Displaying publications 1 - 20 of 61 in total

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  1. Zamli AH, Mustafah NM, Sa'at N, Shaharom S
    Med J Malaysia, 2020 11;75(6):642-648.
    PMID: 33219171
    INTRODUCTION: Neurogenic bladder (NB) is a recognized secondary medical impairment following spinal cord injury (SCI). Ultrasound (US) of the kidneys, ureters and bladder (KUB) has been recommended as a useful, non-invasive surveillance method with good diagnostic sensitivity. This study aims to understand US diagnosed NB complications and identify its associated factors.

    METHODS: We enrolled all patients referred for SCI rehabilitation from 2012 to 2015 that fulfilled our study criteria. Data that were retrospectively reviewed included demographic and clinical characteristic data; and US KUB surveillance studies.

    RESULTS: Out of 136 electronic medical records reviewed, 110 fulfilled the study criteria. The prevalence of NB in our study population was 80.9%. We found 22(20%) of the patients showed evidence of US diagnosed NB complications with the mean detection of 9.61±7.91 months following initial SCI. The reported NB complications were specific morphological changes in the bladder wall 8(36.4%); followed by unilateral/bilateral hydronephrosis 7(31.8%); bladder and/or renal calculi 5(22.7%); and mixed complication 2(9.1%) respectively. Half of the patients with NB complications had urodynamic diagnosis of neurogenic detrusor overactivity with/without evidence of detrusor sphincter dyssynergia. We found co-existing neurogenic bowel, presence of spasticity and mode of bladder management were significantly associated factors with US diagnosed NB complications (p<0.05), while spasticity was its predictor with adjusted Odds Ratio value of 3.93 (1.14, 13.56).

    CONCLUSION: NB is a common secondary medical impairment in our SCI population. A proportion of them had US diagnosed NB complications. Co-existing neurogenic bowel, presence of spasticity and mode of bladder management were its associated factors; while spasticity was its predictor.

    Matched MeSH terms: Electronic Health Records
  2. Zaidan AA, Zaidan BB, Al-Haiqi A, Kiah ML, Hussain M, Abdulnabi M
    J Biomed Inform, 2015 Feb;53:390-404.
    PMID: 25483886 DOI: 10.1016/j.jbi.2014.11.012
    Evaluating and selecting software packages that meet the requirements of an organization are difficult aspects of software engineering process. Selecting the wrong open-source EMR software package can be costly and may adversely affect business processes and functioning of the organization. This study aims to evaluate and select open-source EMR software packages based on multi-criteria decision-making. A hands-on study was performed and a set of open-source EMR software packages were implemented locally on separate virtual machines to examine the systems more closely. Several measures as evaluation basis were specified, and the systems were selected based a set of metric outcomes using Integrated Analytic Hierarchy Process (AHP) and TOPSIS. The experimental results showed that GNUmed and OpenEMR software can provide better basis on ranking score records than other open-source EMR software packages.
    Matched MeSH terms: Electronic Health Records*
  3. Yusof MM
    Int J Med Inform, 2015 Jul;84(7):486-99.
    PMID: 25881560 DOI: 10.1016/j.ijmedinf.2015.03.001
    Clinical information systems have long been used in intensive care units but reports on their adoption and benefits are limited. This study evaluated a Critical Care Information System implementation.
    Matched MeSH terms: Electronic Health Records/utilization*
  4. Yau WC, Phan RC
    J Med Syst, 2013 Dec;37(6):9993.
    PMID: 24194093 DOI: 10.1007/s10916-013-9993-9
    Many authentication schemes have been proposed for telecare medicine information systems (TMIS) to ensure the privacy, integrity, and availability of patient records. These schemes are crucial for TMIS systems because otherwise patients' medical records become susceptible to tampering thus hampering diagnosis or private medical conditions of patients could be disclosed to parties who do not have a right to access such information. Very recently, Hao et al. proposed a chaotic map-based authentication scheme for telecare medicine information systems in a recent issue of Journal of Medical Systems. They claimed that the authentication scheme can withstand various attacks and it is secure to be used in TMIS. In this paper, we show that this authentication scheme is vulnerable to key-compromise impersonation attacks, off-line password guessing attacks upon compromising of a smart card, and parallel session attacks. We also exploit weaknesses in the password change phase of the scheme to mount a denial-of-service attack. Our results show that this scheme cannot be used to provide security in a telecare medicine information system.
    Matched MeSH terms: Electronic Health Records/standards
  5. Yang Y, Østbye T, Tan SB, Abdul Salam ZH, Ong BC, Yang KS
    J Diabetes Complications, 2011 Nov-Dec;25(6):382-6.
    PMID: 21983153 DOI: 10.1016/j.jdiacomp.2011.08.002
    BACKGROUND:
    Among other risk factors, renal disease and ethnicity have been associated with diabetic lower extremity amputation (LEA) in Western populations. However, little is known about risk factors for LEA among Asian patients.

