TY - JOUR AU - Tseng, Chinyang Henry AU - Chen, rayjade AU - Tsai, AU - Wu尚玉，AU - Tsaur, woeijunn AU - Chiu, AU - junn AU - Chiu, AU - Yang, Cheng-Yi AU - Lo, Yu-Sheng PY - 2022 DA - 2022/1/6 TI -探讨COVID-19大流行作为台湾患者健康记录应用程序用户行为变化的催化剂:开发和可用性研究JO - J Med Internet Res SP - e33399 VL - 24 IS - 1kw -个人健康记录KW - COVID-19 KW -我的健康银行KW -区块链KW -公共卫生AB -背景:在COVID-19大流行期间，个人健康记录(PHRs)使患者能够在不去医院的情况下监测和管理他们的医疗数据，从而最大限度地降低他们的感染风险。台湾国家健康保险管理局(NHIA)推出了我的健康银行(MHB)服务，这是一个全国性的PHR系统，通过该系统，被保险人可以访问他们的跨医院医疗数据。此外，在2019年，NHIA发布了MHB软件开发工具包(SDK)，允许开发移动应用程序，受保人可以使用这些应用程序检索他们的MHB数据。然而，NHIA MHB服务有其局限性，投保个人的参与率很低。目的:我们的目标是将MHB SDK与我们开发的支持区块链的PHR移动应用程序集成在一起，使患者能够访问、存储和管理他们的跨医院PHR数据。我们还收集并分析了应用程序的日志数据，以检查COVID-19大流行期间患者的MHB使用情况。方法:我们将现有的支持区块链的移动应用程序与MHB SDK集成在一起，以实现NHIA MHB数据检索。该应用程序利用区块链技术加密下载的NHIA MHB数据。app和区块链节点之间可以同步现有索引和新索引，实现PHR管理的高安全性。 Finally, we analyzed the app’s access logs to compare patients’ activities during high and low COVID-19 infection periods. Results: We successfully integrated the MHB SDK into our mobile app, thereby enabling patients to retrieve their cross-hospital medical data, particularly those related to COVID-19 rapid and polymerase chain reaction testing and vaccination information and progress. We retrospectively collected the app’s log data for the period of July 2019 to June 2021. From January 2020, the preliminary results revealed a steady increase in the number of people who applied to create a blockchain account for access to their medical data and the number of app subscribers among patients who visited the outpatient department (OPD) and emergency department (ED). Notably, for patients who visited the OPD and ED, the peak proportions with respect to the use of the app for OPD and ED notes and laboratory test results also increased year by year. The highest proportions were 52.40% for ED notes in June 2021, 88.10% for ED laboratory test reports in May 2021, 34.61% for OPD notes in June 2021, and 41.87% for OPD laboratory test reports in June 2021. These peaks coincided with Taiwan’s local COVID-19 outbreak lasting from May to June 2021. Conclusions: This study developed a blockchain-enabled mobile app, which can periodically retrieve and integrate PHRs from the NHIA MHB's cross-hospital data and the investigated hospital's self-pay medical data. Analysis of users’ access logs revealed that the COVID-19 pandemic substantially increased individuals’ use of PHRs and their health awareness with respect to COVID-19 prevention. SN - 1438-8871 UR - //www.mybigtv.com/2022/1/e33399 UR - https://doi.org/10.2196/33399 UR - http://www.ncbi.nlm.nih.gov/pubmed/34951863 DO - 10.2196/33399 ID - info:doi/10.2196/33399 ER -