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Introduction and aims. Electronic health records (EHRs) are important tools to facilitate communication between care providers and to improve clinical research. In obstetrics they became essential. The ObsCare software was created to answer to the need for an EHR with specific obstetric features. The present study aimed to develop openEHR-archetypes capable of representing an ObsCare® EHR form and to create an openEHR-template using the developed archetypes. Methods. The study was performed in four phases: 1) selection and description of the ObsCare form; 2) Clinical Knowledge Manager (CKM) analysis; 3) modelling of the archetypes; 4) creation and testing of the template. Results. One openEHRarchetype -- Newborn summary -- was modelled to assemble the following three clinical concepts that were not represented in CKM: hours of life, "Examination of newborn movements" and "Examination of reflexes". Finally, an openEHRtemplate was built and automatically converted into an EHR by VCIntegrator. Conclusions. Considering the potential to improve clinical research, we believe that more obstetric-gynecologic clinical statements should be modelled into openEHR. [ABSTRACT FROM AUTHOR]

Aims: To compare the characteristics of scientific publications performed in hospitals that used with those that didn't use an obstetric electronic health record (EHR). Methods: This study included two reviews (A and B). Review A was an exploratory analysis of all 100 abstracts presented at the Scientific Meeting of the Portuguese Society of Obstetrics and Maternal-Fetal Medicine, in November 2017. Review B was a systematic review of studies in obstetrics, performed in Portugal and published between 2016-18 and indexed in PubMed. In both reviews, the included papers/abstracts were divided into two groups: from hospitals that used ObsCare® (ObsCare group) and from hospitals without a specific obstetric EHR or that didn't use ObsCare (sObsCare group). Results: In both reviews, the sample size was significantly higher in hospitals from the ObsCare group. In review B, the length of the study period was also significantly longer in ObsCare group; no significant difference was found in review A. Conclusion: Publications from hospitals that used an obstetric specific EHR (ObsCare), included a higher number of patients and longer study periods. [ABSTRACT FROM AUTHOR]

Since the Human Genomic Project discovered the sequencing of human genome, the interest about genome content in clinical practice has increased. Genetic information has become a key point to understand diseases or improve treatments, for example, the nutrigenomic and nutrigenetics. However, the huge amount of data generated raises the need for Electronic Health Record (EHR) improvements as it becomes increasingly necessary that it includes more specific genetic information. Thus, we aim to propose standard genetic archetypes (in openEHR) and describe our main challenges in this context. We assessed 2 bibliographical databases (Pubmed and Web of science) to determine the main clinical statements needed to create the archetypes. The clinical statements were organized in archetype-concepts, and they were created in openEHR archetype editor. One archetype - genetic test results - was created from a set of genetic data and submitted to CKM repository for review. Based on the modeled archetypes, an openEHR template can be created from the proposed archetype, mainly in the nutrigenomic area, genetic labs and others related to genetic. [ABSTRACT FROM AUTHOR]

The concerns about privacy and personal data protection resulted in reforms of the existing legislation in European Union (EU). The General Data Protection Regulation (GDPR) aims to reform the existing measures on the topic of personal data protection of the European Union citizens, with a strong input on the rights and freedoms of people and in the establishment of rules for the processing of personal data. OpenEHR is a standard that embodies many principles of interoperable and secure software for electronic health records. This work aims to understand to what extent the openEHR standard can be considered a solution for the requirements needed by GDPR. A list of requirements for a Hospital Information Systems (HIS) compliant with GDPR and an identification of openEHR specifications was made. The requirements were categorized and compared with the specifications. The requirements identified for the systems were matched with the openEHR specifications, which result in 16 requirements matched with openEHR. All the specifications identified matched at least one requirement. OpenEHR is a solution for the development of HIS that reinforce privacy and personal data protection, ensuring that they are contemplated in the system development. The institutions can secure that their Eletronic Health Record are compliant with GDPR while safeguarding the medical data quality and, as a result, the healthcare delivery. [ABSTRACT FROM AUTHOR]

Decision support systems can alert physicians to the existence of drug interactions. The Hospital Italiano de Buenos Aires, Argentina, has an in-house electronic health record with computerized physician order entry and clinical decision support. It includes a drug-drug interaction alert system, initially developed under traditional engineering techniques. As we detected a high alert override rate, we rebuilt the knowledge database and redesigned the alert interface with User-Centered Design techniques. A laboratory crossover study using clinical vignettes showed that new alerts were more usable than traditional ones. This paper aimed to validate these results through a controlled and randomized experimental study with two branches (old vs. new design) in a real setting. We analyzed, quantitatively, every fired alert between April 2015 and September 2016. Finally, we performed user surveys and qualitative interviews to inquire about their satisfaction and perceptions. In real scenarios, user-centered design alerts were more usable, being more effective and satisfactory, but less efficient than traditional alerts. “Safe omission”, as a new concept, emerged from our stratified analyses and interviews. [ABSTRACT FROM AUTHOR]

Healthcare workforce shortage can be compensated by using information and communication technologies. Remote patient monitoring systems allow us to identify and communicate complications and anomalies. Integrating social networking services into remote patient monitoring systems enables users to manage their relationships. User defined relationships may be used to disseminate healthcare related notifications. Hence this integration leads to quicker interventions and may reduce hospital readmission rate. As a proof of concept, a module was integrated to a remote patient monitoring platform. A mobile application to manage relationships and receive notifications was also developed. [ABSTRACT FROM AUTHOR]