    OBJECTIVE:
    The objective was to assess the proportion of hospitalized patients with diabetes who have a LEA among all hospital patients with diabetes mellitus (DM) and to investigate risk factors for diabetic LEA (especially renal disease and ethnicity) using hospital discharge database.

    METHOD:
    A retrospective study of hospital discharge database (2004-2009) was performed to identify patients with DM, LEA and renal disease using the International Statistical Classification of Diseases and Related Health Problems, Ninth Revision, Australian Modification codes.

    RESULTS:
    Of 44 917 hospitalized patients with DM during the 6 years, 7312 (16.3%) patients had renal disease, and 1457 (3.2%) patients had LEA. DM patients with renal disease had significant higher rates of LEA (7.1%) compared to DM patients without renal disease (2.5%, P < .001). The differences were present for foot (2.7% vs. 1.2%), ankle or leg (2.8% vs. 0.9%), and knee or above amputation (1.6% vs. 0.4%, all P
    Matched MeSH terms: Electronic Health Records
  6. Wong PL, Sii HL, P'ng CK, Ee SS, Yong Oong X, Ng KT, et al.
    Influenza Other Respir Viruses, 2020 05;14(3):286-293.
    PMID: 32022411 DOI: 10.1111/irv.12691
    BACKGROUND: Age is an established risk factor for poor outcomes in individuals with influenza-related illness, and data on its influence on clinical presentations and outcomes in the South-East Asian settings are scarce. The aim of this study was to determine the above among adults with influenza-related upper respiratory tract infection at a teaching hospital in Malaysia.

    METHODS: A retrospective case-note analysis was conducted on a cohort of 3935 patients attending primary care at the University Malaya Medical Centre, Malaysia from February 2012 till May 2014 with URTI symptoms. Demographics, clinical characteristics, medical and vaccination history were obtained from electronic medical records, and mortality data from the National Registration Department. Comparisons were made between those aged <25, ≥25 to <65 and ≥65 years.

    RESULTS: 470 (11.9%) had PCR-confirmed influenza virus infection. Six (1.3%) received prior influenza vaccination. Those aged ≥65 years were more likely to have ≥2 comorbidities (P health outcomes. Our findings will now inform future health policies on older persons and economic modelling of adult vaccination programmes.

