Healthcare Information Systems Research Articles

Improved Key Agreement Based Kerberos Protocol for M-Health Security

The development of wireless sensor network with Internet of Things (IoT) predicts various applications in the field of healthcare and cloud computing. This can give promising results on mobile health care (M-health) and Telecare medicine information systems. M-health system on cloud Internet of Things (IoT) through wireless sensor network (WSN) becomes the rising research for the need of modern society. Sensor devices attached to the patients’ body which is connected to the mobile device can ease the medical services. Security is the key connect for optimal performance of the m-health system that share the data of patients in wireless networks in order to maintain the anonymity of the patients. This paper proposed a secure transmission of M-health data in wireless networks using proposed key agreement based Kerberos protocol. The patients processed data are stored in cloud server and accessed by doctors and caregivers. The data transfer between the patients, server and the doctors are accessed with proposed protocol in order to maintain the confidentiality and integrity of authentication. The efficiency of the proposed algorithm is compared with the existing protocols. For computing 100 devices it consumes only 91milllisecond for computation.

Open-source electronic health record systems: A systematic review of most recent advances

Open-source Electronic Health Records (OS-EHRs) are of pivotal importance in the management, operations, and administration of any healthcare organization. With the advancement of health informatics, researchers and healthcare practitioners have proposed various frameworks to assess the maturation of Open-source EHRs. The significance of OS-EHRs stems from the fact that vendor-based EHR implementations are becoming financially burdensome, with some vendors raking in more than $1 billion with one contract. Contrarily, the adoption of OS-EHRs suffers from a lack of systematic evaluation from the standpoint of a standard reference model. To this end, the Healthcare Information and Management Systems Society (HIMSS) has presented a strategic road map called EMR Adoption and Maturity (EMRAM). The HIMSS-EMRAM model proposes a stage-wise model approach that is globally recognized and can be essentially applied as a benchmark evaluation criteria for open-source EHRs. This paper offers an applied descriptive methodology over the frequently studied open-source EHRs currently operational worldwide or has the potential of adoption in healthcare settings. Besides, we also present profiling (User Support, Developer' Support, Customization Support, Technical details, and Diagnostic help) of studied OS-EHRs from developer's and user's perspectives using updated standard metrics. We carried out multi-aspect objective analysis of studied systems covering EHR functions, software based features and implementation. This review portrays systematic aspects of electronic medical record standards for open-source software implementations. As we observed in the literature, prevalent research and working prototypes lack systematic review of the HIMSS-EMRAM model and do not present evolving software features. Therefore, after the application of our assessment measures, the results obtained indicate that OS-EHRs are yet to acquire standard compliance and implementation. The findings in this paper can be beneficial in the planning and implementation of OS-EHRs projects in the future.

Comparative Analysis of Joint Commission International and Healthcare Information and Management Systems - Electronic Medical Record Adoption Model Measurement Models using Text Mining

Comparative Analysis of Joint Commission International and Healthcare Information and Management Systems - Electronic Medical Record Adoption Model Measurement Models using Text Mining

Establishing a minimum data set for Parkinson's (PMDS) in Iran.

The minimum data set (MDS) is one of the important steps in the development of health care information systems. According to the Ministry of Health in Iran, a central and national registry along with Parkinson's MDS (PMDS) has not yet existed. So, this research was conducted to establish a PMDS in Iran. This study was a descriptive-comparative method, which was done in 2019-2021 in four phases: (1) determining data elements related to Parkinson's disease in Iran and selected countries; (2) extracting and categorizing the data elements; (3) making a PMDS draft; (4) evaluating a draft by Delphi technique. The research population was the MDS in Australia, Canada, the United States of America, and Iran. After extracting the data elements of Parkinson's disease from various resources, the primary draft PMDS was developed. Then, the research group divided it into two categories (administrative and clinical). After that, it was sent to 50 healthcare professionals for validation by the Delphi method. Following the results of the two rounds of Delphi technique, Finally, PMDS was established including a total of 223 data elements in two categories: administrative and clinical with 72 and 151, respectively. Every category included 10 and 14 subcategories. The first and the most important step for standardization of data collection nationally is creating MDS. Due to the necessity of the existence of PMDS, a complete list of PMDS was established for collecting data on Parkinson's patients.

