Health information management : journal of the Health Information Management Association of Australia最新文献

{"title":"A multi-method quality improvement approach to systematically improve and promote the quality of national health and social care information.","authors":"Niamh McGrath,&nbsp;Barbara Foley,&nbsp;Caroline Hurley,&nbsp;Maria Ryan,&nbsp;Rachel Flynn","doi":"10.1177/1833358320926422","DOIUrl":"https://doi.org/10.1177/1833358320926422","url":null,"abstract":"<p><p>Safe and reliable healthcare depends on access to health information that is accurate, valid, reliable, timely, relevant, legible and complete. National data collections are repositories of health and social care data and play a crucial role in healthcare planning and clinical decision-making. We describe the development of an evidence-informed multi-method quality improvement program aimed to improve the quality of health and social care data in Ireland. Specific components involved: development of guidance to support implementation of health information standards; review program to assess compliance with standards; and educating health information stakeholders about health data and information quality. Observations from implementation of the program indicate enhanced health information stakeholder awareness of, and increased adoption of information management standards. The methodology used in the review program has proved to be a robust approach to identify areas of good practice and opportunities for improvement in information management practices. There has been positive adoption of the program among organisations reviewed and acceptance of the proposed recommendations. Early indications are that this multi-method approach will drive improvements in information management practices, leading to an improvement in health and social care data quality in Ireland. Aspects of this approach may be adapted to meet the needs of other countries.</p>","PeriodicalId":73210,"journal":{"name":"Health information management : journal of the Health Information Management Association of Australia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1833358320926422","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38085554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personal electronic healthcare records: What influences consumers to engage with their clinical data online? A literature review.","authors":"Kellie-Anne Crameri,&nbsp;Lynne Maher,&nbsp;Pieter Van Dam,&nbsp;Sarah Prior","doi":"10.1177/1833358319895369","DOIUrl":"https://doi.org/10.1177/1833358319895369","url":null,"abstract":"<p><strong>Background: </strong>Online electronic records such as patient portals and personally controlled electronic health records (PEHRs) have been widely viewed as a key component to modernising the delivery of healthcare but the uptake of such systems has been slow.</p><p><strong>Objective: </strong>The purpose of this literature review was to determine what influences consumers to engage and interact with their clinical data online.</p><p><strong>Method: </strong>A scoping literature review following PRISMA guidelines was completed. Electronic patient record research published between January 2009 and December 2018 was included. Following screening and full-text reviews, a total of 64 records were included in this review.</p><p><strong>Results: </strong>Three key areas of influence on consumer engagement with their clinical data online emerged: <i>demographic factors</i> affecting consumer interaction with PEHRs; <i>consumers' perceived benefits and detriments</i> of PEHR use; and the influence of PEHR use on <i>consumer empowerment and responsibility</i>.</p><p><strong>Discussion: </strong>Consumer motivation and readiness for engaging with their clinical data online and their long-term ongoing use of these systems requires further exploration.</p><p><strong>Conclusion: </strong>As worldwide rates of consumer interactions with individual online clinical data remain low, what influences consumer engagement with a PEHR remains unknown. Further research into the consumer perspective of, and interaction with, a PEHR, needs to be undertaken to determine if factors such as frequent usage of the system by consumers leads to improved clinical outcomes.</p>","PeriodicalId":73210,"journal":{"name":"Health information management : journal of the Health Information Management Association of Australia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1833358319895369","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37525781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of SNOMED CT in automated expansion of clinical terms in discharge summaries: Testing issues of coverage.","authors":"Aleksandar Zivaljevic,&nbsp;Koray Atalag,&nbsp;James Warren","doi":"10.1177/1833358320934528","DOIUrl":"https://doi.org/10.1177/1833358320934528","url":null,"abstract":"<p><strong>Objective: </strong>This study tests coverage of SNOMED CT as an expansion source in the process of automated expansion of clinical terms found in discharge summaries. Term expansion is commonly used as a technique in knowledge extraction, query formulation and semantic modelling among other applications. However, characteristics of the sources might affect credibility of outputs, and coverage is one of them.