    Matched MeSH terms: Electronic Health Records
  7. Usir E, Lua PL, Majeed AB
    J Pharm Pract, 2012 Jun;25(3):374-80.
    PMID: 22551563 DOI: 10.1177/0897190012442218
    This study aimed to determine the availability and usage of printed and electronic references and Patient Medication Record in community pharmacy. It was conducted for over 3 months from 15 January to 30 April 2007. Ninety-three pharmacies participated. Structured questionnaires were mailed to community pharmacies. Six weeks later a reminder was sent to all non responders, who were given another six weeks to return the completed questionnaire. Outcomes were analyzed using descriptive statistics and chi-square test of independence. Almost all the pharmacies (96.8%) have at least Monthly Index of Medical Specialties (MIMS) while 78.5% have at least MIMS ANNUAL in their stores. Only about a third (31.2%) of the pharmacies were equipped with online facilities of which the majority referred to medical websites (88.9%) with only a minority (11.1%) referring to electronic journals. More than half (59.1%) of the pharmacists kept Patient Medication Record profiles with 49.1% storing it in paper, 41.8% electronically and 9.1% in both printed and electronic versions. In general, prevalence and usage of electronic references in community pharmacies were rather low. Efforts should be increased to encourage wider usage of electronic references and Patient Medication Records in community pharmacies to facilitate pharmaceutical care.
    Matched MeSH terms: Electronic Health Records/trends; Electronic Health Records/utilization*
  8. Tsai TF
    Br J Dermatol, 2023 Sep 15;189(4):361-362.
    PMID: 37379585 DOI: 10.1093/bjd/ljad197
    Matched MeSH terms: Electronic Health Records
  9. Thiam CN, Hasmukharay K, Lim WC, Ng CC, Pang GHM, Abdullah A, et al.
    Geriatrics (Basel), 2021 Mar 08;6(1).
    PMID: 33800304 DOI: 10.3390/geriatrics6010025
    (1) Background: Older people with COVID-19 infection report worse clinical outcomes. There is a paucity of local data and this study aimed to describe the clinical progression of older people admitted to a university hospital in Malaysia with COVID-19 infection. (2) Methods: Older people (≥60 years) admitted with COVID-19 infection confirmed with RT-PCR from 27 February 2020-25 May 2020 were included in this study. Data on patient characteristics, hospital treatment, and inpatient outcomes were collected via hospital-held electronic medical records. Analysis was done to describe the cohort and identify factors associated with inpatient mortality. (3) Results: 26 participants were included (mean age 76.2 years, female 57.7%). All had at least one comorbid condition and half were frail. About 19.2% had non-respiratory (atypical) symptoms; 23.1% had a severe disease that required intensive care unit monitoring; 46.2% were given COVID-19 targeted therapy. Inpatient mortality and overall complication rates were 23.1% and 42.3%, respectively. Delirium on presentation and lower Ct-value were associated with mortality. (4) Conclusions: Older people with COVID-19 infection have severe infection and poor hospital outcomes. Vigilant hospital care is necessary to address their multimorbidity and frailty, along with appropriate treatment for their infection.
    Matched MeSH terms: Electronic Health Records
  10. Tham TY, Tran TL, Prueksaritanond S, Isidro JS, Setia S, Welluppillai V
    Clin Interv Aging, 2018;13:2527-2538.
    PMID: 30587945 DOI: 10.2147/CIA.S185048
    A rapidly aging population along with the increasing burden of patients with chronic conditions in Asia requires efficient health systems with integrated care. Although some efforts to integrate primary care and hospital care in Asia are underway, overall care delivery remains fragmented and diverse, eg, in terms of medical electronic record sharing and availability, patient registries, and empowerment of primary health care providers to handle chronic illnesses. The primary care sector requires more robust and effective initiatives targeted at specific diseases, particularly chronic conditions such as diabetes, hypertension, depression, and dementia. This can be achieved through integrated care - a health care model of collaborative care provision. For successful implementation of integrated care policy, key stakeholders need a thorough understanding of the high-risk patient population and relevant resources to tackle the imminent population demographic shift due to the extremely rapid rate of increase in the aging population in Asia.
    Matched MeSH terms: Electronic Health Records
  11. Tay KH, Ariffin F, Sim BL, Chin SY, Sobry AC
    Malays J Med Sci, 2019 Jul;26(4):101-109.
    PMID: 31496899 MyJurnal DOI: 10.21315/mjms2019.26.4.12
    Background: Antimicrobial resistance is a global problem that is perpetuated by the inappropriate use of antibiotics among doctors. This study aims to assess the antibiotic prescription rate for patients with acute upper respiratory infection (URI) and acute diarrhoea.