PCaGuard: A Software Platform to Support Optimal Management of Prostate Cancer.

Background and Objective Prostate cancer (PCa) is a severe public health issue and the most common cancer worldwide in men. Early diagnosis can lead to early treatment and long-term survival. The addition of the multiparametric magnetic resonance imaging in combination with ultrasound (mpMRI-U/S fusion) biopsy to the existing diagnostic tools improved prostate cancer detection. Use of both tools gradually increases in every day urological practice. Furthermore, advances in the area of information technology and artificial intelligence have led to the development of software platforms able to support clinical diagnosis and decision-making using patient data from personalized medicine. Methods We investigated the current aspects of implementation, architecture, and design of a health care information system able to handle and store a large number of clinical examination data along with medical images, and produce a risk calculator in a seamless and secure manner complying with data security/accuracy and personal data protection directives and standards simultaneously. Furthermore, we took into account interoperability support and connectivity to legacy and other information management systems. The platform was implemented using open source, modern frameworks, and development tools. Results The application showed that software platforms supporting patient follow-up monitoring can be effective, productive, and of extreme value, while at the same time, aiding toward the betterment medicine clinical workflows. Furthermore, it removes access barriers and restrictions to specialized care, especially for rural areas, providing the exchange of medical images and patient data, among hospitals and physicians. Conclusion This platform handles data to estimate the risk of prostate cancer detection using current state-of-the-art in eHealth systems and services while fusing emerging multidisciplinary and intersectoral approaches. This work offers the research community an open architecture framework that encourages the broader adoption of more robust and comprehensive systems in standard clinical practice.

Developing A Minimum Data Set for A Rheumatoid Arthritis Registry in Iran.

Background:Using Minimum Data Set (MDS) is the first step in creating and developing a health care information system; it includes standard and key data elements to capture and manage patient care.Aims:This study aimed to develop an MDS in order for using it for designing registry of patients with rheumatoid arthritis in Iran.Methods:This study was conducted at two stages in 2018. In stage one, qualitative method and semi-structured interview were used to identify the registry data elements of patients with rheumatoid arthritis. Collected data was analysed using content analysis method. In stage two, using Delphi method, the developed data set was revised and validated by 15 rheumatologists. Descriptive statistics using SPSS software was used to analyse the data in Delphi.Results:The final MDS included 22 data elements, which were divided into two major categories of management data (including demographic data, and admission and discharge) and clinical data (including patient examination, treatment plans, and medication prescribed by physician).Conclusion:Minimum data set is one of the standard data collection tools playing an important role in health care data management. This study presented a MDS as a platform for creating a rheumatoid arthritis registry system in Iran recommended by rheumatologists.

Processo de construção do Programa Nacional de Acesso à Água Potável em Terras Indígenas (PNATI)

Feco-oral diseases account for the largest number of notifications of morbidities recorded in the Indigenous Health Care Information System (SIASI), with diarrhea being the third cause of infant mortality, caused mainly by inadequate sanitation and hygiene conditions, which motivated the construction of the National Program for Access to Potable Water in Indigenous Lands (PNATI), which aims to universalize access to potable water in indigenous communities to provide water in adequate quantity and quality and contribute to improving the health of this population. The objective is to implement new water supply systems and repair existing ones, mobilizing government resources and strategic partners. The PNATI implementation methodology has actions planned for the next 20 years and intends, based on the improvement of the internal management of the Special Indigenous Sanitary Districts, to expand the control of water quality, carry out training on infrastructure management and the connection between water, sanitation and public health for system operators and the indigenous population. The program started in 2022 and is already showing the first results through training in some communities in the north of the country, promoting dialogue between indigenous peoples, health and sanitation professionals.

