Theoretically, the use of Electronic Medical Records (EMRs) holds promise of numerous benefits in healthcare provision, including improvement in continuity of care, quality of care and safety. However, in practice, there is evidence that the adoption of electronic medical records has been slow and where adopted, often lacks meaningful use. Thus there is a clear dichotomy between the ambitions for EMR use and the reality of EMR implementation. In the USA, a legislative approach was taken to turn around the situation. Other countries such as Canada and European countries have followed suit (in their own way) to address the adoption and meaningful use of electronic medical records. The South African e-Health strategy and the National Health Normative Standards Framework for Interoperability in eHealth in South Africa documents both recommend the adoption of EMRs. Much work has been done to establish a baseline for standards to ensure interoperability and data portability of healthcare applications and data. However, even with the increased focus on e-Health, South Africa remains excessively reliant on paper-based medical records. Where health information technologies have been adopted, there is lack of coordination between and within provinces, leading to a multitude of systems and vendors. Thus there is a lack of systematic adoption and meaningful use of EMRs in South Africa. The main objective of this research is to develop the components required to engender meaningful use of electronic medical records in the South African healthcare context. The main contributors are identified as EMR certification and consistent, proper use of certified EMRs. Literature review, a Delphi study and logical argumentation are used to develop the relevant components for the South African healthcare context. The benefits of EMRs can only be realized through systematic adoption and meaningful use of EMRs, thus this research contributes to providing a road map for engendering the meaningful use of EMRs with the ultimate aim of improving healthcare in the South African healthcare landscape.

Thesis (MTech (Information Technology))--Cape Peninsula University of Technology, 2016. / Access to healthcare is regarded as a basic and essential human right. It is widely known that ICT solutions have potential to improve access to healthcare, reduce healthcare cost, reduce medical errors, and bridge the digital divide between rural and urban healthcare centres. The access to personal healthcare records is, however, an astounding challenge for both patients and healthcare professionals alike, particularly within resource-restricted environments (such as rural communities). Most rural healthcare institutions have limited or non-existent access to electronic patient healthcare records. This study explored the accessibility of personal healthcare records by patients and healthcare professionals within a rural community hospital in the Eastern Cape Province of South Africa. The case study was conducted at the St. Barnabas Hospital with the support and permission from the Faculty of Informatics and Design, Cape Peninsula University of Technology and the Eastern Cape Department of Health. Semi-structured interviews, observations, and interactive co-design sessions and focus groups served as the main data collection methods used to determine the accessibility of personal healthcare records by the relevant stakeholders. The data was qualitatively interpreted using thematic analysis. The study highlighted the various challenges experienced by healthcare professionals and patients, including time-consuming manual processes, lack of infrastructure, illegible hand-written records, missing records and illiteracy. A number of recommendations for improved access to personal healthcare records are discussed. The significance of the study articulates the imperative need for seamless and secure access to personal healthcare records, not only within rural areas but within all communities.

Diss. (sammanfattning) Linköping : Linköpings universitet, 2008. / Härtill 4 uppsatser.

The primary purpose of the present study was to determine if information regarding potential parental or legal guardian access to mental health information would deleteriously impact male and female adolescent psychiatric patients' willingness to self-report personal problems and symptoms.

Bakgrund Det finns flera svårigheter vid en överförflyttning från intensivvårdsavdelning till en vårdavdelning. En av dessa är hur all den vård som utförts på intensivvårdsavdelningen ska sammanfattas till en relevant, överblickbar omvårdnadsepikris. Syfte och frågeställning Syftet med denna studie är att undersöka om sjuksköterskor som vårdar traumapatienter anser att omvårdnadsepikrisen innehåller den information som krävs för att omvårdnadens mål ska kunna uppnås. Utöver detta syftar studien till att undersöka vilken information  sjuksköterskorna anser att omvårdnadsepikrisen ska innehålla. Vidare undersöks huruvida åsikterna skiljer sig åt mellan de båda grupperna och vad de tror om införandet av en standardiserad omvårdnadsepikrismall för traumapatienter. Metod Uppsatsen har designen av en kvantitativ studie med ett stratifierat strategiskt urval. Sammanlagt 48 sjuksköterskor har deltagit i studien. Tjugotvå stycken från ett regionsjukhus och 26 stycken från ett länssjukhus. Enkäten bestod av nio frågor där sjuksköterskorna fick bland annat skatta hur pass hur ofta de skrev viss information och vilka av VIPS- sökord de ansåg mest relevanta för omvårdnadsepikrisen. Resultat Det finns skillnader i hur omvårdnadsepikrisen uppfattas av de olika urvalsgrupperna. Regionssjukhusgruppen ansåg att de fick med all relevant information när de sammanställde omvårdnadsepikrisen medan länssjukhusgruppen ansåg att informationen var bristfällig. Vidare visade studien att de båda urvalsgrupperna skattade likvärdigt på flertalet sökord. Slutsats Båda urvalsgrupperna var i stort överrens om vilka VIPS- sökord omvårdnadsepikrisen bör innehålla. Information som ofta saknades var rekommenderade åtgärder. / Background There are numerous difficulties associated with transferring a patient from an intensive care unit to a regular ward. One of these difficulties regards the patient discharge summaries (PDS). It is difficult to summarize a relevant PDS for patients that have been treated at an intensive care unit. Objective This study’s objective is to describe what information registered nurses (RN) that care for, or receives trauma patients’ sees as relevant to include in the PDS for trauma patients. Method The study was made with a quantitative method, using a stratified strategic sample. Forty-eight RNs participated, divided into two study groups (group 1 & 2). 22 RNs were sampled from a regional hospital and 26 RNs were sampled from a county hospital. The RNs assessed how frequent they documented specific information. They also assessed how important they felt specific keywords from the VIPS- documentation tool were to compile a relevant PDS. The two groups’ assessments were then compared. Results Differences were found in how the two groups perceived the amount of information in the PDS. Group 1 felt that they wrote enough information in the patient discharge summary. Group 2 felt that the information in the PDS was insufficient. The study also showed that the two groups assesses similarly on most of the VIPS- keywords Conclusion Both groups mostly agreed on what the PDS should contain. Both groups felt that information about recommended measures was missing.

