Healthcare Information Management Research Articles

Enhancing Patient Consent Management through Blockchain Technology: A Promising Approach for Healthcare Data Security

In contemporary healthcare systems, ensuring patient consent management while safeguarding data privacy and security is a paramount concern. Traditional approaches to managing patient consent often face challenges related to security vulnerabilities, data breaches, and lack of transparency. This research paper proposes a novel approach to address these challenges by leveraging blockchain technology for patient consent management. Blockchain, with its decentralized and immutable ledger, offers a promising solution for securely recording and managing patient consent in healthcare settings. This paper presents a detailed exploration of the concept, design, and implementation of a blockchain-based patient consent management system. Through a comprehensive literature review, methodology description, and evaluation of the proposed system, this research demonstrates the potential benefits of blockchain technology in enhancing patient privacy and data security. The findings of this study contribute to the advancement of healthcare data management practices and provide valuable insights for future research and development in this evolving field. Keywords— Patient consent management, Blockchain technology, Healthcare data security, Privacy protection, Decentralization, Immutable ledger, Transparency, System architecture, Data integrity, Healthcare information management

Reasons for the Success or Failure of a Hospital Information System: A Systematic Review

Objectives: Information and communication technologies have significantly improved the quality of healthcare information management and operations. Hospital information systems (HIS) have become popular and used by most healthcare facilities, both public and private hospitals and clinics. For the best implementation of the health information system, it is necessary to know the reasons leading to failure or success. Objectives is to determine the main reasons for success and failure through a systematic review to help underdeveloped countries like Morocco, which is starting to implement the HIS. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was adhered during the conduct of this systematic review. This systematic review was based on the PubMed database, the Google Scholar search engine Scopus, and science Direct over a considered period of 10 years from 2013 to June 2023. We have included articles dealing with either success factors or failure factors following the implementation of a hospital information system that were published between 2013 and 2023. Results: 28 studies were selected to highlight 8 factors likely to cause success, the most important of which were organizational and behavioral factors containing sub-factors, and 6 factors likely to cause HIS failure, the most important of which was the technical factor. Conclusion: These factors must be considered by the personnel in charge of implementing new information systems to increase the chances of success and to minimize the reasons that can lead to the failure of these systems.

Modeling the enablers of blockchain technology implementation for information management in healthcare supply chains

PurposeBlockchain technology enhances information management in healthcare supply chains by securing healthcare information and providing medical resource traceability. However, there is no decision framework to support blockchain implementation for managing information, especially in emerging economies’ healthcare supply chains. This paper develops a hierarchical decision model for implementing blockchain technology for information management in emerging economies’ healthcare supply chains.Design/methodology/approachThis study uses 20 health supply chain experts in Ghana to rank 17 decision criteria for implementing blockchain for healthcare information management using the best-worst method (BWM) multi-criteria decision technique.FindingsThe results show that “security” and “privacy,” “infrastructural facility” and “presence of training facilities” are the top three critical factors impacting blockchain adoption in the health supply chain for healthcare information management. Other sub-factors are prioritized.Practical implicationsTo implement blockchain effectively to enhance information management in the healthcare supply chain, health institutions, blockchain technology providers and state authorities should concentrate on the highly critical factors extracted from the study.Originality/valueThis is the first study that develops a hierarchical decision model for implementing blockchain technology in emerging economies' health supply chains.

A holistic insight into the privacy & security of cloud-based computing approach on healthcare information management systems in the United States – a grounded theory approach

A holistic insight into the privacy & security of cloud-based computing approach on healthcare information management systems in the United States – a grounded theory approach

Assessment of clinical miscoding errors and potential financial their implications on healthcare management – A case of local hospital in Najran, Saudi Arabia

