Ensuring Information Security in Electronic Health Record System Using Cryptography and Cuckoo Search Algorithm

In the contemporary era,the abundant availability of health information through internet and mobile technology raises concerns.Safeguarding and maintaining the confidentiality of patients’medical data becomes paramount when sharing such information with authorized healthcare providers.Although electronic patient records and the internet have facilitated the exchange of medical information among healthcare providers,concerns persist regarding the security of the data.The security of Electronic Health Record Systems(EHRS)can be improved by employing the Cuckoo Search Algorithm(CS),the SHA-256 algorithm,and the Elliptic Curve Cryptography(ECC),as proposed in this study.The suggested approach involves usingCS to generate the ECCprivate key,thereby enhancing the security of data storage in EHR.The study evaluates the proposed design by comparing encoding and decoding times with alternative techniques like ECC-GA-SHA-256.The research findings indicate that the proposed design achieves faster encoding and decoding times,completing 125 and 175 iterations,respectively.Furthermore,the proposed design surpasses other encoding techniques by exhibiting encoding and decoding times that are more than 15.17%faster.These results imply that the proposed design can significantly enhance the security and performance of EHRs.Through the utilization of CS,SHA-256,and ECC,this study presents promising methods for addressing the security challenges associated with EHRs.

Maturity Assessment of Hospital Information Systems Based on Electronic Medical Record Adoption Model (EMRAM)— Private Hospital Cases in Iran

Introduction: Today, information technology is considered as an important national development principle in each country which is applied in different fields. Health care as a whole and the hospitals could be regarded as a field and organizations with most remarkable IT applications respectively. Although different benchmarks and frameworks have been developed to assess different aspects of Hospital Information Systems (HISs) by various researchers, there is not any suitable reference model yet to benchmark HIS in the world. Electronic Medical Record Adoption Model (EMRAM) has been currently presented and is globally well-known to benchmark the rate of HIS utilization in the hospitals. Notwithstanding, this model has not been introduced in Iran so far. Methods: This research was carried out based on an applied descriptive method in three private hospitals of Isfahan—one of the most important provinces of Iran—in the year 2015. The purpose of this study was to investigate IT utilization stage in three selected private hospitals. Conclusion: The findings revealed that HIS is not at the center of concern in studied hospitals and is in the first maturity stage in accordance with EMRAM. However, hospital managers are enforced and under the pressure of different beneficiaries including insurance companies to improve their HIS. Therefore, it could be concluded that these types of hospitals are still far away from desirable conditions and need to enhance their IT utilization stage significantly.

Psychiatric electronic health records privacy in Jordan: A policy brief

Psychiatric health records are highly sensitive data which requires special policy to maintain its privacy,without affecting data accessibility.The current authors reviewed social,ethical and legal underpinnings for psychiatric electronic health records(EHR),and suggests a policy to maintain privacy and confidentiality of the psychiatric data,without affecting data accessibility.The purpose of this policy brief is to discuss and provide alternatives regarding psychiatric electronic health records privacy and information access.The current policy applied in Jordan still immature to ensure high levels of reliability,as the psychiatric data is openly accessed to the non-specialized personnel.Sensitive personal data policy is recommended in this paper with developing overriding mechanisms to counteract obstacles to data accessibility.

Integrating Electronic Systems for Requesting Clinical Laboratory Test into Digital Clinical Records: Design and Implementation

Clinical laboratory tests are basic elements that support healthcare tasks such as disease detection, diagnosis and monitoring of response to treatments. Current laboratory information systems focus on the patient database, tests and results, with multiple modules available, connecting with the various analytical systems or work areas. However laboratory information systems functioned as “islands of information”, because their design was fundamentally inward-looking and disconnected from other healthcare computer applications. Actually, the Electronic Health Register (EHR) is considered by clinicians as a tool with great potential healthcare benefits. The EHR, in the sense of a unique and complete record of a patient’s healthcare and state of health, regardless of the healthcare level used, is a real attempt to eliminate these “islands of information” and need modules to act as “bridges” with the laboratory information systems. This type of module, which in generic terms may be referred to as a laboratory test request module, has become an essential feature of the EHR. These modules need to use a laboratory coding system as a common language for exchanging information, ensuring that tests and results are unequivocally identified. The development of the laboratory test request module requires the commitment of professionals and political authorities, being necessary time for their design and an adequate pilot phase. The laboratory professionals have to assume a leadership role in the whole process of design, development and implementation of these modules, integrating in the equipment of information technologies of healthcare providers. In our manuscript we review the elements that may prove electronic systems for requesting clinical laboratory test into digital clinical records and the key elements to move from theory to practice.

