Electronical Health Record's Systems. Interoperability

Understanding the importance that the electronic medical health records system has, with its various structural types and grades, has led to the elaboration of a series of standards and quality control methods, meant to control its functioning. In time, the electronic health records system has evolved along with the medical data's change of structure. Romania has not yet managed to fully clarify this concept, various definitions still being encountered, such as "Patient's electronic chart", "Electronic health file". A slow change from functional interoperability (OSI level 6) to semantic interoperability (level 7) is being aimed at the moment. This current article will try to present the main electronic files models, from a functional interoperability system's possibility to be created perspective. \ud \u

ARGOS policy brief on semantic interoperability

Semantic interoperability requires the use of standards, not only for Electronic Health Record (EHR) data to be transferred and structurally mapped into a receiving repository, but also for the clinical content of the EHR to be interpreted in conformity with the original meanings intended by its authors. Accurate and complete clinical documentation, faithful to the patient’s situation, and interoperability between systems, require widespread and dependable access to published and maintained collections of coherent and quality-assured semantic resources, including models such as archetypes and templates that would (1) provide clinical context, (2) be mapped to interoperability standards for EHR data, (3) be linked to well specified, multi-lingual terminology value sets, and (4) be derived from high quality ontologies. Wide-scale engagement with professional bodies, globally, is needed to develop these clinical information standards

Electronic Health Record Architecture: A Systematic Review

Numerous advantages are derived from the electronic health record (EHR).Though achieving such advantages depends on its architecture, at present no unique understanding of the architecture dimensions and specifications is available. Therefore, the aim of the present study is a systematic review of architecture perception of the electronic health record. The authors searched the literature in Science Direct, Scopus, PubMed and Proudest Databases (2000 to Jun 2015).  Data extraction was done by 2 reviewers on content, structure, content/structure relationship, confidentiality and security of the EHR. Subsequent to refining the 87 retrieved studies, 25 studies were finally included in the study. In the studies and paradigms so far proposed for the EHR, a unique comprehensive architecture model from the viewpoint of research criteria has not been investigated and it has been considered only from some dimensions. Hence, we provide a new definition of the EHR architecture

Data standardization

With data rapidly becoming the lifeblood of the global economy, the ability to improve its use significantly affects both social and private welfare. Data standardization is key to facilitating and improving the use of data when data portability and interoperability are needed. Absent data standardization, a “Tower of Babel” of different databases may be created, limiting synergetic knowledge production. Based on interviews with data scientists, this Article identifies three main technological obstacles to data portability and interoperability: metadata uncertainties, data transfer obstacles, and missing data. It then explains how data standardization can remove at least some of these obstacles and lead to smoother data flows and better machine learning. The Article then identifies and analyzes additional effects of data standardization. As shown, data standardization has the potential to support a competitive and distributed data collection ecosystem and lead to easier policing in cases where rights are infringed or unjustified harms are created by data-fed algorithms. At the same time, increasing the scale and scope of data analysis can create negative externalities in the form of better profiling, increased harms to privacy, and cybersecurity harms. Standardization also has implications for investment and innovation, especially if lock-in to an inefficient standard occurs. The Article then explores whether market-led standardization initiatives can be relied upon to increase welfare, and the role governmental-facilitated data standardization should play, if at all

Towards a Conceptual Framework for Persistent Use: A Technical Plan to Achieve Semantic Interoperability within Electronic Health Record Systems

Semantic interoperability within the health care sector requires that patient data be fully available and shared without ambiguity across participating health facilities. Ongoing discussions to achieve interoperability within the health care industry continue to emphasize the need for healthcare facilities to successfully adopt and implement Electronic Health Record (EHR) systems. Reluctance by the healthcare industry to implement these EHRs for the purpose of achieving interoperability has led to the proposed research problem where it was determined that there is no existing single data standardization structure that can effectively share and interpret patient data within heterogeneous systems. \ \ The proposed research proposes a master data standardization and translation (MDST) model – XDataRDF -- which incorporates the use of the Resource Description Framework (RDF) that will allow for the seamless exchange of healthcare data among multiple facilities. Using RDF will allow multiple data models and vocabularies to be easily combined and interrelated within a single environment thereby reducing data definition ambiguity.