Júlio Duarte

Electronic Health Record in Dermatology Service

In this paper we describe the implementation of an Electronic Health Record in the Dermatology service of a Portuguese hospital. This system must follow the principle of simplicity, enabling recording quality and analytical processing. Standards and norms were also followed and it is shown that interoperability has a key role in the whole process. This project is a good example of cooperation between academic and healthcare institutions and shows the impact of new technology on healthcare organizations.

Data Quality Evaluation of Electronic Health Records in the Hospital Admission Process

Data Quality Evaluation is a critical problem, specially in Healthcare, where people may take decisions based on confident, acceptable and secure information. In this paper we show how data quality can be evaluated from electronic health records, in particular in a hospital setting. We construct a dynamic virtual world of complex entities or agents, driven by one criterion alone, intelligence, for the provision of healthcare. This virtual world will witness the emergence and will be based on a versatile and powerful paradigm, where the candidate solutions (here understood as agents) are seen as evolutionary logic programs or theories, being the test if a solution is optimal based on a measure of the quality-of-information that stems from them.

Usability of an electronic health record

The Electronic Health Records (EHR) is a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting. The information included in the type of records can be progress notes, problems, medication, vital signs, medical history, laboratory data, radiology reports and much more. The usability of an EHR is crucial to achieve success, as well as guaranteeing a high level of safe and effective level of patient care system. Therefore, it is important for care providers to take steps to ensure that their EHR will be usable. Aiming to assess the usability of the EHR, a usability evaluation was performed. This paper describes how two usability evaluation methods (heuristic walkthrough and surveys) were used to evaluate its usability. With those evaluations, it was able to recognize the level of usability present in the EHR, along with the usability issues that can be disposed.

Hospital database workload and fault forecasting

With the growing importance of hospital information systems, databases became indispensable tools for day-to-day tasks in healthcare units. They store important and confidential information about patients clinical status and about the other hospital services. Thus, they must be permanently available, reliable and at high performance. In many healthcare units, fault tolerant systems are used. They ensure the availability, reliability and disaster recovery of data. However, these mechanisms do not allow the prediction or prevention of faults. In this context, it emerges the necessity of developing a fault forecasting system. The objectives of this paper are monitoring database performance to verify the normal workload for the main database of Centro Hospitalar do Porto and adapt a forecasting model used in medicine into the database context. Based on percentiles it was created a scale to represent the severity of situations. It was observe that the critical workload period is the period between 10:00 am and 12:00 am. Moreover, abnormal situations were detected and it was possible to send alerts and to request assistance.

Usability evaluation of Electronic Health Record

Electronic Health Records (EHR) is a core part of a hospital information system, as well as a service on duty of the patient to improve the treatment of patients. It can be considered as a longitudinal electronic record of patient heath information, for example vital signs, medical history or laboratory data, generated by one or more encounters in any care delivery setting. Although the great advantages that an EHR system provides to an hospital, its adoption is slow to date due to a fundamental failure on the usability and the associated costs. This paper intends to present a usability evaluation to the EHR of a Portuguese hospital. It discusses how an inspection usability method, Heuristic Walkthrough, was used to evaluate and improve the usability of the EHR system. Outcomes from the evaluation resulted in understanding what can be improved to achieve a better system. Understand the level of usability presented by the EHR was other of the main objectives.

Stand-alone electronic health record

Hospitals have made an effort to ensure the permanent availability of data, with the reliance on the information and scalability at the lowest price. Quality and information access speed are guaranteed. On the other hand, information systems become core systems and progressively clinical paper based records has been dematerialized. The single access to information about patients and electronic media, even in critical situations, are now a reality. Despite the efforts referred to above, there remains the possibility of difficulty in accessing information in case of network or electricity failures, or in the event of a local unpredictable disaster. In this paper, we present an extension to the Electronic Health Record, called stand-alone module, to ensure the hospitals access to patients minimal clinical record in a breakdown scenario.

Step towards paper free hospital through electronic health record

Information technology has great potential for transforming the health care system, improving quality of care. With the increasing expansion of health information systems, the Electronic Health Record (EHR) has become one of the finest sources for clinical information aggregators in the context of digital health. The EHR is a core part of a hospital information system, as well as a service on duty of the patient to improve the treatment of patients. It can be considered as a longitudinal electronic record of patient heath information, for example vital signs, medical history or laboratory data, generated by one or more encounters in any care delivery setting. As the EHR offers many potential opportunities for healthcare systems, it is important to take steps to improve the system. With this in mind, a study of the features present on a Portuguese EHR was made. The basis of this study was an adoption model that evaluates the EHR system accordingly to its current features. After this study, the EHR will be ranked into one of the existing eight stages.

Information systems assessment in pathologic anatomy service

Information technologies changed the way of how the health organizations work, contributing to their effectiveness, efficiency and sustainability. Hospital Information Systems (HIS) are emerging on all of health institutions, helping health professionals and patients. However, HIS are not always implemented and used in the best way, leading to low levels of benefits and acceptance by users of these systems. In order to mitigate this problem, it is essential to take measures able to ensure if the HIS and their interfaces are designed in a simple and interactive way. With this in mind, a study to measure the user satisfaction and their opinion was made. It was applied the Technology Acceptance Model (TAM) on a HIS implemented on various hospital centers (AIDA), being used the Pathologic Anatomy Service. The study identified weakness and strengths features of AIDA and it pointed some solutions to improve the medical record.

Step Towards Interoperability in Nursing Practice

Hospitalinpatientcarecompromisesoneofthemostdemandingservicesinhealthinstitutionsfor providingacarefulandcontinuoushealthcareassistance.Suchdemandsrequireaconstantupdateofthe patients’healthrecordalliedwithsupportsystemsresponsibleformonitoringtheirclinicalinformation. Inthiscontext,theprobleminthisstudybecomesaprocessofcontinuousimprovement.Todefinethe casestudy,itwasnecessarytouseresearchtoolssuchasquestionnairesandinterviews.Withthese techniques,itwaspossibletodelineatethestateanddimensionoftheproblem.Subsequently,the approachandsolutionwasestablishedandanewwebplatformforthedailymonitoringofpatients wasproposedfocusedonnurses.Thetoolincorporatesareal-timedatavisualization,andapatient recordduringaninpatientcareepisode.Moreover,thisarticlealsohighlightstherequiredadaptability ofthisplatformforeachhealthunitaccordingtoneeds.Withthissolution,itisexpectedtocorrect manyoftheproblemsdetectedthroughquantitativeresults. KEywoRdS Healthcare, Hospital Information System, Interoperability, Multi-Agent System, Nursing Practice