Health Care In Digital World
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Running head: HEALTH CARE IN DIGITAL WORLD
HEALTH CARE IN DIGITAL WORLD
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HEALTH CARE IN DIGITAL WORLD
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1HEALTH CARE IN DIGITAL WORLD
Introduction
In this era of modernization, digitals platforms are being used by healthcare professionals
in order to provide patients with better healthcare. Before the emergence of the digital patient
care platforms, healthcare service providers as well as service users had to depend primarily on
paper works and discrepancies were often evidenced. Major discrepancies in paperwork not only
enhance the time needed for providing care to the patents but can also lead to fatality. Digital
health platforms chiefly focus on managing and tracking the health condition of the patents and
its aim is to improve health management for both the healthcare service providers and service
users. Additionally, digital healthcare platforms offer the potential for reduced cost facilitation of
customized medicine (healthit.gov., 2020). In addition, digital technologies allow cross-
disciplinary research and better access to foreign resources irrespective of where they are based.
Some of the most commonly used Digital patient facing digital platforms includes Mobile phone
applications, Electronic Health record. Sensors and wearable technology and online peer support
communities. Amongst various types of patient facing digital technology platforms, one of the
highly used digital platforms is the Electronic Health Record (EHR). In this report, benefits as
well as limitations associated with EHR has been critically analyzed.
Body
An Electronic Health Record (EHR) is an online version of a medical record for the
patient, that has been kept over time by the doctor, which can include any of the important
administrative clinical details related to the patient's treatment under a single physician,
including profiles, progress reports, complications, medications, previous medical records, vital
signs, immunizations, laboratory details which radiology report. The EHR possesses the potential
Introduction
In this era of modernization, digitals platforms are being used by healthcare professionals
in order to provide patients with better healthcare. Before the emergence of the digital patient
care platforms, healthcare service providers as well as service users had to depend primarily on
paper works and discrepancies were often evidenced. Major discrepancies in paperwork not only
enhance the time needed for providing care to the patents but can also lead to fatality. Digital
health platforms chiefly focus on managing and tracking the health condition of the patents and
its aim is to improve health management for both the healthcare service providers and service
users. Additionally, digital healthcare platforms offer the potential for reduced cost facilitation of
customized medicine (healthit.gov., 2020). In addition, digital technologies allow cross-
disciplinary research and better access to foreign resources irrespective of where they are based.
Some of the most commonly used Digital patient facing digital platforms includes Mobile phone
applications, Electronic Health record. Sensors and wearable technology and online peer support
communities. Amongst various types of patient facing digital technology platforms, one of the
highly used digital platforms is the Electronic Health Record (EHR). In this report, benefits as
well as limitations associated with EHR has been critically analyzed.
Body
An Electronic Health Record (EHR) is an online version of a medical record for the
patient, that has been kept over time by the doctor, which can include any of the important
administrative clinical details related to the patient's treatment under a single physician,
including profiles, progress reports, complications, medications, previous medical records, vital
signs, immunizations, laboratory details which radiology report. The EHR possesses the potential
2HEALTH CARE IN DIGITAL WORLD
to help the patients in self management through remote support and treatment adherence. Patients
who reside in rural areas or patents that lack access to healthcare are mostly found to use EHR
platforms in order to obtain medication and treatments. Patients can upload their previous
prescriptions, X-rays and other evidence of health issues and eminent healthcare service users
provides the patents with medication and consultation (Manca, 2015). One of the most popular
EHR platforms includes My health record. This platform can be defined as a secure online
summary of the patient's health information that can be accessed by health service providers
elected by the patient. My Health record provides the patient with access to remote support.
Health providers access the data of the patients through the My health record portal to provide
the best possible care (healthdirect.gov.au., 2020). Additionally, physicians can communicate
directly to the patients through this portal and thus can also enhance their awareness about
certain medical health conditions and thus educating the patients about how to take care of
themselves. To help educate physicians and their patients, various services and devices, such as
medication reaction tests, Framingham calculators, and body mass index calculators can be
obtained easily. Along with remote support, EHRs also allow healthcare service users to obtain
remote treatment through screening.
