This article reflects on the changing nature of health information access and the transition of focus from electronic health records (EHRs) to personal health records (PHRs) along with the challenges and need for alignment of national initiatives for EHR and PHR in the National Health Service (NHS) of the UK. The importance of implementing integrated EHRs as a route to enhance the quality of health delivery has been increasingly understood. EHRs, however, carry several limitations that include major fragmentation through multiple providers and protocols throughout the NHS. Questions over ownership and control of data further complicate the potential for fully utilising records. Analysing the previous initiatives and the current landscape, we identify that adopting a patient health record system can empower patients and allow better harmonisation of clinical data at a national level. We propose regional PHR 'hubs' to provide a universal interface that integrates digital health data at a regional level with further integration at a national level. We propose that these PHR hubs will reduce the complexity of connections, decrease governance challenges and interoperability issues while also providing a safe platform for high-quality scalable and sustainable digital solutions, including artificial intelligence across the UK NHS, serving as an exemplar for other countries which wish to realise the full value of healthcare records.
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http://dx.doi.org/10.1136/bmjopen-2019-029582 | DOI Listing |
JMIR Aging
September 2024
Department of Family Medicine and Community Health, School of Medicine, Duke Univeristy, Durham, NC, United States.
Background: The severity of Alzheimer disease and related dementias (ADRD) is rarely documented in structured data fields in electronic health records (EHRs). Although this information is important for clinical monitoring and decision-making, it is often undocumented or "hidden" in unstructured text fields and not readily available for clinicians to act upon.
Objective: We aimed to assess the feasibility and potential bias in using keywords and rule-based matching for obtaining information about the severity of ADRD from EHR data.
JMIR Med Inform
September 2024
Division of Medical Information Technology and Administration Planning, Kyoto University Hospital, Kyoto, Japan.
Online J Public Health Inform
July 2024
Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States.
Background: Population viral load (VL), the most comprehensive measure of the HIV transmission potential, cannot be directly measured due to lack of complete sampling of all people with HIV.
Objective: A given HIV clinic's electronic health record (EHR), a biased sample of this population, may be used to attempt to impute this measure.
Methods: We simulated a population of 10,000 individuals with VL calibrated to surveillance data with a geometric mean of 4449 copies/mL.
PLOS Digit Health
June 2024
School of Nursing, The University of British Columbia-Okanagan, Kelowna, Canada.
Demand is emerging for personal health records (PHRs), a patient-centric digital tool for engaging in shared decision-making and healthcare data management. This study uses a RE-AIM framework to explore rural patients and providers' perceptions prior to and following implementation of a PHR. Health care providers and their patients were recruited from early-adopter patient medical home clinics and a local patient advisory group.
View Article and Find Full Text PDFJMIR Ment Health
June 2024
Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
Background: In many countries, health care professionals are legally obliged to share information from electronic health records with patients. However, concerns have been raised regarding the sharing of notes with adolescents in mental health care, and health care professionals have called for recommendations to guide this practice.
Objective: The aim was to reach a consensus among authors of scientific papers on recommendations for health care professionals' digital sharing of notes with adolescents in mental health care and to investigate whether staff at child and adolescent specialist mental health care clinics agreed with the recommendations.
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