Healthcare Information Technology Research Articles

Architecting Resilience : A Framework for Secure and Compliant Healthcare IT Infrastructures

Healthcare information technology (IT) systems face unique challenges in maintaining data security and regulatory compliance while supporting critical patient care functions. This article provides a comprehensive analysis of the complex interplay between data protection measures and compliance requirements in the healthcare sector. We examine key components of data security, including encryption, data integrity measures, and secure transfer protocols, with a specific focus on their application to sensitive patient information. The impact of regulations such as HIPAA on system design and maintenance is explored, offering insights into the alignment of IT practices with evolving standards. Through a review of current literature and industry best practices, we present strategies for risk management, employee training, and the implementation of technical controls that address both security and compliance needs. Emerging trends, including cloud computing, the Internet of Medical Things (IoMT), and artificial intelligence in healthcare security, are discussed to provide a forward-looking perspective. This article contributes to the ongoing dialogue on balancing innovation with security in healthcare IT, offering practical recommendations for healthcare organizations to enhance their data protection measures while ensuring regulatory compliance.

A long journey from telemedicine to digital (public) health: the vision of different stakeholders

Abstract The healthcare system willingly adopts new innovative means of communication and solutions offered by computer science. Telemedicine was one of the first terms used in this context. It was initially associated with providing medical services but quickly extended to other areas of health-related activities, including public health. The growth of the global web yielded new prospects for the provision of health services, also resulting in new terms to name the use of information and telecommunication technologies in healthcare. E-health, stemming from the end of 90ies in the 20th century, was initially defined as a new domain strongly associated with public health, especially in the context of access to health information. Quickly, its understanding was extended to all health-related interventions based on innovative digital technologies. Today, digital health and digital public health have emerged as the key terms, signifying the next phase of emerging applications that leverage the advancements made on the technical front. The medical community is probably more inclined to use the former term, while public health professionals are dedicated to the latter. But do these terms carry distinct meanings? Or is it merely a matter of the professional group’s background? Is the focus on individual or population health a differentiating factor? In the meantime, business and technical communities have developed the concept of Health 4.0. This concept emphasizes using technologies like the Internet of Things, cloud computing, big data, and artificial intelligence. However, digital (public) health benefits hugely from these solutions. One can ask whether every professional community needs other concepts and new terms for naming fields, resulting from the multidisciplinary effort. And where are the plain people in this landscape? Do they have sufficient digital and health literacies to accept new modes of health service delivery?

Enhancing Sleep and Reducing Occupational Stress Through Forest Therapy: A Comparative Study Across Job Groups.

The coronavirus disease-2019 (COVID-19) pandemic radically shifted occupational patterns, leading to increased telecommuting and related stressors. Healthcare providers, among the most impacted group, faced heightened risks and workplace changes. Our study examined the efficacy of forest therapy in alleviating work-induced stress across various professions, exploring the need for profession-specific stress-relief strategies in the post-pandemic workplace. To examine the impact of COVID-19 on professionals, 62 participants were recruited, consisting of 20 healthcare providers, 21 information technology (IT) specialists, and 21 teachers. Instruments such as Pittsburgh Sleep Quality Index and Hospital Anxiety and Depression Scale, along with salivary tests for cortisol and melatonin, were used to assess the participants' sleep and stress levels. A specialized forest healing program was implemented among these participants. Data analysis was conducted using SPSS Win Ver. 22.0, utilizing paired t-tests and a repeated measures analysis of variance. Significant improvements were observed in the participants' sleep metrics, depression scales, and stress levels after the forest healing program. Physiological measures indicated an increase in melatonin and a decline in cortisol and dehydroepiandrosterone sulfate levels, with only cortisol changes being statistically significant. Teachers, participating during school vacations, exhibited minimal stress-related physiological changes. Overall, the program demonstrated widespread health benefits regardless of occupation or gender. This study showed that forest therapy reduced stress equally across professions, including healthcare providers, IT specialists, and teachers. Individual physiological responses may play a greater role in stress relief than the specific occupation.

