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Access and authorisation in a Glocal e-Health Policy context.

https://arctichealth.org/en/permalink/ahliterature180735
Source
Int J Med Inform. 2004 Mar 31;73(3):259-66
Publication Type
Article
Date
Mar-31-2004
Author
Richard E Scott
Penny Jennett
Maryann Yeo
Author Affiliation
Global e-Health Research and Training Program, G204 Health Sciences Centre, Faculty of Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, Canada T2N 4N1. rescott@ucalgary.ca
Source
Int J Med Inform. 2004 Mar 31;73(3):259-66
Date
Mar-31-2004
Language
English
Publication Type
Article
Keywords
Access to Information
Canada
Computer Security
Health Policy
Humans
Medical Records Systems, Computerized - organization & administration - standards
Security Measures
World Health
Abstract
Challenges to the development of appropriate yet adaptable policy and tools for security of the individual patient electronic health record (EHR) are proving to be significant. Compounding this is the unique capability of e-health to transgress all existing geo-political and other barriers. Initiatives to develop and advance policy, standards, and tools in relation to EHR access control and authorisation management must address this capability. Currently policy development initiatives take place largely in an isolated manner. This jeopardises the potential of e-health because decisions made in one jurisdiction might hamper, even prevent, an e-health opportunity in another. This paper places access and authorisation issues in an overall policy context through describing current Canadian initiatives. The National Initiative for Telehealth (NIFTE) Guidelines project is developing a framework of national guidelines for telehealth. The Policy and Peer Permission (PPP) project is developing a unique tool that provides persistent protection of data. The new corporate body 'Infoway' is developing a pan-Canadian electronic health record solution. Finally, the Glocal e-Health Policy initiative is developing a tool with which to identify and describe the inter-relationships of e-health issues amongst policy levels, themes, and actors.
PubMed ID
15066556 View in PubMed
Less detail

Access to electronic health records by care setting and provider type: perceptions of cancer care providers in Ontario, Canada.

https://arctichealth.org/en/permalink/ahliterature149234
Source
BMC Med Inform Decis Mak. 2009;9:38
Publication Type
Article
Date
2009
Author
Margo C Orchard
Mark J Dobrow
Lawrence Paszat
Hedy Jiang
Patrick Brown
Author Affiliation
Department of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, M5J 2P1, Canada. margo.orchard@utoronto.ca
Source
BMC Med Inform Decis Mak. 2009;9:38
Date
2009
Language
English
Publication Type
Article
Keywords
Access to Information
Adult
Female
Health Care Surveys
Health Facilities - classification
Health Personnel - classification
Humans
Logistic Models
Male
Medical Records Systems, Computerized - supply & distribution - utilization
Middle Aged
Ontario
Abstract
The use of electronic health records (EHRs) to support the organization and delivery of healthcare is evolving rapidly. However, little is known regarding potential variation in access to EHRs by provider type or care setting. This paper reports on observed variation in the perceptions of access to EHRs by a wide range of cancer care providers covering diverse cancer care settings in Ontario, Canada.
Perspectives were sought regarding EHR access and health record completeness for cancer patients as part of an internet survey of 5663 cancer care providers and administrators in Ontario. Data were analyzed using a multilevel logistic regression model. Provider type, location of work, and access to computer or internet were included as covariates in the model.
A total of 1997 of 5663 (35%) valid responses were collected. Focusing on data from cancer care providers (N = 1247), significant variation in EHR access and health record completeness was observed between provider types, location of work, and level of computer access. Providers who worked in community hospitals were half as likely as those who worked in teaching hospitals to have access to their patients' EHRs (OR 0.45 95% CI: 0.24-0.85, p
Notes
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PubMed ID
19664247 View in PubMed
Less detail

[Access to own health information and services on the Internet by disability pensioners and other citizens]

https://arctichealth.org/en/permalink/ahliterature91436
Source
Laeknabladid. 2008 Nov;94(11):729-35
Publication Type
Article
Date
Nov-2008
Author
Halldórsdóttir Gyda
Thoroddsen Asta St
Author Affiliation
Heilsuneti ehf. gyda@heilsunet.is
Source
Laeknabladid. 2008 Nov;94(11):729-35
Date
Nov-2008
Language
Icelandic
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Consumer Health Information
Disabled Persons - psychology
Health Knowledge, Attitudes, Practice
Health Services Research
Humans
Iceland
Insurance, Disability
Internet
Medical Records Systems, Computerized
Middle Aged
Patient Access to Records
Patient satisfaction
Pensions
Perception
Questionnaires
Social Security
Young Adult
Abstract
OBJECTIVE: To study Icelandic citizens' perception, attitude and preferences regarding access to own health information and interactive services at the State Social Security Institute of Iceland (SSSI). Hypotheses regarding differences between disability pensioners and other citizens were put forward. MATERIAL AND METHODS: A descriptive mail survey was performed with a random sample from the Icelandic population, 1400 individuals, age 16 to 67, divided into two groups of 700 each: (1) persons entitled to disability pension (2) other citizens in Iceland. The questionnaire consisted of 56 questions, descriptive statistics were used and Chi square for comparison with 95% as confidence level of significance. Response rate was 34.9%. RESULTS: Perception of rights to access own's health information was significantly higher by pensioners than other citizens. Attitude concerning impact of access was in general positive, with pensioners significantly more positive about effectiveness, perception of health, communication and decisions owing to services, access at SSSI, maintaining health records and controlling access. CONCLUSIONS: The study, the first of its kind in Iceland, supports previous research. The results, as well as foreign models of research projects, are recommended to be used for evolution of electronic health services and researching employees' viewpoints. Future research in Iceland should address the impact of interactive health communication on quality of life, health and services' efficiency.
PubMed ID
18974434 View in PubMed
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The accordance of diagnoses in a computerized sick-leave register with doctor's certificates and medical records.