BackgroundHealthcare systems can potentially improve their safety, quality of service, and performance efficiency with a cost reduction, through the introduction and implementation of healthcare information management systems. This study aims to examine the frequency of miscoding errors in principal and secondary diagnoses, exploring demographic and coder-related factors contributing to these errors through the use of the QuadraMed system. The study also investigates the association of coding errors with patient safety and service quality to estimate the potential financial implications resulting from these inaccuracies in the healthcare system. MethodsThis analytical cross-sectional retrospective study was conducted at a local hospital in Najran, Saudi Arabia, from July 2021 to February 2022 using the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) coding system. The costing and financial data were collected from the reimbursement department for eligible 750 patient cases in terms of payment mode, services availed, and length of stay. The financial claims were evaluated to estimate the impact on the quality of service and patient safety. The reimbursement amount was calculated based on codes. The data were analyzed using SPSS and the odds ratio was calculated to estimate the risk of major coding errors in different departments. ResultsPrimary codes 240 (32%) and 40 (5.3) secondary codes were reviewed and percentages and inaccuracies were calculated after recording. The percentage of inaccurate medical codes in principal diagnosis was 57(26.8%) and the percentage of inaccurate medical codes in secondary diagnosis was 21 (9.9%). The primary diagnostic codes have more coding errors with a total number of 240 (32%) coding errors with a moderate level of agreement between the original coder and independent coder with a kappa value of 0.462. The identified recording was done by the independent coder, and the secondary diagnostic code showed 40 (5.3%) cases, with a poor kappa value of 0.128. The results showed the highest number of primary diagnostic codes was among surgery clinics 79 (63.2%). The highest number of secondary diagnostic codes were reported among consultant clinics 12 (9.6%) ConclusionsThe study concludes that the identification of miscoding in the healthy population has a financial impact on the healthcare organization's infrastructure.

Human Error and Clinical Data Sharing

Computer security issues have a widespread impact across all sectors and are increasingly influencing the healthcare industry. Since 2019, several reported attacks have been specifically aimed at exploiting vulnerabilities in medical network protocols like 'DICOM' and 'HL7,' as well as file formats, particularly those related to digital imaging and medical communications. While numerous articles delve into subjects such as security and blockchain, they often disregard the significant role that human errors play in compromising security. Human errors within hospital computer systems can lead to substantial implications for both patient care and data security. This article delves into the various forms of human errors that can occur within such systems and assesses their potential consequences on the overall effectiveness and security of healthcare information management. The study underscores the necessity of effective mitigation strategies to reduce the associated risks of these errors and enhance the dependability of hospital computer systems

Healthcare information management and operational cost performance: empirical evidence.

Healthcare knowledge management systems can mitigate hospitals' operational inefficiency. As a healthcare information technology, the electronic health record (EHR) receives much attention from medical institutions due to its considerable impact on operational cost performance. This paper focuses on EHR systems to address operational inefficiency by which patients pay more for health care services, and many U.S. hospitals are filing for bankruptcy. From the theoretical perspective of the practice-based view, this paper introduces a path to implement EHR systems for improving cost performance. The empirical investigation is archival data of 200 hospitals collected from the U.S. healthcare agencies. Findings contribute to prior work by hypothesizing moderating and mediating roles in EHR systems implementation. This paper introduces absorptive capacity and monitoring mechanisms as enablers of implementing EHR systems. The results showed that hospital monitoring strengthens the relationship between absorptive capacity and electronic health record systems implementation, which results in better operational cost performance. Theoretically, this study supports the long-term potential benefits of EHR adoption, and its findings are consistent with optimizing efficiency through data standardization and interoperability. From a practical perspective, this study supports hospitals' investments in evolving healthcare information technology systems through the development of a knowledge-based system employing EHR, particularly when hospitals are merging or need a financial strategic plan to control expenses.

Leveraging Generative AI and Large Language Models: A Comprehensive Roadmap for Healthcare Integration.