A Comprehensive Framework for Machine Learning-Based Threat Intelligence in Health Information Systems

This research work provides a comprehensive architecture of Machine Learning based threat intelligence particularly for Health Information System (HIS). The number of cybersecurity threats executed by healthcare companies is even higher since healthcare organizations continue to introduce digitized data into medical data. This work employs complex machine learning techniques from the MIMIC-III Critical Care Database to develop a practical threat identification and mitigation system. In this case, the strategy of analysis involves selection of data, data processing, modeling and real time dangers identification considering both supervised and unsupervised learning. The results reveal that the proposed framework covers high performance indicators such as: accuracy that equals 97.92%, and the level of precision and recall which also equal 90% ROC AUC has reached 0.94. These results demonstrate that the framework can identify and categorise cybersecurity risks in systems of health information on a regular basis. It not only increases threat perception but also makes the system internally valuable for healthcare IT professionals since it contains real-time monitoring and anomaly detection functionality. Therefore, this study stands in support of the ongoing efforts to enhance the security of the healthcare bodies on the use of policies on cybersecurity so as to ensure the protection of individual patient’s information against new forms of threats.

A secure blockchain framework for healthcare records management systems

AbstractElectronic health records are one of the essential components of health organizations. In recent years, there have been increased concerns about privacy and reputation regarding the storage and use of patient information. In this regard, the information provided as a part of medical and health insurance, for instance, can be viewed as proof of social insurance and governance. Several problems in the past few decades regarding medical information management have threatened patient information privacy. In intelligent healthcare applications, the privacy of patients' data is one of the main concerns. As a result, blockchain is a severe necessity as it can enhance transparency and security in medical applications. Accordingly, this paper uses the design science method to propose a secure blockchain framework for healthcare records management systems. The proposed framework comprises five components: a blockchain network, smart contracts, privacy key management, data encryption, and integration with healthcare information technology. In the proposed framework, healthcare organizations can manage healthcare information securely and privately. Additionally, a secure storage system for electronic records is proposed to meet these organizations' needs. It provides security and privacy for healthcare organizations, especially when managing healthcare information, and also proposes a secure storage system for electronic records to meet the needs of the organizations.

New experience of implementing patient e-referral in the Iranian health system: a qualitative study.

Implementing an electronic system of service categorization and a referral system in healthcare is a strategic approach to improving overall health outcomes and optimizing resource use. This study aimed to investigate challenges experienced with the electronic patient referral system in Mashhad University of Medical Sciences (MUMS). In this qualitative research, data were collected using semi-structured interviews. Participants included physicians, experts, and stakeholders working in the Family Physician Program and the referral system, selected through purposive sampling. The data were analyzed using a thematic analysis framework, in which a thematic framework was developed, and key themes were identified. Data analysis was performed using Atlas.ti8 software. According to the interviewees, the challenges of digitizing the referral system can be categorized into three main themes: structure, process, and outcomes. These themes include ten sub-themes, such as challenges related to Internet Infrastructure and the Sina System, Patients' Choice of Desired Specialists, Receiving Payment for Services, Appointment Scheduling, Interdepartmental Coordination, Recording Definitive Diagnosis Codes Before Referral, False Referrals, Dissatisfaction, Feedbacks, and Health Indicators. To improve the e-referral in Iran's health system, several strategies can be implemented. These include sustainable resource allocation, designing consequence mechanisms within the referral system to motivate collaboration and improving appointment scheduling systems. Furthermore, addressing these challenges requires a collaborative approach involving healthcare providers, IT professionals, and patient representatives to ensure that the system is efficient, user-friendly, and effectively meets the needs of all parties involved. Not paying enough attention to these issues cause reform failure while solving them requires multi-dimensional, systematic and coordinated interventions with a deep understanding of the obstacles and challenges. Disregarding these factors may result in apathy over time, ultimately impacting both the quantity and, more importantly, the quality of services.

