Since the British National Archive put forward the concept of the digital continuity in 2007,several developed countries have worked out their digital continuity action plan.However,the technologies of the digital con...Since the British National Archive put forward the concept of the digital continuity in 2007,several developed countries have worked out their digital continuity action plan.However,the technologies of the digital continuity guarantee are still lacked.At first,this paper analyzes the requirements of digital continuity guarantee for electronic record based on data quality theory,then points out the necessity of data quality guarantee for electronic record.Moreover,we convert the digital continuity guarantee of electronic record to ensure the consistency,completeness and timeliness of electronic record,and construct the first technology framework of the digital continuity guarantee for electronic record.Finally,the temporal functional dependencies technology is utilized to build the first integration method to insure the consistency,completeness and timeliness of electronic record.展开更多
Under the co-promotion of the wave of urbanization and the rise of data science,smart cities have become the new concept and new practice of urban development.Smart cities are the combination of information technology...Under the co-promotion of the wave of urbanization and the rise of data science,smart cities have become the new concept and new practice of urban development.Smart cities are the combination of information technology represented by the Internet of Things,cloud computing,mobile networks and big data,and urbanization.How to effectively achieve the long-term preservation of massive,heterogeneous,and multi-source digital electronic records in smart cities is a key issue thatmust be solved.Digital continuity can ensure the accessibility,integrity and availability of information.The quality management of electronic record,like the quality management of product,will run through every phase of the urban lifecycle.Based on data quality management,this paper constructs digital continuity of smart city electronic records.Furthermore,thework in this paper ensures the authenticity,integrity,availability and timeliness of electronic documents by quality management of electronic record.This paper elaborates on the overall technical architecture of electronic record,as well as the various technical means needed to protect its four characteristics.展开更多
At present,the provenance of electronic records is stored centrally.The centralized way of information storage has huge risks.Whether the database itself is destroyed or the communication between the central database ...At present,the provenance of electronic records is stored centrally.The centralized way of information storage has huge risks.Whether the database itself is destroyed or the communication between the central database and the external interruption occurs,the provenance information of the stored electronic records will not play its role.At the same time,uncertainties such as fires and earthquakes will also pose a potential threat to centralized databases.Moreover,the existing security provenance model is not specifically designed for electronic records.In this paper,a security provenance model of electronic records is constructed based on PREMIS and METS.Firstly,this paper analyses the security requirements of the provenance information of electronic records.Then,based on the characteristics of blockchain decentralization,and combined with coding theory,a distributed secure provenance guarantees technology of electronic records is constructed,which ensures the authenticity,integrity,confidentiality and reliability of the provenance information.展开更多
In the digital era,how to ensure the authenticity and integrity of elec-tronic records has become an open challenging issue.Front-end control is an important concept as well as a basic principle in electronic record m...In the digital era,how to ensure the authenticity and integrity of elec-tronic records has become an open challenging issue.Front-end control is an important concept as well as a basic principle in electronic record management.Under the instruction of front-end control,many original management links in the record-management stage are required to move forward,and the managers enter the formation stage of the electronic records to ensure the originality.How-ever,the front-end control technique primarily focuses on transaction manage-ment,and it lacks the strategy of providing the control of electronic records.In this paper,a novel electronic record front-end control mechanism is proposed by adopting proxy re-encryption and requiring archivists to participate in the man-agement of electronic records before the record is created to solve the problem.Specifically,when an electronic record is generated,the proposed mechanism interacts with the producer of the electronic record to generate a corresponding encryption key.Moreover,electronic records are encrypted by the key to protect their confidentiality,which can prevent the leakage of electronic record informa-tion.In addition,when transferring the electronic record,archivists use proxy re-encryption technology to convert electronic records,allowing management by an archivist,ensuring their originality and authenticity.展开更多
With the rapid development of E-commerce and E-government, there are somany electronic records have been produced. The increasing number of electronicrecords brings about storage difficulties, the traditional electron...With the rapid development of E-commerce and E-government, there are somany electronic records have been produced. The increasing number of electronicrecords brings about storage difficulties, the traditional electronic records center isdifficult to cope with the current fast growth requirements of electronic records storageand management. Therefore, it is imperative to use cloud storage technology to buildelectronic record centers. However, electronic records also have weaknesses in the cloudstorage environment, and one of them is that once electronic record owners or managerslose physical control of them, the electronic records are more likely to be tampered withand destroyed. So, the paper builds a reliable electronic records preservation systembased on coding theory. It can effectively guarantee the reliability of record storage whenthe electronic record is damaged, and the original electronic record can be restored byredundant coding, thus ensuring the reliable storage of electronic records.展开更多
With the wide application of information technology in urban infrastructure,urban construction has entered the stage of smart city,forming a large number of network electronic records.These electronic records play a v...With the wide application of information technology in urban infrastructure,urban construction has entered the stage of smart city,forming a large number of network electronic records.These electronic records play a vital role in the maintenance of urban infrastructure.However,how to preserve the network electronic records in the field of urban construction is still lack of a comprehensive and serious study.Aiming at this problem,the paper proposes to use the technology of broadcast-storage network to preserve the network electronic records for a long time and gives the concrete preservation process.展开更多
