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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
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An exploratory study of disease surveillance systems in Norway.

https://arctichealth.org/en/permalink/ahliterature154750
Source
J Telemed Telecare. 2008;14(7):368-71
Publication Type
Article
Date
2008
Author
Monika A Johansen
Jeremiah Scholl
Gudleif Aronsen
Gunnar Hartvigsen
Johan G Bellika
Author Affiliation
Norwegian Centre for Telemedicine, University Hospital of North Norway, Tromsø, Norway. monika.johansen@telemed.no
Source
J Telemed Telecare. 2008;14(7):368-71
Date
2008
Language
English
Publication Type
Article
Keywords
Cellular Phone
Communicable Disease Control - methods
Communicable Diseases - diagnosis
Disease Outbreaks - prevention & control
Family Practice
Humans
Information Storage and Retrieval - methods
Internet
Medical Records Systems, Computerized - organization & administration - standards
Norway
Practice Guidelines as Topic
Abstract
We conducted a qualitative study of the system for contagious disease surveillance in Norway. Semi-structured interviews were held with five general practitioners (GPs), including one person responsible for informing GPs in their region about potentially serious disease outbreaks. The interviews suggested that the existing system had several limitations, making it of little relevance to local epidemics or daily medical practice. Specifically, it was difficult and time-consuming for physicians to locate relevant information, and there was a substantial delay between reported diagnoses and eventual feedback about outbreaks. This resulted in information that was too old to be of value. The interviews also investigated design matters related to future realtime disease surveillance systems. The GPs expressed interest in a distributed system for realtime extraction and presentation of data from electronic record systems. They required that any such system be customizable to the specific needs of the doctor in order to be relevant in day-to-day practice, and that correct interpretation of data would be possible in the minimum of time.
PubMed ID
18852319 View in PubMed
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Approach to extract billing data from medical documentation in Russia - lessons learned.

https://arctichealth.org/en/permalink/ahliterature277539
Source
Stud Health Technol Inform. 2015;210:349-53
Publication Type
Article
Date
2015
Author
Georgy Kopanitsa
Vladimir Yampolskiy
Source
Stud Health Technol Inform. 2015;210:349-53
Date
2015
Language
English
Publication Type
Article
Keywords
Documentation - methods
Hospital Information Systems - organization & administration
Information Storage and Retrieval - methods
Medical Records Systems, Computerized - organization & administration
Models, organizational
Patient Credit and Collection - organization & administration
Russia
Abstract
Lack of a proper infrastructure of health care providers leads to the breaks in the health care process Informatization. This results in the manifestation of different data entry point. The different data sets that are entered in these different points tend to serve the same task. However, due to the different qualification of staff a consistency of data cannot be preserved. The paper presents an approach where data is split to the different levels.
PubMed ID
25991164 View in PubMed
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Beyond the EPR: complementary roles of the hospital-wide electronic health record and clinical departmental systems.