Multi-Level Hesitant Fuzzy Based Model for Usable-Security Assessment

Present day healthcare sector is frequently victimized by the intruders. 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, usable-security evaluation of healthcare information systems is the need of hour so as to identify the vulnerabilities and provide preventive measures as a shield against the breaches. Usable-security assessment will help the software designers and developers to prioritize usable-security attributes according to the customers’ needs and bridge the security gap. This study, in particular, evaluates the usable-security of Health Information Software Systems (HISS) in design tactics perspective by using Multi Criteria Decision Making (MCDM) problem solving techniques. Hesitant fuzzy based Analytical Hierarchy Process (AHP) and Technique for Order of Preference by Similarity to Ideal-Solutions (TOPSIS) methods have been applied to conduct the quantitative analysis of usable-security of software. Five attributes and 12 sub-attributes with 6 HISS alternatives of Indian hospitals have been considered in this work for usable-security assessment. To draw a priority list from the analysis, the results of the study show that the selected usable-security attributes attained the following ranking order: User-Error protection, Learnability, Data validation, Robustness, Revoke access, Intrusion detection, Authentication, Encryption, Limit access, Reliability, Efficiency, Audit trail respectively. Furthermore, HISS-1 alternative achieved the highest satisfaction degree followed by HISS-2 and HISS-4. HISS-6 got the lowest score in the context of providing ideal usable-security mechanism. The present research endeavour will be helpful for the software designers as the findings of the study will facilitate in developing secure and usable software products from the initial stages of the software development process itself.

The use of healthcare information systems: a research study about health professionals' needs

The use of healthcare information systems: a research study about health professionals' needs

Development of a Healthcare Information System for Community Care of Older Adults and Evaluation of Its Acceptance and Usability.

ObjectiveThe need for health and social care for community-dwelling elderly is on the rise as the population ages. Through the provision of comprehensive services by multiple professionals in local communities, elderly people can receive continual care in a non-medical setting, which is favorable for early detection and intervention of potential problems. However, the lack of digitalization in primary care affects the effectiveness of the services and precludes full exploitation of the data. This study proposed an information system dedicated to caring for community-dwelling elderly people and investigated its acceptance and usability.MethodsAn information system was designed for elderly care centers in the community, where data generated during care delivery, involving socio-demographic data, bio-measurements and health assessments and questionnaires, were digitized and stored for information management and exchange. A study was conducted to evaluate the acceptance and usability of the system after routine use of 6 months. The users of the system at an elderly care center were recruited to respond to a technology acceptance questionnaire and a system usability questionnaire.ResultsThe mean scores of the acceptance and usability questionnaires reached 5.1 out of the highest possible score of 7. The constructs of the acceptance questionnaire had good reliability. The social influence and facilitating conditions constructs had a significant correlation with the behavioral intention construct.ConclusionsThe proposed information system demonstrated good acceptance and usability, which supported the feasibility of implementing it in community care centers for older adults. Further research will be conducted to address the limitation of sample size by extending the system to other elderly care centers, forming a large user base for a more in-depth and comprehensive performance evaluation.

Using Healthcare Information Systems to analysis the Cancer Disease Development in Arab world

Cancer is the major public health problem in developing countries. According to the international Agency for Research on Cancer (IARC). The purpose of the study Coordination of activities within the Arab world and collaborative in cancer research among cancer research Institutes and healthcare organization based on the health information systems. Also, many approaches have been proposed for the some Arab countries to establish the health information systems and starting the cancer registry project in order to provide a good treatment for patients and how to develop effective cancer control programs, enhance cooperation in medical research. However, most of these researches did not address gaps in the decentralized and autonomous in healthcare organizational units. This study cover the recent review the relevant PubMed literature and cancer incidence data from various sources in the Arab world, and describes the health information systems precisely cancer registry project status. The objective from the current research was describes the cancer development in Arab world, the level of adoption the health information systems and Barriers to adapt in Arab world. The analysis of the collected data shows there is cancer incidence in Arab countries is increasing. It has been found that there is a need to adapt the health information system cancer control and prevention, planning strategy among healthcare organizations and research institutes. Is an essential step in facilitating this process, because it can improve cancer registries, create robust infrastructure, improve skills of personnel and lead to effective cancer control and prevention. © 2018 JASET, International Scholars and Researchers Association

Electronic Health Record Implementations and Insufficient Training Endanger Nurses' Well-being: Cross-sectional Survey Study.