ADL is a formal language to express archetypes, independent of standards or domain. However, its specification is not precise enough in relation to the specialization and semantic of archetypes, presenting difficulties in implementation and a few available tools. Archetypes may be implemented using other languages such as XML or OWL, increasing integration with Semantic Web tools. Exchanging and transforming data can be better implemented with semantics oriented models, for example using OWL which is a language to define and instantiate Web ontologies defined by W3C. OWL permits defining significant, detailed, precise and consistent distinctions among classes, properties and relations by the user, ensuring the consistency of knowledge than using ADL techniques. This paper presents a process of an openEHR ADL archetypes representation in OWL ontologies. This process consists of ADL archetypes conversion in OWL ontologies and validation of OWL resultant ontologies using the mutation test. [ABSTRACT FROM AUTHOR]

Studies on the validation of minimum data sets from international information standards have drawn the attention of the academic community to the identification of necessary requirements for the development of Electronic Health Records (EHRs). The primary motivation of such studies is the development of systems using archetypes. The aim of this study was to validate the minimum data set that should be used when constructing an archetyped EHR for prenatal care applications in telehealth. In order to achieve this, a data validation tool was built and used by nine expert obstetricians. The statistical analysis employed was the percentage of agreement and the content validity index. The study was conducted in three steps: 1) Literature review, 2)Instrument development, and 3) Validation of the minimum data set. Of the 179 evaluated pieces of data, 157 of them were validated to be included in the archetyped record of the first prenatal consultation, while 56 of them were allocated for the subsequent consultation record. The benefit of this research is the standardization (data validation for an archetyped system) of prenatal care, with the perspective of employing, both nationally and internationally, an archtyped telehealth system. [ABSTRACT FROM AUTHOR]

Electronic Health Records (EHRs) have made patient information widely available, allowing health professionals to provide better care. However, information confidentiality is an issue that continually needs to be taken into account. The objective of this study is to describe the implementation of rule-based access permissions to an EHR system.. The rules that were implemented were based on a qualitative study. Every time users did not meet the specified requirements, they had to justify access through a pop up window with predetermined options, including a free text option ("other justification"). A secondary analysis of a deidentified database was performed. From a total of 20,540,708 hits on the electronic medical record database, 85% of accesses to the EHR system did not require justification. Content analysis of the "Other Justification" option allowed the identification of new types of access. At the time to justify, however, users may choose the faster or less clicks option to access to EHR, associating the justification of access to the EHR as a barrier. [ABSTRACT FROM AUTHOR]

Traditional population surveys use paper forms that are filled manually by an interviewer. This process can take a long time; in comparison, computerizing the process reduces time, promotes safety and accuracy of data, improves patient care, and offers better control over the compiled information. From this perspective, it can be argued that mobile health supports mechanisms for the diagnosis, control, and prevention of metabolic diseases. In recent years, mobile devices have been applied in several health areas, such as remote monitoring, data logging, clinical decision-making, and with applications that can help maintain or initiate practices beneficial to individual health and wellbeing. However, there is a lack of applications for conducting population surveys. Thus, this work presents an application called mHealth Data Collector (mHDC) as a model for applications used in population surveys that contain such data as Body Mass Index (BMI), health- related issues, and health habit indicators. The design of this system occurred through interviews with health professionals who utilized a prototyping method to extract requirements. To develop this mobile app, the Android platform was adopted and the SQLite database was used to store patients’ health data. The JEx- celAPI and AchartEngine were also employed to generate spreadsheets and charts. The mHDC was tested using a case study in a Brazilian city. The results indicated that the health team took half the time to interview patients. In addition, the sys- tem has reduced the use of paper; centered and organized data; and allowed quick data recovery and standardization to improve the readability of data input. The mHDC proved efficient at collecting, analyzing, and safely exporting the results, thus reducing time collecting and analyzing the population survey. [ABSTRACT FROM AUTHOR]

One of the challenges of implementing health information and communication technology is the need for a skilled workforce that understands health care and ITC. There are also people and organizational challenges involved. This work describes the strategies to create such a workforce for the public network of healthcare facilities in the City of Buenos Aires, which include promoting the adoption of technologies and providing lines of contention for continuous training. [ABSTRACT FROM AUTHOR]

One of the challenges of implementing health information and communication technology is the need for a skilled workforce that understands health care and ITC. There are also people and organizational challenges involved. This work describes the strategies to create such a workforce for the public network of healthcare facilities in the City of Buenos Aires, which include promoting the adoption of technologies and providing lines of contention for continuous training. [ABSTRACT FROM AUTHOR]

An accurate and updated problems’ list is critical in a problemoriented Electronic Health Record (EHR). The lack of organization and maintenance of the problems limits its value. Certain problems have a larger effect on the clinical evolution of the patient, these are known as Comorbidities. The aim of this paper is to evaluate the impact of the automatic loading of comorbidities in the organization and maintenance of inpatient problems’ list using a comorbidities subset. [ABSTRACT FROM AUTHOR]

Studies show a gap between the expressions commonly used by health consumers and health professionals. To bridge this gap, consumer health vocabularies are presented as a solution. The aim of this paper is to describe an on-going project to create a consumer health vocabulary (CHV) in the Brazilian Portuguese language. This project will be developed in three phases: terms extraction and connection to compose a CHV graph structure, human validation, and computacional application development. We expect to make a CHV beta version (including approximately 5,000 valid consumer terms stored in a database graph) available. This project can contribute to the improvement of CHVs. [ABSTRACT FROM AUTHOR]