BMC Med Inform Decis Mak - Analysis of the quality of hospital information systems Audit Trails.

Tópicos

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Resumo

CKGROUND: Audit Trails (AT) are fundamental to information security in order to guarantee access traceability but can also be used to improve Health information System's (HIS) quality namely to assess how they are used or misused. This paper aims at analysing the existence and quality of AT, describing scenarios in hospitals and making some recommendations to improve the quality of information.METHODS: The responsibles of HIS for eight Portuguese hospitals were contacted in order to arrange an interview about the importance of AT and to collect audit trail data from their HIS. Five institutions agreed to participate in this study; four of them accepted to be interviewed, and four sent AT data. The interviews were performed in 2011 and audit trail data sent in 2011 and 2012. Each AT was evaluated and compared in relation to data quality standards, namely for completeness, comprehensibility, traceability among others. Only one of the AT had enough information for us to apply a consistency evaluation by modelling user behaviour.RESULTS: The interviewees in these hospitals only knew a few AT (average of 1 AT per hospital in an estimate of 21 existing HIS), although they all recognize some advantages of analysing AT. Four hospitals sent a total of 7 AT - 2 from Radiology Information System (RIS), 2 from Picture Archiving and Communication System (PACS), 3 from Patient Records. Three of the AT were understandable and three of the AT were complete. The AT from the patient records are better structured and more complete than the RIS/PACS.CONCLUSIONS: Existing AT do not have enough quality to guarantee traceability or be used in HIS improvement. Its quality reflects the importance given to them by the CIO of healthcare institutions. Existing standards (e.g. ASTM:E2147, ISO/TS 18308:2004, ISO/IEC 27001:2006) are still not broadly used in Portugal.

Resumo Limpo

ckground audit trail fundament inform secur order guarante access traceabl can also use improv health inform system qualiti name assess use misus paper aim analys exist qualiti describ scenario hospit make recommend improv qualiti informationmethod respons eight portugues hospit contact order arrang interview import collect audit trail data five institut agre particip studi four accept interview four sent data interview perform audit trail data sent evalu compar relat data qualiti standard name complet comprehens traceabl among other one enough inform us appli consist evalu model user behaviourresult interviewe hospit knew averag per hospit estim exist although recogn advantag analys four hospit sent total radiolog inform system ris pictur archiv communic system pac patient record three understand three complet patient record better structur complet rispacsconclus exist enough qualiti guarante traceabl use improv qualiti reflect import given cio healthcar institut exist standard eg astm isot isoiec still broad use portug

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