Cloud-assisted mobile health (mHealth) monitoring, which applies the prevailing mobile communications and cloud computing technologies to provide feedback decision support, has been considered as a revolutionary approach to improving the quality of healthcare service while lowering the healthcare cost. Unfortunately, it also poses a serious risk on both clients’ privacy and intellectual property of monitoring service providers, which could deter the wide adoption of mHealth technology. This paper is to address this important problem and design a cloud-assisted privacy preserving mobile health monitoring system to protect the privacy of the involved parties and their data. Moreover, the outsourcing decryption technique and a newly proposed …show more content…
In the US, such record keeping and communication are difficult to establish because of the highly diverse and decentralized nature of healthcare. Physicians’ offices, clinics, hospitals, and pharmacies use computer systems that, for the most part, aren’t interoperable. In addition, the development of multiple healthcare systems has resulted in data not being easily translated fromone system to another.1 Standards are the key to solving these interoperability problems and enabling collaboration among computer systems. Several organizations, including AMRITA SAI INSTITUTE OF SCIENCE AND TECHNOLOGY 1 WellPoint, Blue Cross, and Blue Shield, have initiatives under way to develop electronic prescriptions, but today only 2 to 3 percent of the more than three billion prescriptions each year are submitted electronically. Typically, a physician writes a prescription on paper and gives it to the patient. The patient carries the prescription to the pharmacy, waits in line to hand the prescription to the pharmacist, and waits for the pharmacist to fill the prescription. The pharmacist might be unable to read the physician’s handwriting; the patient could modify or forge the prescription; or the physician might be unaware of medications prescribed by other physicians. These and other problems indicate the need to improve the quality of healthcare (see the sidebar “The Quality of
Ultimately, the software, equipment and cloud solutions the companies and vendors provide will have to demonstrate a high quality of security and reliability. Patients’ private medical data as well as their lives are at risk in this new arena of technology.
McDonald (1997) points out that health care data is siloed in multiple areas that are inaccessible to others. This kind of management of patient data does not serve the patient well. It is for this reason that SCEMS approached Providence and Swedish hospitals to propose implementation of HDE. Moreover, as stated in the McDonald article a feasible way to integrate data from disparate sources is through the use of interfaces such as the HDE. In addition, a problem that exists in the integration of these two data sources is the fact that the hospital system communicates via the standard HL7 language, while the pre-hospital system communicates via XML. Fortunately, the HDE structure accounts for this difference by translating back and forth between the two different languages.
Two organizations migrating to a common health information system would need a system that meets current regulatory requirements, meets the needs of the combined organization and their practice environment. The implementation of a common health information system would require an interdisciplinary group of forward thinking innovators, and an interoperable electronic medical record system that includes standard nursing terminology.
Healthcare systems are highly complex, fragmented, and use multiple information technology systems and vendors who incorporate different standards resulting in inefficiency, waste, and medical errors (Healthinformatics, 2016). A patient 's medical information often gets trapped in silos, which prevents information from being shared with members of the healthcare community (Healthinformatics, 2016). With increasing healthcare costs, a system needed to be created that would lead to the development and nationwide implementation of an interoperable health information technology system to improve the quality and efficiency of healthcare. Introducing the National Health Information Network (NHIN), this organization can be defined as a set of
Establishing standards for vocabularies promote data quality within health information systems. Scholarly works support this principle within the Health Information Management profession. The following articles support data quality, standardization, and interoperability as critical components of health information management and exchange. The goal of true exchange will include data sharing of critical information across the care continuum, often across disparate systems.
The passage of the American Recovery and Reinvestment Act encouraged and mandated the use of health information exchange (HIE) technology in the healthcare industry. The time had finally come to enter into the electronic age, and learn how to integrate electronic health records (EHRs) into their environment. Evolution and revolution are never easy, and several issues will arise during the transition. As EHR utilization spread through healthcare organizations, problems with interoperability became evident. How could healthcare organizations successfully achieve interoperability, and collect consistent patient data? A data dictionary may be the key to unlocking an accurate and efficient HIE.
The Director of HIM is expected to keep learning in these areas since the pace of improvement and change is expeditious. As a HIM professional he/she will need to work jointly with internal and external partners to fulfill interoperability and health information exchange agreements. Also to govern the development of standards to meet organizational needs, and engage in the development of standards to address local and national industry needs (LaTour, Eichenwald, and Oachs (2013). This is where health informatics begins to play a significant role for the Director of HIM; who will serve as a professional resource for the healthcare organization who can participate in the standards development task by examining proposed standards and recommending new ones. The HIM viewpoint in the domain of data standards has never been so appreciated.