In the field of electronic record management,especially in the current big data environment,data continuity has become a new topic that is as important as security and needs to be studied.This paper decomposes the dat...In the field of electronic record management,especially in the current big data environment,data continuity has become a new topic that is as important as security and needs to be studied.This paper decomposes the data continuity guarantee of electronic record into a set of data protection requirements consisting of data relevance,traceability and comprehensibility,and proposes to use the associated data technology to provide an integrated guarantee mechanism to meet the above three requirements.展开更多
BACKGROUND The neurological and psychiatric sequelae of coronavirus disease 2019(COVID-19)have been documented,yet further data are needed to thoroughly evaluate the impact of COVID-19 on brain health years after the ...BACKGROUND The neurological and psychiatric sequelae of coronavirus disease 2019(COVID-19)have been documented,yet further data are needed to thoroughly evaluate the impact of COVID-19 on brain health years after the infection.AIM To examine whether COVID-19 infection is associated with exacerbation,recurrence,or progression of pre-existing neurological or psychiatric disorders-a highrisk population that is underrepresented in COVID-19 outcome research in National Guard Health Affair patients in 4-years following a COVID-19 diagnosis.METHODS For this multicenter retrospective cohort study,we used data from the National Guard hospitals electronic health records network(BestCare)with over 10 million patients.Our cohort comprised patients who had a COVID-19 diagnosis;a matched control cohort included patient did not expose to COVID-19 in same period.Age and sex were matching factors.We estimated the incidence of 14 neurological and psychiatric outcomes in nearly 4 years after a confirmed diagnosis of COVID-19.Using a multiple logistic regression,we compared incidences with those in propensity score-matched cohorts of patients with no exposure to COVID-19.Ramadan M et al.Neurological and psychiatric risks post-COVID-19 RESULTS Our primary cohort comprised 4437 patients diagnosed with COVID-19,and our propensity-score 1:1 matched control cohort comprised 4437 individuals.Nearly two-third of the COVID-19 cohort(71%)were diagnosed in 2020,and 2021.The most prevalent diagnoses for both cohorts were epilepsy 30.68%,mood disorder 23.92%,and nerve plexus disorder 22.13%.Dementia was nearly 4 times higher among COVID-19 cohort(8.27%)compared to the control cohort(2.57%).Five neurological and psychiatric outcomes had odds ratios(OR)that were significantly higher than 1 for people who had COVID-19 compared to people who had never been infected.These outcomes were cognitive deficit OR=1.54,95%confidence interval(CI):1.23-1.91,P=0.0001;nerve plexus disorder OR=1.13,95%CI:1.01-1.25,P=0.02;substance use disorder OR=1.95,95%CI:1.12-3.38,P=0.01;mood disorder OR=1.16,95%CI:1.05-1.29,P=0.003;and anxiety disorder OR=1.39,95%CI:1.07-1.79,P=0.01.CONCLUSION The study highlights the persistent risk of neurological and psychiatric conditions in COVID-19 survivors up to four years post-infection.Although the incidence was lower than in previous large studies,long-term consequences remain significant,emphasizing the need for ongoing monitoring and support in mental health and neurological care.展开更多
Objectives:Electronic health records(EHRs)offer valuable real-world data(RWD)for Chinese medicine research.However,significant methodological challenges remain in developing integrative Chinese-Western medicine(ICWM)d...Objectives:Electronic health records(EHRs)offer valuable real-world data(RWD)for Chinese medicine research.However,significant methodological challenges remain in developing integrative Chinese-Western medicine(ICWM)databases.This study aims to establish a best-practice methodological framework,referred to as BRIDGE,to guide the construction of ICWM databases using EHRs.Methods:We developed the methodological framework through a comprehensive process,including systematic literature review,synthesis of empirical experiences,thematic expert discussions,and consultation with an external panel to reach consensus.Results:The BRIDGE framework outlines 6 core components for ICWM-EHR database development:Overall design,database architecture,data extraction and linkage,data governance,data verification,and data quality evaluation.Key data elements include variables related to study population,treatment or exposure,outcomes,and confounders.These databases support various research applications,particularly in evaluating the effectiveness and safety of integrative therapies.To demonstrate its practical value,we developed an ICWM-EHR database on women’s reproductive lifespan,encompassing 2,064,482 patients.This database captures women’s health conditions across the life course,from reproductive age to older adulthood.Conclusions:The BRIDGE methodological framework provides a standardized approach to building high-quality ICWM-EHR databases.It offers a unique opportunity to strengthen the methodological rigor and real-world relevance of Chinese medicine research in integrated healthcare settings.展开更多
Background:Electronic Health Record(EHR)systems are used as an efficient and effective technique for sharing patient’s health records among different hospitals and various other key stakeholders of the healthcare ind...Background:Electronic Health Record(EHR)systems are used as an efficient and effective technique for sharing patient’s health records among different hospitals and various other key stakeholders of the healthcare industry to achieve better diagnosis and treatment of patients globally.However,the existing EHR systems mostly lack in providing appropriate security,entrusted access control and handling privacy and secrecy issues and challenges in current hospital infrastructures.Objective:To solve this delicate problem,we propose a Blockchain-enabled Hyperledger Fabric Architecture for different EHR systems.Methodology:In our EHR blockchain system,Peer nodes from various organizations(stakeholders)create a ledger network,where channels are created to enable secure and private communication between different stakeholders on the ledger network.Individual patients and other stakeholders are identified and registered on the network by unique digital certificates issued by membership service provider(MSP)component of the fabric architecture.Results:We created and implemented different Chaincodes to handle the business logic for executing separate EHR transactions on the network.The proposed fabric architecture provides a secure,transparent and immutable mechanism to store,share and exchange EHRs in a peer-to-peer network of different healthcare stakeholders.It ensures interoperability,scalability and availability in adapting the existing EHRs for strengthening and providing an effective and secure method to integrate and manage patient records among medical institutions in the healthcare ecosystem.展开更多
