Feasibility of extracting data from electronic medical records for research: an international comparative study (original) (raw)
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Neuromethods, 2012
Electronic health records (EHRs) are the collection of all digitalized information regarding individual's health. EHRs are not only the base for storing clinical information for archival purposes, but they are also the bedrock on which clinical research and data science thrive. In this chapter, we describe the main aspects of good quality EHR systems, and some of the standard practices in their implementation, to then conclude with details and reflections on their governance and private management.
BMC Medical Informatics and Decision Making
Immediate access to patients' complete health records via electronic databases could improve healthcare and facilitate health research. However, the possible benefits of a national electronic health records (EHR) system must be balanced against public concerns about data security and personal privacy. Successful development of EHR requires better understanding of the views of the public and those most affected by EHR: users of the National Health Service. This study aims to explore the correlation between personal healthcare experience (including number of healthcare contacts and number and type of longer term conditions) and views relating to development of EHR for healthcare, health services planning and policy and health research. A multi-site cross-sectional self-complete questionnaire designed and piloted for use in waiting rooms was administered to patients from randomly selected outpatients' clinics at a university teaching hospital (431 beds) and general practice sur...
A Review of Electronic Health Records Systems Around the World
2015
Electronic Medical Records (EMR) are digitised versions of the paper charts in clinician offices, clinics and hospitals. The information in an EMR is usually stored locally at a practice or a hospital, and it contains the medical and treatment history of a patient. [1] [2] [3] Electronic Health Records (EHR) focus on the total health of a patient, and are designed to reach out beyond the health organisation. The EHR systematically collate and store digitised data on patients from the different healthcare and medical organisations and providers. They also enable the secure electronic sharing of these data between the different healthcare settings, and in some instances, the patient. The information, which includes the EMR, moves with the patient between different healthcare settings, providing a more holistic view of the state of a patient across time. The EHR can also provide information on population health by aggregating relevant data (permissions providing). Sometimes EHR is also...
Problems Encountered in Electronic Health Record Research
2000
This paper draws upon experience gained while conducting research into Electronic Health Records in the Durham and Darlington Electronic Health Record Project (DuDEHR) of the Electronic Records Development and Implementation Project (ERDIP) set up by the NHS Information Authority (NHSIA) in the U.K., and follow-up work for the Strategic Health Authority of County Durham and Tees Valley (CDTVSHA) in preparation for the Integrated Care Record Service (ICRS) of the National Programme for Information Technology (NPfit). As a starting point this paper gives a description of the Electronic Health Record environment in the context of the developments above seen from the perspective of a social researcher. The focusing being upon the need for a greater understanding of the organisational and interpersonal complexity of health and social care organisations and their operating environments in the development and implementation of EHR 'solutions'. This paper then suggests that there are at least five fundamental and interrelated problems hindering quality Electronic Health Records research data: 1. The Problem of Fitness for Purpose; 2. The Problem of Modelling; 3. The Problem of Previous Research Strategies; 4 The problem of gatekeepers; 5. The Practical Problem of Data Representation. The discussion suggests the possible need for a compromise solution in this research area.
Electronic health records (EHRs) have emerged among health information technology as Bmeaningful use^ to improve the quality and efficiency of healthcare, and health disparities in population health. In other instances, they have also shown lack of interoperability, functionality and many medical errors. With proper implementation and training, are electronic health records a viable source in managing population health? The primary objective of this systematic review is to assess the relationship of electronic health records' use on population health through the identification and analysis of facilitators and barriers to its adoption for this purpose. Authors searched Cumulative Index of Nursing and Allied Health Literature (CINAHL) and MEDLINE (PubMed), 10/02/2012-10/02/2017, core clinical/academic journals, MEDLINE full text, English only, human species and evaluated the articles that were germane to our research objective. Each article was analyzed by multiple reviewers. Group members recognized common facilitators and barriers associated with EHRs effect on population health. A final list of articles was selected by the group after three consensus meetings (n = 55). Among a total of 26 factors identified, 63% (147/232) of those were facilitators and 37% (85/232) barriers. About 70% of the facilitators consisted of productivity/efficiency in EHRs occurring 33 times, increased quality and data management each occurring 19 times, surveillance occurring 17 times, and preventative care occurring 15 times. About 70% of the barriers consisted of missing data occurring 24 times, no standards (interoperability) occurring 13 times, productivity loss occurring 12 times, and technology too complex occurring 10 times. The analysis identified more facilitators than barriers to the use of the EHR to support public health. Wider adoption of the EHR and more comprehensive standards for interoperability will only enhance the ability for the EHR to support this important area of surveillance and disease prevention. This review identifies more facilitators than barriers to using the EHR to support public health, which implies a certain level of usability and acceptance to use the EHR in this manner. The public-health industry should combine their efforts with the interoperability projects to make the EHR both fully adopted and fully interoperable. This will greatly increase the availability, accuracy, and comprehensiveness of data across the country, which will enhance benchmarking and disease surveillance/prevention capabilities.