BackgroundHigh expectations have been set for the implementations of health information systems (HIS) in health care. However, nurses have been dissatisfied after implementations of HIS. In particular, poorly functioning electronic health records (EHRs) have been found to induce stress and cognitive workload. Moreover, the need to learn new systems may require considerable effort from nurses. Thus, EHR implementations may have an effect on the well-being of nurses.ObjectiveThis study aimed to examine the associations of EHR-to-EHR implementations and the sufficiency of related training with perceived stress related to information systems (SRIS), time pressure, and cognitive failures among registered nurses. Moreover, we examined the moderating effect of the employment sector (hospital, primary care, social services, and others) on these associations.MethodsThis study was a cross-sectional survey study of 3610 registered Finnish nurses in 2020. EHR implementation was measured by assessing whether the work unit of each respondent had implemented or will implement a new EHR (1) within the last 6 months, (2) within the last 12 months, (3) in the next 12 months, and (4) at no point within the last 12 months or in the forthcoming 12 months. The associations were examined using analyses of covariance adjusted for age, gender, and employment sector.ResultsThe highest levels of SRIS (adjusted mean 4.07, SE 0.05) and time pressure (adjusted mean 4.55, SE 0.06) were observed among those who had experienced an EHR implementation within the last 6 months. The lowest levels of SRIS (adjusted mean 3.26, SE 0.04), time pressure (adjusted mean 4.41, SE 0.05), and cognitive failures (adjusted mean 1.84, SE 0.02) were observed among those who did not experience any completed or forthcoming implementations within 12 months. Nurses who perceived that they had received sufficient implementation-related training experienced less SRIS (F1=153.40, P<.001), time pressure (F1=80.95, P<.001), and cognitive failures (F1=34.96, P<.001) than those who had received insufficient training. Recent implementations and insufficient training were especially strongly associated with high levels of SRIS in hospitals.ConclusionsEHR implementations and insufficient training related to these implementations may endanger the well-being of nurses and even lead to errors. Thus, it is extremely important for organizations to offer comprehensive training before, during, and after implementations. Moreover, easy-to-use systems that allow transition periods, a re-engineering approach, and user involvement may be beneficial to nurses in the implementation process. Training and other improvements would be especially important in hospitals.

Healthcare Information System using DEMATEL Method

In India, the most popular agricultural products include wheat, barley, fruits, vegetables, and fodder. Socioeconomic sustainability in agriculture is dependent on the weather. A farmer can make more money at a reduced cost by increasing productivity through wise crop selection. Based on available natural resources and cost Sort out crop alternatives, Promote sustainable agricultural practices and Identify the best suitable crop a multi-criteria decision-making model (MCDM) can be used. The most crucial factors are taken into consideration to determine if agricultural activities are sustainable. This study comprised four sustainability-related criteria. Using MCDM for sustainable agricultural practices in India The research focuses on developing the model. The most suited crop was determined using MCDM approaches, then Soybean, Apple, Rice, Corn, and Cucumber. And fruits emerged as a high-yielding crop. Such a system also applies to other areas, and for sustainable agricultural practices can be further extended to various crops. Water to develop an appropriate agricultural policy in India, The Ministry of Environment and Agriculture is anticipating assistance from the study. Corn is first place in wind-solar hybrid farm and the last rank is cucumber.

Medical treatment process modeling based on process mining and treatment patterns

Clinical practice guidelines (CPGs) are statements relating to evidence-based and economically reasonable medical treatment processes (MTPs) for certain clinical circumstances. The executable MTPs in healthcare information systems can assist the clinical processes. In our previous work, several treatment patterns and their modeling proposals were proposed to reduce the effort spent in modeling MTPs. However, given a CPG document, all the process elements are modeled manually. Besides, business process mining can extract MTP models automatically from execution logs. However, the existing process mining algorithms focus on the control-flow of structured processes. This paper proposes an integrated framework for modeling executable MTPs based on process mining and treatment patterns, taking both the efficiency of mining and the quality of modeling into account. In this framework, an execution log processing approach is presented to identify the subsequences and decision points conforming to the treatment patterns and represent them with abstract activities. Experiments on a synthetic log of the non-secondary hypertension MTP and empirical findings demonstrate the effectiveness of our approach. The results show that the process mining in our approach framework can automatically generate more accurate MTP models, and the subprocess models based on treatment patterns make the models easy to understand.