</p><p><strong>Method: </strong>We developed an automated method for testing coverage of more than one source at a time. We used several methods to clean our corpus of discharge summaries before we extracted text fragments as candidates for clinical concepts. We then used Unified Medical Language System (UMLS) sources and UMLS REST API to filter concepts from the pool of text fragments. Statistical measures like true positive rate and false negative rate were used to decide on the coverage of the source. We also tested the coverage of the individual SNOMED CT hierarchies using the same methods.</p><p><strong>Results: </strong>Findings suggest that a combination of four terminologies tested (SNOMED CT, NCI, LNC and MSH) achieves over 90% of coverage for term expansion. We also found that the SNOMED CT hierarchies that hold clinically relevant concepts provided 60% of coverage.</p><p><strong>Conclusion: </strong>We believe that our findings and the method we developed will be of use to both scientists and practitioners working in the domain of knowledge extraction.</p>","PeriodicalId":73210,"journal":{"name":"Health information management : journal of the Health Information Management Association of Australia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1833358320934528","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38182574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved efficiency of patient admission with electronic health records in neurosurgery.","authors":"Witold H Polanski,&nbsp;Adrian Danker,&nbsp;Amir Zolal,&nbsp;David Senf-Mothes,&nbsp;Gabriele Schackert,&nbsp;Dietmar Krex","doi":"10.1177/1833358320920990","DOIUrl":"https://doi.org/10.1177/1833358320920990","url":null,"abstract":"<p><strong>Background: </strong>Electronic health records (EHRs) may be controversial but they have the potential to improve patient care. We investigated whether the introduction of an electronic template-based admission form for the collection of information about the patient's medical history and neurological and clinical state at admission in the neurosurgical unit might have an impact on the quality of documentation in a discharge record and the amount of time taken to produce this documentation.</p><p><strong>Method: </strong>A new digital template-based admission form (EHR) was developed and assessed with QNOTE, an assessment tool of medical notes with standardised criteria and the possibility to benchmark the quality of documentations. This was compared to 30 prior paper-based handwritten documentations (HWD) regarding the utilisation of these medical notes for dictation of medical discharge records.</p><p><strong>Results: </strong>Implementation of the EHR significantly improved the quality of patient admission documentation with a QNOTE mean grand score of 87 ± 22 (<i>p</i> < 0.0001) compared to prior HWD with 44 ± 30. The mean documentation time for HWD was 8.1 min ± 4.1 min and the dictation time for discharge records was 10.6 min ± 3.5 min. After implementation of EHR, the documentation time increased slightly to 9.6 min ± 2.3 min (n.s.), while the time for dictation of discharge records was reduced to 5.1 min ± 1.2 min (<i>p</i> < 0.0001). There was a clear correlation between a higher quality of documentation and a higher needed documentation time as well as higher quality of documentation and lower dictation times of discharge records.</p><p><strong>Conclusion: </strong>Implementation of the EHR improved the quality of patient admission documentation and reduced the dictation time of discharge records.</p><p><strong>Implications: </strong>It is crucial to involve stakeholders and users of EHRs in a timely manner during the stage of development and implementation phase to ensure optimal results and better usability.</p>","PeriodicalId":73210,"journal":{"name":"Health information management : journal of the Health Information Management Association of Australia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1833358320920990","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37956834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The likelihood of requiring a diagnostic test: Classifying emergency department patients with logistic regression.","authors":"Görkem Sarıyer,&nbsp;Mustafa Gökalp Ataman","doi":"10.1177/1833358320908975","DOIUrl":"https://doi.org/10.1177/1833358320908975","url":null,"abstract":"<p><strong>Background: </strong>Emergency departments (EDs) play an important role in health systems since they are the front line for patients with emergency medical conditions who frequently require diagnostic tests and timely treatment.</p><p><strong>Objective: </strong>To improve decision-making and accelerate processes in EDs, this study proposes predictive models for classifying patients according to whether or not they are likely to require a diagnostic test based on referral diagnosis, age, gender, triage category and type of arrival.