English due to the limited tools available for the Malay language, and it is very language-dependent. Additional credible Malay documents are incorporated as sources to enhance the development. The targeted health entities in this research include penyakit (diseases), simptom (symptoms), and rawatan (treatments). The primary objective is to facilitate the development of NER algorithms specifically tailored to the healthcare domain in the Malay language. The methodology encompasses data collection, preprocessing, annotation of text in both English and Malay, and corpus creation. The outcome of this research is the establishment of the Malay Health Document Annotated Corpus, which serves as a valuable resource for training and evaluating NLP models in the Malay language. Future research directions may focus on developing domain-specific NER models, exploring alternative algorithms, and enhancing performance. Overall, this research aims to address the challenges of healthcare NER in the Malay language by constructing an annotated corpus and facilitating the development of tailored NER algorithms for the healthcare domain.

Management of electronic records to support judicial systems at Temba Magistrates’ Court in the North West Province of South Africa

The management of electronic records has been a burning issue in many sectors, particularly the justice sector. Criminal justice institutions, such as courts and ministries of justice, suffer from inadequate management of court records, which undermines the legal and judicial systems. South African courts are overburdened with backlogs, delays, and corruption due to poor electronic record management. The dysfunctional management of electronic records has led to poor service delivery and justice for citizens. These concerns provided the impetus for research to assess the management of electronic records at Temba Magistrates’ Court in the North West Province of South Africa. To achieve the stated aim, the study adopted a qualitative approach through a case study design. Data were collected by conducting interviews with purposely selected records officers, a records manager, registry clerks and document controllers. The findings of the study indicated that Temba Magistrates’ Court has put in place relevant legislation and policies for managing electronic records. The study findings showed that staff are not complying with records management policy. The major findings of the study revealed that the Temba Magistrates’ Court has experienced unforeseen consequences, including a backlog of cases, challenges of data storage, loss, and misplacement of electronic court records resulting from poor records management practices. The study concluded with recommendations for the need to motivate and encourage staff members to adhere to the records management policy. The study also revealed the need to adopt multifactor authentication mechanisms such as biometrics, passwords, and fingerprints to reduce or prevent unauthorised access to electronic court records. A comprehensive records management programme should be developed and implemented. It is concluded that staff members working at Temba Magistrates’ Court should be suitably trained in all aspects of electronic court management.&#x0D;  

A hackathon as a tool to enhance research and practice on electronic health record systems' interoperability for chronic disease management and prevention.

The development of a standardized technical framework for exchanging electronic health records is widely recognized as a challenging endeavor that necessitates appropriate technological, semantic, organizational, and legal interventions to support the continuity of health and care. In this context, this study delineates a pan-European hackathon aimed at evaluating the efforts undertaken by member states of the European Union to develop a European electronic health record exchange format. This format is intended to facilitate secure cross-border healthcare and optimize service delivery to citizens, paving the way toward a unified European health data space. The hackathon was conducted within the scope of the X-eHealth project. Interested parties were initially presented with a representative clinical scenario and a set of specifications pertaining to the European electronic health record exchange format, encompassing Laboratory Results Reports, Medical Imaging and Reports, and Hospital Discharge Reports. In addition, five onboarding webinars and two professional training events were organized to support the participating entities. To ensure a minimum acceptable quality threshold, a set of inclusion criteria for participants was outlined for the interested teams. Eight teams participated in the hackathon, showcasing state-of-the-art applications. These teams utilized technologies such as Health Level Seven-Fast Healthcare Interoperability Resources (HL7 FHIR) and Clinical Document Architecture (CDA), alongside pertinent IHE integration profiles. They demonstrated a range of complementary uses and practices, contributing substantial inputs toward the development of future-proof electronic health record management systems. The execution of the hackathon demonstrated the efficacy of such approaches in uniting teams from diverse backgrounds to develop state-of-the-art applications. The outcomes produced by the event serve as proof-of-concept demonstrators for managing and preventing chronic diseases, delivering value to citizens, companies, and the research community.

Impact of Set-Day Clinic on Physician Continuity in a Family Medicine Residency Clinic.

Continuity of care between patients and their primary care providers is associated with improved patient outcomes and experience, decreased health care costs, and improved provider well-being. Strategies to enhance continuity of care in residency programs involve electronic health record, scheduling, and panel management methods. Our study compared physician-patient continuity rates (pre and post) for one family medicine residency's implementation of a set-day clinic (SDC) scheduling model. In July 2019, Bethesda Clinic switched from a rotation-driven scheduling (RDS) model to SDC. Physicians were divided into two scheduling groups: Monday, Thursday, or Friday; or Tuesday, Wednesday, or Friday. We used visit data from two 6-month periods, October 2018 to March 2019 (RDS) and October 2021 to March 2022 (SDC), to calculate continuity using the continuity for physician formula. We used t tests to compare mean continuity rates between the RDS and SDC periods. In June 2022, faculty and residents were emailed a nine-question survey about SDC. Adherence to the SDC model ranged from 65% to 76%. Postgraduate year (PGY) 3 residents' continuity increased significantly (P&lt;.001) from 44% (RDS) to 56% (SDC), while PGY2 residents' continuity increased, nonsignificantly, from 38% to 43%. Among those that completed the survey, 94% of residents and 78% of faculty were in favor of SDC. We demonstrated that SDC is feasible and well received by residents and faculty alike. Continuity was highest for PGY2 and PGY3 residents during the SDC period. Predictable clinic schedules have the potential to improve continuity in family medicine residency clinics and may improve physician well-being.