Block Medcare: Advancing Healthcare Through Blockchain Integration

In an era driven by information exchange, transparency and security hold crucial importance, particularly within the healthcare industry, where data integrity and confidentiality are paramount. This paper investigates the integration of blockchain technology in healthcare, focusing on its potential to revolutionize Electronic Health Records (EHR) management and data sharing. By leveraging Ethereum-based blockchain implementations and smart contracts, we propose a novel system that empowers patients to securely store and manage their medical data. Our research addresses critical challenges in implementing blockchain in healthcare, including scalability, user privacy, and regulatory compliance. We propose a solution that combines digital signatures, Role-Based Access Control, and a multi-layered architecture to enhance security and ensure controlled access. The system's key functions, including user registration, data append, and data retrieval, are facilitated through smart contracts, providing a secure and efficient mechanism for managing health information. To validate our approach, we developed a decentralized application (dApp) that demonstrates the practical implementation of our blockchain-based healthcare solution. The dApp incorporates user-friendly interfaces for patients, doctors, and administrators, showcasing the system's potential to streamline healthcare processes while maintaining data security and integrity. Additionally, we conducted a survey to gain insights into the perceived benefits and challenges of blockchain adoption in healthcare. The results indicate strong interest among healthcare professionals and IT experts, while also highlighting concerns about integration costs and technological complexity. Our findings underscore the transformative potential of blockchain technology in healthcare, pointing towards a new era of patient-centric and secure healthcare services. By addressing current limitations and exploring future enhancements, such as integration with IoT devices and AI-driven analytics, this research contributes to the ongoing evolution of secure, efficient, and interoperable healthcare systems.

User-resistance behaviours toward electronic health records: uncovering the determinants of perceived threats

ABSTRACT This study uncovers the determinants of perceived threats that have long been associated with resistance to healthcare information technology in general, and electronic health records in particular. Conceptualised as perceived dissatisfaction with outcomes and perceived helplessness over process, these threats are discussed from the perspective of the Psychological Reactance Theory. Study participants consisting of a diverse group of healthcare professionals were drawn from sample frame of health practices. Data from a sample of 217 participants were used to test the model. Using structural equation modeling, the model relationships were analyzed, and hypotheses were tested. The study results show that perceived threats to electronic health records are triggered by two types of factors: namely, intrinsic stimuli like self-efficacy and performance expectancy; and extrinsic causes such as social enabling effect and social influence. The implications of these findings are particularly useful to both research and practice. Managers and informaticians in both healthcare and non-healthcare settings will find the results both instructive and helpful in mitigating resistance. Theorists will be enriched by the insights from the antecedents of perceived threats to advance research.

Research on Collaborative Defense Method of Hospital Network Cloud based on End-to-end Edge Computing

This research introduces a groundbreaking collaborative defense mechanism that utilizes end-to-end edge computing to bolster the security of decentralized hospital cloud systems. By integrating intrusion detection systems, firewalls, anomaly detection, and threat intelligence in a unified manner through the efficiency of edge computing, this approach marks a significant advancement in healthcare cybersecurity. Through rigorous testing with a substantial dataset, the system demonstrated exceptional performance metrics, including a remarkable 95% accuracy in threat detection, a low false positive rate, and a swift response time of merely 0.25 seconds. Notably, the system effectively mitigates computational overhead, thereby optimizing resource utilization. Comparative analysis with existing methodologies underscores the superiority of this novel framework, particularly in terms of geolocation accuracy, the minimization of false positives, and expedited reaction capabilities. This study’s collaborative defense strategy, underpinned by end-to-end edge computing, presents a holistic and innovative solution to the escalating cyber threats facing healthcare infrastructures. By redefining the parameters of security in medical settings, it paves the way for a safer and more resilient healthcare information technology ecosystem.

A comparative analysis of generative artificial intelligence responses from leading chatbots to questions about endometriosis

IntroductionThe use of generative artificial intelligence (AI) has begun to permeate most industries, including medicine, and patients will inevitably start using these large language model (LLM) chatbots as a modality for education. As healthcare information technology evolves, it is imperative to evaluate chatbots and the accuracy of the information they provide to patients and to determine if there is variability between them. ObjectiveThis study aimed to evaluate the accuracy and comprehensiveness of three chatbots in addressing questions related to endometriosis and determine the level of variability between them. Study DesignThree LLMs, including Chat GPT-4 (Open AI), Claude (Anthropic), and Bard (Google) were asked to generate answers to 10 commonly asked questions about endometriosis. The responses were qualitatively compared to current guidelines and expert opinion on endometriosis and rated on a scale by nine gynecologists. The grading scale included the following: (1) Completely incorrect, (2) mostly incorrect and some correct, (3) mostly correct and some incorrect, (4) correct but inadequate, (5) correct and comprehensive. Final scores were averaged between the nine reviewers. Kendall's W and the related chi-square test were used to evaluate the reviewers’ strength of agreement in ranking the LLMs’ responses for each item. ResultsAverage scores for the 10 answers amongst Bard, Chat GPT, and Claude were 3.69, 4.24, and 3.7, respectively. Two questions showed significant disagreement between the nine reviewers. There were no questions the models could answer comprehensively or correctly across the reviewers. The model most associated with comprehensive and correct responses was ChatGPT. Chatbots showed an improved ability to accurately answer questions about symptoms and pathophysiology over treatment and risk of recurrence. ConclusionThe analysis of LLMs revealed that, on average, they mainly provided correct but inadequate responses to commonly asked patient questions about endometriosis. While chatbot responses can serve as valuable supplements to information provided by licensed medical professionals, it is crucial to maintain a thorough ongoing evaluation process for outputs to provide the most comprehensive and accurate information to patients. Further research into this technology and its role in patient education and treatment is crucial as generative AI becomes more embedded in the medical field.