In the existing Electronic Health Records(EHRs),the medical information of patients is completely controlled by various medical institutions.As such,patients have no dominant power over their own EHRs.These personal d...In the existing Electronic Health Records(EHRs),the medical information of patients is completely controlled by various medical institutions.As such,patients have no dominant power over their own EHRs.These personal data are not only inconvenient to access and share,but are also prone to cause privacy disclosure.The blockchain technology provides a new development direction in the medical field.Blockchain-based EHRs are characterized by decentralization,openness and non-tampering of records,which enable patients to better manage their own EHRs.In order to better protect the privacy of patients,only designated receivers can access EHRs,and receivers can authenticate the sharer to ensure that the EHRs are real and effective.In this study,we propose an identity-based signcryption scheme with multiple authorities for multiple receivers,which can resist N-1 collusion attacks among N authorities.In addition,the identity information of receivers is anonymous,so the relationship between them and the sharer is not disclosed.Under the random oracle model,it was proved that our scheme was secure and met the unforgeability and confidentiality requirements of signcryption.Moreover,we evaluated the performance of the scheme and found that it had the moderate signcryption efficiency and excellent signcryption attributes.展开更多
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, whic...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.展开更多
With the rapid development of information technology,the electronifi-cation of medical records has gradually become a trend.In China,the population base is huge and the supporting medical institutions are numerous,so ...With the rapid development of information technology,the electronifi-cation of medical records has gradually become a trend.In China,the population base is huge and the supporting medical institutions are numerous,so this reality drives the conversion of paper medical records to electronic medical records.Electronic medical records are the basis for establishing a smart hospital and an important guarantee for achieving medical intelligence,and the massive amount of electronic medical record data is also an important data set for conducting research in the medical field.However,electronic medical records contain a large amount of private patient information,which must be desensitized before they are used as open resources.Therefore,to solve the above problems,data masking for Chinese electronic medical records with named entity recognition is proposed in this paper.Firstly,the text is vectorized to satisfy the required format of the model input.Secondly,since the input sentences may have a long or short length and the relationship between sentences in context is not negligible.To this end,a neural network model for named entity recognition based on bidirectional long short-term memory(BiLSTM)with conditional random fields(CRF)is constructed.Finally,the data masking operation is performed based on the named entity recog-nition results,mainly using regular expression filtering encryption and principal component analysis(PCA)word vector compression and replacement.In addi-tion,comparison experiments with the hidden markov model(HMM)model,LSTM-CRF model,and BiLSTM model are conducted in this paper.The experi-mental results show that the method used in this paper achieves 92.72%Accuracy,92.30%Recall,and 92.51%F1_score,which has higher accuracy compared with other models.展开更多
Background： The usage of modem technology in healthcare record system is now a must throughout the world. However, many doctors and nurses has been reporting facing numerous challenges and obstacles in the implementa...Background： The usage of modem technology in healthcare record system is now a must throughout the world. However, many doctors and nurses has been reporting facing numerous challenges and obstacles in the implementation. The aim of the present study is to determine the prevalence of depression, anxiety and stress among doctors and nurses who utilize EMR （electronic medical record） and its associated factor. Methods： A comparative cross-sectional study was conducted ~om January till April 2012 among doctors and nurses in two public tertiary hospitals in Johor in which one of them uses EMR and the other one still using the MMR （manual medical record） system. Data was collected using self-administered validated Malay version of DASS-21 （Depression, Anxiety, and Stress Scales-21） items questionnaire. It comprises of socio-demographic and occupational characteristics. Findings： There were 130 respondents with a response rate of 91% for EMR and 123 respondents with a response rate of 86% for MMR. The mean （SD） age of respondents in EMR and MMR groups were 34.7 （9.42） and 29.7 （6.15） respectively. The mean （SD） duration of respondents using EMR was 46.1 （35.83） months. The prevalence of depression, anxiety and stress among respondents using EMR were 6.9%, 25.4% and 12.3%. There were no significant difference between the study groups related to the depression, anxiety and stress scores. In multivariable analysis, the significant factors associated with depression among respondents using EMR was age （OR 1.10, 95% CI 1.02, 1.19）. The significant factors associated with stress among respondents using EMR was marital status （OR 3.33, 95% CI 1.10, 10.09） and borderline significant was computer skill course （OR 2.94, 95% CI 0.98, 8.78）. Conclusion： The prevalence of depression, anxiety and stress of those who uses EMR were within acceptable range. Age, marital status and computer skill are the identified factor associated with the depression and stress level which need to be considered in its implementation.展开更多
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...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.展开更多
1|DEVELOPMENT AND ADOPTION OF EHR IN THE UNITED STATES At present,health-care systems in the United States face enormous challenges in providing quality care,characterized by safe,effective,efficient,patientcentered,t...1|DEVELOPMENT AND ADOPTION OF EHR IN THE UNITED STATES At present,health-care systems in the United States face enormous challenges in providing quality care,characterized by safe,effective,efficient,patientcentered,timely,and equitable care while containing health-care costs[1,2].To understand and address patients'increasingly complicated health-care needs,we need safe access to quality information that is characterized by integrity,reliability,and accuracy[3],and establish mutually beneficial relationships among a multidisciplinary team of professionals[4].Traditional paper-based clinical workflow produces many issues such as illegible handwriting,inconvenient access,the possibility of computational prescribing errors,inadequate patient hand-offs,and drug administration errors.These problems can lead to medical errors,omissions,and duplications and,ultimately,poor patient outcomes and compromised quality of care[2].展开更多
