Use Of Personal Health Research Articles

Anticipating multisectoral use of services with the support of AI

Introduction: This paper presents the preliminary results of a collaborative R&D project which aims at developing artificial intelligence (AI) supported anticipation of multisectoral use of services. If we were able to predict the escalation of health and social problems of clients and the use of several different services, we could plan and offer them early preventive services with the objective of improving the quality of life and reducing the costs of service provision in the longer term.
 Approach and methods: The multidisciplinary project in progress collaborates at four spheres of research and development within the elderly care of one welfare region in Finland.
 1) Anticipatory management practices concerning risk client groups and anticipatory case management practices concerning individual clients in risk are being developed supported by predictive AI technology. The requirements concerning the information the AI based prediction model should produce to the managers and to the case managers have provisionally been defined. The current practices are co-studied, and the new practices supported by AI are co-designed by involving the “relevant” health and social care managers and practitioners in the welfare region.
 2) A machine learning (ML) predictive model based on health and social care data is being developed. The prediction model will be developed based on retrospective analysis of health and social data of the welfare region. The available data includes clinical data recorded during healthcare encounters, decisions, and usage of social services as well as physical function assessments. The data is used to train and test potential machine learning algorithms for predicting future service use of the elderly individuals based on their current health status and past use of services.
 3) The implementation of the AI/ML model within the IT infrastructure and information systems (IS) in use will be supported and investigated. The developed ML model would eventually be integrated into the IT/IS environment of the case organization. That entails connecting the specific data sources, running the model computations, and passing the results to the digital workflow of the care production management for knowledge management.
 
 4) The EU and Finnish legislation that regulate the use of personal health and social data in the development and use of AI based predictive models is being analyzed. Requirements and potential limitations imposed by current legislation on the use of predictive models are identified. In particular, the strict conditions applicable to making automated risk assessments of individuals for purposes of taking anticipatory measures are analyzed and avenues for meeting them by health and social care organizations are discussed.
 Results and outputs: Working on these four spheres, the project produces a generic model on developing the anticipation practices of multisectoral use of services with the help of AI technology. The model will available to all the organizations which are developing AI based anticipation of multisectoral use of services.
 Key words: Anticipation, prediction, health and social services usage, machine learning model, AI software, legislation, elderly care

Personal Protective Equipment Compliance in Midwifery Services in Eastern Indonesia

At the begining of pademic, Indonesiam goverment suggested that midwifery services be carried by using appropriate personal protective equipment according to the guidelines to avoid cross-infection between health worker to mother and child. The purposes of this strudy is to determine the midwife's compliance in following the use of PPE when administering mother and child health services during COVID 19 pandemic. This survey was conducted at the begining of pandemi COVID-19, 403 registered midwives participated by filled an online survey with Google form application for data collection. Variable of this research are midwife compliance of using PPE in midwifery services. The data were analyzed using the statistical test used was Pearson's chi-square. Results showed that 89.8% of midwives were not following the health protocol, as 49.8% offered inadequate PPE in the workplace and the price of PPE was very high during the pandemic. Conclusions: Midwives were unable to comply with the use of personal health and safety equipment (PPE) in services. Age and duration of work had factor had a significant impact on whether or not midwives were able to use PPE appropriately.

The Use of a Technology Acceptance Model (TAM) to Predict Patients' Usage of a Personal Health Record System: The Role of Security, Privacy, and Usability.

Personal health records (PHR) systems are designed to ensure that individuals have access and control over their health information and to support them in being active participants rather than passive ones in their healthcare process. Yet, PHR systems have not yet been widely adopted or used by consumers despite their benefits. For these advantages to be realized, adoption of the system is necessary. In this study, we examined how self-determination of health management influences individuals' intention to implement a PHR system, i.e., their ability to actively manage their health. Using an extended technology acceptance model (TAM), the researchers developed and empirically tested a model explaining public adoption of PHRs. In total, 389 Saudi Arabian respondents were surveyed in a quantitative cross-sectional design. The hypotheses were analysed using structural equation modelling-partial least squares (SEM-PLS4). Results indicate that PHR system usage was influenced by three major factors: perceived ease of use (PEOU), perceived usefulness (PU), and security towards intention to use. PHR PEOU and PHR intention to use were also found to be moderated by privacy, whereas usability positively moderated PHR PEOU and PHR intention to use and negatively moderated PHR PU and PHR intention to use. For the first time, this study examined the use of personal health records in Saudi Arabia, including the extension of the TAM model as well as development of a context-driven model that examines the relationship between privacy, security, usability, and the use of PHRs. Furthermore, this study fills a gap in the literature regarding the moderating effects of privacy influence on PEOU and intention to use. Further, the moderating effects of usability on the relationship between PEOU, PU, and intention to use. Study findings are expected to assist government agencies, health policymakers, and health organizations around the world, including Saudi Arabia, in understanding the adoption of personal health records.