https://arctichealth.org/en/permalink/ahliterature225797
Source
Scand J Soc Med. 1991 Sep;19(3):148-53
Publication Type
Article
Date
Sep-1991
Author
L O Ljungdahl
P. Bjurulf
Author Affiliation
Department of Community Medicine, Faculty of Health Sciences, Linköping University, Sweden.
Source
Scand J Soc Med. 1991 Sep;19(3):148-53
Date
Sep-1991
Language
English
Publication Type
Article
Keywords
Absenteeism
Diagnosis
Diagnosis, Differential
Humans
Medical Record Linkage
Medical Records Systems, Computerized
Registries
Sweden
Abstract
A register has been built for planned epidemiological studies of sick-leave, containing all cases exceeding 6 days in a population of 184,000, over a period of 3 years. The diagnoses were coded from medical certificates. To assess the quality of this information this study reviews the medical certificates of 2,364 cases. In 299 cases the corresponding medical records are reviewed and independent diagnoses made. The coding and entering of data into the register is correct in 98% of cases. The independently-made diagnoses match exactly the ones registered in 50% of cases. When grouping the diagnoses into 39 groups, the match on group level is 72%. Ten percentage points of the mismatch are caused by specified overlaps between groups. The remaining 18% mismatch is caused mainly by different interpretations or unspecific labelling of the disease states, not so much by them being obscure in themselves or by doctor covering up unpleasant diagnoses.
PubMed ID
1796246 View in PubMed
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Accuracy in the recording of pressure ulcers and prevention after implementing an electronic health record in hospital care.

https://arctichealth.org/en/permalink/ahliterature155835
Source
Qual Saf Health Care. 2008 Aug;17(4):281-5
Publication Type
Article
Date
Aug-2008
Author
L. Gunningberg
M Fogelberg Dahm
A. Ehrenberg
Author Affiliation
Surgery Division, Uppsala University Hospital, Uppsala, Sweden. lena.gunningberg@akademiska.se
Source
Qual Saf Health Care. 2008 Aug;17(4):281-5
Date
Aug-2008
Language
English
Publication Type
Article
Keywords
Data Collection - methods - standards
Hospitals, University
Humans
Medical Records Systems, Computerized
Pressure Ulcer - epidemiology - prevention & control
Prevalence
Retrospective Studies
Sweden
Abstract
To compare the accuracy in recording of pressure-ulcer prevalence and prevention before and after implementing an electronic health record (EHR) with templates for pressure-ulcer assessment.
All inpatients at the departments of surgery, medicine and geriatrics were inspected for the presence of pressure ulcers, according to the European Pressure Ulcer Advisory Panel-methodology, during 1 day in 2002 (n = 357) and repeated in 2006 (n = 343). The corresponding patient records were audited retrospectively for the presence of documentation on pressure ulcers.
In 2002, the prevalence of pressure ulcers obtained by auditing paper-based patient records (n = 413) was 14.3%, compared with 33.3% in physical inspection (n = 357). The largest difference was seen in the geriatric department, where records revealed 22.9% pressure ulcers and skin inspection 59.3%. Four years later, after the implementation of the EHR, there were 20.7% recorded pressure ulcers and 30.0% found by physical examination of patients. The accuracy of the prevalence data had improved most in the geriatric department, where the EHR showed 48.1% and physical examination 43.2% pressure ulcers. Corresponding figures in the surgical department were 22.2% and 14.1%, and in the medical department 29.9% and 10.2%, respectively. The patients received pressure-reducing equipment to a higher degree (51.6%) than documented in the patient record (7.9%) in 2006.
The accuracy in pressure-ulcer recording improved in the EHR compared with the paper-based health record. However, there were still deficiencies, which mean that patient records did not serve as a valid source of information on pressure-ulcer prevalence and prevention.
PubMed ID
18678726 View in PubMed
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Accuracy of Canadian health administrative databases in identifying patients with rheumatoid arthritis: a validation study using the medical records of rheumatologists.