Aim： To improve workflow and usability by introduction of a new electronic patient record （EPR） and database. Methods： Establishment of an EPR based on open source technology （MySQL database and PI-IP scripting l...Aim： To improve workflow and usability by introduction of a new electronic patient record （EPR） and database. Methods： Establishment of an EPR based on open source technology （MySQL database and PI-IP scripting language） in a tertiary care andrology center at a university clinic. Workflow analysis, a benchmark comparing the two systems and a survey for usability and ergonomics were carried out. Results： Workflow optimizations （electronic ordering of laboratory analysis, elimination of transcription steps and automated referral letters） and the decrease in time required for data entry per patient to 71% ± 27%, P 〈 0.05, lead to a workload reduction. The benchmark showed a significant performance increase （highest with starting the respective system： 1.3 ± 0.2 s vs. 11.1 ± 0.2 s, mean ± SD）. In the survey, users rated the new system at least two ranks higher over its predecessor （P 〈 0.01） in all sub-areas. Conclusion： With further improvements, today＇s EPR can evolve to substitute paper records, saving time （and possibly costs）, supporting user satisfaction and expanding the basis for scientific evaluation when more data is electronically available. Newly introduced systems should be versatile, adaptable for users, and workflow-oriented to yield the highest benefit. If ready-made software is purchased, customization should be implemented during rollout. （Asian J Andro12006 Mar; 8： 235-241）展开更多
The trusted sharing of Electronic Health Records(EHRs)can realize the efficient use of medical data resources.Generally speaking,EHRs are widely used in blockchain-based medical data platforms.EHRs are valuable privat...The trusted sharing of Electronic Health Records(EHRs)can realize the efficient use of medical data resources.Generally speaking,EHRs are widely used in blockchain-based medical data platforms.EHRs are valuable private assets of patients,and the ownership belongs to patients.While recent research has shown that patients can freely and effectively delete the EHRs stored in hospitals,it does not address the challenge of record sharing when patients revisit doctors.In order to solve this problem,this paper proposes a deletion and recovery scheme of EHRs based on Medical Certificate Blockchain.This paper uses cross-chain technology to connect the Medical Certificate Blockchain and the Hospital Blockchain to real-ize the recovery of deleted EHRs.At the same time,this paper uses the Medical Certificate Blockchain and the InterPlanetary File System(IPFS)to store Personal Health Records,which are generated by patients visiting different medical institutions.In addition,this paper also combines digital watermarking technology to ensure the authenticity of the restored electronic medical records.Under the combined effect of blockchain technology and digital watermarking,our proposal will not be affected by any other rights throughout the process.System analysis and security analysis illustrate the completeness and feasibility of the scheme.展开更多
The clinical decision support system makes electronic health records(EHRs)structured,intelligent,and knowledgeable.The nursing decision support system(NDSS)is based on clinical nursing guidelines and nursing process t...The clinical decision support system makes electronic health records(EHRs)structured,intelligent,and knowledgeable.The nursing decision support system(NDSS)is based on clinical nursing guidelines and nursing process to provide intelligent suggestions and reminders.The impact on nurses’work is mainly in shortening the recording time,improving the quality of nursing diagnosis,reducing the incidence of nursing risk events,and so on.However,there is no authoritative standard for the NDSS at home and abroad.This review introduces development and challenges of EHRs and recommends the application of the NDSS in EHRs,namely the nursing assessment decision support system,the nursing diagnostic decision support system,and the nursing care planning decision support system(including nursing intervene),hoping to provide a new thought and method to structure impeccable EHRs.展开更多
Obesity is a critical health condition that severely affects an individual’s quality of life andwell-being.The occurrence of obesity is strongly associated with extreme health conditions,such as cardiac diseases,diab...Obesity is a critical health condition that severely affects an individual’s quality of life andwell-being.The occurrence of obesity is strongly associated with extreme health conditions,such as cardiac diseases,diabetes,hypertension,and some types of cancer.Therefore,it is vital to avoid obesity and or reverse its occurrence.Incorporating healthy food habits and an active lifestyle can help to prevent obesity.In this regard,artificial intelligence(AI)can play an important role in estimating health conditions and detecting obesity and its types.This study aims to see obesity levels in adults by implementing AIenabled machine learning on a real-life dataset.This dataset is in the form of electronic health records(EHR)containing data on several aspects of daily living,such as dietary habits,physical conditions,and lifestyle variables for various participants with different health conditions(underweight,normal,overweight,and obesity type I,II and III),expressed in terms of a variety of features or parameters,such as physical condition,food intake,lifestyle and mode of transportation.Three classifiers,i.e.,eXtreme gradient boosting classifier(XGB),support vector machine(SVM),and artificial neural network(ANN),are implemented to detect the status of several conditions,including obesity types.The findings indicate that the proposed XGB-based system outperforms the existing obesity level estimation methods,achieving overall performance rates of 98.5%and 99.6%in the scenarios explored.展开更多
基金This work is supported by the NSFC(Nos.61772280,61772454)the Changzhou Sci&Tech Program(No.CJ20179027)the PAPD fund from NUIST.Prof.Jin Wang is the corresponding author。
文摘Since the British National Archive put forward the concept of the digital continuity in 2007,several developed countries have worked out their digital continuity action plan.However,the technologies of the digital continuity guarantee are still lacked.At first,this paper analyzes the requirements of digital continuity guarantee for electronic record based on data quality theory,then points out the necessity of data quality guarantee for electronic record.Moreover,we convert the digital continuity guarantee of electronic record to ensure the consistency,completeness and timeliness of electronic record,and construct the first technology framework of the digital continuity guarantee for electronic record.Finally,the temporal functional dependencies technology is utilized to build the first integration method to insure the consistency,completeness and timeliness of electronic record.
