Inter-rater reliability of medication error classification in a voluntary patient safety incident reporting system HaiPro in Finland.

Background: Medication errors are common in healthcare. Medication error reporting systems can be established for learning from medication errors and risk prone processes, and their data can be analysed and used for improving medication processes in healthcare organisations. However, data reliability testing is crucial to avoid biases in data interpretation and misleading findings informing patient safety improvement.

Literature Review of Patient Record Structures from the Physician's Perspective.

The Finnish Patient Data Repository is a nationwide electronic health record (EHR) system collecting patient data from all healthcare providers. The usefulness of the large amount of data stored in the system depends on the underlying data structures, and thus a solid understanding of these structures is in focus in further development of the data repository. This study seeks to improve that understanding by a systematic literature review.

Impacts of structuring the electronic health record: Results of a systematic literature review from the perspective of secondary use of patient data.

Purpose: To explore the impacts that structuring of electronic health records (EHRs) has had from the perspective of secondary use of patient data as reflected in currently published literature. This paper presents the results of a systematic literature review aimed at answering the following questions; (1) what are the common methods of structuring patient data to serve secondary use purposes; (2) what are the common methods of evaluating patient data structuring in the secondary use context, and (3) what impacts or outcomes of EHR structuring have been reported from the secondary use perspective.

Methods: The reported study forms part of a wider systematic literature review on the impacts of EHR structuring methods and evaluations of their impact.

Steps in Moving Evidence-Based Health Informatics from Theory to Practice.

Objectives: To demonstrate and promote the importance of applying a scientific process to health IT design and implementation, and of basing this on research principles and techniques.

Methods: A review by international experts linked to the IMIA Working Group on Technology Assessment and Quality Development.

Results: Four approaches are presented, linking to the creation of national professional expectations, adherence to research-based standards, quality assurance approaches to ensure safety, and scientific measurement of impact.

Evolving Health IT Systems Evaluation: The Convergence of Health Informatics and HTA.

The credibility and reliability of health IT systems as a means of achieving changes towards safer and cost-effective care have been questioned for over two decades due to the lack of methodologically strong evidence. As national level adoption and implementation of health IT are becoming widespread across the EU and globally, but are also being offset by adverse reports, the demands for evidence become more pronounced and the stakes higher. The adaptation of HTA (health technology assessment) methodology as a means to address gaps in health IT evidence production has been proposed repeatedly and tested in the field of telemedicine services.

Secondary use of structured patient data: interim results of a systematic review.

In addition to patient care, EHR data are increasingly in demand for secondary purposes, e.g. administration, research and enterprise resource planning.

Impacts of structuring the electronic health record: a systematic review protocol and results of previous reviews.

Purpose: This paper (1) presents the protocol of an on-going systematic literature review on the methods of structuring electronic health record (EHR) data and studying the impacts of implemented structures, thus laying basis for the analysis of the empirical articles (2) describes previous reviews published on the subject and retrieved during the search of bibliographic databases, and (3) presents a summary of the results of previous reviews.

Methods: Cochrane instructions were exploited to outline the review protocol - phases and search elements. Test searches were conducted to refine the search.

PARENT joint action: increasing the added value of patient registries in a cross-border setting.

Patient registries are poorly interoperable and as a result data exchange or aggregation across organizations, regions and countries for secondary purposes (i.e. research and public health) is difficult to perform.

Using EHR data for monitoring and promoting patient safety: reviewing the evidence on trigger tools.

Trigger tools, both paper and automated, have been viewed as a promising technology for patient record content analysis and identification of patient safety adverse events. The requirements and potential barriers for implementation of each line of tools have been explored by means of a literature review focusing on two interconnected subject areas: the Institute of Healthcare Improvement's paper-based Global Trigger Tool, which is currently taken up by several national level patient safety programs, and automated trigger tools, because of their increased feasibility as electronic health record (EHR) adoption grows. This paper provides an overview of the existing evidence on the strengths and weaknesses of each approach, and discusses the implications of the findings from the perspectives of healthcare organizations' management and staff, and from the viewpoint of demands on EHR systems.

Towards a National Health Information System evaluation.

Most EU Member States have a documented policy on eHealth. Documented follow-up and evaluation strategies for assessing whether national level systems have reached their set aims and outcomes are, however, rare. Methodologies for large scale information system assessment and evaluation are poorly established.

Planning for national health information system evaluation.

Most EU member states have a documented policy on eHealth. Documented follow-up and evaluation policies to assess reaching of the set aims, as well as evaluating outcomes of implemented systems at a national level are, however, rare. Methodologies for large scale information system assessment and evaluation are poorly established.

Finland's strategy and implementation of citizens' access to health information.

The strategy for utilizing information technology in the field of social welfare and health care in Finland was published in 1996. It was redefined in the year 2006. This updated strategy defined basic principles how digitized EHRs should be stored, accessed, disclosed and archived.

Sharing and management of EHR data through a national archive: experiences from Finland.

The management of Electronic Health Records is a complex business ranging beyond just digital archiving. This article looks at the challenges involved, the different models for EHR data archiving and the impact on health-care provider systems, as well as expected benefits. Particular attention is paid to the Finnish system and its experiences.

eHealth in Greece: strategic and implentation perpectives.

The main elements of the Greek Strategy for eHealth are presented, against a background overview of recent, relevant policy development. These elements, together with the current state of implementation were captured by the eHealth ERA survey on progress in individual Member States. An assessment of findings against targets set by the EU eHealth Action Plan and a reflection on the key success factors for converting policy into results are also presented.

Implementing interoperable secure health information systems.

Ensuring the privacy and confidentiality of individuals has made security an indispensable component of health information systems. Delivery of healthcare services beyond the enterprise level to the regional, national or cross-border area places new challenges for security implementation. We review the current status and uptake of security measures in healthcare settings across European countries and examine in more detail some of the leading eHealth applications.

eHealth in Europe: towards higher goals.

Significant events are unfolding in the field of eHealth in Europe. eHealth has been a strategic priority of the European Commission in both the eEurope 2002 and 2005 Action Plans. But how are developments on the national level progressing? The authors contrast the status-quo of eHealth in the EU-15 with the latest trends and key action priorities in the EU-25 after the Union's latest enlargement in May 2004.

Design and implementation considerations for a personalized patient education system in burn care.

Patient education is a significant factor in the provision of health care services, contributing to improved disease management and health care outcomes. Personalization has been suggested as a means for increasing patient education effectiveness and computer-based approaches have been explored as a possible means of achieving this goal. The success and capabilities of the resulting applications have been restricted by the absence of a direct link to patient data and the reliance on locally produced written material, which is expensive to produce, update and tailor.

Design considerations for a personalised patient education system.

Patient education is a significant factor in the provision of health care services, contributing to improved disease management and health care outcomes. In order to be most effective, patient education should be adapted to the characteristics of the individual recipient. Computer-based approaches have been explored as a possible means of achieving this goal.