The model of taking electronic medical records as the core for information construction in hospitals＂

The development of hospital information has been carried out for nearly 50 years, and originally started Le hospital information system （HIS）1 So far HIS isas the hospital information system （HIS）J So far HIS is the most widely and deeply used management system for hospitals in China.2 ＂General function standard for hospital information system＂ issued by China＇s Ministry of Health in 2002 defined that ＂The hospital information system refers to using of computer hardware and software technology, network communications technology, and other modem technology to comprehensively manage personnel, logistics, and finance in various departments in hospital. Gather, store, treat, extract, transport, aggregate,and process data in various stages of the medical activities, so that provide comprehensive and automatic information management and service to the hospital.＂

Smart Dynamic Resource Allocation Model for Patient-Driven Mobile Medical Information System Using C4.5 Algorithm

A mobile medical information system (MMIS) is an integrated application (app) of traditional hospital information systems (HIS) which comprise a picture archiving and communications system (PACS), laboratory information system (LIS), pharmaceutical management information system (PMIS), radiology information system (RIS), and nursing information system (NIS). A dynamic resource allocation table is critical for optimizing the performance to the mobile system, including the doctors, nurses, or other relevant health workers. We have designed a smart dynamic resource allocation model by using the C4.5 algorithm and cumulative distribution for optimizing the weight of resource allocated for the five major attributes in a cooperation communications system. Weka is used in this study. The class of concept is the performance of the app, optimal or suboptimal. Three generations of optimization of the weight in accordance with the optimizing rate are shown.

The Effects of Information and Communication Technology on Health Service Delivery at Tafo Government Hospital

This study sought to find out the effects of Information and Communication Technology (ICT) on health service delivery at Tafo Government Hospital. A descriptive survey design was used. Data were collected through the use of semi-structured questionnaire and administered to 50 respondents where stratified random sampling technique was used by ranking position as strata. Data were analyzed using descriptive statistics. From the findings, 56% of the respondents overwhelmingly agreed to the fact that the applications of ICT provide quicker medical diagnoses, reduced workload among users, improvement in patients’ waiting time and information accessibility. Nonetheless, 72% bemoaned lack of ICT infrastructure, poor ICT network concerns coupled with that insufficient knowledge on the use of ICT could impede the impact of ICT in quality service delivery. This could be deduced from the findings that ICT improves collaboration and clinical decision support in facilitating clinical work flow integration among nurses and other medical professionals. Moreover, the findings above affirm the fact that without electricity, ICT infrastructure, insufficient skills and technical knowledge in dealing with ICT innovations, it is impossible to successfully adopt ICT resources in health care delivery. The above findings show that the majority of healthcare professional generally had a positive attitude towards ICT prospects as they rated their skill as fairly well. The study recommends that the Ministry of Health plays a supporting role by investing in health care ICT.