基金the NSFC (Nos. 61772280, 62072249)the AIrecognition scoring system of weather map (No. SYCX202011)+1 种基金the national training programsof innovation and entrepreneurship for undergraduates (Nos. 201910300123Y, 202010300200)the PAPD fund from NUIST. Jinyue Xia is the corresponding author.
文摘Under the co-promotion of the wave of urbanization and the rise of data science,smart cities have become the new concept and new practice of urban development.Smart cities are the combination of information technology represented by the Internet of Things,cloud computing,mobile networks and big data,and urbanization.How to effectively achieve the long-term preservation of massive,heterogeneous,and multi-source digital electronic records in smart cities is a key issue thatmust be solved.Digital continuity can ensure the accessibility,integrity and availability of information.The quality management of electronic record,like the quality management of product,will run through every phase of the urban lifecycle.Based on data quality management,this paper constructs digital continuity of smart city electronic records.Furthermore,thework in this paper ensures the authenticity,integrity,availability and timeliness of electronic documents by quality management of electronic record.This paper elaborates on the overall technical architecture of electronic record,as well as the various technical means needed to protect its four characteristics.
基金This work is supported by the NSFC(61772280,61672290)the PAPD fund from NUIST.Yongjun Ren is the corresponding author.
文摘At present,the provenance of electronic records is stored centrally.The centralized way of information storage has huge risks.Whether the database itself is destroyed or the communication between the central database and the external interruption occurs,the provenance information of the stored electronic records will not play its role.At the same time,uncertainties such as fires and earthquakes will also pose a potential threat to centralized databases.Moreover,the existing security provenance model is not specifically designed for electronic records.In this paper,a security provenance model of electronic records is constructed based on PREMIS and METS.Firstly,this paper analyses the security requirements of the provenance information of electronic records.Then,based on the characteristics of blockchain decentralization,and combined with coding theory,a distributed secure provenance guarantees technology of electronic records is constructed,which ensures the authenticity,integrity,confidentiality and reliability of the provenance information.
基金Y.J.Ren gratefully acknowledges the financial support of the NSFC(61772280,62072249),http://www.nsfc.gov.cn.
文摘In the digital era,how to ensure the authenticity and integrity of elec-tronic records has become an open challenging issue.Front-end control is an important concept as well as a basic principle in electronic record management.Under the instruction of front-end control,many original management links in the record-management stage are required to move forward,and the managers enter the formation stage of the electronic records to ensure the originality.How-ever,the front-end control technique primarily focuses on transaction manage-ment,and it lacks the strategy of providing the control of electronic records.In this paper,a novel electronic record front-end control mechanism is proposed by adopting proxy re-encryption and requiring archivists to participate in the man-agement of electronic records before the record is created to solve the problem.Specifically,when an electronic record is generated,the proposed mechanism interacts with the producer of the electronic record to generate a corresponding encryption key.Moreover,electronic records are encrypted by the key to protect their confidentiality,which can prevent the leakage of electronic record informa-tion.In addition,when transferring the electronic record,archivists use proxy re-encryption technology to convert electronic records,allowing management by an archivist,ensuring their originality and authenticity.
文摘With the rapid development of E-commerce and E-government, there are somany electronic records have been produced. The increasing number of electronicrecords brings about storage difficulties, the traditional electronic records center isdifficult to cope with the current fast growth requirements of electronic records storageand management. Therefore, it is imperative to use cloud storage technology to buildelectronic record centers. However, electronic records also have weaknesses in the cloudstorage environment, and one of them is that once electronic record owners or managerslose physical control of them, the electronic records are more likely to be tampered withand destroyed. So, the paper builds a reliable electronic records preservation systembased on coding theory. It can effectively guarantee the reliability of record storage whenthe electronic record is damaged, and the original electronic record can be restored byredundant coding, thus ensuring the reliable storage of electronic records.
文摘With the wide application of information technology in urban infrastructure,urban construction has entered the stage of smart city,forming a large number of network electronic records.These electronic records play a vital role in the maintenance of urban infrastructure.However,how to preserve the network electronic records in the field of urban construction is still lack of a comprehensive and serious study.Aiming at this problem,the paper proposes to use the technology of broadcast-storage network to preserve the network electronic records for a long time and gives the concrete preservation process.
基金This work is supported by the NSFC(61772280)the national training programs of innovation and entrepreneurship for undergraduates(Nos.201910300123Y,202010300200)the PAPD fund from NUIST.
文摘In the field of electronic record management,especially in the current big data environment,data continuity has become a new topic that is as important as security and needs to be studied.This paper decomposes the data continuity guarantee of electronic record into a set of data protection requirements consisting of data relevance,traceability and comprehensibility,and proposes to use the associated data technology to provide an integrated guarantee mechanism to meet the above three requirements.
