Advanced EHR architectures--promises or reality.
OBJECTIVE
Forming the informational reflection of the patients and their care, the Electronic Health Record (EHR) is the core application of any complex health information system or health network. Such an ideally lifelong history file must be reliable, flexible, adaptable to new concepts and technologies, and robust, to allow for sharing knowledge over its lifetime. A sophisticated architecture must be chosen for meeting this challenge.


METHODS
An advanced EHR architecture for designing and implementing future-proof EHR systems must be a model of generic properties required for any Electronic Patient Record to provide communicable, comprehensive, useful, effective, and legally binding records that preserve their integrity over the time, independent of platforms and systems as well as of national specialties. the resulting approach is based on the ISO Reference Model-Open Distributed Processing.


RESULTS
Based on advanced architectural principles introduced in the paper, a new generation of HER systems has been designed and implemented for demonstrating the feasibility of the approach. This result is presented and evaluated regarding the achievements and problems using the component-based paradigm of model-driven health information system architectures.


CONCLUSIONS
The future-proof EHR approach that has been established has been shortly evaluated. Advantages regarding flexibility, reliability, and portability of policy-driven, highly secure, role-dependent applications have to be considered in the light of performance as well as of the availability of network and application services.
Fraunhofer Institute for Integrated Circuits IIS, Department of Imaging and Biomedical Technology, Health Telematics Project Group, Am Wolfsmantel 33, 91058 Erlangen, Germany. bernd.blobel@iis.fraunhofer.de
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Blobel
D003199:Computer Systems; D005858:Germany; D016347:Medical Records Systems, Computerized / Q000458:organization & administration*; D013997:Time Factors; D014584:User-Computer Interface