In the traditional approach, handwritten documents and paper charts are used by
physicians to keep track of the medical history of the patients. Not only was the procedure time
consuming, but medical errors were highly frequent while data were maintained through a
traditional approach. The Electronic health records platform provides information to health care
providers in ways that were not feasible with paper charts (Greiver 2015). Primary care
professionals will also display and print attributes graphs such as weight, levels of cholesterol,
and blood pressure, measuring improvements over time. The EMR increases the accomplishment
to help the patients in self management through remote support and treatment adherence. Patients
who reside in rural areas or patents that lack access to healthcare are mostly found to use EHR
platforms in order to obtain medication and treatments. Patients can upload their previous
prescriptions, X-rays and other evidence of health issues and eminent healthcare service users
provides the patents with medication and consultation (Manca, 2015). One of the most popular
EHR platforms includes My health record. This platform can be defined as a secure online
summary of the patient's health information that can be accessed by health service providers
elected by the patient. My Health record provides the patient with access to remote support.
Health providers access the data of the patients through the My health record portal to provide
the best possible care (healthdirect.gov.au., 2020). Additionally, physicians can communicate
directly to the patients through this portal and thus can also enhance their awareness about
certain medical health conditions and thus educating the patients about how to take care of
themselves. To help educate physicians and their patients, various services and devices, such as
medication reaction tests, Framingham calculators, and body mass index calculators can be
obtained easily. Along with remote support, EHRs also allow healthcare service users to obtain
remote treatment through screening.
In the traditional approach, handwritten documents and paper charts are used by
physicians to keep track of the medical history of the patients. Not only was the procedure time
consuming, but medical errors were highly frequent while data were maintained through a
traditional approach. The Electronic health records platform provides information to health care
providers in ways that were not feasible with paper charts (Greiver 2015). Primary care
professionals will also display and print attributes graphs such as weight, levels of cholesterol,
and blood pressure, measuring improvements over time. The EMR increases the accomplishment
3HEALTH CARE IN DIGITAL WORLD
of expectations for chronic disease control, prevention, and screening, as seen in research
demonstrating increased quality measures. Electronic medical records also possess the potential
to provide treatment goals as well as alerts for reminding emergency screening and maneuvers
that are due on an urgent basis. This in turn helped the healthcare providers to tackles areas of
high needs. According to Cms.gov., (2020) , EHRs like the My health records provides the
following benefits that were not provided by the traditional approach of healthcare.
ï‚· Providing precise, up-to-date, and full patient details at the point of treatment
ï‚· Allowing easy access to medical information for more effective and organized treatment
ï‚· Securely sharing electronic information with patients and other clinicians
ï‚· Allows clinicians to treat patients more accurately, minimize medical problems and
deliver balanced treatment (healthit.gov., 2020)
ï‚· Improvement of patient and physician contact and coordination, and quality in health care
ï‚· Allowing more safe and effective prescribing
ï‚· Encouraging the advancement of legible, full reporting and accurate, efficient labeling
and billing
ï‚· Protecting the safety and confidentiality of patient records
ï‚· Empowering providers to enhance quality and work-life balance
ï‚· Allowing providers to increase performance and achieve their business targets
ï‚· Lowering costs by reduced paperwork, enhanced protection, reduced duplication
The EHR platform along with enabling the health care service providers to provide high
quality and error-free care, also enhances the relationship between the healthcare service
providers and the healthcare service users. Before the emergence of EHR platforms, patients
were not being able to see or understand their health records an lack of understanding awareness
of expectations for chronic disease control, prevention, and screening, as seen in research
demonstrating increased quality measures. Electronic medical records also possess the potential
to provide treatment goals as well as alerts for reminding emergency screening and maneuvers
that are due on an urgent basis. This in turn helped the healthcare providers to tackles areas of
high needs. According to Cms.gov., (2020) , EHRs like the My health records provides the
following benefits that were not provided by the traditional approach of healthcare.