文摘BACKGROUND The neurological and psychiatric sequelae of coronavirus disease 2019(COVID-19)have been documented,yet further data are needed to thoroughly evaluate the impact of COVID-19 on brain health years after the infection.AIM To examine whether COVID-19 infection is associated with exacerbation,recurrence,or progression of pre-existing neurological or psychiatric disorders-a highrisk population that is underrepresented in COVID-19 outcome research in National Guard Health Affair patients in 4-years following a COVID-19 diagnosis.METHODS For this multicenter retrospective cohort study,we used data from the National Guard hospitals electronic health records network(BestCare)with over 10 million patients.Our cohort comprised patients who had a COVID-19 diagnosis;a matched control cohort included patient did not expose to COVID-19 in same period.Age and sex were matching factors.We estimated the incidence of 14 neurological and psychiatric outcomes in nearly 4 years after a confirmed diagnosis of COVID-19.Using a multiple logistic regression,we compared incidences with those in propensity score-matched cohorts of patients with no exposure to COVID-19.Ramadan M et al.Neurological and psychiatric risks post-COVID-19 RESULTS Our primary cohort comprised 4437 patients diagnosed with COVID-19,and our propensity-score 1:1 matched control cohort comprised 4437 individuals.Nearly two-third of the COVID-19 cohort(71%)were diagnosed in 2020,and 2021.The most prevalent diagnoses for both cohorts were epilepsy 30.68%,mood disorder 23.92%,and nerve plexus disorder 22.13%.Dementia was nearly 4 times higher among COVID-19 cohort(8.27%)compared to the control cohort(2.57%).Five neurological and psychiatric outcomes had odds ratios(OR)that were significantly higher than 1 for people who had COVID-19 compared to people who had never been infected.These outcomes were cognitive deficit OR=1.54,95%confidence interval(CI):1.23-1.91,P=0.0001;nerve plexus disorder OR=1.13,95%CI:1.01-1.25,P=0.02;substance use disorder OR=1.95,95%CI:1.12-3.38,P=0.01;mood disorder OR=1.16,95%CI:1.05-1.29,P=0.003;and anxiety disorder OR=1.39,95%CI:1.07-1.79,P=0.01.CONCLUSION The study highlights the persistent risk of neurological and psychiatric conditions in COVID-19 survivors up to four years post-infection.Although the incidence was lower than in previous large studies,long-term consequences remain significant,emphasizing the need for ongoing monitoring and support in mental health and neurological care.
基金supported by the National Key Research&Development Program of China(No.2024YFC3505800)the National Natural Science Foundation of China(Nos.82474334,82474335 and 72174132)+3 种基金National Science Fund for Distinguished Young Scholars(No.82225049)the Key Research&Development Projects of Sichuan Provincial Department of Science and Technology(Nos.2024YFFK0174 and 2024YFFK0152)1.3.5 Project for Disciplines of Excellence,West China Hospital,Sichuan University(Nos.ZYYC24010 and ZYGD23004)the Special Fund for Traditional Chinese Medicine of Sichuan Provincial Administration of Traditional Chinese Medicine(No.2024zd023).
文摘Objectives:Electronic health records(EHRs)offer valuable real-world data(RWD)for Chinese medicine research.However,significant methodological challenges remain in developing integrative Chinese-Western medicine(ICWM)databases.This study aims to establish a best-practice methodological framework,referred to as BRIDGE,to guide the construction of ICWM databases using EHRs.Methods:We developed the methodological framework through a comprehensive process,including systematic literature review,synthesis of empirical experiences,thematic expert discussions,and consultation with an external panel to reach consensus.Results:The BRIDGE framework outlines 6 core components for ICWM-EHR database development:Overall design,database architecture,data extraction and linkage,data governance,data verification,and data quality evaluation.Key data elements include variables related to study population,treatment or exposure,outcomes,and confounders.These databases support various research applications,particularly in evaluating the effectiveness and safety of integrative therapies.To demonstrate its practical value,we developed an ICWM-EHR database on women’s reproductive lifespan,encompassing 2,064,482 patients.This database captures women’s health conditions across the life course,from reproductive age to older adulthood.Conclusions:The BRIDGE methodological framework provides a standardized approach to building high-quality ICWM-EHR databases.It offers a unique opportunity to strengthen the methodological rigor and real-world relevance of Chinese medicine research in integrated healthcare settings.
基金funded by the Deanship of Scientific Research at Princess Nourah bint Abdulrahman University through the Fast-track Research Funding Program.
文摘Background:Electronic Health Record(EHR)systems are used as an efficient and effective technique for sharing patient’s health records among different hospitals and various other key stakeholders of the healthcare industry to achieve better diagnosis and treatment of patients globally.However,the existing EHR systems mostly lack in providing appropriate security,entrusted access control and handling privacy and secrecy issues and challenges in current hospital infrastructures.Objective:To solve this delicate problem,we propose a Blockchain-enabled Hyperledger Fabric Architecture for different EHR systems.Methodology:In our EHR blockchain system,Peer nodes from various organizations(stakeholders)create a ledger network,where channels are created to enable secure and private communication between different stakeholders on the ledger network.Individual patients and other stakeholders are identified and registered on the network by unique digital certificates issued by membership service provider(MSP)component of the fabric architecture.Results:We created and implemented different Chaincodes to handle the business logic for executing separate EHR transactions on the network.The proposed fabric architecture provides a secure,transparent and immutable mechanism to store,share and exchange EHRs in a peer-to-peer network of different healthcare stakeholders.It ensures interoperability,scalability and availability in adapting the existing EHRs for strengthening and providing an effective and secure method to integrate and manage patient records among medical institutions in the healthcare ecosystem.