Generative artificial intelligence (AI) and large language models (LLMs), exemplified by ChatGPT, are promising for revolutionizing data and information management in healthcare and medicine. However, there is scant literature guiding their integration for non-AI professionals. This study conducts a scoping literature review to address the critical need for guidance on integrating generative AI and LLMs into healthcare and medical practices. It elucidates the distinct mechanisms underpinning these technologies, such as Reinforcement Learning from Human Feedback (RLFH), including few-shot learning and chain-of-thought reasoning, which differentiates them from traditional, rule-based AI systems. It requires an inclusive, collaborative co-design process that engages all pertinent stakeholders, including clinicians and consumers, to achieve these benefits. Although global research is examining both opportunities and challenges, including ethical and legal dimensions, LLMs offer promising advancements in healthcare by enhancing data management, information retrieval, and decision-making processes. Continued innovation in data acquisition, model fine-tuning, prompt strategy development, evaluation, and system implementation is imperative for realizing the full potential of these technologies. Organizations should proactively engage with these technologies to improve healthcare quality, safety, and efficiency, adhering to ethical and legal guidelines for responsible application.

The burden of scoliosis: a nationwide database study on demographics, incidence, and surgical rates.

Scoliosis is characterized as a three-dimensional deformity of the spine, affected by variety of factors, including biological, mechanical, hormonal, and genetics. Our study's primary objective was to delineate the demographics, incidence, and prevalence of scoliosis from a nationwide perspective, analyze the surgical intervention rates, with the aim of offering more insightful guidance to orthopedic physicians. This nationwide cohort study was conducted from digital database for healthcare information management. Relevant population data, for children under 18 years old, was extracted from the official government census within the period of January 2015 to December 2022. Utilizing diagnostic code of M41 [Scoliosis] was used to define the patient pool from ICD-10. Demographic variables, type of operations (posterior only, anterior only, or combined), and complications were documented. Incidence and prevalence values were calculated using population figures and case numbers. There were 276,521 patients with an average incidence of 129 per 100,000. Frequency of females was 1.45 times greater than that of males (p < 0.001). A total of 10,417 surgeries were performed in 10,311 patients during the inspection period (3.8% of all cases). Posterior fusion was by far the most common surgical approach (n = 10.111; 97%) followed by anterior fusion (n = 200; 1,9%). Our findings reveal a significant increase in the average incidence of scoliosis diagnosis, rising from 107 per 100,000 individuals in 2015 to 161 per 100,000 in 2022. Scoliosis now impacts an estimated 1.2% of children and adolescents in Turkey. The risk is 1.45 times higher in females than in males.

The minimum data set of electronic personal health records for Alzheimer's disease using design science methodology

ObjectiveLong-term management of healthcare information for chronic patients such as Alzheimer's is complex and tedious. An electronic Personal Health Record (ePHR) can help patients by maintaining a history of healthcare data from various centers. The purposes of this research were to develop a minimum data set (MDS) to design an ePHR for caregivers of patients with Alzheimer's disease (AD) using design science methodology and to identify the necessary measures for a smooth ePHR implementation in Iran. MethodsThis study was performed in Kerman from February 2020 to October 2021. To inform caregivers about ePHRs, information sessions were held and a pictorial method was used. Then, 20 semi-structured interviews were conducted with seven physicians and 13 caregivers involved in the care of Alzheimer's patients. Using thematic analysis based on the Information System Research (ISR) framework, the data were encoded and analyzed. ResultsThe MDS of an ePHR for AD contained 178 data elements, categorized into six main sections. The participants considered the use of an ePHR essential to achieve quality care. Using an ePHR can serve as the main method of collecting accurate histories of each Alzheimer's patient in different disease stages and monitoring their behavioral changes. Data confidentiality and security were considered as one of the main measures for AD ePHR implementation. ConclusionThis study identified an AD-specific MDS, as the first major step in launching ePHRs for Alzheimer's patients in the future. The MDS was developed based on the requirements of neurologists and caregivers.

Bluetooth-Based Healthcare Information and Medical Resource Management System.