Information System Implementation in Healthcare: Case Study of Croatia

Abstract Background: In today’s environment, health professionals are overwhelmed by the rapid pace of advancement in both information technology and medical practice. Objectives: This paper aims to point out the importance of developing an electronic health record system that will meet the needs of all stakeholders in healthcare, support health professionals’ work, and enable continuous quality improvement at all levels and in all healthcare segments. Methods/Approach: Non-systematic literature review has been used to develop a discussion on the healthcare systems’ usage. Results: Close cooperation of participants at all levels is essential for the quality implementation and application of digital solutions in healthcare. Conclusions: The paper highlights the factors that contribute to the acceptance of the public healthcare information system in the Republic of Croatia, which is being developed according to the EU regulations.

Health Professionals' Perspectives on Electronic Medical Record Infusion and Individual Performance: Model Development and Questionnaire Survey Study.

BackgroundElectronic medical records (EMRs) are integrated information sources generated by health care professionals (HCPs) from various health care information systems. EMRs play crucial roles in improving the quality of care and medical decision-making and in facilitating cross-hospital health information exchange. Although many hospitals have invested considerable resources and efforts to develop EMRs for several years, the factors affecting the long-term success of EMRs, particularly in the EMR infusion stage, remain unclear.ObjectiveThe aim of this study was to investigate the effects of technology, user, and task characteristics on EMR infusion to determine the factors that largely affect EMR infusion. In addition, we examined the effect of EMR infusion on individual HCP performance.MethodsA questionnaire survey was used to collect data from HCPs with >6 months experience in using EMRs in a Taiwanese teaching hospital. A total of 316 questionnaires were distributed and 211 complete copies were returned, yielding a valid response rate of 66.8%. The collected data were further analyzed using WarpPLS 5.0.ResultsEMR infusion (R2=0.771) was mainly affected by user habits (β=.411), portability (β=.217), personal innovativeness (β=.198), technostress (β=.169), and time criticality (β=.168), and individual performance (R2=0.541) was affected by EMR infusion (β=.735). This finding indicated that user (habit, personal innovativeness, and technostress), technology (portability), and task (mobility and time criticality) characteristics have major effects on EMR infusion. Furthermore, the results indicated that EMR infusion positively affects individual performance.ConclusionsThe factors identified in this study can extend information systems infusion theory and provide useful insights for the further improvement of EMR development in hospitals and by the government, specifically in its infusion stage. In addition, the developed instrument can be used as an assessment tool to identify the key factors for EMR infusion, and to evaluate the extent of EMR infusion and the individual performance of hospitals that have implemented EMR systems. Moreover, the results can help governments to understand the urgent needs of hospitals in implementing EMR systems, provide sufficient resources and support to improve the incentives of EMR development, and develop adequate EMR policies for the meaningful use of electronic health records among hospitals and clinics.

Smart healthcare IoT applications based on fog computing: architecture, applications and challenges

The history of human development has proven that medical and healthcare applications for humanity always are the main driving force behind the development of science and technology. The advent of Cloud technology for the first time allows providing systems infrastructure as a service, platform as a service and software as a service. Cloud technology has dominated healthcare information systems for decades now. However, one limitation of cloud-based applications is the high service response time. In some emergency scenarios, the control and monitoring of patient status, decision-making with related resources are limited such as hospital, ambulance, doctor, medical conditions in seconds and has a direct impact on the life of patients. To solve these challenges, optimal computing technologies have been proposed such as cloud computing, edge computing, and fog computing technologies. In this article, we make a comparison between computing technologies. Then, we present a common architectural framework based on fog computing for Internet of Health Things (Fog-IoHT) applications. Besides, we also indicate possible applications and challenges in integrating fog computing into IoT Healthcare applications. The analysis results indicated that there is huge potential for IoHT applications based on fog computing. We hope, this study will be an important guide for the future development of fog-based Healthcare IoT applications.