    Methods: A completed clinical audit cycle was conducted in 2018 in the busy emergency department of a public hospital in Malaysia. Pre- and post-intervention antibiotic prescription data were collected, and changes were implemented through a multifaceted intervention similar to Thailand's Antibiotics Smart Use programme.

    Results: Data from a total of 1,334 pre-intervention and 1,196 post-intervention patients were collected from the hospital's electronic medical records. The mean (SD) age of participants was 19.88 (17.994) years. The pre-intervention antibiotic prescription rate was 11.2% for acute diarrhoea and 29.1% for acute URI, both of which are above the average national rates. These antibiotic prescription rates significantly reduced post-intervention to 6.2% and 13.7%, respectively, falling below national averages. Antibiotic prescription rate was highest for young children. There were no significant changes in rates of re-attendance or hospital admission following the intervention.

    Conclusion: The multifaceted intervention, which included continuing medical education, physician reminders and patient awareness, was effective in improving the antibiotic prescription rates for these two conditions.

    Matched MeSH terms: Electronic Health Records
  12. Syed-Mohamad SM, Ali SH, Mat-Husin MN
    Health Inf Manag, 2010;39(1):30-5.
    PMID: 20335647
    This paper describes the method used to develop the One Stop Crisis Centre (OSCC) Portal, an open source web-based electronic patient record system (EPR) for the One Stop Crisis Center, Hospital Universiti Sains Malaysia (HUSM) in Kelantan, Malaysia. Features and functionalities of the system are presented to demonstrate the workflow. Use of the OSCC Portal improved data integration and data communication and contributed to improvements in care management. With implementation of the OSCC portal, improved coordination between disciplines and standardisation of data in HUSM were noticed. It is expected that this will in turn result in improved data confidentiality and data integrity. The collected data will also be useful for quality assessment and research. Other low-resource centers with limited computer hardware and access to open-source software could benefit from this endeavour.
    Matched MeSH terms: Electronic Health Records*
  13. Syed-Mohamad SM, Ali SH, Mat-Husin MN
    Health Inf Manag, 2010 Mar;39(1):30-35.
    PMID: 28683624 DOI: 10.1177/183335831003900105
    This paper describes the method used to develop the One Stop Crisis Centre (OSCC) Portal, an open-source web-based electronic patient record system (EPR) for the One Stop Crisis Center, Hospital Universiti Sains Malaysia (HUSM) in Kelantan, Malaysia. Features and functionalities of the system are presented to demonstrate the workflow. Use of the OSCC Portal improved data integration and data communication and contributed to improvements in care management. With implementation of the OSCC portal, improved coordination between disciplines and standardisation of data in HUSM were noticed. It is expected that this will in turn result in improved data confidentiality and data integrity. The collected data will also be useful for quality assessment and research. Other low-resource centers with limited computer hardware and access to open-source software could benefit from this endeavour.
    Matched MeSH terms: Electronic Health Records
  14. Simon SK, Seldon HL
    Stud Health Technol Inform, 2012;182:125-32.
    PMID: 23138087
    A target of telehealth is to maintain or improve the health of people outside the normal healthcare infrastructure. A modern paradigm in healthcare, and one which fits perfectly with telehealth, is "person self-monitoring", and this fits with the concept of "personal health record" (PHR). One factor in maintaining health is to monitor physiological parameters; this is of course especially important in people with chronic maladies such as diabetes or heart disease. Parameters to be monitored include blood pressure, pulse rate, temperature, weight, blood glucose, oxygen saturation, electrocardiogram (ECG), etc. So one task within telehealth would be to help monitor an individual's physiological parameters outside of healthcare institutions and store the results in a PHR in a way which is available, comprehensible and beneficial to the individual concerned and to healthcare providers. To date many approaches to this problem have been fragmented - emphasizing only part of the problem - or proprietary and not freely verifiable. We describe a framework to approach this task; it emphasizes the implementation of standards for data acquisition, storage and transmission in order to maximize the compatibility among disparate components, e.g. various PHR systems. Data from mobile biosensors is collected on a smartphone using the IEEE 11073 standard where possible; the data can be stored in a PHR on the phone (using standard formats) or can be converted in real-time into more useful information in the PHR, which is based on the International Classification for Primary Care (ICPC2e). The phone PHR data or information can be uploaded to a central online PHR using either the Wi-Fi or GSM transmission protocol together with the Continuity of Care Record message format (CCR, ASTM E2369).
    Matched MeSH terms: Electronic Health Records/instrumentation; Electronic Health Records/organization & administration*
  15. Schüz J, Fored M
    Methods Inf Med, 2017 Aug 11;56(4):328-329.
    PMID: 28726979 DOI: 10.3414/ME17-14-0004
    BACKGROUND: This accompanying editorial is an introduction to the focus theme of "chronic disease registries - trends and challenges".