Единые Государственные Информационные Системы Здравоохранения (ЕГИСЗ) в странах Востока.

The introduction of information technology (IT) in healthcare has led to a real revolution in the provision and management of medical care. However, they are developing with different intensity in different countries. The purpose of the study was to test criteria to determine the degree of IT development in healthcare, as well as to illustrate the assessment of IT development in different countries to compare them with each other. To achieve this goal, we have identified a set of criteria covering key aspects of the implementation and use of IT in medical practice. We have selected the countries of the East for this study. We searched information on the level of IT development in healthcare in the Eastern countries in Google open sources and PubMed databases manually, as well as using GPT-3.5 Turbo. According to the availability and development of criteria, the degree of IT development in healthcare was assessed and the categories «Highly», «Medium» and «Less» developed were assigned. As a result, within the study’s methodology framework, the UAE, Saudi Arabia, Qatar, Israel, Singapore, Indonesia, the Philippines, Laos, South Korea, Japan and China were classified as countries with highly developed IT in healthcare. Countries with medium-developed IT in healthcare included Jordan, Oman, Afghanistan, Iran, Iraq, Bahrain, Vietnam, Thailand, Myanmar, Cambodia, India and Bangladesh. Lebanon, Kuwait, East Timor and Brunei were among the countries with the least developed IT in healthcare.

Evaluating applied security controls for safeguarding medical device‐integrated electronic medical records

AbstractRationale, Aims, and ObjectivesMedical device‐integrated electronic medical records (MDI‐EMR) pose significant challenges in ensuring effective usage, data security and patient safety. The complexities of MDI‐EMR necessitate applying various security mechanisms to safeguard against cyber threats. Therefore, we evaluated cyber threats to MDI‐EMR and the effectiveness of applied security controls using a proposed framework from sociotechnical and risk assessment perspectives.MethodWe conducted a qualitative case study evaluation in a general hospital in Saudi Arabia using interviews, observation, and document analysis from the perspectives of major MDI‐EMR stakeholders, including healthcare providers, IT professionals and cybersecurity specialists.ResultsThe results showed the interplay among physical, technical and administrative security controls that maintained a secure posture of MDI‐EMR. The effectiveness of security controls is highly influenced by the staff's cybersecurity awareness and training. The perceived effectiveness of security controls varied among users, with some expressing satisfaction with the ease of use and reliability, while others highlighting challenges such as password complexity and access procedures. Understanding these diverse perspectives is crucial for tailoring security measures to meet the needs of different stakeholders effectively.ConclusionCollaboration among the key stakeholders is crucial for implementing security controls for MDI‐EMR. Balancing security measures with usability concerns is essential, as highlighted by challenges in implementing technical controls. A comprehensive approach encompassing physical, technical and administrative controls, continuous education and awareness initiatives are significant to empower staff in recognising and mitigating cyber threats effectively to safeguard medical data and ensure the integrity of healthcare systems.

Use of Digital Technologies for the Conduct of Work in the Government System Based on the Demans of the Current Times

This article deals with the issues of ensuring the safety of the population in the residences of citizens. It is planned to implement an electronic platform that allows for quick collection and analysis of information on the technical and social condition of residential areas. These strategies focus on digital transformation in the national economy, industry, and society. In Uzbekistan, significant steps have been taken to implement modern information and communication technologies (ICT) in public administration, education, healthcare, and agriculture. One notable challenge addressed in this study is the management of carbon monoxide poisoning, fire hazards, and explosions during the heating season. The research highlights the limitations of manual data collection, including the risk of data loss, difficulty in locating information, and inefficiencies in processing critical safety data. The program processes data in less than a minute, facilitating more efficient emergency management and preventive measures. This system exemplifies the role of digital technology in enhancing public safety and optimizing government operations.