</p><p><strong>Method: </strong>Retrospective data were categorised into four output patient groups: not requiring any diagnostic test (group A); requiring a radiology test (group B); requiring a laboratory test (group C); requiring both tests (group D). Multivariable logistic regression models were used, with the outcome classifications represented as a series of binary variables: test (1) or no test (0); in the case of group A, no test (1) or test (0).</p><p><strong>Results: </strong>For all models, age, triage category, type of arrival and referral diagnosis were significant predictors whereas gender was not. The main referral diagnosis with high model coefficients varied by designed output groups (groups A, B, C and D). The overall accuracies of the logistic regression models for groups A, B, C and D were, respectively, 74.11%, 73.07%, 82.47% and 85.79%. Specificity metrics were higher than the sensitivities for groups B, C and D, meaning that these models were better able to predict negative outcomes.</p><p><strong>Implications: </strong>These results provide guidance for ED triage staff, researchers and practitioners in making rapid decisions regarding patients' diagnostic test requirements based on specified variables in the predictive models. This is critical in ED operations planning as it potentially decreases waiting times, while increasing patient satisfaction and operational performance.</p>","PeriodicalId":73210,"journal":{"name":"Health information management : journal of the Health Information Management Association of Australia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1833358320908975","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37780399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Under-coding of dementia and other conditions indicates scope for improved patient management: A longitudinal retrospective study of dementia patients in Australia.","authors":"Kara Cappetta,&nbsp;Luise Lago,&nbsp;Jan Potter,&nbsp;Lyn Phillipson","doi":"10.1177/1833358319897928","DOIUrl":"https://doi.org/10.1177/1833358319897928","url":null,"abstract":"<p><strong>Background: </strong>Under-coding of dementia during hospitalisation results in an inability to identify all patients with dementia using hospital administrative data. Clinical coding can be viewed as a proxy for management; therefore, under-coding indicates dementia was not considered in the patient's management. While under-coding of dementia is well established, there is sparse evidence on whether dementia is coded in subsequent hospitalisations among patients with a known diagnosis.</p><p><strong>Objective: </strong>(a) To describe patterns of dementia coding over 5 years after a first-coded (i.e. index) admission for dementia; (b) to identify factors associated with clinical coding of dementia; and (c) to identify patient subgroups at risk of not being coded to inform future interventions to improve hospital identification and management of dementia.</p><p><strong>Method: </strong>Retrospective study of longitudinal hospital data from 1 July 2006 to 30 June 2015 for 7919 patients hospitalised during the 5 years' post-index admission for dementia in a regional local health district of New South Wales, Australia.</p><p><strong>Results: </strong>Dementia was coded in 63.9% of admissions in the 12 months following index admission for dementia; this decreased to 53.7% after 5 years. Patients were 20% more likely to have dementia actively managed when it co-occurred with delirium. Under-coding varied across conditions, with dementia more likely to be coded in admissions for falls and pneumonitis, and less likely for heart failure, pneumonia and urinary tract infection (UTI).</p><p><strong>Conclusion: </strong>The frequency with which dementia was not coded highlights opportunities to improve identification and management of dementia through dementia-specific care, enhanced clinical protocols, and interventions focused around heart failure, pneumonia and UTI admissions.</p>","PeriodicalId":73210,"journal":{"name":"Health information management : journal of the Health Information Management Association of Australia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1833358319897928","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37571297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of an evidence-based e-health readiness assessment framework for Uganda.","authors":"Vincent M Kiberu,&nbsp;Maurice Mars,&nbsp;Richard E Scott","doi":"10.1177/1833358319839253","DOIUrl":"https://doi.org/10.1177/1833358319839253","url":null,"abstract":"<p><strong>Background: </strong>While e-health readiness assessment is vital to the successful implementation of e-health innovations, there is little published guidance (i.e. e-health readiness assessment frameworks (eHRAFs)) for institutions and countries.</p><p><strong>Objective: </strong>To develop an evidence-based and locally relevant eHRAF for Uganda.</p><p><strong>Method: </strong>A list of possible e-health readiness domains and constructs was developed through a structured review of the e-health literature. This list was first refined using author experience, insight and reflection. Based on this refined list, an eHRAF questionnaire was developed, which was initially pilot tested for face and content validity. Thereafter, it was distributed to 13 purposively selected study participants who were Ugandan e-health experts from the fields of health, information and communications technology (ICT) and academia. The questionnaire was discussed in a focus group setting for consensus input, where study participants confirmed, rejected or revised proposed domains and constructs suitable to guide e-health readiness assessment at either the national or site-specific level within Uganda.