This paper presents a healthcare information and medical resource management platform utilizing wearable devices, physiological sensors, and an indoor positioning system (IPS). This platform provides medical healthcare information management based on the physiological information collected by wearable devices and Bluetooth data collectors. The Internet of Things (IoT) is constructed for this medical care purpose. The collected data are classified and used to monitor the status of patients in real time with a Secure MQTT mechanism. The measured physiological signals are also used for developing an IPS. When the patient is out of the safety zone, the IPS will send an alert message instantly by pushing the server to remind the caretaker, easing the caretaker's burden and offering extra protection for the patient. The presented system also provides medical resource management with the help of IPS. The medical equipment and devices can be tracked by IPS to tackle some equipment rental problems, such as lost and found. A platform for the medical staff work coordination information exchange and transmission is also developed to expedite the maintenance of medical equipment, providing the shared medical information to healthcare and management staff in a timely and transparent manner. The presented system in this paper will finally reduce the loading of medical staff during the COVID-19 pandemic period.

Blockchain innovation for consent self-management in health information exchanges

With the increasing digitalization of health data, patients need to make informed decisions about the online sharing of their protected health information. This necessitates a robust technical infrastructure that enables patients to self-manage consent and the trusted exchange of this information across sharing entities. Unfortunately, current health information exchange systems in the U.S. are limited in both these regards. While there is recent work on digital patient consent management, there is limited work that provides effective solutions for patient self-management of consent. Further, interoperability issues in the way health information exchanges are currently architected and differences in regulations across localities exacerbate the challenges of consent management. In this research, we survey potential patients' willingness to self-manage healthcare-related consent. Having established the desire for consent self-management, we propose a solution that enables the seamless sharing of patient consent across different healthcare providers and health information exchanges. Specifically, we use a rigorous design science approach to create a blockchain-based, self-managed patient consent system and we evaluate the design through an instantiated prototype. The results of our study should be useful to researchers in healthcare information management as well as to practitioners designing consent management systems. Our research contributes to design science research with an innovative, rigorously evaluated, design principles-based artifact that addresses a critical problem of sharing protected health information.

DESIGN AND EVALUATION OF AN IOTA-BASED MEDICAL INFORMATION SYSTEM

The traditional medical information systems are plagued by issues such as data breaches, lack of privacy, and data integrity concerns. This paper presents the design and evaluation of an IOTA-based medical information system aimed at addressing these challenges. In recent years, blockchain technology has emerged as a powerful tool for securing and managing data in a decentralized manner. One area where this technology has the potential to revolutionize the way we do things is in e-medicine. E-medicine, or electronic medicine, refers to the use of technology to deliver healthcare services remotely. This includes telemedicine, online consultations, and remote monitoring of patients' health status. IOTA blockchain technology, in particular, has a lot of potential in e-medicine. IOTA is a distributed ledger technology that uses a directed acyclic graph (DAG) instead of a traditional blockchain. The main ad-vantage of this approach is that it eliminates the need for miners and makes the system more scalable, fast, and energy-efficient. IOTA is also designed to be feeless, making it an ideal choice for microtransactions. In e-medicine, IOTA can be used in several ways. One potential use case is for secure and decentralized storage of patients' medical records. Medical records are highly sensitive and contain confidential information that needs to be protected from unauthorized access. By using IOTA's tamper-proof and immutable ledger, patients can have more control over their medical records and choose who has access to them. This can be especially useful in situations where patients need to share their medical records with multiple healthcare providers or research institutions. By leveraging the unique features of IOTA, such as its feeless microtransactions, scalability, and distributed ledger technology, the proposed system enhances security, privacy, and interoperability in healthcare information management. The evaluation of the system involves performance tests, and a comparison with existing solutions.

Design Theory for Societal Digital Transformation: The Case of Digital Global Health

With societal challenges, including but not limited to human development, equity, social justice, and climate change, societal-level digital transformation (SDT) is of imminent relevance and theoretical interest. While building on local-level efforts, societal-level transformation is a nonlinear extension of the local level. Unfortunately, academic discourse on digital transformation has largely left SDT unaccounted for. Drawing on more than 25 years of intensive, interventionist research engagement with the digital transformation of public healthcare information management and delivery in more than 80 countries in the Global South, we contribute to theorizing SDT in the form of a design theory consisting of six interconnected design principles. These design principles articulate the interplay and tensions of accommodating over time increased diversity and flexibility in digital solutions, while simultaneously connecting local, national, and regional/ global efforts.

