Applied Bimatics - An Informatics & eHealth Blog

I am a clinician with a passion for informatics. This blog is about my eHealth journey exploring interoperability in Electronic Medical Records (EMR/EHR), Patient Safety, Pharmacovigilance, Data Analytics, Clinical Research and Bioinformatics in a clinical context. Comparing Canadian, Indian and Middle Eastern healthcare systems and services. Join our open facebook group here: https://www.facebook.com/groups/clinical.bioinformaticians/


AngularJS and Electronic Health Records

I am not an Angular expert (as yet) though I used it for one of my successful applications called LesionMapper™. For the uninitiated, AngularJS is (yet another) javascript framework that is different in many ways. It extends HTML and implements the exciting concept of two-way data binding for dynamic web apps. If you are still skeptical about whether angular is big, please take a note of their logo that has a small (in)significant subscript: ‘by Google’. My intention here is not to dissect AngularJS and compare its many features or to disambiguate the diverse terminologies such as ‘directives’ and ‘expressions’ that makes it seem more daunting than it actually is.

Photocredit AngularJS @ github and jfcherry @ flikr (Images altered)

For health professionals, the bottom line is that AngularJS makes browsers powerful and can perform some of the tasks that are traditionally relegated to the server. So how is it going to improve our EMRs? During my student days, I have seen a popular regional EMR with a dismal user-interface. I have also seen a health analytics platform with more than 100 dropdowns on a single page. I have seen doctors returning to paper after failed EMR experiments. I have seen regional clinical viewers reeling under usability concerns. Can angularJS make any difference?


A tool cannot change everything. Angular as a tool is not going to be a panacea. But the concept may change the way we think and organize our electronic health record systems. The traditional way of seeing EMRs as data-centric models was rejected by us, health professionals. Blame it on technology averse senior doctors or blame it on the inefficient healthcare system not learning from banks and airline industry, the fact is, eHealth failed to deliver! Will a new version with an improved interface change this? Unlikely!

EHealth has to accommodate our workflow, not the other way round. Because EMR is the tool, not us, physicians!
I know this is not my idea, and we have discussed this here before. How can AngularJS change this?
I am a huge fan of reverse innovation, and I am excited to see initiatives such as http://www.bahmni.org/ building AngularJS based customization layer on top of OpenMRS.org. True open source projects such as OpenMRS foster innovation (reverse or not).. It should open the eyes of others calling themselves open-source without being truly open! (Well.. that is another story..)


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Health Information Exchange Benefits Realization Tool HIEBR

One of the most promising trends in Health Information Technology (HIT) is Health Information Exchange (HIE). Several HIE initiatives are jostling for space in the HIT arena in many areas. Like most other public HIT projects, funding depends on benefits evaluation. Benefits evaluation could be a difficult undertaking requiring careful planning even for an Electronic Health Records system.

Health Information Exchange Benefits Realization Tool
Image credit USDA @ Flikr (Image altered and text added)

The goal of HIE is to facilitate access to and retrieval of clinical data to provide safer, timely, efficient, effective, and equitable patient-centered care. All the goals are subjective open to varied interpretations, making benefits evaluation in HIE, a nightmare.

Canada Health Infoway (CHI) published a benefits evaluation indicator technical report in 2006, that was upgraded to a new version in 2012. After comprehensive search and literature evaluation CHI has proposed the various parameters that are important under various scenarios with a broad focus.

HIEBR is an attempt at creating a simple tool based on the CHI report for evaluating HIE benefits from a user perspective. The focus is on simplicity and HIEBR is not claimed to be a comprehensive HIE benefits evaluation tool. The questionnaire has 10 Likert scale questions that have to be scored from 0-4 giving you a score ranging from 0-40. This is multiplied by 2.5 to represent this on a more user-friendly scale of 100. However, it should be noted that HIEBR score does not represent a percentage. The main purpose of HIEBR is to assess the impact of an HIE initiative. So it is designed to be administered pre and post HIE implementation and compared using non-parametric statistical tools.

SUSie is another tool that combines System Usability Scale with basic benefits realization questions incorporated, retaining the SUS style. Please cite this page as below, add your study reference in our wiki page, and share this page if you use this tool.

  • Eapen BR (2014). “HIEBR: Health Information Exchange Benefits Realization Tool” Applied Bimatics - An Informatics and eHealth Blog.[Internet] Accessible from: http://bioblog.gulfdoctor.net/2014/11/health-information-exchange-benefits-evaluation-HIEBR.html

Please Like/Share below to download a PDF copy of HIEBR


HIEBR TOOL

My current methods of obtaining patient health information from external organizations are:
Strongly Agree Agree Undecided Somewhat disagree Strongly Disagree
Complete
Accurate
Relevant
Timely
Available when needed
Organized



My current methods of obtaining patient health information from external organizations have a POSITIVE impact on:
Strongly Agree Agree Undecided Somewhat disagree Strongly Disagree
My work performance
Improving healthcare costs 
Quality of patient care
Privacy and security of Personal Health Information


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About Me

As a Dermatologist and Informatician my research mainly involves application of bioinformatics techniques and tools in dermatological conditions. However my research interests are varied and I have publications in areas ranging from artificial intelligence, sequence analysis, systems biology, ontology development, microarray analysis, immunology, computational biology and clinical dermatology. I am also interested in eHealth, Health Informatics and Health Policy.

Address

Bell Raj Eapen
Hamilton, ON
Canada