ICT Effect on India's Healthcare Management Services Development

In today's healthcare services, information and communication technology is no longer only employed to automate procedures. Rather, Information Communication Technology is being utilized as a significant system for offering kinds of help to individuals. The execution of ICT in the clinical benefits region enjoys accomplished different benefits, such as enhanced revenue, effectiveness, efficacy, faster service, customer satisfaction, ease for customers, flexibility in operation, continuously operations, capacity money saved, and expense benefits. ICT has been used in the healthcare industry in many creative ways that have improved communication between physicians, patients, and other stakeholders. This can be accomplished by enlisting the aid of social entrepreneurs to help create a wealth opportunity. The researcher's goal in this study is to evaluate how widely ICT is being used in India's various health fields. It is additionally considered critical to identify and evaluate the technology in the medical services area to recommend appropriate proactive, protecting, and advancing methodologies that would improve the authenticity and viability of medical services offices in India

Graph neural collaborative filtering with medical content-aware pre-training for treatment pattern recommendation

Recently, considering the advancement of information technology in healthcare, electronic medical records (EMRs) have become the repository of patients’ treatment processes in hospitals, including the patient’s treatment pattern (standard treatment process), the patient’s medical history, the patient’s admission diagnosis, etc. In particular, EMRs-based treatment recommendation systems have become critical for optimizing clinical decision-making. EMRs contain complex relationships between patients and treatment patterns. Recent studies have shown that graph neural collaborative filtering can effectively capture the complex relationships in EMRs. However, none of the existing methods take into account the impact of medical content such as the patient’s admission diagnosis, and medical history on treatment recommendations. In this work, we propose a graph neural collaborative filtering model with medical content-aware pre-training (CAPRec) for learning initial embeddings with medical content to improve recommendation performance. First the model constructs a patient-treatment pattern interaction graph from EMRs data. Then we attempt to use the medical content for pre-training learning and transfer the learned embeddings to a graph neural collaborative filtering model. Finally, the learned initial embedding can support the downstream task of graph collaborative filtering. Extensive experiments on real world datasets have consistently demonstrated the effectiveness of the medical content-aware training framework in improving treatment recommendations.

The Role of Health Information Technology During Hospital to Home Transitions.

The use of healthcare information technology (HIT) is vital for storing and exchanging health information during patient transitions, playing a significant role in care coordination for sepsis survivors. The critical role of HIT was evident during the pre-implementation phase of a study to implement an evidence-based protocol supporting the timely transition of sepsis survivors to home health and outpatient care. Through 61 semi-structured interviews involving 91 stakeholders, over half of the 33 identified themes were related to HIT. Notably, electronic health record (EHR) alert systems led to over-capture and alarm fatigue. Efficient information transfer during HHC referral highlighted the need for improved EHR access. The study underscores HIT's importance and potential while emphasizing the need for collaborative policy and interface development to promote effective transitions in care.

Plugging Public Health Data into the Health IT Ecosystem to Protect National Health

The Covid-19 pandemic exposed many challenges in the United States’ public health systems, and in particular the antiquated data ecosystem that hinders the nation’s ability to use timely data to detect and respond to emerging public health threats. One key challenge of the public health data ecosystem is the limited use of electronic, standardized, and interoperable ways for data to be readily shared between health care delivery and public health systems. At the start of the Covid-19 pandemic, most data exchange between health care and public health, and across public health, was manual, relying on faxes, labor-intensive data entry, and other outdated technology. Although significant progress has been made over the last several years to introduce more standardization and connectivity between public health and health care IT systems, more work is needed. This commentary describes the benefits and potential of robust, modern interoperability between health care and public health systems, defines key policies and technology activities that will drive toward a future state of a highly connected public health and health care data ecosystem, and summarizes potential challenges that must be overcome.