https://arctichealth.org/en/permalink/ahliterature150329
Source
BMC Med Inform Decis Mak. 2009;9:29
Publication Type
Article
Date
2009
Author
Eivind Vedvik
Aksel H Tjora
Arild Faxvaag
Author Affiliation
Norwegian Research Centre for Electronic Patient Records, Faculty of medicine Norwegian University of Science and Technology, Medical-technical research centre, N-7489 Trondheim, Norway. eivind.vedvik@gmail.com
Source
BMC Med Inform Decis Mak. 2009;9:29
Date
2009
Language
English
Publication Type
Article
Keywords
Attitude to Computers
Computer Security
Decision Support Techniques
Documentation - methods
Hospital Departments
Hospital Information Systems - organization & administration
Humans
Medical Informatics Applications
Medical Order Entry Systems - organization & administration
Medical Records Systems, Computerized - organization & administration
Norway
Quality Assurance, Health Care
Software
Abstract
Many hospital departments have implemented small clinical departmental systems (CDSs) to collect and use patient data for documentation as well as for other department-specific purposes. As hospitals are implementing institution-wide electronic patient records (EPRs), the EPR is thought to be integrated with, and gradually substitute the smaller systems. Many EPR systems however fail to support important clinical workflows. Also, successful integration of systems has proven hard to achieve. As a result, CDSs are still in widespread use. This study was conducted to see which tasks are supported by CDSs and to compare this to the support offered by the EPR.
Semi-structured interviews with users of 16 clinicians using 15 different clinical departmental systems (CDS) at a Medium-sized University hospital in Norway. Inductive analysis of transcriptions from the audio taped interviews.
The roles of CDSs were complementary to those of the hospital-wide EPR system. The use of structured patient data was a characteristic feature. This facilitated quality development and supervision, tasks that were poorly supported by the EPR system. The structuring of the data also improved filtering of information to better support clinical decision-making. Because of the high value of the structured patient data, the users put much effort in maintaining their integrity and representativeness. Employees from the departments were also engaged in the funding, development, implementation and maintenance of the systems.
Clinical departmental systems are vital to the activities of a clinical hospital department. The development, implementation and clinical use of such systems can be seen as bottom-up, user-driven innovations.
Notes
Cites: Stud Health Technol Inform. 2006;124:298-30317108540
Cites: BMC Med Inform Decis Mak. 2007;7:1417565667
Cites: BMC Med Inform Decis Mak. 2008;8:218186935
Cites: Soc Sci Med. 2009 Feb;68(3):519-2519054601
Cites: Stud Health Technol Inform. 1999;68:25-3010724881
Cites: Pharmacotherapy. 2006 Mar;26(3):323-3216503712
Cites: BMJ. 2001 Dec 8;323(7325):1344-811739222
Cites: Int J Med Inform. 2002 Dec 18;68(1-3):27-3712467788
Cites: Methods Inf Med. 2003;42(4):428-3214534645
Cites: Ann Intern Med. 1998 Mar 15;128(6):460-69499330
Cites: Int J Med Inform. 1998 Oct-Dec;52(1-3):3-279848399
Cites: Int J Med Inform. 2000 Sep;58-59:157-6610978918
PubMed ID
19523198 View in PubMed
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Big is beautiful: electronic patient records in large Norwegian hospitals 1980s-2001.

https://arctichealth.org/en/permalink/ahliterature183366
Source
Methods Inf Med. 2003;42(4):366-70
Publication Type
Article
Date
2003
Author
G. Ellingsen
E. Monteiro
Author Affiliation
University Hospital of Northern Norway, 9038 Breivika, Norway. gunnar.ellingsen@unn.no
Source
Methods Inf Med. 2003;42(4):366-70
Date
2003
Language
English
Publication Type
Article
Keywords
Diffusion of Innovation
Health Care Reform
Hospital Information Systems - organization & administration - trends
Hospitals, University - organization & administration - trends
Humans
Medical Records Systems, Computerized - organization & administration - trends
Norway
Program Development
Abstract
This paper aims to describe and analyze the prolonged efforts - spanning close to two decades - of developing and using electronic patient records in the large, university-based hospitals in Norway.
This study belongs to an interpretative approach to the development and use of information systems.
The increase in organizational, institutional, political and technological complexity has been seriously underestimated. This paper describes and analyses the prolonged efforts - spanning close to two decades - of developing and using EPRs in the large, university-based hospitals in Norway. The investments involved were considerable, implying that a crucial aspect of these efforts has been the way alliances have been forged with public institutions and agendas.
The conditions for small-scale, bottom-up and evolutionary approaches never succeeded in constructing themselves as a viable alternative to the larger, more sweeping electronic patient record initiative, reiterating a more general tendency to privilege the more comprehensive and daring projects.
PubMed ID
14534635 View in PubMed
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Case study: leading change across two sites: introduction of a new documentation system.