北京市麻醉科电子病历信息化及药品管理智能化系统建设现状分析

目的探究北京市麻醉科电子病历信息化及药品管理智能化系统的建设现状。方法选取2021年1~12月北京市辖区内109家二级及以上医院上报的质控数据进行分析,对麻醉科电子病历信息化及药品管理智能化系统相关的质控指标实行动态管理,探讨其在临床麻醉及质控管理中的应用现状。结果截至2021年12月,64家医院(58.7%)启用麻醉科电子记录系统,63家(57.8%)医院启用电子化麻醉记录单,45家(41.3%)医院启用电子化术前访视记录单,49家(45.0%)医院启用电子化术后随访记录单,32家(29.4%)医院启用电子化麻醉恢复室记录单,23家(21.1%)医院配备智能药柜,68家(62.4%)医院配备彩色药品标签。朝阳区、海淀区、东城区、西城区麻醉科电子病历信息化医院数量较多,顺义区、门头沟区、通州区、平谷区上报的医院中只有1~2家医院启用麻醉信息管理系统,麻醉科电子病历信息化程度较低,怀柔区、密云区上报的医院中尚未启用麻醉信息管理系统。结论北京市部分区域麻醉电子病历信息化及药品管理智能化仍偏低、麻醉信息化建设滞后,需进一步加强麻醉质控管理标准化和医疗服务同质化建设。

Word Embedding Bootstrapped Deep Active Learning Method to Information Extraction on Chinese Electronic Medical Record

Electronic medical record (EMR) containing rich biomedical information has a great potential in disease diagnosis and biomedical research. However, the EMR information is usually in the form of unstructured text, which increases the use cost and hinders its applications. In this work, an effective named entity recognition (NER) method is presented for information extraction on Chinese EMR, which is achieved by word embedding bootstrapped deep active learning to promote the acquisition of medical information from Chinese EMR and to release its value. In this work, deep active learning of bi-directional long short-term memory followed by conditional random field (Bi-LSTM+CRF) is used to capture the characteristics of different information from labeled corpus, and the word embedding models of contiguous bag of words and skip-gram are combined in the above model to respectively capture the text feature of Chinese EMR from unlabeled corpus. To evaluate the performance of above method, the tasks of NER on Chinese EMR with “medical history” content were used. Experimental results show that the word embedding bootstrapped deep active learning method using unlabeled medical corpus can achieve a better performance compared with other models.

信息链视域下电子病历数据驱动临床决策的需求模型构建

[目的/意义]在信息链视域下,提炼电子病历数据驱动临床决策的用户需求,构建需求模型,帮助弥合临床决策支持服务与现实临床工作需要的差距,为电子病历数据提供价值释放靶点,拓展信息链的应用域,助益临床决策支持系统和平台建设,进而为面向临床的情报服务提供指导。[方法/过程]以信息链为理论基础,利用模板分析的方法,通过对访谈资料的分析,提炼了7个一级需求主题、24个二级主题、54个三级主题、43个四级主题以及2个五级主题,构建了电子病历数据驱动临床决策的需求层级模型。[结果/结论]沿着信息链,可以将电子病历数据驱动临床决策的用户需求归纳为病历的智能化记录、临床关键信息的组织与提取识别、电子病历数据驱动的疾病风险预测、疾病诊疗经验与知识的提炼补充、疾病诊断辅助、病情异常原因分析、治疗方案的辅助制定与推荐。医生对电子病历数据驱动临床决策的应用采纳呈现出不同程度的积极性,表现出了对数据确权不清、信息技术成熟度不高等风险的担忧。

基于自然语言处理与结构化算法的病历信息高精度抽取方法研究

目的:综合运用自然语言处理、结构化算法和知识图谱等技术,探索实现电子病历高精度信息抽取和结构化处理的方法。方法:通过构建命名实体识别模型、关系识别模型、同义词识别模型完成病历文本的句内信息抽取;提出了一种病历生成树算法,可以有效实现大段落病历文本分层结构的解析;同时利用知识图谱技术存储信息抽取与分层解析的构造模型,实现病历文本信息高精度抽取。结果:形成了一套融合深度学习算法与结构化解析算法的病历信息高精度抽取方法,其中实体识别模型准确率达95.74%,关系识别模型准确率达89.20%,最终生成具有清晰层次结构、可精确定位和抽取信息的结构化病历。结论:本文所探索的病历信息高精度抽取方法,将深度学习算法与结构化解析算法相融合,兼顾了病历文本的句内信息抽取与病历结构层次的解析,可以实现对病历数据的自动抽取、精准定位与高效管理,可以为临床医学研究奠定数据基础,也可以为其他疾病病历文本数据的挖掘提供方法学参考。