The Effect of Health Information Technology Assets on the Sustainability of Health Management Information Systems Usage Moderated by Strategy in Kendari City

Background:Health policies in Indonesia facilitate public access to healthcare information in efforts to improve public health. These policies rely on the support of electronic healthcare information systems to provide health data and information. However, the usage of these systems faces various challenges that affect their sustainability. Objective:To determine the effect of healthcare information technology assets on the sustainability of healthcare management information systems and the role of healthcare information technology strategies as a moderating variable. Methods:This is a quantitative and explanatory research study. The sample consisted of 350 respondents, with a significance level of 0.05. Latent variables included the sustainability of healthcare management information system usage, healthcare information technology assets, and information system strategies, which also served as an intervening variable. Results:The direct effect test yielded a p-value of 0.000 (<0.05), leading to the rejection of the null hypothesis. Thus, healthcare information technology assets and healthcare information technology strategies have a positive and significant effect on the sustainability of healthcare management information system usage. The indirect effect test yielded a p-value of 0.003 (<0.05), also leading to the rejection of the null hypothesis. These results indicate that the healthcare information technology strategies variable moderates the effect of healthcare information technology assets on the sustainability of healthcare management information system usage. Conclusion:Healthcare information technology strategies strengthen the effect of healthcare information technology assets on the sustainability of healthcare management information system usage. Keywords:Health Policy; Health Information Systems; Information Technology; Indonesia

Socio-Economic Aspects of the Development of Medical Information Technologies in Russia

Introduction. The article explores current trends in the development of information technologies in healthcare, as well as the problems and needs that can be addressed through their implementation. In conclusion, it emphasizes the necessity of promoting and applying information technologies in the healthcare sector for socio-economic development, improvement of quality, and ensuring universal access to medical services. Purpose. The aim of this analysis was to examine current trends in the development of medical informatics in modern society. The primary focus was on application of information technologies in the healthcare sector, encompassing aspects such as computers, software, electronic medical records, telemedicine, and other innovative technologies. This analysis was focused on identifying current trends, changes, and innovations in the field of medical informatics, as well as understanding the impact of these technologies on the quality and efficiency of medical practice. Materials and Methods. An analysis of Russian and foreign open sources, including peer-reviewed specialized scientific journals, articles obtained from electronic search platforms such as PubMed, Google Scholar, Elibrary.ru, as well as reports from Russian and international analytical companies from 2015 to 2023, was carried out. Results. The conducted analysis reveals challenges and prospects in the development and implementation of information technologies in Russian healthcare sector. Trends and development vectors in the digital technology sector were identified emphasizing the necessity of technology transfer from research to industry, internationalization of developments, creating conditions for attracting foreign investments to Russia, and protecting national strategic sectors.

Centering Digital Health Equity During Technology Innovation: Protocol for a Comprehensive Scoping Review of Evidence-Based Tools and Approaches.

In the rush to develop health technologies for the COVID-19 pandemic, the unintended consequence of digital health inequity or the inability of priority communities to access, use, and receive equal benefits from digital health technologies was not well examined. This scoping review will examine tools and approaches that can be used during digital technology innovation to improve equitable inclusion of priority communities in the development of digital health technologies. The results from this study will provide actionable insights for professionals in health care, health informatics, digital health, and technology development to proactively center equity during innovation. Based on the Arksey and O'Malley framework, this scoping review will consider priority communities' equitable involvement in digital technology innovation. Bibliographic databases in health, medicine, computing, and information sciences will be searched. Retrieved citations will be double screened against the inclusion and exclusion criteria using Covidence (Veritas Health Innovation). Data will be charted using a tailored extraction tool and mapped to a digital health innovation pathway defined by the Centre for eHealth Research roadmap for eHealth technologies. An accompanying narrative synthesis will describe the outcomes in relation to the review's objectives. This scoping review is currently in progress. The search of databases and other sources returned a total of 4868 records. After the initial screening of titles and abstracts, 426 studies are undergoing dual full-text review. We are aiming to complete the full-text review stage by May 30, 2024, data extraction in October 2024, and subsequent synthesis in December 2024. Funding was received on October 1, 2023, from the Centre for Health Equity Incubator Grant Scheme, University of Melbourne, Australia. This paper will identify and recommend a series of validated tools and approaches that can be used by health care stakeholders and IT developers to produce equitable digital health technology across the Centre for eHealth Research roadmap. Identified evidence gaps, possible implications, and further research will be discussed. DERR1-10.2196/53855.