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Adoption of security and confidentiality features in an operational community health information network: the Comox Valley experience--case example.

https://arctichealth.org/en/permalink/ahliterature204710
Source
Int J Med Inform. 1998 Mar;49(1):81-7
Publication Type
Article
Date
Mar-1998
Author
J R Moehr
J G McDaniel
Author Affiliation
School of Health Information Science, University of Victoria, BC, Canada.
Source
Int J Med Inform. 1998 Mar;49(1):81-7
Date
Mar-1998
Language
English
Publication Type
Article
Keywords
British Columbia
Clinical Laboratory Information Systems
Community Networks
Computer Communication Networks
Computer Security
Confidentiality
Database Management Systems
Databases as Topic
Group Practice
Hospital Information Systems
Hospitals, General
Humans
Medical Records Systems, Computerized
Abstract
Since 1993, a budding community health information network (CHIN) has been in operation in the Comox Valley in Canada. A general hospital and three multi-doctor clinics are linked electronically. The clinics operate without paper charts using a comprehensive clinic information system. The link is provided by RSALink, a commercial message exchange service, based on Health Link, a system developed at the University of Victoria (McDaniel et al., Can. Med. Inform. 1 (1994) 40-41; McDaniel, Dissertation, University of Victoria, Canada, 1994). Health Link is a highly adaptable message exchange service with rich functionality. Despite this, the system is used exclusively to receive laboratory results transmitted by the hospital's laboratory system (RSAStat). The results are deposited in the patient data base of a commercial clinic information system (CliniCare). This case is instructive because the users' selection of services available through Health Link allows us to observe the preferences in this informational sophisticated environment. Laboratory data transmission is appreciated as highly beneficial. The reliability, security and ample privacy protection and authentication features of Health Link, in contrast, are used in a black box mode and are not consciously exploited. This is consistent with our experience of the use of other systems which have operated for a substantial time, essentially without serious protection features. Our experience suggests that security and confidentiality features are exploited only to the extent that they do not require additional effort or conscientious intervention. This puts the system provider in the difficult position of either offering interactive systems that nobody will use, or providing automated features that nobody is aware of and that are therefore not used to full advantage--if at all.
PubMed ID
9723805 View in PubMed
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Guidelines, the Internet, and personal health: insights from the Canadian HEALNet experience.

https://arctichealth.org/en/permalink/ahliterature189123
Source
Methods Inf Med. 2002;41(3):230-4
Publication Type
Article
Date
2002
Author
J R Moehr
Author Affiliation
School of Health Information Science, University of Victoria, Victoria, BC, Canada. jmoehr@uvic.ca
Source
Methods Inf Med. 2002;41(3):230-4
Date
2002
Language
English
Publication Type
Article
Keywords
Canada
Humans
Internet
Medical Informatics
Patient Education as Topic
Patient Participation
Research
Abstract
To summarize the insights gained in collaborative research in a Canadian Network of Centres of Excellence, devoted to the promotion of evidence-based practice, and to relate this experience to Internet support of health promotion and consumer health informatics.
A subjective review of insights is undertaken.
Work directed the development of systems incorporating guidelines, care maps, etc., for use by professionals met with limited acceptance. Evidence-based tools for health care consumers are a desirable complement but require radically different content and delivery modes. In addition to evidence-based material offered by professionals, a wide array of Internet-based products and services provided by consumers for consumers emerged and proved a beneficial complement.
The consumer-driven products and services provided via the Internet are a potentially important and beneficial complement of traditional health services. They affect the health consumer-provider roles and require changes in healthcare practices.
PubMed ID
12162149 View in PubMed
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Internet for teaching and learning introductory health informatics.

