Personal Health Records / Clouds

The implications of intergovernmental agencies may forever change the way in which governments provide common services within a federated Australia. As governments seek to reduce duplication and inconsistencies across state and territory borders, intergovernmental agencies, born out of intergovernmental agreements, without any link to specific state or territory legislation, are challenging managers to develop, new approaches to procurement and implement information systems within this new legal dynamic framework. This paper considers the implications to managing health related records and their IT systems, having common legislative obligations across all Australia jurisdictions, to determine whether these new forms of government allow for the disposal of information, aimed at saving costs, improving the quality of data and reduce litigious risk. The paper also investigates the more general implications for any organisation operating nationally, to data sovereignty and how legislati...

New Zealand health sector has increasing demands in theageing population and ongoing inflation of medical costs. These demands are growing, and the importance of technology could optimise the healthcare sector performance. Advancement in technology drives Electronic Health Records implementation to add substantial value to health delivery systems. The investment and promotion of health informationinfrastructure have positioned New Zealand as a world leader in the field of primary care sector. Factors such as organisation structure, culture, leadership and workflow design are important to achieving successful implementation of Electronic Health Records. This review intends to critically appraise the advantages of EHRs over paper-based records (PBRs). It outlines the measures introduced by Ministry of Health to implement EHRs across the health sector in New Zealand. Furthermore, the review will provide an international comparison in implementing EHRs with that of New Zealand.

Kişisel veriler alanının önemli bir parçasını ve özel nitelikli halini oluşturan kişisel sağlık verileri ile ilgili düzenlemeleri içeren “Kişisel Sağlık Verilerinin İşlenmesi ve Mahremiyetinin Sağlanması Hakkında Yönetmelik” 29863 sayılı ve 20 Ekim 2016 tarihli Resmi Gazete’de yayımlanarak yürürlüğe girmişti. Kişisel veriler anlamında temel kanun olan 6698 sayılı Kişisel Verilerin Korunması Kanunu’nun 7 Nisan 2016 tarihinde yayımlanmış olması ve bu kanunda öngörülen Kişisel Verileri Koruma Kurulu oluşturulup görevine başlamadan Kişisel Sağlık Verileri yönetmeliğinin yayımlanması, söz konusu kurulun görüşü alınmadan hazırlandığı için henüz erken bir düzenleme olduğu yönünde eleştirilmekteydi. Kanun henüz tam olarak anlaşılmamışken, içerisinde yer alan bazı kavram ve tanımlar henüz çok yeniyken ve en önemlisi sık sık atıf yapılan Kişisel Verilerin Korunması Kurulu henüz göreve başlamamış ve çalışma usul ve esaslarının belirlenmiş olmadan Kişisel Sağlık Verileri Yönetmeliğinin yayınlanmasına yönelik eleştirilere katılmaktayım. Dolayısıyla 6698 sayılı Kişisel Verilerin Korunması Kanunu’nun ne demek istediğinin zamanla daha iyi anlaşılması, Kişisel Verileri Koruma Kurulu için seçilen üyelerin 12 Ocak 2017 tarihinde yemin ederek göreve başlaması, 28 Ekim 2017 tarihinde “Kişisel Verilerin Silinmesi, Yok Edilmesi veya Anonim Hale Getirilmesi Hakkında Yönetmelik”in yayımlanması ve son olarak 16 Kasım 2017 tarihinde “Kişisel Verileri Koruma Kurulu Çalışma Usul ve Esaslarına Dair Yönetmelik” ’in yayımlanması gibi gelişmeler, söz konusu yönetmelikte birtakım değişiklikler yapmayı ve yayımlanan düzenlemelerle uyumlulaştırmayı zorunlu hale getirmiştir. İşte bu nedenle “Kişisel Sağlık Verilerinin İşlenmesi ve Mahremiyetinin Sağlanması Hakkında Yönetmelikte Değişiklik Yapılmasına Dair Yönetmelik” 30250 sayılı Resmi Gazete’de 24 Kasım 2017 tarihinde yayımlandı ve yayımlandığı tarihte yürürlüğe girdi. Aşağıda başlıklar halinde yönetmelikle getirilen yeni düzenlemelere, Kişisel Sağlık Verileri Yönetmeliğini 6698 sayılı Kanuna uyumlu hale getirmek amacıyla yapılan değişikliklere ve açıklanması gereken diğer hususlara değinip; detaylı bir inceleme ve değerlendirmede bulunacağım.

""The existing literature in relation to electronic personal
health records (PHRs) has typically focused on the discussion
of several key issues—namely, their design, functional evaluation, privacy, security and architecture. The benefits of PHRs and barriers preventing their adoption are also widely discussed. These issues are affected by technology infrastructure, and current and
planned technology infrastructure deployment will be key determinants in the selection and design of PHR architectures. Assumptions about the community-wide deployment of required technologies such as hardware and internet accessibility are implicit in the architectural selection of PHRs and these dependencies have not been fully appreciated or addressed in the existing literature. This review article introduces and describes
two infrastructural drivers—ubiquitous technology baseline for PHRs and connectivity coverage—and examines their inter-relationships with the selected PHR architectures. Eleven functional capabilities are also described, providing a basis for the analysis of the relationships between the two infrastructural drivers and architectural selection.""