https://arctichealth.org/en/permalink/ahliterature165392
Source
Nurs Leadersh (Tor Ont). 2006 Dec;19(4):34-40
Publication Type
Article
Date
Dec-2006
Author
Andrea R Walker
Author Affiliation
Providence Health Care Vancouver, BC. awalker@providencehealth.bc.ca
Source
Nurs Leadersh (Tor Ont). 2006 Dec;19(4):34-40
Date
Dec-2006
Language
English
Publication Type
Article
Keywords
British Columbia
Catholicism
Forecasting
Health services needs and demand
Hospital Information Systems - organization & administration
Hospitals, Religious - organization & administration
Humans
Leadership
Medical Records Systems, Computerized - organization & administration
Multi-Institutional Systems - organization & administration
Nurse Administrators - organization & administration
Nurse's Role
Nursing Records
Organizational Innovation
Abstract
Leading change initiatives across multiple geographic locations has become increasingly frequent among nursing leaders as hospitals merge to form more effective and powerful organizations. This case study illustrates how strong nursing leadership, in conjunction with a transformational change approach, led to the successful implementation of a new documentation system at two hospitals within one organization. The project process is described in detail, including a discussion of lessons learned, and recommendations are provided for the leadership of future multi-site projects.
PubMed ID
17265672 View in PubMed
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Chronic disease management: it's time for transformational change!

https://arctichealth.org/en/permalink/ahliterature162796
Source
Healthc Pap. 2007;7(4):43-7; discussion 68-70
Publication Type
Article
Date
2007
Author
Sarah C Muttitt
Richard C Alvarez
Author Affiliation
Innovation and Adoption, Canada Health Infoway.
Source
Healthc Pap. 2007;7(4):43-7; discussion 68-70
Date
2007
Language
English
Publication Type
Article
Keywords
Canada
Chronic Disease - economics - prevention & control - therapy
Disease Management
Health Care Rationing - organization & administration
Humans
Information Systems - economics - organization & administration
Medical Records Systems, Computerized - organization & administration
National Health Programs - economics - organization & administration
Practice Guidelines as Topic
Primary Health Care - organization & administration
Quality of Health Care - organization & administration
Abstract
The authors of the lead essay present a compelling case for the development and implementation of a national strategy on chronic disease prevention and management (CDPM). The literature demonstrates that the Chronic Care Model can improve quality and reduce costs. Substantial evidence supports the role of health information technologies such as electronic health records (EHRs) in achieving these goals. However, an interoperable pan-Canadian health infostructure does not exist; funding is required to establish this across the continuum of care. An investment of $350 per capita would provide a robust health technology platform to support a national CDPM strategy. Such an investment would deliver annual benefits of $6-$7.6 billion; this could be leveraged to support national healthcare priorities such as CDPM. EHRs will improve decisions about care, reduce system errors and increase efficiency. They will also improve our ability to measure, assess and manage care. We cannot run a high-performing health system without sound data. This was a key step to enabling progress on wait times management. Leadership is required if a national CDPM strategy is to become reality. The authors made a convincing case for the development of a national strategy; we need to turn their words into actionable events to gain necessary momentum.
Notes
Comment On: Healthc Pap. 2007;7(4):6-2317595546
PubMed ID
17595551 View in PubMed
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Cognitive tools in medical teamwork: the spatial arrangement of patient records.

https://arctichealth.org/en/permalink/ahliterature183367
Source
Methods Inf Med. 2003;42(4):331-6
Publication Type
Article
Date
2003
Author
M. Bång
T. Timpka
Author Affiliation
Department of Computer and Information Science, Linköping University, S-581 83 Linköping, Sweden. magba@ida.liu.se
Source
Methods Inf Med. 2003;42(4):331-6
Date
2003
Language
English
Publication Type
Article
Keywords
Cognition
Cooperative Behavior
Documentation
Efficiency, Organizational
Humans
Medical Records Systems, Computerized - organization & administration
Organizational Culture
Patient care team
Sweden
Abstract
As a preliminary for the design of Computer-Based Patient Records, the aim of this paper is to build an understanding of the roles physical artifacts like paper-based patient records play in supporting cognition and collaboration in the health-care settings.
A small ethnographically-informed study was conducted in the emergency room at a 250-bed hospital in Sweden from the perspective of Distributed Cognition.
To track work-in-progress, clinicians placed patient records on a desk to form a shared public display that represented the current problem state for the health-care team. The results of the study suggest that the patient records and other physical artifacts are used by clinicians in different ways to form cognitive tools that offload memory tasks and support joint attention and collaboration.
To design Computer-Based Patient Records that more appropriately support cognition and teamwork, it is important to investigate how clinicians make use of the paper-based patient records. Practitioners take advantage of existing tools frequently to deal with cognitively demanding tasks and collaboration issues.
PubMed ID
14534630 View in PubMed
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Collaborative practice in health systems change: the Nova Scotia experience with the Strengthening Primary Care Initiative.