基于五级电子病历的医院信息基础建设历程与实践成果

随着医疗系统电子信息化应用地不断深入以及我国医改新政强调进一步提升医院信息化建设水平,以电子病历为核心的医院信息化建设已成为进一步提升医疗质量、诊疗效率的重要工作。电子病历系统应用水平分级评价是衡量医院信息化建设水平的国家标准。为向更高标准五级跨进,中山大学附属第六医院通过持续长达1年的升级改造措施,于2023年8月正式通过了国家电子病历五级评审。文章基于电子病历分级评价标准五级要求对中山大学附属第六医院电子病历基础建设的现状进行分析,介绍医院信息基础建设历程以及五级电子病历系统升级改造措施和取得的成果。

智慧医院评价推动临床医技业务整合的路径探索

目的探索智慧医院评价推动医院临床医技业务整合的路径。方法以宁夏某三甲医院为例,对临床与药学、临床与检验、临床与影像等进行业务整合。结果通过对标智慧医院评价标准进行临床医技业务整合,实现了用药全流程管控,统一检验诊断降本增效,智慧影像体系提升诊断质量等。结论智慧医院评价标准促进了临床医技业务整合,推动了医院综合改革和高质量发展。

改进麻醉信息管理系统提高麻醉文书质量

为探讨改进麻醉信息管理系统(AIM S)对提高麻醉文书质量的作用,该文通过对AIM S的4大体系细节功能的改进,随机抽取改进前和改进后的麻醉文书各6000份,对麻醉文书的合格量、合格率、缺陷项、缺陷率进行数据的统计分析,并探讨AI M S细节功能的改进对麻醉文书的质量及麻醉医生文书工作时间的影响。结果证明,改进后的麻醉文书合格率较改进前升高34.9%,4大体系均有明显改善,9项缺陷率均显著下降(P<0.05);麻醉医生文书工作时间显著减少(P<0.05)。说明改进的AIMS明显提高麻醉文书的质量,显著降低了缺陷率;大大减少麻醉医生的工作时间,提高质控效率;麻醉信息系统细节功能的改进促进了麻醉质量管理更加的实时、完整且精确。

基于临床决策支持的电子护理病历后馈控制系统的建立及效果评价

目的:建立基于临床决策支持系统(CDSS)的电子护理病历后馈控制系统并进行效果评价。方法:2023年1月,南京大学医学院附属鼓楼医院启动CDSS建设项目,成立电子护理病历小组,通过文献查阅、访谈后提供建立CDSS所需的信息资料和建设思路,软件工程师开发CDSS电子护理病历后馈控制系统。随机选取南京大学医学院附属鼓楼医院的16个病区,对传统护理质控和基于CDSS的电子护理病历后馈控制系统的质控效果进行比较。采用随机数字表的方法,将16个病区分为试验组(n=8)和对照组(n=8)。试验组对出院病历采用信息化后馈控制系统进行质控;对照组对于出院病历采取传统的人工核查方法进行质检,分析两组质控系统的质控时长和发现问题的能力。结果:试验组的质控时长为(2.00±0.66)min,低于对照组的(6.20±1.54)min,差异有统计学意义(P<0.05)。试验组核查出的护理量表评估记录单、护理会诊记录单、护理记录单、体温单、护理培训及质控记录单、出院记录单以及发现的问题总数量均高于对照组,差异有统计学意义(P<0.05)。试验组的电子护理病历后馈控制系统满意度高于对照组的传统人工核查,差异有统计学意义(P<0.05)。结论:基于CDSS的电子护理病历后馈控制系统的建立,有利于提高电子护理病历质量,缩短出院病历质控时长,提高用户使用满意度,值得在临床应用。

电子病历评级实证材料管理系统建设实践

目的根据国家卫健委提出的国家电子病历系统应用水平评级标准,研究为医院参加国家电子病历等级评审前的实证材料截图工作提供了信息化解决方案。方法搭建一套低代码平台,对基本的表单、功能进行创建维护,并为用户提供实现方式、截图、说明等录入功能。结果在平台中通过调用自定义外部链接的方式,将录入的条款内容、截图整合并导出标准的、符合实证材料格式规范的Word文档。结论摒弃了繁琐易错的手工整合操作,为待评级医院提供经验参考,赢得更多提升截图质量的时间,提高实证材料审核通过率。