    METHODS: A call for papers was announced on the website of Methods of Information in Medicine in April 2016 with submission deadline in September 2016. A peer review process was established to select the papers for the focus theme, managed by two guest editors.

    RESULTS: Three papers were selected to be included in the focus theme. Topics range from contributions to patient care through implementation of clinical decision support functionality in clinical registries; analysing similar-purposed acute coronary syndrome registries of two countries and their registry-to-SNOMED CT maps; and data extraction for speciality population registries from electronic health record data rather than manual abstraction.

    CONCLUSIONS: The focus theme gives insight into new developments related to disease registration. This applies to technical challenges such as data linkage and data as well as data structure abstraction, but also the utilisation for clinical decision making.

    Matched MeSH terms: Electronic Health Records
  16. Sayyah Gilani M, Iranmanesh M, Nikbin D, Zailani S
    Inform Health Soc Care, 2017 Mar;42(2):153-165.
    PMID: 27100821 DOI: 10.3109/17538157.2016.1160245
    Electronic medical records (EMRs) have been proven to be effective tools for improving the safety and quality of healthcare despite their relatively low usage rate in hospitals. The long-term development by EMRs depends on the continued use of healthcare professionals. In this study, technology continuance theory (TCT) was used to evaluate the short-term and long-term continuance acceptance of EMRs among healthcare professionals. Data were gathered by surveying 195 medical professionals in Iran. The data were analyzed using the partial least squares (PLS) technique. The analysis showed that the TCT provided a deep understanding of user continuance intention toward EMRs. In addition, the findings illustrated that the determinants of continuance intention vary between short-term and long-term users. The theoretical and practical implications of the study are discussed.
    Matched MeSH terms: Electronic Health Records/utilization*
  17. Salmasi S, Wimmer BC, Khan TM, Zaidi STR, Ming LC
    Res Social Adm Pharm, 2018 Feb;14(2):207-209.
    PMID: 28330781 DOI: 10.1016/j.sapharm.2017.02.015
    Matched MeSH terms: Electronic Health Records
  18. Salleh MIM, Abdullah R, Zakaria N
    BMC Med Inform Decis Mak, 2021 02 25;21(1):75.
    PMID: 33632216 DOI: 10.1186/s12911-021-01447-4
    BACKGROUND: The Ministry of Health of Malaysia has invested significant resources to implement an electronic health record (EHR) system to ensure the full automation of hospitals for coordinated care delivery. Thus, evaluating whether the system has been effectively utilized is necessary, particularly regarding how it predicts the post-implementation primary care providers' performance impact.

    METHODS: Convenience sampling was employed for data collection in three government hospitals for 7 months. A standardized effectiveness survey for EHR systems was administered to primary health care providers (specialists, medical officers, and nurses) as they participated in medical education programs. Empirical data were assessed by employing partial least squares-structural equation modeling for hypothesis testing.