Identifying the Knowledge Structure and Trends of Nursing Informatics: A Text Network Analysis.

With the advent of the information age and technological development, the importance of digital health technologies has increased. Subsequently, nursing informatics has been developed to enhance the effectiveness of healthcare information management and communication. This study aimed to identify the nursing informatics knowledge structure and research trends through quantitative analysis using text network analysis. Here, we analyzed 14 225 studies published by 2020. The knowledge structure of nursing informatics and changes therein were clarified by identifying and analyzing the core keywords, topics, and changes in the topics of related studies over time. We identified "patient," "health," "system," and "information" as core keywords connecting other keywords. Over time, the networks between "information," "communication," and "technology" strengthened, and "patient safety" and "quality" have recently emerged as research keywords. This change indicates an increase in the importance of nursing education on technology. Similar changes appeared in the topic analysis, showing an increased proportion of research related to system and technology and nursing education. These results can broaden a systematic understanding of nursing informatics research. Furthermore, given these findings, the importance of nursing informatics on patient safety and nursing education-based on the development of systems and technology-can be expected to continue growing.

Respect for patients’ rights in health facilities: experiences of patients during the early period of the COVID-19 pandemic in Ghana

PurposeThis paper aims to identify human rights violations of patients during the early periods of the COVID-19 pandemic in Ghana by investigating the experiences of people on how health-care professionals discharged their responsibilities during the time in question.Design/methodology/approachExplanatory design of the mixed methods approach was adopted, with the intention of collecting both quantitative and qualitative data sequentially, and then integrating the results at the interpretation stage. The approach enriched the quality of data collected as it offered the advantage of shedding light on the primary motivations and reasons for attitudes and behaviours and helped to provide an in-depth understanding of how individuals interpret the happenings around them and their experiences. Thus, although some amount of quantitative method was used in the data collection, the core of this paper is based on the qualitative interpretations.FindingsThe study reveals that health-care professionals, especially those in the Tema Metropolis, undermined certain fundamental human rights of patients during the early period of the COVID-19 pandemic. This includes failure to provide information to patients about treatment options and potential risks of medications; failure to seek the informed consent of patients before performing medical procedures; denial of access to medical files of patients for transfer; and inability or failure to provide medical ambulances services to patients on time.Originality/valueAlthough many publications on human rights dimensions and health protective issues on COVID-19 pandemic are available on a global scale, still little information pertaining to experiences of individuals with health-care professionals during the early days of the COVID-19 pandemic, especially in Ghana through the lens of patient’s rights exists. This paper, therefore, fills an important gap in health-care management information, critical for policy decision-making processes regarding patient’s rights in times of pandemic control.

Bacterial and Fungal Coinfection in Critically Ill COVID-19 Cases and Predictive Role of Procalcitonin During the First Wave at an Academic Health Center

BackgroundCoinfection at various sites can complicate the clinical course of coronavirus disease of 2019 (COVID-19) patients leading to worse prognosis and increased mortality. We aimed to investigate the occurrence of coinfection in critically ill COVID-19 cases, and the predictive role of routinely tested biomarkers on admission for mortality.MethodsThis is a retrospective study of all SARS-CoV-2-infected cases, who were admitted to King Fahad Hospital of the University between March 2020 and December 2020. We reviewed the data in the electronic charts in the healthcare information management system including initial presentation, clinical course, radiological and laboratory findings and reported all significant microbiological cultures that indicated antimicrobial therapy. The mortality data were reviewed for severely ill patients who were admitted to critical care units.ResultsOf 1091 admitted patients, there were 70 fatalities (6.4%). 182 COVID-19 persons were admitted to the critical care service, of whom 114 patients (62.6%) survived. The in-hospital mortality was 13.4%. Coinfection was noted in 67/68 non-survivors, and Gram-negative pathogens (Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter baumanni) represented more than 50% of the etiological agents. We noted that the serum procalcitonin on admission was higher for non-survivors (Median = 1.6 ng/mL ± 4.7) than in survivors (Median = 0.2 ng/mL ± 4.2) (p ≤ 0.05).ConclusionCoinfection is a serious complication for COVID-19 especially in the presence of co-morbidities. High levels of procalcitonin on admission may predict non-survival in critically ill cases in whom bacterial or fungal co-infection is likely.