https://arctichealth.org/en/permalink/ahliterature179280
Source
Nurs Leadersh (Tor Ont). 2004 May;17(2):33-45
Publication Type
Article
Date
May-2004
Author
Ruth Martin-Misener
John McNab
Ingrid S Sketris
Lynn Edwards
Author Affiliation
School of Nursing, Dalhousie University, Halifax, NS.
Source
Nurs Leadersh (Tor Ont). 2004 May;17(2):33-45
Date
May-2004
Language
English
Publication Type
Article
Keywords
Cooperative Behavior
Family Practice - organization & administration
Health Care Reform - organization & administration
Humans
Interprofessional Relations
Liability, Legal
Malpractice
Medical Records Systems, Computerized - organization & administration
National health programs - organization & administration
Nova Scotia
Nurse Practitioners - organization & administration - psychology
Nurse's Role
Organizational Innovation
Organizational Objectives
Patient Care Team - organization & administration
Personnel Selection
Primary Health Care - organization & administration
Abstract
Recently attention has been focussed on the significance of primary care to the Canadian healthcare system. Nova Scotia. Like other provinces, is seeking ways to improve the healthcare that it provides within a financially constrained publicly funded system. The Strengthening Primary Care Initiative in Nova Scotia (SPCI) was a primary care demonstration project to evaluate specific goals related to primary care. Although the provincial government conceived the SPCI, the approach to its planning and implementation was participatory and consultative. Funded through the federal Health Transition Fund (HTF) (Health Canada 2002) and the government of Nova Scotia, the SPCI involved changes in four communities over a three-year period (2000-2002). These changes included the introduction of a primary healthcare nurse practitioner in collaborative practice with one or more family physicians; remuneration of the family physician(s) with methods other than a solely fee-for-service (FFS) arrangement; and the introduction and utilization of a computerized patient medical record. The SPCI was committed to a consultative process with stakeholders, and this gave rise to several challenges. Initially there was disagreement on the requirement for nurse practitioners at each of the demonstration sites. The Minister of Health confirmed that a nurse practitioner was a required component at each demonstration site. Differences in perspectives on the role of allied health professionals in the SPCI were encountered, and the significance of the role pharmacists have in primary care was not fully appreciated until after the SPCI had started. At the time the SPCI began there was no legislation for nurse practitioners in Nova Scotia; therefore, an approval mechanism for nurse practitioner practice was authorized through the provincial regulatory bodies for nursing and medicine. Malpractice and liability issues, particularly on the part of providers who had never worked with nurse practitioners before, were an initial concern. Recruitment of nurse practitioners into the three rural sites mirrored the difficulties with recruitment of healthcare providers encountered in other parts of rural Canada. The authors discuss their perspectives on the challenges related to interdisciplinary collaboration in health systems change that were encountered during the planning and implementation of the SPCI. Although nurse practitioner Legislation has existed in Ontario and Newfoundland and Labrador for several years, many provinces are grappling with the challenges associated with the introduction of nurse practitioners and collaborative practice. This paper conveys the experience of one province and will be of interest to administrators, educators and practitioners elsewhere in Canada who are engaged in primary healthcare renewal.
Notes
Comment In: Nurs Leadersh (Tor Ont). 2004 May;17(2):45-615239316
PubMed ID
15239315 View in PubMed
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99 records – page 1 of 10.