A Novel System Architecture for the National Integration of Electronic Health Records: A Semi-Centralized Approach

Abstract

The goal of a national electronic health records integration system is to aggregate electronic health records concerning a particular patient at different healthcare providers' systems to provide a complete medical history of the patient. It holds the promise to address the two most crucial challenges to the healthcare systems: improving healthcare quality and controlling costs. Typical approaches for the national integration of electronic health records are a centralized architecture and a distributed architecture. This paper proposes a new approach for the national integration of electronic health records, the semi-centralized approach, an intermediate solution between the centralized architecture and the distributed architecture that has the benefits of both approaches. The semi-centralized approach is provided with a clearly defined architecture. The main data elements needed by the system are defined and the main system modules that are necessary to achieve an effective and efficient functionality of the system are designed. Best practices and essential requirements are central to the evolution of the proposed architecture. The proposed architecture will provide the basis for designing the simplest and the most effective systems to integrate electronic health records on a nation-wide basis that maintain integrity and consistency across locations, time and systems, and that meet the challenges of interoperability, security, privacy, maintainability, mobility, availability, scalability, and load balancing.

A Systematic Literature Review on Security and Privacy of Electronic Health Record Systems: Technical Perspectives

“…Policies, such as CEN prENV 1306 policy, required mandating and formulating to be able to provide interoperability (Blobel & Pharow 2007;Barber 1998 (Hsieh & Chen 2012). Broker-based composite EHR authorisation provides interoperability by establishing a small system, and then the Health Information System Broker (HISB) organises the patient data in the local and public databases (Aljarullah & El-Masri 2012).…”

“…The availability of patient data can be implemented with security technologies, such as digital clustering, RAID systems and back-up procedures(van der Haak et al 2003). Utility means the system usability based on security implementation, and privacy and security establishments(Aljarullah & El-Masri 2012;Chen, Lu & Jan 2012;Stingl & Slamanig 2011;Sun et al 2011;Tsai 2010;van der Haak et al 2003;Zhang & Liu 2010). Cloud computing designs can help provide a high level of availability and utility of EHR information(Aljarullah & El-Masri 2012;Hsieh & Chen 2012;Huang et al 2013;Li et al 2013;Singh et al 2013;Stingl & Slamanig 2011).…”

Interoperabilidad de Historias Clínicas Electrónicas en el Perú

“…Son tres los modelos de cómo interoperan los distintos centros de salud a nivel nacional, entre estos los más usados y exitosos son la arquitectura centralizada y la arquitectura distribuida. [7]…”

An Efficient Three-Party Authentication Scheme for Data Exchange in Medical Environment

“…Our scheme features three roles: medical institution , medical institution , and authentication server . Our scheme is functional if it provides that (1) , , and can authenticate each other; (2) and can obtain a common session key; (3) and can exchange electronic medical records; (4) is not required to have a public key; and (5) it is efficient to implement.…”

“…The digitization of medical measurement equipment (e.g., blood pressure monitors, blood glucose meters) allows for diagnostic information to be stored electronically and transmitted to remote locations for analysis and monitoring, enabling patients to avoid hospital visits while enabling their health care to closely monitor their status. Such electronic medical records (EMR) [1][2][3] has many advantages over conventional paper medical records, such as easy transmission, high efficiency, better accuracy, and ease of storage. However, their increased convenience raises significant security issues such as patient privacy and data integrity.…”