ï‚· Providing precise, up-to-date, and full patient details at the point of treatment
ï‚· Allowing easy access to medical information for more effective and organized treatment
ï‚· Securely sharing electronic information with patients and other clinicians
ï‚· Allows clinicians to treat patients more accurately, minimize medical problems and
deliver balanced treatment (healthit.gov., 2020)
ï‚· Improvement of patient and physician contact and coordination, and quality in health care
ï‚· Allowing more safe and effective prescribing
ï‚· Encouraging the advancement of legible, full reporting and accurate, efficient labeling
and billing
ï‚· Protecting the safety and confidentiality of patient records
ï‚· Empowering providers to enhance quality and work-life balance
ï‚· Allowing providers to increase performance and achieve their business targets
ï‚· Lowering costs by reduced paperwork, enhanced protection, reduced duplication
The EHR platform along with enabling the health care service providers to provide high
quality and error-free care, also enhances the relationship between the healthcare service
providers and the healthcare service users. Before the emergence of EHR platforms, patients
were not being able to see or understand their health records an lack of understanding awareness
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4HEALTH CARE IN DIGITAL WORLD
resulted in enhanced dependency of the patents towards physicians. Not only this, lack of
understanding of what treatments were given to them, hinders the development of trust. With the
emergence of EHR platforms like My health Records, patients are able to see as well as track
their own health records (Mitchell & Begoray, 2010). Additionally, a description of the health
outcomes in the portal enables the patients to develop effective understanding and awareness and
thus shift the balance power. The My Health Record systems help in building trust and
confidence of the patents on the healthcare professionals. Patients recognize that their providers
have a full patient record that makes for evidence-based recommendations on their diagnosis and
care plans. Likewise, doctors who have access to detailed records make better decisions that lead
to better outcomes. An interoperable ecosystem that aggregates information across the entire
range of services, both internally and with external EHR networks, means exchanging
information with everyone that wants to learn it and anyone who doesn't. Integrated frameworks
strengthen the interaction between the communication and service teams. A perfect program
facilitates data gathering and dissemination from diverse networks and patients and transforms
the data into easy-to-interpret, actionable knowledge that helps clinicians and medical teams.
Additionally, the EHR system helps the healthcare management to protect the privacy and
confidentiality of the patents and thus further helps in trust-building. Health information systems
built into EHR apps facilitates teamwork in real-time in areas that doctors haven't seen before.
Naturally, because mobile devices provide direct access to patient files and on-the-go charting,
priority must be given to data protection and patient privacy. Exceptional programs provide
doctors with resources to improve their patients' accountability and usability while carefully
monitoring the flow of information to protect against cyber threats and unwanted access.
Facilitating knowledge sharing in a safe atmosphere not only creates trust but also encourages
resulted in enhanced dependency of the patents towards physicians. Not only this, lack of
understanding of what treatments were given to them, hinders the development of trust. With the
emergence of EHR platforms like My health Records, patients are able to see as well as track
their own health records (Mitchell & Begoray, 2010). Additionally, a description of the health
outcomes in the portal enables the patients to develop effective understanding and awareness and
thus shift the balance power. The My Health Record systems help in building trust and
confidence of the patents on the healthcare professionals. Patients recognize that their providers
have a full patient record that makes for evidence-based recommendations on their diagnosis and
care plans. Likewise, doctors who have access to detailed records make better decisions that lead
to better outcomes. An interoperable ecosystem that aggregates information across the entire
range of services, both internally and with external EHR networks, means exchanging
information with everyone that wants to learn it and anyone who doesn't. Integrated frameworks
strengthen the interaction between the communication and service teams. A perfect program
facilitates data gathering and dissemination from diverse networks and patients and transforms
the data into easy-to-interpret, actionable knowledge that helps clinicians and medical teams.
Additionally, the EHR system helps the healthcare management to protect the privacy and
confidentiality of the patents and thus further helps in trust-building. Health information systems
built into EHR apps facilitates teamwork in real-time in areas that doctors haven't seen before.
Naturally, because mobile devices provide direct access to patient files and on-the-go charting,
priority must be given to data protection and patient privacy. Exceptional programs provide
doctors with resources to improve their patients' accountability and usability while carefully
monitoring the flow of information to protect against cyber threats and unwanted access.
Facilitating knowledge sharing in a safe atmosphere not only creates trust but also encourages
5HEALTH CARE IN DIGITAL WORLD
patients to become allies in maintaining their wellbeing (Palmer et al., 2019). Better educated
patients who have faith in their treatment practitioners are also more likely to share confidential
health and financial details that may affect the procedure on care.
