Sofiaängen (http://sofiaangen.com/) är en psykoterapeutisk dagverksamhet och skola som ligger på Södermalm i Stockholm. Sofiaängen riktar sig till ungdomar i åldern 14 till 20 med psykiska och sociala problem. Det nuvarande systemet som används av Sofiaängen för att hantera patientjournaler är i form av textfiler placerade i en delad mapp på en Mac-server, vilketvarken är strukturerat, effektivt eller flexibelt. Syftet med detta examensarbete har därför varit att hitta det bästa sättet att implementera ett journalsystem för patientjournaler på, samt att utforma, utveckla och driftsätta den valda lösningen. Arbetet delades in i fyra olika faser. Under den första fasen genomfördes en förstudie där möjliga implementeringar (fristående eller webbaserad) studerades och resultatet överlämnades till beställaren som fick välja den mest lämpliga lösningen. De tre övriga faserna var att utforma, genomföra (och testa) och distribuera den valda lösningen, samt att skriva en användarmanual. Den valda lösningen, att skapa systemet som ett fristående program, implementerades med JavaFX:s plattform och MySQL:s databas-server. Vi använde en iterativ arbetsprocess för att stegvis utveckla de funktionella kraven. Detta för att kunna utvärdera vårt arbete tidigt, utifrån feedback på utvecklingen från beställaren, innan nästa uppsättning krav genomfördes. Examensarbetet har resulterat iett journalsystem som uppfyller alla krav på funktionalitet och design av användargränssnittet som krävdes av Sofiaängen. / Sofiaängen (http://sofiaangen.com/)is a psychotherapeutic day activities center and school located in Södermalm in Stockholm. Sofiaängen targets young peo-ple between the age of 14 and 20 and who have psychological orsocial prob-lems. The current system used by Sofiaängen for handling patient medical records is a Microsoft word file-system on a Mac server, which is neitherefficient norflex-ible. The objective of this bachelor thesis has therefore been to find the best way of implementing an EMRS as well asdesigning, developingand deployingthe selected solution. The work was divided into four different phases. The first phase was conduct-ing feasibility study where possible implementations (standalone and web based) were studied. The result was submitted to Sofiaängen so they couldmake a selection.   The second,third and fourth phases were respectively de-signing, implementing (and testing) and deploying the selected solution. The selected solution was to implement the system as a standalone application. The system was implemented using the JavaFX platform andaMySQL data-base server. We used an iterative software developmentmodel in order to implement the functional requirements incrementally andin doing so we were able to evaluate our work early, before the next set of requirements were implemented after get-tingfeedback on the development from Sofiaängen. The Degree project has resulted in an EMRS which fulfills all of the functional and look-and-feel requirements required by Sofiaängen.

This thesis investigates the use of electronic medical record (EMR) systems and risk management in hospitals. It provides a critical analysis of recognized EMR systems and potential failures and discusses six traditional risk management techniques including brain storming, cause, effect analysis, failure mode effective analysis (FMEA), fault tree analysis (FTA), and Binary Decision Diagram (BDD) in addition, to one of the most recent systematic risk management techniques, Systems Theoretic Accident Model Process (STAMP). The traditional techniques are not as well suited to managing risks and preventing failures in modern information systems with complex software that involves human and machine interaction. The thesis introduces the implementation of common traditional risk management technique such as BDD and FTA which is mostly used in nuclear plants, transportation and medical devices backed by a hypothetical example to help and explain the process of the FTA usage. Most traditional techniques rely on a direct cause-and-effect chain and have no clear formal guidance. The systematic technique introduced and used in this study, is known as Systems Theoretic Accident Model Process (STAMP). It is one of the recent systematic techniques developed and used in many sectors including aerospace. This study applied the STAMP technique to the EMR system failure at King Khalid General Hospital (KKGH) in Riyadh. One of the reasons for selecting the STAMP technique is that it is based on system theory and established the risk factors that lead to system failure. It also provides guidance for managing and controlling risk factors. This thesis discusses the implementation of STAMP, supported by examples, to explain how the technique conducted. System failures occur unexpectedly and have the potential to affect health services; they can compromise patient health and sometimes lead to death. The aims of this study are to explore The Kingdom of Saudi Arabia healthcare usage of EMRs and risk factors that leads to system failure and demonstrate the benefit of STAMP for RM in EMR system, define gaps and provide suggestion based on international best practice The study was conducted in three phases. The first phase explored EMR system usage and failures. The second phase implemented the STAMP risk management technique at one hospital of our 8 surveyed hospitals, the King Khalid General Hospital’s (KKGH), to identify and manage risks. In the third phase, the study modified the STAMP technique and reapplied it. The modified technique STAMP Checklist (STAMPC) was compared with the original STAMP technique. We found that STAMPC is much more usable and subjectively beneficial for the hospital that uses a hybrid system. Data extracted using the modified technique provided more useful information to improve EMR system safety, and prevent potential failures. This study addresses the challenges of how effectively RM techniques used to reduce the potential risk of EMR system failures in hospitals. It improves the efficiency of the STAMP risk management technique by proposing a new (STAMPC) technique. There are 3 important implications for both RM and EMRs practice: first, the study suggests that RM and EMRs are integral parts of the management decision-making process; second, they are necessary to improve human health and safety; and, third, RM may minimise the possibility of system failure.

