Department of Computer Science, Quaid-e-Awam University of Engineering Science and Technology, Nawabshah, Pakistan.
CEO, Extensive Web, Technologies Pvt. Ltd, Karachi, Pakistan.
Health Informatics J. 2022 Apr-Jun;28(2):14604582221099828. doi: 10.1177/14604582221099828.
Open-source Electronic Health Records (OS-EHRs) are of pivotal importance in the management, operations, and administration of any healthcare organization. With the advancement of health informatics, researchers and healthcare practitioners have proposed various frameworks to assess the maturation of Open-source EHRs. The significance of OS-EHRs stems from the fact that vendor-based EHR implementations are becoming financially burdensome, with some vendors raking in more than $1 billion with one contract. Contrarily, the adoption of OS-EHRs suffers from a lack of systematic evaluation from the standpoint of a standard reference model. To this end, the Healthcare Information and Management Systems Society (HIMSS) has presented a strategic road map called EMR Adoption and Maturity (EMRAM). The HIMSS-EMRAM model proposes a stage-wise model approach that is globally recognized and can be essentially applied as a benchmark evaluation criteria for open-source EHRs. This paper offers an applied descriptive methodology over the frequently studied open-source EHRs currently operational worldwide or has the potential of adoption in healthcare settings. Besides, we also present profiling (User Support, Developer' Support, Customization Support, Technical details, and Diagnostic help) of studied OS-EHRs from developer's and user's perspectives using updated standard metrics. We carried out multi-aspect objective analysis of studied systems covering EHR functions, software based features and implementation. This review portrays systematic aspects of electronic medical record standards for open-source software implementations. As we observed in the literature, prevalent research and working prototypes lack systematic review of the HIMSS-EMRAM model and do not present evolving software features. Therefore, after the application of our assessment measures, the results obtained indicate that OS-EHRs are yet to acquire standard compliance and implementation. The findings in this paper can be beneficial in the planning and implementation of OS-EHRs projects in the future.
开源电子健康记录（OS-EHRs）在任何医疗保健组织的管理、运营和管理中都至关重要。随着健康信息学的进步，研究人员和医疗保健从业者已经提出了各种框架来评估开源 EHR 的成熟度。OS-EHR 的重要性在于，基于供应商的 EHR 实施变得越来越昂贵，一些供应商仅通过一份合同就赚取了超过 10 亿美元。相比之下，由于缺乏基于标准参考模型的系统评估，开源 EHR 的采用受到了阻碍。为此，医疗保健信息和管理系统协会（HIMSS）提出了一个名为 EMR 采用和成熟度（EMRAM）的战略路线图。HIMSS-EMRAM 模型提出了一种分阶段的模型方法，该方法在全球范围内得到认可，并且可以作为开源 EHR 的基准评估标准。本文提供了一种针对当前全球范围内运行或有潜力在医疗保健环境中采用的常用开源 EHR 的应用描述性方法。此外，我们还从开发者和用户的角度使用更新的标准指标来展示研究的 OS-EHR 的概况（用户支持、开发者支持、定制支持、技术细节和诊断帮助）。我们对研究系统进行了多方面的客观分析，涵盖了 EHR 功能、基于软件的功能和实施。本综述描绘了开源软件实现的电子病历标准的系统方面。正如我们在文献中观察到的那样，流行的研究和工作原型缺乏对 HIMSS-EMRAM 模型的系统审查，并且没有呈现不断发展的软件功能。因此，在应用我们的评估措施后，得到的结果表明，OS-EHR 尚未获得标准合规性和实施。本文的研究结果可为未来 OS-EHR 项目的规划和实施提供参考。