    RESULTS: The results demonstrated that knowledge quality had the highest score for predicting performance and had a large effect size, whereas system compatibility was the most substantial system quality component. The findings indicated that EHR systems supported the clinical tasks and workflows of care providers, which increased system quality, whereas the increased quality of knowledge improved user performance.

    CONCLUSION: Given these findings, knowledge quality and effective use should be incorporated into evaluating EHR system effectiveness in health institutions. Data mining features can be integrated into current systems for efficiently and systematically generating health populations and disease trend analysis, improving clinical knowledge of care providers, and increasing their productivity. The validated survey instrument can be further tested with empirical surveys in other public and private hospitals with different interoperable EHR systems.

    Matched MeSH terms: Electronic Health Records*
  19. Rahmat RF, Andreas TSM, Fahmi F, Pasha MF, Alzahrani MY, Budiarto R
    J Healthc Eng, 2019;2019:5810540.
    PMID: 31316743 DOI: 10.1155/2019/5810540
    Compression, in general, aims to reduce file size, with or without decreasing data quality of the original file. Digital Imaging and Communication in Medicine (DICOM) is a medical imaging file standard used to store multiple information such as patient data, imaging procedures, and the image itself. With the rising usage of medical imaging in clinical diagnosis, there is a need for a fast and secure method to share large number of medical images between healthcare practitioners, and compression has always been an option. This work analyses the Huffman coding compression method, one of the lossless compression techniques, as an alternative method to compress a DICOM file in open PACS settings. The idea of the Huffman coding compression method is to provide codeword with less number of bits for the symbol that has a higher value of byte frequency distribution. Experiments using different type of DICOM images are conducted, and the analysis on the performances in terms of compression ratio and compression/decompression time, as well as security, is provided. The experimental results showed that the Huffman coding technique has the capability to compress the DICOM file up to 1 : 3.7010 ratio and up to 72.98% space savings.
    Matched MeSH terms: Electronic Health Records
  20. Qureshi N, Akyea RK, Dutton B, Humphries SE, Abdul Hamid H, Condon L, et al.
    Heart, 2021 12;107(24):1956-1961.
    PMID: 34521694 DOI: 10.1136/heartjnl-2021-319742
    OBJECTIVE: Familial hypercholesterolaemia (FH) is a common inherited disorder that remains mostly undetected in the general population. Through FH case-finding and direct access to genetic testing in primary care, this intervention study described the genetic and lipid profile of patients found at increased risk of FH and the outcomes in those with positive genetic test results.

    METHODS: In 14 Central England general practices, a novel case-finding tool (Familial Hypercholetserolaemia Case Ascertainment Tool, FAMCAT1) was applied to the electronic health records of 86 219 patients with cholesterol readings (44.5% of total practices' population), identifying 3375 at increased risk of FH. Of these, a cohort of 336 consenting to completing Family History Questionnaire and detailed review of their clinical data, were offered FH genetic testing in primary care.

    RESULTS: Genetic testing was completed by 283 patients, newly identifying 16 with genetically confirmed FH and 10 with variants of unknown significance. All 26 (9%) were recommended for referral and 19 attended specialist assessment. In a further 153 (54%) patients, the test suggested polygenic hypercholesterolaemia who were managed in primary care. Total cholesterol and low-density lipoprotein-cholesterol levels were higher in those patients with FH-causing variants than those with other genetic test results (p=0.010 and p=0.002).

    CONCLUSION: Electronic case-finding and genetic testing in primary care could improve identification of FH; and the better targeting of patients for specialist assessment. A significant proportion of patients identified at risk of FH are likely to have polygenic hypercholesterolaemia. There needs to be a clearer management plan for these individuals in primary care.

    TRIAL REGISTRATION NUMBER: NCT03934320.

    Matched MeSH terms: Electronic Health Records/statistics & numerical data*
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