Use of Medical Information and Digital Services for Self-Empowerment before, during, and after a Major Disaster.

Disaster response procedures have been developed and improved following the Great East Japan Earthquake. Innovative services have also been created through digital transformation, including an acceleration and deepening of artificial intelligence technology. Things that were once technically impossible are now possible. These innovative technologies will spread across various fields, and disaster response will not be an exception. The Ministry of Health, Labour and Welfare is promoting the use of personal health records in a way that effectively supports the management of treatments by using data from wearable devices and specific applications. During the COVID-19 pandemic, the trade-off between protecting personal information and enabling social benefits, such as in the use of digital tracking, and infodemics, including misinformation, have become new social challenges. Reviewing past disaster preparedness and the services and value provided by digital transformation indicates what new disaster preparedness should be. Digital transformation does not require literacy (ability to collect, analyze, and use information) but competence (beneficial behavioral traits derived from experience). Understanding behavior through data and enabling rational behavior are crucial. By increasing human productivity, we can save time and improve self- and mutual-help in times of disaster. Medical information and digital services must be properly used in normal times. A society that uses such services will be more disaster resilient.

Obstacles to continued use of personal health records

ABSTRACT The purpose of this paper was to examine organisational change in a hospital setting. Specifically, the paper examines how patients responded to the introduction of personal health records (PHR). This research was an empirical investigation based on surveys completed by 136 patients in the United States. The paper draws on Lewin’s Force Field Analysis Model to explain patient responses to new PHR technology. The results indicate that affective and cognitive resistance factors exist, but the presence of change information can mitigate the resistance. While both resistance factors were relevant, the study found that reducing cognitive resistance had a stronger influence than reducing affective resistance. This research will contribute to the health care literature by offering insight into the factors associated with resistance and the continued use of PHR systems. The research also contributes to the individual IT literature by examining attitudes and beliefs that lead to continued use of IT systems.

Potential Use of Personal Health Records in Managing Hypertension: A Systematic Review

Hypertension is a major problem in both developed and developing countries. In 2015, worldwide cases of hypertension reached 1.13 billion people, and in 2025, it is expected to increase to 1.5 billion people. Every year, 9.4 million people die from hypertension and complications, but hypertension could be prevented by risk control. This literature study aims to assess the potential use of personal health records to manage hypertension. The method used in this research was the systematic literature review following the PRISMA protocol. Scientific articles were obtained from five electronic databases, namely PubMed, JSTOR, EBSCOhost, ProQuest, and Google Scholar, with publication dates between 2009 and 2019. Initially, we obtained 103 articles, but after screening there were only four articles that met the requirements for this study. The articles, which come from the USA, Canada and France, show the potential use of PHRs to manage hypertension because of their ability to keep a record of complete health data. There was a decrease of 5.25 diastolic BP points from 25.7% of active users. Based on this data, the tool can assess user level of hypertension risk. A further benefit of the PHR as a mobile application tool is the potential to increase awareness of and encouragement to engage in healthy behaviors so the risk of hypertension can be managed. The PHR is a tool to monitor physical exercise, diet, weight and the extent to which hypertension has been controlled based on blood pressure readings, examination results and related laboratory results.

Shadow-Chain: A Decentralized Storage System for Log Data

Better use of personal health and clinical data from different stakeholders is essential and highly significant. However, the sharing of such data could easily raise concerns over preserving personal privacy, particularly when the risk of disclosure is uncertain. To tackle this issue, shadow- chain, a decentralized storage system for log data based on blockchain, is proposed for realizing data sharing between parties that do not trust each other. In the system, a behavior monitor is designed to intercept the data reading activities. Through an asynchronous read-write mechanism, the monitor can minimize operational impact on the source's storage system. Meanwhile, the homomorphic encryption scheme and the distributed log collection system are adopted to guarantee the validity and reliability of the log data. Furthermore, the hybrid storage strategy is developed to reduce the storage overhead of the log data. In the strategy, only the hash of log data is stored in the blockchain of the shadow-chain, while the data itself and the associated index information are placed in common storage media. Experiments have been conducted to estimate the performance of our shadow-chain. The results show that the impact of shadow-chain on the source storage system can be controlled within 5 percent, and 75 percent log storage overhead can be reduced through hybrid storage strategy.

A Prospective Analysis of Health Information Portals in Four Years.