Secure And Efficient Access Control Over Blockchain PHR Cloud Storage System

A novel architecture of blockchain-based secured electronic health record (EHR) management system is presented in this paper. Electronic health data record-keeping in cloud-based storage systems always pose a threat to information security. Intruders can delete EHR of patients, giving benefits to insurance companies or hiding medical malpractices. A secured EHR management system is required that would essentially solve such issues. The blockchain is an emerging technology that can be adapted to develop a secured and an efficient data management system. Storing and sharing health records through electronic systems pose security risks. However, establishing a new blockchain based system replacing the existing system is expensive. In our proposed architecture, we introduced an integration mechanism, named as the blockchain handshaker, between the existing cloud based EHR management system and public blockchain network to develop a secured health record management system. A blockchain-based protocol that secures health records, addressing all of the main security and complementary properties defined in current regulations. A prototype to provide evidence on the feasibility of the proposed concept is presented in this paper. The performance assessments demonstrate the efficiency of our proposed solution in terms of computation, communication, and storage.

Effects of Electronic Records Management Best Practices and Records Professionals in Malaysia

Records management operation is vital as it can protect the organization and also helps in achieving its goal. Proper record keeping is critical to ensuring the administration's successful and productive record management. A wide range of records management difficulties and problems in dealing with electronic records, requires a qualified records manager in an organization to implement records management best practices, including how records are kept and maintained. This paper suggests a qualitative study on records managers to find a solution to the problems mentioned. The findings can benefit organizations dealing with electronic records, thus contributing to the body of knowledge.

Electronic Medical Record Management in Monitoring Loan and Return of Medical Records at Majalaya Hospital

This study aims to develop an electronic-based governance system for monitoring borrowing and returning medical record files at Majalaya Hospital. The Waterfall method was chosen as the main approach because the detailed and structured nature of this method allows planned and scheduled development. This approach also guarantees the quality of the resulting system, as each phase is completed in stages, avoiding over-reliance on a single stage. System development documentation is well organized, where each phase must be completed comprehensively before the next step can be carried out. One of the problems identified related to borrowing medical record files is the absence of an expedition book to record borrowing and returning. The existence of this expedition book is critical in monitoring the distribution of medical record files. Therefore, the authors designed a management system in accordance with the procedures for borrowing and returning medical record files. This system is expected to be able to efficiently monitor the distribution of medical records and organize borrowing and return processes more smoothly. With the existence of an effective monitoring mechanism, it is hoped that it can reduce potential problems that may occur when borrowing and returning medical records, even being able to deal with them proactively

Implementation Assessment of Electronic Records Management System in Bayelsa State, Nigeria

The quality of information available to medical practitioners when delivering treatment to patients influences the outcome of service delivery. In the healthcare industry, health information technology has been shown to improve patient safety and treatment quality. The purpose of this research is to identify the facilitators and hurdles to the deployment of an electronic records management system at NDUTH, Okolobiri. For this study, a descriptive cross-sectional research design was used. The stratified random sample was taken from the 204 staff members that participated in the survey at NDUTH Okolobiri. Telephone interviews were also conducted with a small number of hospital staff who had deployed the electronic records system. According to the findings, the majority of participants (51.0%) were female, with an average age of 37(SD+9.0) years. The respondents’ overall understanding of electronic records management systems was 45.9%. The overall implementation rate was 22.8%. The study’s facilitators were leadership support along with the availability of ICT equipment, whereas the barriers were funding, a lack of power, insufficient ICT infrastructures, administrative challenges, poor staff compliance, a lack of government support, and poor maintenance of software and ICT equipment. The findings indicate that government and private enterprises should invest more in healthcare delivery via electronic records management systems. This is critical because the quality of information that medical practitioners have access to when caring for patients influences the effectiveness of health service delivery. It has also been discovered to ensure the proper operation of health institutions.

Increasing Student Understanding and Concentration Through Virtual Reality Learning Media in Electronic Records Management Courses

Technology development today gives students many references to learn new things. The development of technology-based learning media is an alternative for teaching staff to make a breakthrough in the world of education. Virtual Reality is a technology that can make its users feel like they are in another room without having to move. This technology is supported with audiovisual features, which can make users feel isolated and focus on VR media. The purpose of developing this VR learning media is to measure students' understanding of the material presented in VR learning media and to measure student concentration when using VR learning media. This research was conducted on students from the State University of Malang who taught the Electronic Records Management course. Learning media adapts from sub-CPMK to 1.1. The development of this VR learning media uses the multimedia development method from Luther. The results of the material expert validator and media expert show that learning media is very suitable for learning media by getting a score of 94%. The results obtained from this study show that learning media influences students' understanding of the material, which is indicated by an increase in the class average at the learning stage. Post-test by 11%. This study also found that this learning media made students concentrate more because they felt more focused when using Virtual Reality.

Audit of A Web-Based Electronic Documents and Record Management System (WEDRMS): Oversight Efforts to Improve Administration in Higher Educational Institutions

An electronic records had important role in organizations including a university or higher educational institutions. It was important to stay abreast of best practices and new technologies to manage these records effectively. A Web-Based Electronic Documents and Records Management System (WEDRMS) was a web-based system that was expected to reach a wide range of system users. This system had functions to store, archive and retrieve electronic documents. The purpose of this research was to explain further an audit implication for Web-Based Electronic Documents and Record Management System (WEDRMS) as an effort to supervise administration of higher educational Institutions. This research used a descriptive research approach with observation and document analysis for the data collection process. With the existence of an audit, it can become an alternative to managing electronic documents in the higher education environment. This research provides perspective and urgency regarding the audit implication of web-based electronic documentation dan recording management.