医疗数据共享中的患者隐私信息泄露溯源方法研究

[目的/意义]利用区块链技术可以实现电子病历在不同医院之间的共享,但可能会出现患者隐私信息被泄露的情况,本研究试图对患者隐私信息的泄漏点排查方法进行探索。[方法/过程]利用区块链技术构建一个医疗区块链模型,以此为基础,在共享的电子病历文档中插入访问标志,在区块链中永久地保存访问行为;当发生隐私信息泄露时,借助于上述访问痕迹进行泄漏点排查。[结果/结论]当泄露隐私信息的文档中能检测出访问标志时,可准确地定位一个泄露点;否则,可结合访问行为记录和隐私信息来源识别结果,较准确地定位若干个疑似泄露点。

推进电子病历信息化提高病历内涵质量的研究

目的以2022年国家病案管理质量控制中心发布的《提升病历内涵质量专项行动计划》文件为指导,探索提高病历内涵质量的管理方式。方法:以三级甲等公立医院2022—2023年度病历为研究对象。随机抽取2022年度手术病历、肿瘤化疗/放疗病历和输血病历各500份,共2000份为实验组;2023年度手术病历、肿瘤化疗/放疗病历和输血病历各500份,共2000份为对照组。实验组通过优化医疗数据利用、创新与扩展结构化电子病历模板、深化病历内涵质量系统信息化以及强化院级病历质量反馈工具信息化等质量监管方法,对照组采用传统方法。结果与对照组相比,实验组手术病历组出院记录24 h内完成率、CT/MRI检查记录符合率、病理检查记录符合率、抗菌药物使用记录符合率、手术相关记录完整率、医师查房记录完整率和知情同意书规范签署率明显提高,不合理复制病历发生率明显降低;肿瘤化疗病历组入院记录24 h内完成率、出院记录24 h内完成率、CT/MRI检查记录符合率、抗菌药物使用记录符合率、医师查房记录完整率和知情同意书规范签署率明显提高;肿瘤放疗病历组出院记录24 h内完成率、CT/MRI检查记录符合率、恶性肿瘤放射治疗记录符合率、医师查房记录完整率和知情同意书规范签署率明显提高,不合理复制病历发生率明显降低;输血病历组CT/MRI检查记录符合率、抗菌药物使用记录符合率、临床用血相关记录符合率、医师查房记录完整率和知情同意书规范签署率明显提高,差异具有统计学意义(P<0.05)。结论推进电子病历信息化可有效提升病历内涵质量。

电子病案对医院病案管理发展的推动作用探讨

通过电子病案的应用,医院能够实现病案信息的数字化、电子化和集约化管理,减少数据输入错误的可能性,提高病案管理的效率和质量。在保证病案的准确性、完整性、真实性的同时,还可以进一步减轻医务人员的工作负担,在一定程度上提高医务人员的工作效率。同时,电子病案采用数字化方式进行管理,通过信息系统将病历数据存储在电子平台上,实现了信息的快速共享和传递,促进了医院的信息化建设和医疗质量的提升。本文重点讨论电子病案对医院病案管理发展的推动作用,并提出相应的建议。

面向真实世界的知识挖掘与知识图谱补全研究(三):基于正则表达式对膀胱癌真实世界数据的结构化信息抽取

随着医疗大数据的发展,真实世界研究近些年来越来越受到重视,发展前景良好,但真实世界研究的实施仍存在一些挑战,引起学者们广泛讨论。真实世界数据的非结构化是目前最亟待解决的问题。本研究以正则表达式为基础,通过基于规则的信息抽取方法对武汉大学中南医院近几年膀胱癌患者的入院记录、病理报告、手术记录和影像记录等数据进行结构化信息抽取,并以准确率和召回率为指标评价其抽取效果,旨在为后续研究提供参考。