https://arctichealth.org/en/permalink/ahliterature216257
Source
Proc Annu Symp Comput Appl Med Care. 1995;:532-6
Publication Type
Article
Date
1995
Author
D J Bigsby
J R Moehr
Author Affiliation
School of Health Information Science, University of Victoria, B.C., Canada.
Source
Proc Annu Symp Comput Appl Med Care. 1995;:532-6
Date
1995
Language
English
Publication Type
Article
Keywords
British Columbia
Computer Communication Networks - utilization
Computer Literacy
Computer User Training - methods
Computer-Assisted Instruction
Female
Humans
Information Science - education
Male
Medical Informatics - education
Questionnaires
Abstract
Internet resources seem attractive for teaching and learning. But are they usable and useful in their present form? We explored Internet, in particular its World Wide Web (WWW) resources, in a course on "Medical Methodology" (HINF270) for students of health information science. This course offers a systematic overview of the methodological principles of clinical care. Its broad scope and low depth makes this course a reasonable model to explore the limits of WWW resources. During the course, students wrote summaries of individual lectures. After critiquing and appropriate corrections, the texts were edited with Hypertext Mark-up Language (HTML) and augmented with links to WWW resources. Grading based on the papers, on their improvements through HTML and WWW, and on the provision of information on the search experience were incentives to use WWW. A formal questionnaire, administered on-line on a voluntary basis, concluded the investigation. Results show: 1) Even under considerable pressure to use WWW, libraries remain the reference source of choice for research; 2) Internet provides entertainment appeal even though practical utility is currently limited; 3) Technological proficiency with HTML and search engines is perceived as an asset; 4) Varying availability of Internet resources, uncertain and varying quality of sources, and limited specificity of research results are the major disadvantages of WWW. The teaching implications of these findings are discussed.
PubMed ID
8563341 View in PubMed
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Performance evaluation frameworks for vertically integrated health care systems: shifting paradigms in Canada.

https://arctichealth.org/en/permalink/ahliterature196602
Source
Proc AMIA Symp. 2000;:315-9
Publication Type
Article
Date
2000
Author
C J Green
J R Moehr
Author Affiliation
School of Health Information Science, University of Victoria, British Columbia, Canada.
Source
Proc AMIA Symp. 2000;:315-9
Date
2000
Language
English
Publication Type
Article
Keywords
Canada
Evaluation Studies as Topic
Health services
Health Services Research
Humans
Information Systems
Outcome and Process Assessment (Health Care)
Quality Assurance, Health Care
Systems Analysis
Notes
Cites: Health Serv Manage Res. 1998 Feb;11(1):24-41; discussion 41-810178368
Cites: Jt Comm J Qual Improv. 1993 Oct;19(10):424-47; discussion 448-528252125
PubMed ID
11079896 View in PubMed
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Video conferencing-based telehealth--its implications for health promotion and health care.

https://arctichealth.org/en/permalink/ahliterature174524
Source
Methods Inf Med. 2005;44(2):334-41
Publication Type
Article
Date
2005
Author
J R Moehr
C R Anglin
J P Schaafsma
S V Pantazi
S. Anglin
N A Grimm
Author Affiliation
School of Health Information Science, University of Victoria, P.O. Box 3050, STN CSC, Victoria, British Columbia V8W 3P5, Canada. jmoehr@uvic.ca
Source
Methods Inf Med. 2005;44(2):334-41
Date
2005
Language
English
Publication Type
Article
Keywords
British Columbia
Education, Medical
Group Processes
Health Promotion - methods - organization & administration - standards
Health Services Administration
Humans
Program Evaluation
Regional Health Planning - organization & administration
Specialization
Telemedicine - methods - organization & administration - standards
Videoconferencing
Abstract
To review the experience with a province-wide telehealth system in Canada, and its implications for health care and health promotion. To explore whether group support systems (GSS) based on networked computers can substitute for video conferencing technology.
Key results of the evaluation of the BC Telehealth Program are summarized. The potential of extending the successful principles through use of GSS is explored based on literature review, demonstrations, and trial use for educational applications.
The BC Telehealth Program was designed to support health professionals at secondary care facilities, such as regional and district hospitals in two application domains: children's and women's health (C&W) and emergency room and trauma care (ER-Trauma). Successful applications extended beyond health professionals and focused on chronic conditions, the management of which is contingent on visual information, and involves established teams in regular scheduled visits or in sessions scheduled well in advance. Ad hoc applications, in particular applications under emergency conditions proved problematic. Administrative applications in support of telehealth implementation, e.g., through facilitation of management and provider education, are essential for clinical success. Savings from support of administrative applications exceeded the substantial capital investment and made educational and clinical applications available at variable cost. Educational applications were shown to have significant clinical benefits. Exploration of GSS technology showed that it may not be mature enough to substitute for video conferencing technology in support of sophisticated training and education aiming at clinical impact.
The substantial clinical and efficiency gains provided by video conferencing-based telehealth may for now continue to depend on mature video-conferencing technology.
PubMed ID
15924203 View in PubMed
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