Along with this, through identifying appropriate contact mechanisms based on the
preferences of their patients, doctors can assure that their clients don't feel lonely. Young adults
are nearly always familiar with text messaging and IVR appointment updates, elderly patients
may not be using tablets, and electronic alerts may be difficult to comprehend. Analytics can
help doctors determine which means of contact are better for individuals and subgroups within
the community.
HIPAA Privacy and Security Regulations are administered by the HHS Office for Civil
Rights (OCR), which aims to keep agencies protected by HIPAA responsible for the protection
and security of health records for patients. While EHRs empower clinicians to use information
more efficiently to increase the consistency and reliability of patient services, they do not remove
the responsibilities that clinicians have to keep confidential and safeguard patient safe health
records (Friend, Jennings & Levine, 2017). The HIPAA Protection Law allows health care
facilities to set up human, financial, and technological protections to secure the electronic health
records, primarily to secure the information contained in EHRs. Despite the fact that a huge
number of parents worldwide use multiple protections to protect the information stored in My
Health Record programs, such as strict encryption, firewalls, stable authentication procedures,
and audit monitoring, are in place. There are individuals, procedures, technology and regulations
that ensure the records stored safely in My Health Record.
Some protection mechanisms that could be integrated into EHR programs include:
patients to become allies in maintaining their wellbeing (Palmer et al., 2019). Better educated
patients who have faith in their treatment practitioners are also more likely to share confidential
health and financial details that may affect the procedure on care.
Along with this, through identifying appropriate contact mechanisms based on the
preferences of their patients, doctors can assure that their clients don't feel lonely. Young adults
are nearly always familiar with text messaging and IVR appointment updates, elderly patients
may not be using tablets, and electronic alerts may be difficult to comprehend. Analytics can
help doctors determine which means of contact are better for individuals and subgroups within
the community.
HIPAA Privacy and Security Regulations are administered by the HHS Office for Civil
Rights (OCR), which aims to keep agencies protected by HIPAA responsible for the protection
and security of health records for patients. While EHRs empower clinicians to use information
more efficiently to increase the consistency and reliability of patient services, they do not remove
the responsibilities that clinicians have to keep confidential and safeguard patient safe health
records (Friend, Jennings & Levine, 2017). The HIPAA Protection Law allows health care
facilities to set up human, financial, and technological protections to secure the electronic health
records, primarily to secure the information contained in EHRs. Despite the fact that a huge
number of parents worldwide use multiple protections to protect the information stored in My
Health Record programs, such as strict encryption, firewalls, stable authentication procedures,
and audit monitoring, are in place. There are individuals, procedures, technology and regulations
that ensure the records stored safely in My Health Record.
Some protection mechanisms that could be integrated into EHR programs include:
6HEALTH CARE IN DIGITAL WORLD
ï‚· "Access locks" such as passwords and PIN numbers to help restrict access to your
information
ï‚· "Encryption" of your encrypted data. It ensures that the confidential history cannot be
read or interpreted only by someone who can "decrypt" it, using a special "key" made
open to designated persons only;
ï‚· An "audit trail," which tracks who has accessed the history, what improvements have
been made and when.
When it comes to equity issues associated with EHRs, it can be pointed out to be similar to
the majority of the other patient facing digital platforms (Tieu et al. 2017). One of the major
equity issues associated with the access to EHR to lack of access to the internet in remote areas.
While the majority of the population residing in cities of Australia possess internet access and
thus can use EHR platforms on an effective basis, people with lower financial capital who cannot
access the internet as well as people residing in areas that lack internet connection are unable to
obtain facilities like remote treatment and remote support through EHR system (Cheek et al.,
2017). Not only this, a good number of Australian specially majority of the indigenous
population are not aware of how to use technology. Additionally, lack of trust of the indigenous
population on healthcare is also a big challenge for the Australian healthcare system to ensure
equity through EHR.
In order to deal with this, the chief role of both local and federal government is to enhance
the funding so that access to the internet and digital gadgets can be provided in remote regions
that are in dire need of remote services (Kruse et al., 2016). Additionally more are more
campaigns need to conducted in order to enhance the knowledge and capability of the population
to use HER systems.
ï‚· "Access locks" such as passwords and PIN numbers to help restrict access to your
information
ï‚· "Encryption" of your encrypted data. It ensures that the confidential history cannot be
read or interpreted only by someone who can "decrypt" it, using a special "key" made
open to designated persons only;
ï‚· An "audit trail," which tracks who has accessed the history, what improvements have
been made and when.
