The growing technological advancement of electronic health records can become an issue with quality and electronic patient information exchange if hospitals do not adhere to federal guidelines. It is recommended that hospitals utilize certified electronic health records (EHRs) to receive financial incentives. This certification is supposedly also associated with the quality of the EHR itself. The certification process is criticized for allowing EHR vendors to meet a set of limited functions known in advance. EHRs can affect healthcare quality and electronic health information exchange. This dissertation explored what is known about the effects of certified EHRs on length of stay (LOS) and patient generated health data (PGHD), the relationship between hospital utilization of certified EHRs and LOS, and the relationship between hospital utilization of certified EHRs with hospital capability of allowing the function of PGHD. The first analysis was a scoping review guided by the PRISMA protocol to explore what is known of the effects of certified EHRs on LOS and PGHD. The second analysis used datasets from the American Hospital Association Survey and Information Technology Supplement and Kentucky Cabinet for Health and Family Services, Office of Health Policy from 2015 to 2019 to understand the relationship between hospital utilization of certified EHRs and LOS through a fixed effects regression model. The final paper analysis used datasets from the American Hospital Association Survey and Information Technology Supplement from 2016 to 2020 to understand the relationship between hospital utilization of certified EHRs and the function of enabling PGHD through a binary logistic regression. There is support amongst researchers on EHRs improving quality, such as, LOS and the function of PGHD improving technology efficiency and others supporting EHRs with more customization and open architecture. There is less known about whether an EHR, certified or non-certified, are different from one another with providing advantages for hospitals. Hospitals with certified EHRs have a longer LOS compared to hospitals with non-certified EHRs. Most hospitals experienced barriers with receiving, sending, or other electronic information exchange. Most hospitals with certified EHRs were more likely to not enable the function for PGHD compared to hospitals with non-certified EHRs. EHRs can be problematic while hospitals are providing hospital care. Although most hospitals possess certified EHRs, most do not enable the function of PGHD. Secondary sources from the survey were completed by the Chief Technology Officer or Chief Information Officer. Further research could be continued with understanding different groups’ health effects with health information technology. Hospitals may be satisfied with their EHRs but not as abreast on how functional the EHR is and how the EHR can benefit patients. 

An analysis of the effects of certified electronic health records on organizations and patients.

Increasingly, biobanks are being developed to support organized collections of biological specimens and associated clinical information on broadly consented, diverse patient populations. We describe the implementation of a pediatric biobank, comprised of a fully-informed patient cohort linking specimens to phenotypic data derived from electronic health records (EHR). The Biobank was launched after multiple stakeholders’ input and implemented initially in a pilot phase before hospital-wide expansion in 2016. In-person informed consent is obtained from all participants enrolling in the Biobank and provides permission to: (1) access EHR data for research; (2) collect and use residual specimens produced as by-products of routine care; and (3) share de-identified data and specimens outside of the institution. Participants are recruited throughout the hospital, across diverse clinical settings. We have enrolled 4900 patients to date, and 41% of these have an associated blood sample for DNA processing. Current efforts are focused on aligning the Biobank with other ongoing research efforts at our institution and extending our electronic consenting system to support remote enrollment. A number of pediatric-specific challenges and opportunities is reviewed, including the need to re-consent patients when they reach 18 years of age, the ability to enroll family members accompanying patients and alignment with disease-specific research efforts at our institution and other pediatric centers to increase cohort sizes, particularly for rare diseases.

Development of the Precision Link Biobank at Boston Children’s Hospital: Challenges and Opportunities

Abstract Background Research infrastructures such as biorepositories are essential to facilitate genomics and its growing applications in health research and translational medicine in Africa. Using a cervical cancer cohort, this study describes the establishment of a biorepository consisting of biospecimens and matched phenotype data for use in genomic association analysis and pharmacogenomics research. Method Women aged &gt; 18 years with a recent histologically confirmed cervical cancer diagnosis were recruited. A workflow pipeline was developed to collect, store, and analyse biospecimens comprising donor recruitment and informed consent, followed by data and biospecimen collection, nucleic acid extraction, storage of genomic DNA, genetic characterization, data integration, data analysis and data interpretation. The biospecimen and data storage infrastructure included shared -20 °C to -80 °C freezers, lockable cupboards, secured access-controlled laptop, password protected online data storage on OneDrive software. The biospecimen or data storage, transfer and sharing were compliant with the local and international biospecimen and data protection laws and policies, to ensure donor privacy, trust, and benefits for the wider community. Results This initial establishment of the biorepository recruited 410 women with cervical cancer. The mean (± SD) age of the donors was 52 (± 12) years, comprising stage I (15%), stage II (44%), stage III (47%) and stage IV (6%) disease. The biorepository includes whole blood and corresponding genomic DNA from 311 (75.9%) donors, and tumour biospecimens and corresponding tumour DNA from 258 (62.9%) donors. Datasets included information on sociodemographic characteristics, lifestyle, family history, clinical information, and HPV genotype. Treatment response was followed up for 12 months, namely, treatment-induced toxicities, survival vs. mortality, and disease status, that is disease-free survival, progression or relapse, 12 months after therapy commencement. Conclusion The current work highlights a framework for developing a cancer genomics cohort-based biorepository on a limited budget. Such a resource plays a central role in advancing genomics research towards the implementation of personalised management of cancer. 

https://bmccancer.biomedcentral.com/counter/pdf/10.1186/s12885-022-10413-w

A cervical cancer biorepository for pharmacogenomics research in Zimbabwe

Increasingly, biobanks are being developed to support organized collections of biological specimens and associated clinical information on broadly consented, diverse patient populations. We describe the implementation of a pediatric biobank, comprised of a fully-informed patient cohort linking specimens to phenotypic data derived from electronic health records (EHR). The Biobank was launched after multiple stakeholders' input and implemented initially in a pilot phase before hospital-wide expansion in 2016. In-person informed consent is obtained from all participants enrolling in the Biobank and provides permission to: (1) access EHR data for research; (2) collect and use residual specimens produced as by-products of routine care; and (3) share de-identified data and specimens outside of the institution. Participants are recruited throughout the hospital, across diverse clinical settings. We have enrolled 4900 patients to date, and 41% of these have an associated blood sample for DNA processing. Current efforts are focused on aligning the Biobank with other ongoing research efforts at our institution and extending our electronic consenting system to support remote enrollment. A number of pediatric-specific challenges and opportunities is reviewed, including the need to re-consent patients when they reach 18 years of age, the ability to enroll family members accompanying patients and alignment with disease-specific research efforts at our institution and other pediatric centers to increase cohort sizes, particularly for rare diseases.

https://www.mdpi.com/2075-4426/7/4/21/pdf

Including Patient-Generated Health Data in Electronic Health Records.

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Including Patient-Generated Health Data in Electronic Health Records.