基金This work was supported by the National Key Research and Development Project of China(Grant No.2017YFB0802302)the Science and Technology Support Project of Sichuan Province(Grant Nos.2016FZ0112,2017GZ0314,and 2018GZ0204)+2 种基金the Academic and Technical Leaders Training Funding Support Projects of Sichuan Province(Grant No.2016120080102643)the Application Foundation Project of Sichuan Province(Grant No.2017JY0168)the Science and Technology Project of Chengdu(Grant Nos.2017-RK00-00103-ZF,and 2016-HM01-00217-SF).
文摘In the existing Electronic Health Records(EHRs),the medical information of patients is completely controlled by various medical institutions.As such,patients have no dominant power over their own EHRs.These personal data are not only inconvenient to access and share,but are also prone to cause privacy disclosure.The blockchain technology provides a new development direction in the medical field.Blockchain-based EHRs are characterized by decentralization,openness and non-tampering of records,which enable patients to better manage their own EHRs.In order to better protect the privacy of patients,only designated receivers can access EHRs,and receivers can authenticate the sharer to ensure that the EHRs are real and effective.In this study,we propose an identity-based signcryption scheme with multiple authorities for multiple receivers,which can resist N-1 collusion attacks among N authorities.In addition,the identity information of receivers is anonymous,so the relationship between them and the sharer is not disclosed.Under the random oracle model,it was proved that our scheme was secure and met the unforgeability and confidentiality requirements of signcryption.Moreover,we evaluated the performance of the scheme and found that it had the moderate signcryption efficiency and excellent signcryption attributes.
基金the Artificial Intelligence Innovation and Development Project of Shanghai Municipal Commission of Economy and Information (No. 2019-RGZN-01081)。
文摘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.
基金This research was supported by the National Natural Science Foundation of China under Grant(No.42050102)the Postgraduate Education Reform Project of Jiangsu Province under Grant(No.SJCX22_0343)Also,this research was supported by Dou Wanchun Expert Workstation of Yunnan Province(No.202205AF150013).
文摘With the rapid development of information technology,the electronifi-cation of medical records has gradually become a trend.In China,the population base is huge and the supporting medical institutions are numerous,so this reality drives the conversion of paper medical records to electronic medical records.Electronic medical records are the basis for establishing a smart hospital and an important guarantee for achieving medical intelligence,and the massive amount of electronic medical record data is also an important data set for conducting research in the medical field.However,electronic medical records contain a large amount of private patient information,which must be desensitized before they are used as open resources.Therefore,to solve the above problems,data masking for Chinese electronic medical records with named entity recognition is proposed in this paper.Firstly,the text is vectorized to satisfy the required format of the model input.Secondly,since the input sentences may have a long or short length and the relationship between sentences in context is not negligible.To this end,a neural network model for named entity recognition based on bidirectional long short-term memory(BiLSTM)with conditional random fields(CRF)is constructed.Finally,the data masking operation is performed based on the named entity recog-nition results,mainly using regular expression filtering encryption and principal component analysis(PCA)word vector compression and replacement.In addi-tion,comparison experiments with the hidden markov model(HMM)model,LSTM-CRF model,and BiLSTM model are conducted in this paper.The experi-mental results show that the method used in this paper achieves 92.72%Accuracy,92.30%Recall,and 92.51%F1_score,which has higher accuracy compared with other models.
文摘Background： The usage of modem technology in healthcare record system is now a must throughout the world. However, many doctors and nurses has been reporting facing numerous challenges and obstacles in the implementation. The aim of the present study is to determine the prevalence of depression, anxiety and stress among doctors and nurses who utilize EMR （electronic medical record） and its associated factor. Methods： A comparative cross-sectional study was conducted ~om January till April 2012 among doctors and nurses in two public tertiary hospitals in Johor in which one of them uses EMR and the other one still using the MMR （manual medical record） system. Data was collected using self-administered validated Malay version of DASS-21 （Depression, Anxiety, and Stress Scales-21） items questionnaire. It comprises of socio-demographic and occupational characteristics. Findings： There were 130 respondents with a response rate of 91% for EMR and 123 respondents with a response rate of 86% for MMR. The mean （SD） age of respondents in EMR and MMR groups were 34.7 （9.42） and 29.7 （6.15） respectively. The mean （SD） duration of respondents using EMR was 46.1 （35.83） months. The prevalence of depression, anxiety and stress among respondents using EMR were 6.9%, 25.4% and 12.3%. There were no significant difference between the study groups related to the depression, anxiety and stress scores. In multivariable analysis, the significant factors associated with depression among respondents using EMR was age （OR 1.10, 95% CI 1.02, 1.19）. The significant factors associated with stress among respondents using EMR was marital status （OR 3.33, 95% CI 1.10, 10.09） and borderline significant was computer skill course （OR 2.94, 95% CI 0.98, 8.78）. Conclusion： The prevalence of depression, anxiety and stress of those who uses EMR were within acceptable range. Age, marital status and computer skill are the identified factor associated with the depression and stress level which need to be considered in its implementation.
文摘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.