When it comes to equity issues associated with EHRs, it can be pointed out to be similar to
the majority of the other patient facing digital platforms (Tieu et al. 2017). One of the major
equity issues associated with the access to EHR to lack of access to the internet in remote areas.
While the majority of the population residing in cities of Australia possess internet access and
thus can use EHR platforms on an effective basis, people with lower financial capital who cannot
access the internet as well as people residing in areas that lack internet connection are unable to
obtain facilities like remote treatment and remote support through EHR system (Cheek et al.,
2017). Not only this, a good number of Australian specially majority of the indigenous
population are not aware of how to use technology. Additionally, lack of trust of the indigenous
population on healthcare is also a big challenge for the Australian healthcare system to ensure
equity through EHR.
In order to deal with this, the chief role of both local and federal government is to enhance
the funding so that access to the internet and digital gadgets can be provided in remote regions
that are in dire need of remote services (Kruse et al., 2016). Additionally more are more
campaigns need to conducted in order to enhance the knowledge and capability of the population
to use HER systems.
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7HEALTH CARE IN DIGITAL WORLD
Conclusion
From the above discussion, it can be concluded that EHR system is indeed an efficient way to
support the patients, provide better treatments and enhance accessibility to healthcare. The
Electronic health records platform provides information to health care providers in ways that
were not feasible with paper charts. Primary care professionals will also display and print
attributes graphs such as weight, levels of cholesterol, and blood pressure, measuring
improvements over time. The EHR system helps the healthcare management to protect the
privacy and confidentiality of the patents and thus further helps in trust building.
Conclusion
From the above discussion, it can be concluded that EHR system is indeed an efficient way to
support the patients, provide better treatments and enhance accessibility to healthcare. The
Electronic health records platform provides information to health care providers in ways that
were not feasible with paper charts. Primary care professionals will also display and print
attributes graphs such as weight, levels of cholesterol, and blood pressure, measuring
improvements over time. The EHR system helps the healthcare management to protect the
privacy and confidentiality of the patents and thus further helps in trust building.
8HEALTH CARE IN DIGITAL WORLD
References
Cheek, J., Advani, A., Reilley, B., Hack, F., Groom, A., Hayslett, J., ... & Cullen, T. (2017). Use
of an electronic health record system for public health surveillance. In International
Society for Disease Surveillance 10 th Annual Conference 2011 Building the Future of
Public Health Surveillance. Retrieved from:
https://www.researchgate.net/profile/James_Cheek/publication/276225089_Use_of_an_E
lectronic_Health_Record_System_for_Public_Health_Surveillance/links/
55e5c02608aebdc0f58b799b/Use-of-an-Electronic-Health-Record-System-for-Public-
Health-Surveillance.pdf
Cms.gov. (2020). Electronic Health Records | CMS. Retrieved 18 April 2020, from
https://www.cms.gov/Medicare/E-Health/EHealthRecords
Friend, T. H., Jennings, S. J., & Levine, W. C. (2017). Communication patterns in the
perioperative environment during epic electronic health record system implementation.
Journal of medical systems, 41(2), 22. Retrieved from:
https://link.springer.com/article/10.1007/s10916-016-0674-3
Greiver, M., 2015. Do electronic medical records improve quality of care?: No. Canadian
Family Physician, 61(10), p.847.
healthdirect.gov.au. (2020). About My Health Record. Retrieved 18 April 2020, from
https://www.healthdirect.gov.au/my-health-record
healthit.gov. (2020). What are the advantages of electronic health records? | HealthIT.gov.
Retrieved 18 April 2020, from https://www.healthit.gov/faq/what-are-advantages-
electronic-health-records
References
Cheek, J., Advani, A., Reilley, B., Hack, F., Groom, A., Hayslett, J., ... & Cullen, T. (2017). Use
of an electronic health record system for public health surveillance. In International
Society for Disease Surveillance 10 th Annual Conference 2011 Building the Future of
Public Health Surveillance. Retrieved from:
https://www.researchgate.net/profile/James_Cheek/publication/276225089_Use_of_an_E
lectronic_Health_Record_System_for_Public_Health_Surveillance/links/
55e5c02608aebdc0f58b799b/Use-of-an-Electronic-Health-Record-System-for-Public-
Health-Surveillance.pdf
Cms.gov. (2020). Electronic Health Records | CMS. Retrieved 18 April 2020, from
https://www.cms.gov/Medicare/E-Health/EHealthRecords
Friend, T. H., Jennings, S. J., & Levine, W. C. (2017). Communication patterns in the
perioperative environment during epic electronic health record system implementation.