Health care providers as well as nurses must keep track of all pertinent patient information and failure to do so leads to detrimental effect on the patient's life. CIS clinical information systems are "large, computerized database management systems that support several types of activities that include physician order entry, result retrieval, documentation and decision support". CIS is intended to replace medical records department of a hospital or any other medical institution. Physicians and clinicians can safely and quickly access information, order medication and treatments and implement appropriate care. CIS will hopefully improve productivity, increase quality care and reduce costs across the organization.
E prescribing can be a part of the EHR in Epic, which would include patient data, and not just prescription information. When e prescriptions are utilized in Epic, the medication is checked for interactions with the patient’s other medications and allergies. Check systems within Epic look for drug-allergy, drug-drug, and how the medication reacts with the disease. In a case study of 17 physicians in an ambulatory clinic conducted by Abramson et al., error rates from prescribing decreased from 35.7 per 100 prescriptions to 12.2 per 100 prescriptions in a year of e-prescribing as reviewed in this study. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 stated that healthcare providers would have access to EHRs to ensure the meaningful use standards per the Centers for Medicaid and Medicare Services (CMS). Meaningful use is attained by increasing the quality of patient outcomes by having access to the medication data, the patient’s history, and diagnosis by the prescriber. Prescribing is safer, when the provider is aware of the patient’s history, current medications, and allergies, therefore better patient outcomes. In the United States, the HITECH Act and the meaningful use standards stated by CMS have increased the use of e-prescribing per Friedman (2009). The CMS made e prescribing a
In 2013, the HIMSS Board of Directors defined interoperability in health care as having the ability to have different information technology systems and software applications communicate, exchange date, and then use the information that has been exchanged (HIMSS, 2015). Data exchange permits data accessibility between organizational boundaries, while interoperability means health systems have the ability to work together in order to advance the health status of the individuals and communities the system serves. For two systems to be interoperable, they must be able to exchange data that can be understood by a user (HIMSS, 2015). This is extremely important to the goals of HITECH and meaningful use because it aligns with the government standard
Containing ninety participants, 36% of the respondents were hospital CIOs and I.T. executives, 19% from integrated delivery systems headquarters, 19% from group practices, and 27% from other facilities. Survey results pertained to patient health records, electronic health record (EHR) certification, and other IT issues in healthcare. According to the survey, “81% of respondents said their I.T. budgets will grow, with the most common prediction being growth of 5% to 10%. Implementing electronic health records was the No. 1 software investment priority for the coming year for hospitals, integrated delivery systems and group practices alike.” (CIOs Predict Future Trends, n.d) Interestingly, despite the economy at the time showing signs of a recession, “the vast majority of health care organizations expect their information technology budgets to grow during the next fiscal year, and this growth is driven primarily by a need to improve access to information for clinicians, the survey shows.” (CIOs Predict Future Trends, n.d) This improved access to information can be applied to patients as well, as the push towards cloud storage and record/test results access alleviates the need to wait, call, and require record searches from the physician’s staff. On the subject of streamlining access to the implementation to patient EHRs, 19% of
It is hard to take a snapshot of the current technology used in healthcare as tomorrow a new innovative idea is right around the corner. A major change that has occurred over time comes from the use of electronic health records (EHR). Electronic health records usage has been on the rise for several years. It has been used by physicians, ambulatory staff, and HMOs. Since data can be easily altered the copies that must be certified for any medical provider to reference. There is a criterion for the composition of this data due to the exchanging of patient information within an interoperable medical
Over the past decade, virtually every major industry invested heavily in computerization. Relative to a decade ago, today more Americans buy airline tickets and check in to flights online, purchase goods on the Web, and even earn degrees online in such disciplines as nursing,1 law,2 and business,3 among others. Yet, despite these advances in our society, the majority of patients are given handwritten medication prescriptions, and very few patients are able to email their physician4 or even schedule an appointment to see a provider without speaking to a live receptionist. Electronic health record (EHR) systems have the potential to transform the health care system from a mostly paper-based industry to one that utilizes clinical
As the implementation of electronic health records (EHR) progress nationwide, the concepts of interoperability and health information exchange (HIE) must be discussed. The Healthcare Information and Management Systems Society (2005, p. 2) define interoperability as “the ability of health information systems to work together within and across organizational boundaries in order to advance the effective delivery of healthcare for individuals and communities.” Interoperability is the enabling of two systems, including those that do not share
Electronic-prescribing, often referred to as e-prescribing, is a fairly new, innovative way for physicians and other medical personnel to prescribe medications and keep track of patients’ medical history. Not only has e-prescribing enabled prescribers to electronically send a prescription to the patients’ pharmacy of choice, in the short amount of time it has been available, it has significantly reduced health care costs, not only for the patient, but for the medical facilities as well. In 2003, e-prescribing was included in the Medicare Modernization Act (MMA) which jumpstarted the role of e-prescribing in healthcare. It has proven to significantly reduce the yearly number medication errors and prescription fraud, and its widespread