Patient access to electronic health records: Differences across ten countries
RePEc: Research Papers in Economics, 2017
and the United States. All 10 countries regulated some level of patient access to medical records; however, policies, systems and technological processes were highly variable. Particularly variable were login procedures (security), adolescent access to data (user rights), and medical data types available to the patient (data sets). Comment (RW): This paper provides an interesting insight into the different ways patients get access to their digital health records in 10 countries. Not only are there differences in mandatory requirements, access methods, and the data that are made accessible, but some of the other learnings are also useful. Provider adherence to policy on providing data is a key issue regardless of whether this is mandatory or opt in, automatic data transfer from electronic health records (EHRs) to PAEHRs facilitates systematic engagement in other countries. Not deliberately considering access of parents and children to their records in adolescence can lead to issues in managing their health. Sweden has developed forums where healthcare professionals and patients can provide input into the development of PAEHR systems and regulations. This paper calls for more open dissemination of practices and collaboration between countries, as New Zealand commences the journey towards a national electronic health record, learning from the successes and difficulties experienced in other countries will be extremely valuable and may prevent us from making mistakes.
JMIR Medical Informatics, 2020
Background: Patient access to electronic health records (EHRs) is associated with increased patient engagement and health care quality outcomes. However, the adoption of patient portals and personal health records (PHRs) that facilitate this access is impeded by barriers. The Clinical Adoption Framework (CAF) has been developed to analyze EHR adoption, but this framework does not consider the patient as an end-user. Objective: We aim to extend the scope of the CAF to patient access to EHRs, develop guidance documentation for the application of the CAF, and assess the interrater reliability. Methods: We systematically reviewed existing systematic reviews on patients' access to EHRs and PHRs. Results of each review were mapped to one of the 43 CAF categories. Categories were iteratively adapted when needed. We measured the interrater reliability with Cohen’s unweighted kappa and statistics regarding the agreement among reviewers on mapping quotes of the reviews to different CAF categories. Results: We further defined the framework’s inclusion and exclusion criteria for 33 of the 43 CAF categories and achieved a moderate agreement among the raters, which varied between categories. Conclusions: In the reviews, categories about people, organization, system quality, system use, and the net benefits of system use were addressed more often than those about international and regional information and communication technology infrastructures, standards, politics, incentive programs, and social trends. Categories that were addressed less might have been underdefined in this study. The guidance documentation we developed can be applied to systematic literature reviews and implementation studies, patient and informal caregiver access to EHRs, and the adoption of PHRs.
Healthcare policy = Politiques de santé, 2014
While the barriers to electronic medical record (EMR) adoption by physicians are well-known, we have much less knowledge about the broader challenges regarding EMR use faced by primary healthcare (PHC) EMR stakeholders in Canada. Therefore, we conducted interviews (from June 2009 to September 2010) and consultation sessions (in October and November 2009) with these stakeholders, as well as carrying out a research capacity assessment, to identify, describe and prioritize gaps in PHC EMR knowledge and research. Twelve thematic gaps emerged; four were identified as the most important: the need to ascertain the value of EMRs, the need to better understand elements of EMR implementation and adoption, the need to develop innovative data entry and extraction procedures, and a lack of agreement and understanding of data sharing. To advance EMR use, Canada needs to address these gaps; yet, we currently have a lack of research capacity with which to accomplish this.
BMC Medical Informatics and Decision Making, 2017
Background: Primary care data gathered from Electronic Health Records are of the utmost interest considering the essential role of general practitioners (GPs) as coordinators of patient care. These data represent the synthesis of the patient history and also give a comprehensive picture of the population health status. Nevertheless, discrepancies between countries exist concerning routine data collection projects. Therefore, we wanted to identify elements that influence the development and durability of such projects. Methods: A systematic review was conducted using the PubMed database to identify worldwide current primary care data collection projects. The gray literature was also searched via official project websites and their contact person was emailed to obtain information on the project managers. Data were retrieved from the included studies using a standardized form, screening four aspects: projects features, technological infrastructure, GPs' roles, data collection network organization. Results: The literature search allowed identifying 36 routine data collection networks, mostly in English-speaking countries: CPRD and THIN in the United Kingdom, the Veterans Health Administration project in the United States, EMRALD and CPCSSN in Canada. These projects had in common the use of technical facilities that range from extraction tools to comprehensive computing platforms. Moreover, GPs initiated the extraction process and benefited from incentives for their participation. Finally, analysis of the literature data highlighted that governmental services, academic institutions, including departments of general practice, and software companies, are pivotal for the promotion and durability of primary care data collection projects. Conclusion: Solid technical facilities and strong academic and governmental support are required for promoting and supporting long-term and wide-range primary care data collection projects.