Mortality statistics are much used although their accuracy is often questioned. Producers of mortality statistics check for errors in death certification but current methods only capture obvious mistakes. This thesis investigates whether non-obvious errors can be found by linking death certificates to hospital discharge data. Data: 69,818 deaths in Sweden 1995. Paper I: Analysing differences between the underlying cause of death from the death certificate (UC) and the main discharge condition from the patient’s last hospitalization (MDC). Paper II: Testing whether differences can be explained by ICD definitions of UC and MDC. Paper III: Surveying methods in 44 current studies on the accuracy of death certificates. Paper IV: Checking death certificates against case summaries for: i) 573 deaths where UC and MDC were the same or the difference could be explained; ii) 562 deaths where the difference could not be explained. Results: In 54% of deaths the MDC differed from the UC. Almost two-thirds of the differences were medically compatible since the MDC might have developed as a complication of the UC. Of 44 recent evaluation studies, only 8 describe the methods in such detail that the study could be replicated. Incompatibility between MDC and UC indicates a four-fold risk that the death certificate is inaccurate. For some diagnostic groups, however, death certificates are often inaccurate even when the UC and MDC are compatible. Conclusion: Producers of official mortality statistics could reduce the number of non-obvious errors in the statistics by collecting additional information on incompatible deaths and on deaths in high-risk diagnostic groups. ICD conventions contribute to the quality problem since they presuppose that all deaths are due to a single underlying cause. However, in an ageing population an increasing number of deaths are due to an accumulation of etiologically unrelated conditions.

Class of 2017 Abstract / Objectives: The purpose of this study is to demonstrate the effect of using advanced pharmacy practice experience (APPE) students in the collection of admission medication history at an academic teaching hospital prior to pharmacist review. Methods: The study is a retrospective, descriptive study. Using electronic medical records, the study looked at patients admitted to specific floors during a two-month period. The primary outcome was number of discrepancies found by the APPE students. The secondary outcome was the type of discrepancy found (omission, duplication, wrong dose, wrong frequency, wrong dosage form, and medications the subject no longer takes). Results: Over eight weeks, the APPE students identified 2,666 discrepancies, which equates to approximately 4.71 ± 4.76 discrepancies per patient. The majority of these discrepancies were identified as omissions of therapy (39.1%), followed by medications the patients were no longer taking (29.8%), and wrong dosing frequencies (18.1%). Conclusions: APPE students assisted the medication reconciliation process by identifying numerous medication discrepancies which may have prevented patient harm. APPE students are an underutilized resource and prove to be an asset to the healthcare team.

In the literature of information technology acceptance, much empirical evidence exists that is inconsistent with Technology Acceptance (TA) Models. The purpose of this study is to find out why the extant TA models fail to predict in reality as they purport to in theory. This research argues that the extant literature has not been able to explain how individuals actually form their perceptions about using an information technology. Since past research attempting to do this has been unsuccessful or empirically refuted, this research uses an interpretive case study to investigate the experiences of professionals’ adoption and use of an information technology. In particular, this study focuses on the adoption of an Electronic Medical Records System in a healthcare setting. The results of this interpretive investigation show that the interpretive understanding by the traditional TA models researchers is based on the faulty presumption that the people in the organizations are “monolithic users” or “rational decision makers”. This research provides a new interpretive understanding on the adoption and use of an information technology. The adoption and use of an information technology is an emergent phenomenon resulting from the interaction between the technology and the social actors’ different roles. Based on the interpretive understanding, a new positivist understanding is suggested.

The thesis deals with the rules of the protection of personal data in the process of rendering healthcare. This topic is highly relevant because the act no. 89/2012 Coll., The Civil Code, came recently into force and influenced the topic of this thesis, mainly in case of the settlement called "The Healthcare". The work is divided into four chapters. The first chapter contains the most important legal sources for the protection of personal data in the process of rendering healthcare. The chapter also describes the major decisions of the European Court of Human Rights and the most important decisions of courts in Czech Republic. The second chapter deals with the protection of personality, right to privacy and with the protection of personal data. The protection of personal data in healthcare is undoubtedly a part of above mentioned rights. The third chapter deals with the duty of confidentiality of healthcare workers, the possibility of breaking the confidentiality and the legal liability for breach of a duty of confidentiality. The fourth chapter describes the regulation of medical records. The conclusion includes an evaluation of existing legal regulation and proposals de lege ferenda. The conclusion also contains topics which were not included in the thesis but due to their attractiveness are at...

The Duty of Confidentiality in Health Care (Section 99 of Czech Criminal Procedure Code and other provisions) The aim of the thesis is to introduce the issue of medical confidentiality in Czech Republic. Although most stress is put on the connection with criminal law, the work also explains what medical confidentiality is and outlines some disputable points in this field as well as it further on mentions international treaties, statutes and other sources where the duty of confidentiality is incorporated. The thesis then shows medical confidentiality in connection with the matter of medical records and afterwards focuses on the exceptions when duty of confidentiality can legally be broken and finally a chapter is given to describe the questions of lability for breaching the duty of cofidentiality in health care where criminal law consequences and disciplinary consequences are described. All the matters are discussed in the light of the Health Services Act (372/2011 Coll.) which came into force on April 1, 2012.