Personal Health Records (PHRs) is based on cloud virtual machine in web oriented application in which the lifelong health data of patients, who should be able to show them conveniently and securely to selected disables in an institution. The MyPHRMachines, a cloud-based PHR system taking a radically new architectural solution to health record portability. In MyPHR Machines, health-related data and the application software to view and analyze it are separately deployed in the PHR system. After uploading their medical data to MyPHRMachines, patients can access them again from remote virtual machines that contain the right software to visualize and analyze them without any need for conversion. Patients can share their remote virtual machine session with selected caregivers, my aim at providing patients (and their trusted caregivers) remote desktop or tablet computer access to all their PHR data, and support this access by the software that matches the data format. Since do not tackle semantic data integration in the paper, one can more specifically label this as health record mobility and portability. The person will need only a Web browser to access the pre-loaded fragments of their lifelong PHR.

Due to the Health Information Technology for Econom ic and Clinical Health Act (HITECH), the US medical industry has been given a directive to tran sition to electronic health records. Electronic Hea lth Records will enhance efficiency and quality of pati ent care. In this paper, open-source health informa tion systems are surveyed.These systems include electron ic medical records, electronic health records and personal health record systems. Their functionality , implementation technologies used, and security features are discussed.

Due to the Health Information Technology for Econom
ic and Clinical Health Act (HITECH), the US
medical industry has been given a directive to tran
sition to electronic health records. Electronic Hea
lth
Records will enhance efficiency and quality of pati
ent care. In this paper, open-source health informa
tion
systems are surveyed.These systems include electron
ic medical records, electronic health records and
personal health record systems. Their functionality
, implementation technologies used, and security
features are discussed.

Medical research increasingly requires the linkage of data from different sources. Conducting a requirements analysis for a new application is an established part of software engineering, but rarely reported in the biomedical literature; and no generic approaches have been published as to how to link heterogeneous health data. Literature review, followed by a consensus process to define how requirements for research, using, multiple data sources might be modeled. We have developed a requirements analysis: i-ScheDULEs - The first components of the modeling process are indexing and create a rich picture of the research study. Secondly, we developed a series of reference models of progressive complexity: Data flow diagrams (DFD) to define data requirements; unified modeling language (UML) use case diagrams to capture study specific and governance requirements; and finally, business process models, using business process modeling notation (BPMN). These requirements and their associated models should become part of research study protocols.

Behaviors carried out by the person with diabetes (e.g., healthy eating, physical activity, judicious use of medication, glucose monitoring, coping and problem-solving, regular clinic visits, etc.) are of central importance in diabetes management. To assist with these behaviors, we developed a prototype PHA for diabetes self-management that was based on User-Centered Design principles and congruent with the anticipatory vision of Project Health Design (PHD). This article presents aspects of the prototype PHA's functionality as conceived under PHD and describes modifications to the PHA now being undertaken under new sponsorship, in response to user feedback and timing tests we have performed. In brief, the prototype Personal Health Application (PHA) receives data on the major diabetes management domains from a Personal Health Record (PHR) and analyzes and provides feedback based on clinically vetted educational content. The information is presented within "gadgets" within a portal-based website. The PHR used for the first implementation was the Common Platform developed by PHD. Key changes include a re-conceptualization of the gadgets by topic areas originally defined by the American Association of Diabetes Educators, a refocusing on low-cost approaches to diabetes monitoring and data entry, and synchronization with a new PHR, Microsoft® HealthVault™.

The KNOWLEDGE-CARE vision is to enable new e-health services that are personalized, preventive, predictive, pre-emptive, participatory, pervasive and precise. This vision aims to make a move from reactive medicine to predictive medicine, developing dynamic and responsive models through knowledge extraction and using such models for personalized clinical healthcare. The proposed healthcare ecosystem can learn over time and can adapt to the variation seen in the actual real-world population.

Personal Health Records (PHR) emerge as an alternative to integrate patient's health information to give a global view of patients' status. However, integration is not a trivial feature when dealing with a variety electronic health systems from healthcare centers. Access to PHR sensitive information must comply with privacy policies defined by the patient. Architecture PHR design should be in accordance to these, and take advantage of nowadays technology. Cloud computing is a current technology that provides scalability, ubiquity, and elasticity features. This paper presents a scoping review related to PHR systems that achieve three characteristics: integrated, reliable and cloud-based. We found 101 articles that addressed thosecharacteristics. We identified four main research topics: proposal/developed systems, PHR recommendations for development, system integration and standards, and security and privacy. Integration is tackled with HL7 CDA standard. Information reliability is based in ABE security-privacy mechanism. Cloud-based technology access is achieved via SOA.

To summarize lessons learned from the European Commission (EC) co-funded project SmartPersonalHealth, a project to promote a greater understanding of the value of interoperability among Personal Health Systems (PHS) and between them and other eHealth systems, in the landscape of continuity of care and across multi-cultural environments in Europe. Key concepts in PHS interoperability, challenges, barriers and benefits were discussed with stakeholders (policy makers, regulators, procurers, healthcare providers, health professionals, patient representatives, industry, researchers) in three consultation workshops and a final conference. The results were synthesized in final report to the European Commission. The survey and analysis presented, which are designed to set the scene on the key requirements of device level interoperability within a context of using sensors, signals and imaging informatics in healthcare, set out key interoperability standards for PHS as provided for in the Con...

Health literacy is a concept that describes a patient's ability to understand materials provided by physicians or other providers. Several factors, including education level, income, and age, can influence health literacy. Research conducted at one medical practice in Florida indicated that in spite of the patients' relatively low education level, the majority indicated a broad acceptance of personal health record (PHR) technology. The key variable explaining patient willingness to adopt a PHR was the patient's health literacy as measured by the eHealth Literacy Scale (eHEALS). Adoption and use rates may also depend on the availability of office staff for hands-on training as well as assistance with interpretation of medical information. It is hoped that technology barriers will disappear over time, and usefulness of the information will promote increased utilization of PHRs. Patient understanding of the information remains a challenge that must be overcome to realize th...