基金funded by the Organized Research and Creative Activities(ORCA)Program at the University of Houston-Downtown(PI:Song Ge)。
文摘1|DEVELOPMENT AND ADOPTION OF EHR IN THE UNITED STATES At present,health-care systems in the United States face enormous challenges in providing quality care,characterized by safe,effective,efficient,patientcentered,timely,and equitable care while containing health-care costs[1,2].To understand and address patients'increasingly complicated health-care needs,we need safe access to quality information that is characterized by integrity,reliability,and accuracy[3],and establish mutually beneficial relationships among a multidisciplinary team of professionals[4].Traditional paper-based clinical workflow produces many issues such as illegible handwriting,inconvenient access,the possibility of computational prescribing errors,inadequate patient hand-offs,and drug administration errors.These problems can lead to medical errors,omissions,and duplications and,ultimately,poor patient outcomes and compromised quality of care[2].
文摘Aim： To improve workflow and usability by introduction of a new electronic patient record （EPR） and database. Methods： Establishment of an EPR based on open source technology （MySQL database and PI-IP scripting language） in a tertiary care andrology center at a university clinic. Workflow analysis, a benchmark comparing the two systems and a survey for usability and ergonomics were carried out. Results： Workflow optimizations （electronic ordering of laboratory analysis, elimination of transcription steps and automated referral letters） and the decrease in time required for data entry per patient to 71% ± 27%, P 〈 0.05, lead to a workload reduction. The benchmark showed a significant performance increase （highest with starting the respective system： 1.3 ± 0.2 s vs. 11.1 ± 0.2 s, mean ± SD）. In the survey, users rated the new system at least two ranks higher over its predecessor （P 〈 0.01） in all sub-areas. Conclusion： With further improvements, today＇s EPR can evolve to substitute paper records, saving time （and possibly costs）, supporting user satisfaction and expanding the basis for scientific evaluation when more data is electronically available. Newly introduced systems should be versatile, adaptable for users, and workflow-oriented to yield the highest benefit. If ready-made software is purchased, customization should be implemented during rollout. （Asian J Andro12006 Mar; 8： 235-241）
基金supported by the National Natural Science Foundation of China under grant 61972207,U1836208,U1836110,61672290the Major Program of the National Social Science Fund of China under Grant No.17ZDA092+2 种基金by the National Key R&D Program of China under grant 2018YFB1003205by the Collaborative Innovation Center of Atmospheric Environment and Equipment Technology(CICAEET)fundby the Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD)fund.
文摘The trusted sharing of Electronic Health Records(EHRs)can realize the efficient use of medical data resources.Generally speaking,EHRs are widely used in blockchain-based medical data platforms.EHRs are valuable private assets of patients,and the ownership belongs to patients.While recent research has shown that patients can freely and effectively delete the EHRs stored in hospitals,it does not address the challenge of record sharing when patients revisit doctors.In order to solve this problem,this paper proposes a deletion and recovery scheme of EHRs based on Medical Certificate Blockchain.This paper uses cross-chain technology to connect the Medical Certificate Blockchain and the Hospital Blockchain to real-ize the recovery of deleted EHRs.At the same time,this paper uses the Medical Certificate Blockchain and the InterPlanetary File System(IPFS)to store Personal Health Records,which are generated by patients visiting different medical institutions.In addition,this paper also combines digital watermarking technology to ensure the authenticity of the restored electronic medical records.Under the combined effect of blockchain technology and digital watermarking,our proposal will not be affected by any other rights throughout the process.System analysis and security analysis illustrate the completeness and feasibility of the scheme.
基金This project was supported by the Development and application of nursing decision support system based on artificial intelligence(No.2019ZD006).
文摘The clinical decision support system makes electronic health records(EHRs)structured,intelligent,and knowledgeable.The nursing decision support system(NDSS)is based on clinical nursing guidelines and nursing process to provide intelligent suggestions and reminders.The impact on nurses’work is mainly in shortening the recording time,improving the quality of nursing diagnosis,reducing the incidence of nursing risk events,and so on.However,there is no authoritative standard for the NDSS at home and abroad.This review introduces development and challenges of EHRs and recommends the application of the NDSS in EHRs,namely the nursing assessment decision support system,the nursing diagnostic decision support system,and the nursing care planning decision support system(including nursing intervene),hoping to provide a new thought and method to structure impeccable EHRs.
基金The authors would like to acknowledge the support of the Deputy for Research and Innovation-Ministry of Education,Kingdom of Saudi Arabia,for this research through a grant(NU/IFC/ENT/01/020)under the Institutional Funding Committee at Najran University,Kingdom of Saudi Arabia.
文摘Obesity is a critical health condition that severely affects an individual’s quality of life andwell-being.The occurrence of obesity is strongly associated with extreme health conditions,such as cardiac diseases,diabetes,hypertension,and some types of cancer.Therefore,it is vital to avoid obesity and or reverse its occurrence.Incorporating healthy food habits and an active lifestyle can help to prevent obesity.In this regard,artificial intelligence(AI)can play an important role in estimating health conditions and detecting obesity and its types.This study aims to see obesity levels in adults by implementing AIenabled machine learning on a real-life dataset.This dataset is in the form of electronic health records(EHR)containing data on several aspects of daily living,such as dietary habits,physical conditions,and lifestyle variables for various participants with different health conditions(underweight,normal,overweight,and obesity type I,II and III),expressed in terms of a variety of features or parameters,such as physical condition,food intake,lifestyle and mode of transportation.Three classifiers,i.e.,eXtreme gradient boosting classifier(XGB),support vector machine(SVM),and artificial neural network(ANN),are implemented to detect the status of several conditions,including obesity types.The findings indicate that the proposed XGB-based system outperforms the existing obesity level estimation methods,achieving overall performance rates of 98.5%and 99.6%in the scenarios explored.
