Department of Information Systems, College of Computer and Information Sciences, King Saud University, Riyadh, Saudi Arabia,
J Med Syst. 2013 Aug;37(4):9953. doi: 10.1007/s10916-013-9953-4. Epub 2013 Jun 19.
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.
国家电子健康记录集成系统的目标是聚合不同医疗服务提供者系统中特定患者的电子健康记录，提供患者完整的医疗历史。它有望解决医疗系统面临的两个最关键的挑战：提高医疗质量和控制成本。电子健康记录国家集成的典型方法是集中式架构和分布式架构。本文提出了一种新的国家电子健康记录集成方法，即半集中式方法，这是一种集中式架构和分布式架构之间的中间解决方案，具有两种方法的优点。半集中式方法具有明确定义的架构。定义了系统所需的主要数据元素，并设计了实现系统有效和高效功能所需的主要系统模块。最佳实践和基本要求是所提出架构发展的核心。所提出的架构将为设计最简单、最有效的系统提供基础，以便在全国范围内整合电子健康记录，在地点、时间和系统之间保持完整性和一致性，并应对互操作性、安全性、隐私性、可维护性、移动性、可用性、可扩展性和负载平衡的挑战。