This study explored the phenomenon of electronic medical records systems in Zimbabwean primary healthcare institutions. The goal of the study was to investigate the lack of adoption of electronic medical records systems by primary healthcare institutions in developing countries using an interpretative case study approach focusing on the Zimbabwean context. Despite the positive benefits that are associated with EMRs, developing countries have been reluctant in implementing this technology within their primary healthcare institutions. A number of studies have been conducted on EMR systems but only a few have investigated the reasons for the limited use of EMR technology in developing countries particularly within the Zimbabwean context. This study primarily adopted a case study approach and was qualitative in nature. The study made use of in-depth interviews to obtain its data, and purposive sampling method was used to identify participants for the study. The study made use of a sample size of fourteen respondents who were identified based on their knowledge and could assist explore this particular topic relevant to the research. The targeted population for this research were key staff members privy to patients’ medical records management within the primary healthcare facilities. The data collected was analysed using thematic analysis soon after the transcription process. The results of the study show that EMRs technology in Zimbabwe has been implemented on a limited scale within its public hospitals. The technology is being used mostly in HIV/AIDS management or in particular departments. The study reveals that although healthcare institutions in Zimbabwe have adopted EMRs technology, most of the information is still being archived on the paper based system. The findings of the study show that Zimbabwe hasn’t adopted EMRs due to challenges such as lack of proper infrastructures, resistance in the use of EMRs, remoteness, shortages in skilled labour and concerns of confidentiality and privacy. Furthermore, the study shows that though the application of the EMR system is limited in Zimbabwean hospitals, the study found that its benefits have been noticeable. EMR technology has made it easy to access information, averted redundant expenditure and has made time improvements. However, the study revealed that EMR systems come with their own shortcomings such as lack of access to patient documents due to network faults and the need for familiarity with computer systems.

Sofiaängen är en psykoterapeutisk dagverksamhet och skola som ligger på Södermalm i Stockholm. Sofiaängen riktar sig till ungdomar mellan 13–20 år med psykiska och sociala problem. Sofiaängen var i behov av ett fullständigt journalsystem för att kunna underlätta deras arbetsrutiner med bokföring av patientbehandlingar. Då deras nuvarande system inte är färdigställd och behövs vidareutvecklas. Detta ledde till att arbetet delades upp i två delar, först att ta fram ett förslag på en generell processmodell för hantering av en icke färdigställda IT-system till akademin och därefter att leverera ett fullt fungerande journalsystem åt Sofiaängen. Examensarbetet har resulterat till att man har tagit fram ett förslag på generell processmodell för hantering av icke färdigställda projekt samt ett fullt fungerande journalsystem åt Sofiaängen som kan sättas direkt i drift. / Sofiaängen is a psychotherapeutic day school and school located at Södermalm in Stockholm. Sofiaängen is aimed at young people between 13-20 years with mental and social problems. Sofiaängen needed a complete journal system to facilitate their work routines with records of patient treatments. Their current system is not completed and needed further development. Thus, the work was divided into two parts, first to develop a proposal for a general process model for managing an unfinished IT system to the academy and then to deliver a fully functioning journal system for Sofiaängen. The thesis has resulted in a proposal for a general process model for handling unfinished projects as well as a fully functioning journal system for Sofiaängen, which can be put into operation immediately.

<p>Efficient strategies for diabetes management in primary care provide avenues through which the disease may be monitored and controlled, but systems and processes must be more than adequate. The use of Electronic Medical Record systems (EMRs) assist healthcare providers in delivering quality care to patients to help better manage chronic conditions, and integrate services throughout the healthcare system so that relevant chronic disease programs may be made available to individuals and communities. Usability issues have often been blamed for poor EMR adoption rates, underutilization of systems, endangerment of patient health and inadequacies in providing positive health outcomes for patients while improving the quality of chronic disease management.</p> <p>This thesis investigates the use of EMRs in managing diabetes within primary care, and evaluates their usability and its effects in managing diabetes in patients, with special reference to patient safety, healthcare provider workflow and adherence to clinical practice guidelines (CPGs).</p> <p>Existing evidence emphasizing the management of diabetes and the role of the EMR in primary care is presented, while three levels of usability and several usability guidelines are identified and investigated. Data gathered from the local environment, show the relationships between EMR usability, patient safety, clinician workflow and adherence to CPGs in managing diabetes, and three models of EMR usability are suggested.</p> <p>The primary proposition for this study is that EMRs provide promise in helping to control diabetes in patients. However EMR usability may present significant hindrances in maximizing outcomes for individuals and in providing support programs and services to communities.</p> / Master of Science (MSc)