Journal of medical systems, 41(2), 22. Retrieved from:
https://link.springer.com/article/10.1007/s10916-016-0674-3
Greiver, M., 2015. Do electronic medical records improve quality of care?: No. Canadian
Family Physician, 61(10), p.847.
healthdirect.gov.au. (2020). About My Health Record. Retrieved 18 April 2020, from
https://www.healthdirect.gov.au/my-health-record
healthit.gov. (2020). What are the advantages of electronic health records? | HealthIT.gov.
Retrieved 18 April 2020, from https://www.healthit.gov/faq/what-are-advantages-
electronic-health-records
9HEALTH CARE IN DIGITAL WORLD
Kruse, C. S., Kristof, C., Jones, B., Mitchell, E., & Martinez, A. (2016). Barriers to electronic
health record adoption: a systematic literature review. Journal of medical systems,
40(12), 252. doi: 10.1097/MED.0000000000000227
Manca, D. P. (2015). Do electronic medical records improve quality of care?: Yes. Canadian
Family Physician, 61(10), 846. Retrieved from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4607324/
Mitchell, B., & Begoray, D. (2010). Electronic personal health records that promote self-
management in chronic illness. OJIN: The Online Journal of Issues in Nursing, 15(3),
1B-10B. retrieved from :
http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/
OJIN/TableofContents/Vol152010/No3-Sept-2010/Articles-Previously-Topic/Electronic-
Personal-Health-Records-and-Chronic-Illness.html
Palmer, E. L., Higgins, J., Hassanpour, S., Sargent, J., Robinson, C. M., Doherty, J. A., & Onega,
T. (2019). Assessing data availability and quality within an electronic health record
system through external validation against an external clinical data source. BMC medical
informatics and decision making, 19(1), 143. Retrieved from:
https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-019-0864-2
Tieu, L., Schillinger, D., Sarkar, U., Hoskote, M., Hahn, K. J., Ratanawongsa, N., ... & Lyles, C.
R. (2017). Online patient websites for electronic health record access among vulnerable
populations: portals to nowhere?. Journal of the American Medical Informatics
Association, 24(e1), e47-e54. Retrieved from: https://doi.org/10.1093/jamia/ocw098
Kruse, C. S., Kristof, C., Jones, B., Mitchell, E., & Martinez, A. (2016). Barriers to electronic
health record adoption: a systematic literature review. Journal of medical systems,
40(12), 252. doi: 10.1097/MED.0000000000000227
Manca, D. P. (2015). Do electronic medical records improve quality of care?: Yes. Canadian
Family Physician, 61(10), 846. Retrieved from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4607324/
Mitchell, B., & Begoray, D. (2010). Electronic personal health records that promote self-
management in chronic illness. OJIN: The Online Journal of Issues in Nursing, 15(3),
1B-10B. retrieved from :
http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/
OJIN/TableofContents/Vol152010/No3-Sept-2010/Articles-Previously-Topic/Electronic-
Personal-Health-Records-and-Chronic-Illness.html
Palmer, E. L., Higgins, J., Hassanpour, S., Sargent, J., Robinson, C. M., Doherty, J. A., & Onega,
T. (2019). Assessing data availability and quality within an electronic health record
system through external validation against an external clinical data source. BMC medical
informatics and decision making, 19(1), 143. Retrieved from:
https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-019-0864-2
Tieu, L., Schillinger, D., Sarkar, U., Hoskote, M., Hahn, K. J., Ratanawongsa, N., ... & Lyles, C.
R. (2017). Online patient websites for electronic health record access among vulnerable
populations: portals to nowhere?. Journal of the American Medical Informatics
Association, 24(e1), e47-e54. Retrieved from: https://doi.org/10.1093/jamia/ocw098
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