</p><p><strong>Results: </strong>Of 148 identified literature resources, 13 met inclusion criteria. A subjective review highlighted 11 frequently used e-health domains. Further reflection reduced these to nine domains, which were shared with study participants by means of the questionnaire. Based upon prior use of, and familiarity with, a management tool (PESTEL), participants' consensus on factors essential for readiness assessment in Uganda was aligned with PESTEL's six domains: political, economic, sociocultural, technological, environmental, and legal and regulatory. The participants considered engagement, and core and societal readiness as optional domains. Based on this input, the authors developed a proposed eHRAF suitable for Uganda, comprised of domains, sub-domains and constructs.</p><p><strong>Conclusion: </strong>The eHRAF developed in this research is an evidence-based framework (literature and cross-sectoral expert opinion) and consists of primary domains, sub-domains and constructs suitable for assessing e-health readiness in Uganda, either nationally or locally, prior to implementation of any e-health system. The process and principles may have utility in other countries.</p><p><strong>Implications: </strong>A national, culturally relevant, context-specific Ugandan eHRAF could facilitate efficient and effective planning and implementation of new e-health programmes across the country and assist policymakers and legislators to develop consistent and reliable guidelines and regulations.</p>","PeriodicalId":73210,"journal":{"name":"Health information management : journal of the Health Information Management Association of Australia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1833358319839253","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37172877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge and documentation of patient health information among traditional health practitioners in urban and peri-urban areas of eThekwini Municipality, KwaZulu-Natal Province, South Africa.","authors":"Tracy Zhandire,&nbsp;Nceba Gqaleni,&nbsp;Mlungisi Ngcobo,&nbsp;Exnevia Gomo","doi":"10.1177/1833358319890475","DOIUrl":"https://doi.org/10.1177/1833358319890475","url":null,"abstract":"<p><strong>Background: </strong>Documentation of patient health information (PHI) is a regulatory requirement and hence a standard procedure in allopathic healthcare practice. The opposite is true for African traditional medicine (ATM) in most African countries, including South Africa, despite legal and policy frameworks that recognise and mandate the institutionalisation of ATM. Developing good practice standards for PHI documentation is an essential step in the institutionalisation of ATM.</p><p><strong>Objective: </strong>This study examined the knowledge and practices of documentation of PHI by traditional health practitioners (THPs) in Durban, eThekwini Municipality, KwaZulu-Natal Province, South Africa.</p><p><strong>Methods: </strong>In this quantitative cross-sectional study, snowball sampling was used to identify and recruit THPs. An interviewer-administered questionnaire was used to gather data. Chi-square tests and logistic regression were used to assess associations of knowledge and practice of documentation of PHI with potential predictors; age, gender, education, type of practitioner, experience, number of patients seen per day and location of the practice.</p><p><strong>Results: </strong>Of the 248 THPs who participated, 71.8% were female. Mean (SD) age was 47.4 (14.2), ranging 18-81 years. The majority (65.7%) were <i>Izangoma</i> (diviners). Overall, 42.9% of the THPs reported knowledge of patient medical records (PMRs). In logistic regression, only number of patients seen per day remained a significant predictor of knowledge about PMR. THPs who reported seeing 6-10 patients were five times more likely (Odds Ratio (OR): 5.164, 95% Confidence Interval (CI): 1.270-20.996; <i>p</i> = 0.022) to report knowledge of PMR than those seeing <6 patients per day. Overall, 25.0% of THPs reported that they were documenting some PHI. Documentation was associated with having knowledge of PMR (OR: 29.323, 95% CI: 10.455-82.241; <i>p</i> < 0.0001) and being an <i>Isangoma</i> (OR: 3.251, 95% CI: 1.092-9.679; <i>p</i> = 0.02). Not knowing what (56.5%) and how (50.5%) to record were the most commonly cited reasons for not documenting.</p><p><strong>Conclusion: </strong>Knowledge of PMR is low, and the practice of documenting PHI is even lower among THPs in eThekwini. That knowledge of PMR was a strong predictor of documentation practice, and the most common reason for not documenting was lack of knowledge about what and how to document suggests that training could improve PHI documentation in traditional medicine practice.