Objectives: We examined 17 health information portals to determine the status of web-based health information services in the United States (USA), South Korea, the United Kingdom (UK), and Australia. Methods: We analyzed longitudinal trends in 35 items of online health information over four years among representative health information portals (eight based in the USA, seven in South Korea, one in the UK, and one in Australia), focusing on external portal structure, content scope, service characteristic, and service function with four stakeholder groups of six stakeholders. Results: The most notable change was in the service items, and overall, in 44.1% of total items: 17.6% in service characteristic, 41.2% in external portal structure, 58.8% in service function, and 58.8% in content scope change. More specifically, these changes included increases in the “mobile application utility” (service function), “use of personal health records” on public health portals (content scope change), “Charts and videos” (service characteristic), and “renewal date” (external portal structure). Conclusions: This review of existing health portals will be a footnote for enabling health care providers to confirm whether the needs of consumers are reflected on their website with high reliability. Furthermore, these findings will help to enhance the quality of portals by delivering relevant information to stakeholders and to the consumers of online health information.

Expectations to data: Perspectives of service providers and users of future health and wellness services

The healthcare and wellness sector currently attempts to provide more proactive service models with data-driven solutions. This study examines the expectations and values related to personal data i.e. data valences from the perspective of service providers and individual users. The study is based on the analysis of extensive empirical material collected through interviews and a collaborative workshop. The data was collected in one cultural context, Finland. The results suggest that the potential service providers and users have similar expectations regarding self-evidence of data while the main differences concern the expectations of transparency. The results of the study propose some basic requirements for the development of personalised data-driven services in future. The study suggests that basic requirements for the development of future data driven services concern expectations to usable data visualisations, data as a motivator, data accuracy and data transparency. Even though there are varying expectations to personal health data and even some concerns, it can be seen that here different ecosystem actors primarily perceived the wider use of personal health and wellness data as a positive trend. It can be concluded that collaborative personal data-driven service ecosystems are an integral part of development towards proactive service models in healthcare.

Egyptian patients’ perceptions of using personal health records (PHRs): an exploratory study

PurposeThis paper aims to investigate the perception of Egyptian patients about the use of personal health records (PHRs).Design/methodology/approachA quantitative research methodology was adopted in the form of a survey.FindingsOver one-third of the selected sample was found to use PHRs. The study found that the use of PHRs by Egyptian patients was moderate. All PHRs users confirmed that they were very interested in the doctors’ notes and the laboratory reports recorded in their records. A very large number of PHR users confirmed that their use of these records was at least fairly easy for them and all of them confirmed that the use of these records was at least fairly useful. Above two-third of PHR users answered at least “somewhat yes” that their PHRs were accurate and over half of them answered at least “somewhat yes” that their PHRs were complete. The highest percentage of PHR users agreed that the use of PHRs would enhance their trust in their doctors and nurses. Close to half of PHR users expressed some concern about sharing their records. Violation of privacy in the use of these medical records, followed by the complexity of using them, as well as lack of awareness about them, was also significant to PHR users.Originality/valueUnderstanding Egyptian patients perceptions of using PHRs may significantly aid in eliminating barriers and accelerating the adoption and use of these records to improve patient care.

Effects of presentation formats on consumers’ performance and perceptions in the use of personal health records among older and young adults

ObjectiveTo examine the effects of presentation formats on consumers’ performance and perceptions in the use of personal health records (PHRs) and to compare the effects between older and young adults. MethodsA two-factor, mixed design experiment was conducted, where 36 older and 36 young participants were presented with hypothetical PHRs. The PHRs were randomly presented by six presentation formats: three tables and three line graphs, varying by visual cues. Participants’ performance and perceptions in the use of PHRs were measured. ResultsPresentation formats affected participants’ performance and perceptions. Visual cue-enhanced line graphs and tables yielded less time and fewer errors, were considered easier and more useful in information comprehension, and resulted in higher confidence in correct comprehension of PHRs (all p's < 0.01), compared with their basic counterparts. There were age-related differences in task performance (all p's < 0.05), while young and older adults had similar perceptions for the six formats. Line graph with colored background was most preferred by both groups. ConclusionVisual cue-enhanced presentation formats appear effective in facilitating comprehension and eliciting favorable perceptions of PHRs for both young and older adults. Practice implicationsConsumer-facing displays of PHRs could use visual cue-enhanced presentation formats to facilitate comprehension.

Using Electronic Health Records to Enhance a Peer Health Navigator Intervention: A Randomized Pilot Test for Individuals with Serious Mental Illness and Housing Instability.