https://arctichealth.org/en/permalink/ahliterature114676
Source
Arthritis Care Res (Hoboken). 2013 Oct;65(10):1582-91
Publication Type
Article
Date
Oct-2013
Author
Jessica Widdifield
Sasha Bernatsky
J Michael Paterson
Karen Tu
Ryan Ng
J Carter Thorne
Janet E Pope
Claire Bombardier
Author Affiliation
University of Toronto, Toronto, Ontario, Canada.
Source
Arthritis Care Res (Hoboken). 2013 Oct;65(10):1582-91
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Adult
Aged
Algorithms
Arthritis, Rheumatoid - diagnosis - epidemiology
Data Mining - statistics & numerical data
Databases, Factual - statistics & numerical data
Drug Prescriptions - statistics & numerical data
Fees and Charges - statistics & numerical data
Female
Hospitalization - statistics & numerical data
Humans
Male
Medical Records Systems, Computerized - statistics & numerical data
Middle Aged
Ontario - epidemiology
Reproducibility of Results
Retrospective Studies
Rheumatology - statistics & numerical data
Single-Payer System - statistics & numerical data
Abstract
Health administrative data can be a valuable tool for disease surveillance and research. Few studies have rigorously evaluated the accuracy of administrative databases for identifying rheumatoid arthritis (RA) patients. Our aim was to validate administrative data algorithms to identify RA patients in Ontario, Canada.
We performed a retrospective review of a random sample of 450 patients from 18 rheumatology clinics. Using rheumatologist-reported diagnosis as the reference standard, we tested and validated different combinations of physician billing, hospitalization, and pharmacy data.
One hundred forty-nine rheumatology patients were classified as having RA and 301 were classified as not having RA based on our reference standard definition (study RA prevalence 33%). Overall, algorithms that included physician billings had excellent sensitivity (range 94-100%). Specificity and positive predictive value (PPV) were modest to excellent and increased when algorithms included multiple physician claims or specialist claims. The addition of RA medications did not significantly improve algorithm performance. The algorithm of "(1 hospitalization RA code ever) OR (3 physician RA diagnosis codes [claims] with =1 by a specialist in a 2-year period)" had a sensitivity of 97%, specificity of 85%, PPV of 76%, and negative predictive value of 98%. Most RA patients (84%) had an RA diagnosis code present in the administrative data within ±1 year of a rheumatologist's documented diagnosis date.
We demonstrated that administrative data can be used to identify RA patients with a high degree of accuracy. RA diagnosis date and disease duration are fairly well estimated from administrative data in jurisdictions of universal health care insurance.
PubMed ID
23592598 View in PubMed
Less detail

Administrative hospitalization database validation of cardiac procedure codes.

https://arctichealth.org/en/permalink/ahliterature130676
Source
Med Care. 2013 Apr;51(4):e22-6
Publication Type
Article
Date
Apr-2013
Author
Douglas S Lee
Audra Stitt
Xuesong Wang
Jeffery S Yu
Yana Gurevich
Kori J Kingsbury
Peter C Austin
Jack V Tu
Author Affiliation
Institute for Clinical Evaluative Sciences, Toronto, ON, Canada M4N3M5. dlee@ices.on.ca
Source
Med Care. 2013 Apr;51(4):e22-6
Date
Apr-2013
Language
English
Publication Type
Article
Keywords
Cardiac Surgical Procedures - classification
Cardiovascular Diseases - epidemiology - surgery
Clinical Coding - standards - statistics & numerical data
Cohort Studies
Coronary Artery Bypass - classification
Coronary Care Units - organization & administration
Databases as Topic
Endovascular Procedures - classification
Forms and Records Control - standards
Hospitalization - statistics & numerical data
Humans
Medical Records Systems, Computerized - standards
Ontario - epidemiology
Registries
Reproducibility of Results
Abstract
Although cardiac procedures are commonly used to treat cardiovascular disease, they are costly. Administrative data sources could be used to track cardiac procedures, but sources of such data have not been validated against clinical registries.
To examine accuracy of cardiac procedure coding in administrative databases versus a prospective clinical registry.
We examined a total of 182,018 common cardiac procedures including percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG) surgery, valve surgery, and cardiac catheterization procedures during fiscal years 2005 and 2006 across 18 cardiac centers in Ontario, Canada.
Accuracy of codes in the Canadian Institute for Health Information (CIHI) administrative databases were compared with the clinical registry of the Cardiac Care Network.
Comparing 17,511 CIHI and 17,404 registry procedures for CABG surgery, the positive predictive value (PPV) of CIHI-coded CABG surgery was 97%. In 6229 CIHI-coded and 5885 registry-coded valve surgery procedures, the PPV of the administrative data source was 96%. Comparing 38,527 PCI procedures in CIHI to 38,601 in the registry, the PPV of CIHI was 94%. Among 119,751 CIHI-coded and 111,725 registry-coded cardiac catheterization procedures, the PPV of administrative data was 94%. When the procedure date window was expanded from the same day to ±1 days, the PPV was 96% (PCI) and exceeded 98% (CABG surgery), 97% (valve surgery), and 95% (cardiac catheterization).
Using a clinical registry as the gold standard, the coding accuracy of common cardiac procedures in the CIHI administrative database was high.
PubMed ID
21979370 View in PubMed
Less detail

Administrator urges penalties for doctors who don't use electronic medical records.

https://arctichealth.org/en/permalink/ahliterature133924
Source
CMAJ. 2011 Jul 12;183(10):E646
Publication Type
Article
Date
Jul-12-2011

701 records – page 1 of 71.