</p>","PeriodicalId":73210,"journal":{"name":"Health information management : journal of the Health Information Management Association of Australia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1833358319890475","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37500407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysing EHR navigation patterns and digital workflows among physicians during ICU pre-rounds.","authors":"Cameron Coleman,&nbsp;David Gotz,&nbsp;Samantha Eaker,&nbsp;Elaine James,&nbsp;Thomas Bice,&nbsp;Shannon Carson,&nbsp;Saif Khairat","doi":"10.1177/1833358320920589","DOIUrl":"https://doi.org/10.1177/1833358320920589","url":null,"abstract":"<p><strong>Background: </strong>Some physicians in intensive care units (ICUs) report that electronic health records (EHRs) can be cumbersome and disruptive to workflow. There are significant gaps in our understanding of the physician-EHR interaction.</p><p><strong>Objective: </strong>To better understand how clinicians use the EHR for chart review during ICU pre-rounds through the characterisation and description of screen navigation pathways and workflow patterns.</p><p><strong>Method: </strong>We conducted a live, direct observational study of six physician trainees performing electronic chart review during daily pre-rounds in the 30-bed medical ICU at a large academic medical centre in the Southeastern United States. A tailored checklist was used by observers for data collection.</p><p><strong>Results: </strong>We observed 52 distinct live patient chart review encounters, capturing a total of 2.7 hours of pre-rounding chart review activity by six individual physicians. Physicians reviewed an average of 8.7 patients (range = 5-12), spending a mean of 3:05 minutes per patient (range = 1:34-5:18). On average, physicians visited 6.3 (±3.1) total EHR screens per patient (range = 1-16). Four unique screens were viewed most commonly, accounting for over half (52.7%) of all screen visits: results review (17.9%), summary/overview (13.0%), flowsheet (12.7%), and the chart review tab (9.1%). Navigation pathways were highly variable, but several common screen transition patterns emerged across users. Average interrater reliability for the paired EHR observation was 80.0%.</p><p><strong>Conclusion: </strong>We observed the physician-EHR interaction during ICU pre-rounds to be brief and highly focused. Although we observed a high degree of \"information sprawl\" in physicians' digital navigation, we also identified common launch points for electronic chart review, key high-traffic screens and common screen transition patterns.</p><p><strong>Implications: </strong>From the study findings, we suggest recommendations towards improved EHR design.</p>","PeriodicalId":73210,"journal":{"name":"Health information management : journal of the Health Information Management Association of Australia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1833358320920589","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37991796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protection of digital health information: Examining guidance from the physician regulatory colleges in Canada.","authors":"Neil G Barr, Glen E Randall","doi":"10.1177/1833358319873968","DOIUrl":"10.1177/1833358319873968","url":null,"abstract":"<p><strong>Background: </strong>The use of information and communication technology (ICT) has tremendous potential to enhance communication among physicians, leading to improvements in service delivery. However, the protection of health information in digital/electronic format is an ongoing concern.</p><p><strong>Objective: </strong>The purpose of this study was to examine guidance for the protection of health information when using ICT from all 10 of Canada's provincial regulatory colleges for physicians and to discuss the potential policy and service delivery implications.</p><p><strong>Method: </strong>A search of the regulatory college websites was conducted, followed by a document analysis (content and thematic).</p><p><strong>Results: </strong>The college website search identified 522 documents; 12 of these documents (from 8 of the 10 colleges) met the study criteria. These documents were notable for the considerable variation in the scope and detail of guidance provided across the colleges.</p><p><strong>Conclusion: </strong>While the federal-provincial division of powers in Canada enables different jurisdictional approaches to health service delivery and, thus, opportunities for policy learning, this governing structure may also contribute to a lack of incentive for collaboration, leading to an absence of standardised guidance for health information protection when using ICT. This, in turn, may result in unequal and inequitable protection of health information across the provinces. Therefore, a macro-level approach to policy development in this area may hold the greatest promise for enhancing the protection of health information and doing so in a more standardised manner in countries with federal systems of governance.</p>","PeriodicalId":73210,"journal":{"name":"Health information management : journal of the Health Information Management Association of Australia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9105104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}