Individuals with serious mental illnesses have high rates of comorbid physical health issues and have numerous barriers to addressing their health and health care needs. The present pilot study tested the feasibility of a modified form of the "Bridge" peer-health navigator intervention delivered in a usual care setting by agency personnel. The modifications concerned the use of an electronic personal health record with individuals experiencing with housing instability. Twenty participants were randomized to receive the intervention immediately or after 6 months. Health navigator contacts and use of personal health records were associated with improvements in health care and self-management. This pilot study demonstrated promising evidence for the feasibility of adding personal health record use to a peer-led intervention.

Characteristics of personal health information management groups: findings from an online survey using Amazon's mTurk.

Objective:The study characterized three groups with different levels of familiarity with personal health information management (PHIM) in terms of their demographics, health knowledge, technological competency, and information sources and barriers. In addition, the authors examined differences among PHIM groups in subjective self-ratings and objective test scores for health literacy.Methods:A total of 202 survey participants were recruited using Amazon’s Mechanical Turk (mTurk) service, a crowdsourcing Internet service. Using K-means clustering, three groups with differing levels of familiarity with PHIM were formed: Advanced, Intermediate, and Basic.Results:The Advanced group was the youngest, and the Basic group contained the highest proportion of males, whereas the Intermediate group was the oldest and contained the fewest males. The Advanced group was significantly more likely to engage in provider- or hospital-initiated PHIM activities such as emailing with providers, viewing test results online, and receiving summaries of hospital visits via email or websites than the other groups. The Basic group had significantly lower information management skills and Internet use than the other groups. Advanced and Basic groups reported significant differences in several information barriers. While the Advanced group self-reported the highest general literacy, they scored lowest on an objective health literacy test.Conclusions:For effective personal health records management, it is critical to understand individual differences in PHIM using a comprehensive measure designed to assess personal health records–specific activities. Because they are trained to perform an array of information management activities, medical librarians or patient educators are well positioned to promote the effective use of personal health records by health consumers.

Barriers to the use of personal health records by patients: a structured review.

IntroductionAn increasing focus on personal electronic health records (PHRs) offers healthcare benefits for patients, particularly those in undeserved and marginalised populations, who are at risk of receiving less effective healthcare, and may have worse health outcomes. However, PHRs are likely to favour text, technical and health literate users, and be less suitable for disadvantaged patients. These concerns have prompted this review of the literature, which seeks evidence about barriers to the adoption and continued use of PHRs, the nature of the evidence for those barriers, and the stage of PHR implementation where particular barriers apply.MethodsSearches in PubMed, Embase, CINAHL and ProQuest databases were used to retrieve articles published in English after 2003 in a refereed journal, or presented in a refereed conference or scientific meeting. After screening to remove items which were out of scope, the phase of the PHR implementation, the type of investigation, and PHR barriers were categorised using thematic coding.ResultsThe search retrieved 395 items; screening identified 34 in-scope publications, which provided evidence of 21 identified barriers to patient adoption and continued use of PHRs, categorised here as Individual, Demographic, Capability, Health-related, PHR or Attitudinal factors. Barriers were identified in most phases of PHR implementation, and in most types of study. A secondary outcome identified that eleven of the publications may have introduced a bias by excluding participants who were less affluent, less capable, or marginalised.ConclusionsPHR barriers can interfere with the decision to start using a PHR, with the adoption process, and with continued use, and the impact of particular barriers may vary at different phases of PHR adoption. The complex interrelationships which exist between many of the barriers is suggested in some publications, and emerges more clearly from this review. Many PHR barriers appear to be related to low socioeconomic status. A better understanding is needed of how the effect of barriers is manifested, how that effect can be countered, and how planning and implementation of PHR initiatives can make allowance for patient level barriers to PHR adoption and use, with appropriate actions to mitigate the effect of those barriers for more disadvantaged patients.

Young adults on the perceived benefits and expected use of personal health records: a qualitative descriptive study

BackgroundPersonal health records (PHRs) are tools that allow individuals to access, share and manage their health information online. Despite apparent interest, adoption rates remain low. There is a gap in...

A Qualitative Study of How Patients with Type 2 Diabetes Use an Electronic Stand-Alone Personal Health Record

Patient use of personal health records (PHRs) to manage their health information has been proposed to enhance patient knowledge and empower patients to make changes in their self-care behaviors. However, there remains a gap in understanding about patients' actual PHR use behaviors. The purpose of this qualitative study was to explore how patients with type 2 diabetes used a PHR to manage their diabetes-related health information for self-care. Fifty-nine patients with type 2 diabetes were interviewed 3-6 months after receiving initial training on a free-of-charge, Web-based PHR. Interviews were audio-recorded, transcribed, and analyzed using an iterative process of in vivo coding, categorization, and theme development. Nine themes emerged, three of which expressed positive experiences: complete and accessible record; increased awareness; and behavioral changes. The remaining six themes expressed negative experiences: out of sight, out of mind; I would have used it if I were sicker; economic, infrastructure, and computer literacy barriers; lack of patient-provider engagement; double tracking; and privacy and security concerns. Despite some potential positive benefits resulting from PHR use, several barriers inhibited sustained and effective use over time. Provider and patient education about the benefits of PHR use and about the potential for filling in information gaps in the provider-based record is key to engage patients and stimulate PHR adoption and use.

