A distributed framework for health information exchange using smartphone technologies

Nationwide health information exchange (NHIE) continues to be a persistent concern for government agencies, despite the many efforts and the conceived benefits of sharing patient data among healthcare providers. Difficulties in ensuring global connectivity, interoperability, and concerns on security have always hampered the government from successfully deploying NHIE. By looking at NHIE from a fresh perspective and bearing in mind the pervasiveness and power of modern mobile platforms, this paper proposes a new approach to NHIE that builds on the notion of consumer-mediated HIE, albeit without the focus on central health record banks. With the growing acceptance of smartphones as reliable, indispensable, and most personal devices, we suggest to leverage the concept of mobile personal health records (PHRs installed on smartphones) to the next level. We envision mPHRs that take the form of distributed storage units for health information, under the full control and direct possession of patients, who can have ready access to their personal data whenever needed. However, for the actual exchange of data with health information systems managed by healthcare providers, the latter have to be interoperable with patient-carried mPHRs. Computer industry has long ago solved a similar problem of interoperability between peripheral devices and operating systems. We borrow from that solution the idea of providing special interfaces between mPHRs and provider systems. This interface enables the two entities to communicate with no change to either end. The design and operation of the proposed approach is explained. Additional pointers on potential implementations are provided, and issues that pertain to any solution to implement NHIE are discussed.

The landscape of research on smartphone medical apps: Coherent taxonomy, motivations, open challenges and recommendations

OBJECTIVE

To survey researchers' efforts in response to the new and disruptive technology of smartphone medical apps, mapping the research landscape form the literature into a coherent taxonomy, and finding out basic characteristics of this emerging field represented on: motivation of using smartphone apps in medicine and healthcare, open challenges that hinder the utility, and the recommendations to improve the acceptance and use of medical apps in the literature.

METHODS

We performed a focused search for every article on (1) smartphone (2) medical or health-related (3) app, in four major databases: MEDLINE, Web of Science, ScienceDirect, and IEEE Xplore. Those databases are deemed broad enough to cover both medical and technical literature.

RESULTS

The final set included 133 articles. Most articles (68/133) are reviews and surveys that refer to actual apps or the literature to describe medical apps for a specific specialty, disease, or purpose; or to provide a general overview of the technology. Another group (43/133) carried various studies, from evaluation of apps to exploration of desired features when developing them. Few researchers (17/133) presented actual attempts to develop medical apps, or shared their experiences in doing so. The smallest portion (5/133) proposed general frameworks addressing the production or operation of apps.

DISCUSSION

Since 2010, researchers followed the trend of medical apps in several ways, though leaving areas or aspect for further attention. Regardless of their category, articles focus on the challenges that hinder the full utility of medical apps and do recommend mitigations to them.

CONCLUSIONS

Research on smartphone medical apps is active and various. We hope that this survey contribute to the understanding of the available options and gaps for other researchers to join this line of research.

A security framework for nationwide health information exchange based on telehealth strategy

This study focuses on the situation of health information exchange (HIE) in the context of a nationwide network. It aims to create a security framework that can be implemented to ensure the safe transmission of health information across the boundaries of care providers in Malaysia and other countries. First, a critique of the major elements of nationwide health information networks is presented from the perspective of security, along with such topics as the importance of HIE, issues, and main approaches. Second, a systematic evaluation is conducted on the security solutions that can be utilized in the proposed nationwide network. Finally, a secure framework for health information transmission is proposed within a central cloud-based model, which is compatible with the Malaysian telehealth strategy. The outcome of this analysis indicates that a complete security framework for a global structure of HIE is yet to be defined and implemented. Our proposed framework represents such an endeavor and suggests specific techniques to achieve this goal.

Evaluation and selection of open-source EMR software packages based on integrated AHP and TOPSIS

Evaluating and selecting software packages that meet the requirements of an organization are difficult aspects of software engineering process. Selecting the wrong open-source EMR software package can be costly and may adversely affect business processes and functioning of the organization. This study aims to evaluate and select open-source EMR software packages based on multi-criteria decision-making. A hands-on study was performed and a set of open-source EMR software packages were implemented locally on separate virtual machines to examine the systems more closely. Several measures as evaluation basis were specified, and the systems were selected based a set of metric outcomes using Integrated Analytic Hierarchy Process (AHP) and TOPSIS. The experimental results showed that GNUmed and OpenEMR software can provide better basis on ranking score records than other open-source EMR software packages.

Open source EMR software: profiling, insights and hands-on analysis

BACKGROUND

The use of open source software in health informatics is increasingly advocated by authors in the literature. Although there is no clear evidence of the superiority of the current open source applications in the healthcare field, the number of available open source applications online is growing and they are gaining greater prominence. This repertoire of open source options is of a great value for any future-planner interested in adopting an electronic medical/health record system, whether selecting an existent application or building a new one. The following questions arise. How do the available open source options compare to each other with respect to functionality, usability and security? Can an implementer of an open source application find sufficient support both as a user and as a developer, and to what extent? Does the available literature provide adequate answers to such questions? This review attempts to shed some light on these aspects.

OBJECTIVE

The objective of this study is to provide more comprehensive guidance from an implementer perspective toward the available alternatives of open source healthcare software, particularly in the field of electronic medical/health records.

METHODS

The design of this study is twofold. In the first part, we profile the published literature on a sample of existent and active open source software in the healthcare area. The purpose of this part is to provide a summary of the available guides and studies relative to the sampled systems, and to identify any gaps in the published literature with respect to our research questions. In the second part, we investigate those alternative systems relative to a set of metrics, by actually installing the software and reporting a hands-on experience of the installation process, usability, as well as other factors.

RESULTS

The literature covers many aspects of open source software implementation and utilization in healthcare practice. Roughly, those aspects could be distilled into a basic taxonomy, making the literature landscape more perceivable. Nevertheless, the surveyed articles fall short of fulfilling the targeted objective of providing clear reference to potential implementers. The hands-on study contributed a more detailed comparative guide relative to our set of assessment measures. Overall, no system seems to satisfy an industry-standard measure, particularly in security and interoperability. The systems, as software applications, feel similar from a usability perspective and share a common set of functionality, though they vary considerably in community support and activity.

CONCLUSION

More detailed analysis of popular open source software can benefit the potential implementers of electronic health/medical records systems. The number of examined systems and the measures by which to compare them vary across studies, but still rewarding insights start to emerge. Our work is one step toward that goal. Our overall conclusion is that open source options in the medical field are still far behind the highly acknowledged open source products in other domains, e.g. operating systems market share.

An enhanced security solution for electronic medical records based on AES hybrid technique with SOAP/XML and SHA-1

This study aims to provide security solutions for implementing electronic medical records (EMRs). E-Health organizations could utilize the proposed method and implement recommended solutions in medical/health systems. Majority of the required security features of EMRs were noted. The methods used were tested against each of these security features. In implementing the system, the combination that satisfied all of the security features of EMRs was selected. Secure implementation and management of EMRs facilitate the safeguarding of the confidentiality, integrity, and availability of e-health organization systems. Health practitioners, patients, and visitors can use the information system facilities safely and with confidence anytime and anywhere. After critically reviewing security and data transmission methods, a new hybrid method was proposed to be implemented on EMR systems. This method will enhance the robustness, security, and integration of EMR systems. The hybrid of simple object access protocol/extensible markup language (XML) with advanced encryption standard and secure hash algorithm version 1 has achieved the security requirements of an EMR system with the capability of integrating with other systems through the design of XML messages.