Healthcare information system use under techno-uncertainty: evidence from long-term care

Dans des contextes dynamiques, dans lesquels les méthodes de travail et les systèmes d’information (SI) sont constamment en décalage, l’étude des aspects psychologiques de l’utilisation des SI est de plus en plus pertinente. Cet article étudie les impacts de la techno-incertitude, l’un des principaux facteurs de technostress, sur l’utilisation des Systèmes d’Information de santé. Le modèle exploratoire de médiations en série proposé concernant l’impact de la techno-incertitude sur l’utilisation des systèmes d’information de santé suggère que les effets se développent via la perception d’utilité et l’utilisation exploitante. Les tests de médiation auprès de 301 soignants confortent ces prédictions. Afin d’aider les institutions de santé dans l’amélioration de l’utilisation des systèmes d’information de santé, cette étude ouvre la boîte noire des mécanismes par lesquels la techno-incertitude détermine l’utilisation exploratoire des systèmes d’information de santé, prenant en compte le rôle de l’expérience dans l’évaluation des caractéristiques du système. L’article souligne également les potentiels effets positifs du technostress, indiquant la nécessité d’étudier les techno-stressors de manière distincte, dans des contextes spécifiques.

Security Engineering of Patient-Centered Health Care Information Systems in Peer-to-Peer Environments: Systematic Review.

BackgroundPatient-centered health care information systems (PHSs) enable patients to take control and become knowledgeable about their own health, preferably in a secure environment. Current and emerging PHSs use either a centralized database, peer-to-peer (P2P) technology, or distributed ledger technology for PHS deployment. The evolving COVID-19 decentralized Bluetooth-based tracing systems are examples of disease-centric P2P PHSs. Although using P2P technology for the provision of PHSs can be flexible, scalable, resilient to a single point of failure, and inexpensive for patients, the use of health information on P2P networks poses major security issues as users must manage information security largely by themselves.ObjectiveThis study aims to identify the inherent security issues for PHS deployment in P2P networks and how they can be overcome. In addition, this study reviews different P2P architectures and proposes a suitable architecture for P2P PHS deployment.MethodsA systematic literature review was conducted following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) reporting guidelines. Thematic analysis was used for data analysis. We searched the following databases: IEEE Digital Library, PubMed, Science Direct, ACM Digital Library, Scopus, and Semantic Scholar. The search was conducted on articles published between 2008 and 2020. The Common Vulnerability Scoring System was used as a guide for rating security issues.ResultsOur findings are consolidated into 8 key security issues associated with PHS implementation and deployment on P2P networks and 7 factors promoting them. Moreover, we propose a suitable architecture for P2P PHSs and guidelines for the provision of PHSs while maintaining information security.ConclusionsDespite the clear advantages of P2P PHSs, the absence of centralized controls and inconsistent views of the network on some P2P systems have profound adverse impacts in terms of security. The security issues identified in this study need to be addressed to increase patients’ intention to use PHSs on P2P networks by making them safe to use.

Blockchain-Based Healthcare Information Preservation Using Extended Chaotic Maps for HIPAA Privacy/Security Regulations

A healthcare information system allows patients and other users to remotely login to medical services to access health data through the Internet. To protect the privacy of patients and security over the public network, secure communication is required. Therefore, the security of data in transmission has been attracting increasing attention. In recent years, blockchain technology has also attracted more attention. Relevant research has been published at a high rate. Most methods of satisfying relevant security-related regulations use modular and exponential calculation. This study proposes a medical care information preservation mechanism that considers the entire process of data storage in devices from wearable devices to mobile devices to medical center servers. The entire process is protected and complies with HIPAA privacy and security regulations. The proposed scheme uses extended chaotic map technology to develop ID-based key negotiation for wearable devices, and thereby reduces the amount of computing that must be carried out by wearable devices and achieve lightness quantify. It also uses the non-tamperability of the blockchain to ensure that the data have not been tampered with, improving data security. The proposed mechanism can resist a variety of attacks and is computationally lighter than the elliptic curve point multiplication that has been used elsewhere, while retaining its security characteristics.