Developing a framework for meaningful use of personal health records (PHRs)

Significant advancements have been made in the technological development of the personal health record (PHR). The goal of the PHR is to encourage patients and health consumers to take individual responsibility for their health by being more engaged in the health care process through the use of the PHR. Many PHR applications are extensions of the electronic health record (EHR) and have limited patient input in their design. As more patients and health consumers use PHRs, there is an increasing need to understand the ways in which patients or health consumers use them. The major objective of this paper is to introduce a framework for understanding meaningful use of PHRs and to discuss the associated challenges that may impede meaningful use. The primary challenges that may hinder meaningful use of PHRs relate to health system challenges such as health care regulatory and managerial policies and multiple institutional, societal, cultural, and economic issues. Additional challenges, such as technology, design, usability, and implementation, still exist that relate to socio-technical issues.

Role of nurse practitioners in encouraging use of personal health records.

With increased mobility, it is important that individuals keep their own personal health records (PHRs). Nurse practitioners are encouraged to assume greater responsibility for PHR adoption and recognize the key role they play in recommending PHR use. This article also briefly discusses college students' perceptions of their exposure to online PHRs.

Implementing the lifelong personal health record in a regionalised health information system: The case of Lombardy, Italy

BackgroundThe use of personal health records (PHRs) can help people make better health decisions and improves the quality of care by allowing access to and use of the information needed to communicate effectively with others concerning their health care. ObjectiveThis work presents the lifelong PHR system of the Lombardy region as an example of the implementation of an e-health solution that is capable of providing personal clinical documents from a lifelong perspective, integrating different healthcare providers over a large territory. MethodsThe lifelong PHR is embedded in the regional healthcare information system of Lombardy, which is characterised by a large and heterogeneous territory, a large number of different healthcare providers and organisations, and a significant population. ResultsThe lifelong PHR makes clinical documents available to healthcare professionals and citizens when needed, and it is automatically updated with all of the documents regarding a clinical event regardless of which healthcare provider is currently taking care of the patient. Present statistics show that the lifelong PHR has experienced a wide diffusion in a short period of time, and at the end of 2010, it was active for more than five million Lombardy citizens. Digital reports and e-prescription transactions have almost doubled since 2007 and have reached a coverage of almost 100%. ConclusionsThe qualified and exhaustive collection of patient clinical data and documents should impact daily medical practice, as well as the care pathways and services provided to patients, and should help in the renewal of health assistance and the simplification of patients' access to care.

Genetic Counselors’ Current Use of Personal Health Records‐Based Family Histories in Genetic Clinics and Considerations for Their Future Adoption

Given the widespread adoption of electronic medical records and recent emergence of electronic family history tools, we examined genetic counselors' perspectives on the emerging technology of the personal health record (PHR)-based family history tool that links to an electronic medical record (EMR). Two-hundred thirty-three genetic counselors responded to an on-line survey eliciting current use of electronic family history (EFH) tools and familiarity with PHR-based family history tools. Additionally, after being shown a series of screen shots of a newly developed PHR-based family history tool based on the U.S. Surgeon General's My Family Health Portrait (United States Department of Health and Human Services 2009), participants were surveyed about the perceived usefulness, ease of use, and impact on current workflow that this kind of tool would have in their practices. Eighty-three percent reported that their institution has an EMR, yet only 35% have a dedicated space for family history. Eighty-two percent reported that less than 5% of their patients have a PHR, and only 16% have worked with patients who have a PHR. Seventy-two percent or more agreed that a PHR-based family history tool would facilitate communication, increase accuracy of information, ensure consistency in recording information, increase focus on actual counseling, reduce repetitive questions, improve efficiency, and increase the legibility and clarity. Our findings suggest that participants were familiar with existing EFH tools, but that the majority did not use them in practice. Genetic counselors' adoption of such tools is limited due to non-existence of this kind of technology or inability to integrate it into their clinics. They are also strongly in favor of adopting a PHR-based family history tool in genetics clinics, but have practical concerns that must be addressed before the tool can be implemented.