Theoretical and practical applications of blockchain in healthcare information management

A primary objective of blockchain technology is to address information security and efficiency issues related to existing information sharing systems. For the sharing of health records, little is known about the application of blockchain in management information systems. There are strict regulations for sharing health information due to insecure systems and privacy concerns. To significantly and effectively improve medical diagnosis, it is beneficial to have efficient, reliable, and accurate accessibility to a patient's full medical history. Due to concerns with the security of health systems and privacy concerns, medical histories are not always accessible to healthcare providers. To help increase accessibility options, this research proposes a blockchain-based model that facilitates sharing medical records in a manner that is beneficial to both healthcare providers and patients. Social exchange theory provides the theoretical support for the conceptual model presented. Experimental findings based on 151 participants revealed that the blockchain technology can provide a secure information system and increase patient motivation to share medical records. To show the applicability of the proposed use of blockchain from a practical managerial perspective, we show feasibility by developing an Android software application.

Main directions of the improvement of healthcare information and communication management in the conditions of utc in the post-war period

The paper is devoted to the important problem of determining the directions of improving the management of the information and communication component of health care in the context of administrative-territorial reform, for example, united territorial communities. The problems of forecasting social contradictions and organization of relations in these conditions in the post-war period are studied. Possible measures for organized confrontation of crisis phenomena provoked by the conflict situation, by introducing modern information and communication support as a mean of regulating economic activity in the state, are considered. Measures to ensure effective consideration of applications and complaints and the impact on the quality of UTC medical care, prevention of negative consequences are proposed. The practical value of the research results on this topic is marked. It consists in the wide possibilities of using scientific developments and proposals and in particular the organizational and economic mechanism for state regulation of the national economy in the post-war period and improving the management of social and labour relations. functioning in the period of restoration of the post-war sphere of services. The author's approach to the investigation of theoretical and practical aspects of management of information and communication component of health care institutions in the administrative-territorial reform on the example of communication support of functional activities of medical institutions of united territorial communities, thus making more coordinated socio-humanitarian development of UTC economy is presented. The correspondence of the research topic to the current problem in accordance with the directions of implementation of the modern social economy and policy in Ukraine in accordance with the European integration processes is determined. It is investigated that the practical implementation of the obtained results consists in wide possibilities of using the developments to improve the quality of information and communication services by health care institutions, the development of advertising and strengthening the stability of UTC.

A Usability Management Framework for Securing Healthcare Information System

Transformation from conventional business management systems to smart digital systems is a recurrent trend in the current era. This has led to digital revolution, and in this context, the hardwired technologies in the software industry play a significant role However, from the beginning, software security remains a serious issue for all levels of stakeholders. Software vulnerabilities lead to intrusions that cause data breaches and result in disclosure of sensitive data, compromising the organizations’ reputation that translates into, financial losses and compromising software usability as well. Most of the data breaches are financially motivated, especially in the healthcare sector. The cyber invaders continuously penetrate the E- Health data because of the high cost of the data on the dark web. Therefore, security assessment of healthcare web-based applications demands immediate intervention mechanisms to weed out the threats of cyber-attacks for the sake of software usability. The proposed disclosure is a unique process of three phases that are combined by researchers in order to produce and manage usability management framework for healthcare information system. In this most threatened time of digital era where, Healthcare data industry has borne the brunt of the highest number of data breach episodes in the last few years. The key reason for this is attributed to the sensitivity of healthcare data and the high costs entailed in trading the data over the dark web. Hence, usability management of healthcare information systems is the need of hour as to identify the vulnerabilities and provide preventive measures as a shield against the breaches. The proposed unique developed model of usability management workflow is prepared by associating steps like learn; analyze and manage. All these steps gives an all in one package for the healthcare information management industry because there is no systematic model available which associate identification to implementation steps with different evaluation steps.