Abstract
This chapter outlines the challenges of providing accurate and timely health information as a way to improving patient outcomes and reducing costs. The last decades experience shows that computerization alone does not improve quality and safety. In order to achieve the expected effectiveness and a positive return on the investment, EHR should be transform in a clinical workflow management system with built in decision support system. These require adoption of business process management technologies that have to be aware of the detailed context of each individual patient.
There are many challenges which diminish the impact of information technology on healthcare, among them, the limited interoperability, technological barrier for most of the elderly people, security, privacy and trust issues. An overview of the methods and tools able to overcome those limitations are presented, including the use of standards for EHR architecture and communication, the progress in terminology and classification systems adoption and the ways to overcome the security threats.
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References
Amatayakul, M.K.: Electronic Health Records. AHIMA, Chicago (2007)
ARTEMIS. Deliverable D5.1.1: Relevant Electronic Healthcare Record Standards and protocols for accessing medical information, http://www.srdc.metu.edu.tr/webpage/projects/artemis (accessed June 2006)
ASTM E2369 - 05e2 Standard Specification for Continuity of Care Record (CCR), http://www.astm.org/Standards/E2369.htm (accessed April 2012)
Ball, M.J., Garets, D.E., Handler, T.J.: Leveraging IT to improve patient safety. In: Kulikowski, C., Haux, R. (eds.) IMIA Yearbook of Medical Informatics. Schattauer, Stuttgart (2003)
Beale, T.: Archetypes: Constraint-based Domain Models for Future-proof Information Systems, Revision: 2.2.1. In: Baclawski, K., Kilov, H. (eds.) Eleventh OOPSLA Workshop on Behavioral Semantics: Serving the Customer, Seattle, Washington, USA, November 4, pp. 16–32. Northeastern University, Boston (2002)
Bowman, S.: Coordination of SNOMED-CT® and ICD-10: Getting the Most Out of Electronic Health Record Systems. In: AHIMA Report - Perspectives in Health Information Management (2005)
CEN/ISO EN13606 standard, http://www.en13606.org (accessed April 2012)
Chaudhry, B., Wang, J., Wu, S., et al.: Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Ann. Intern. Med. 144, 742–752 (2006)
Connolly, T., Begg, C.: Database Systems - A Practical Approach to Design, Implementation and Management. Addison, Wesley (2001)
EUROREC. Inventory of Relevant Standards for EHR Systems, http://www.eurorec.org/services/standards/index.cfm (accessed April 2012)
ICD - International Classification of Diseases, http://www.who.int/classifications/icd (accessed May 2012)
ISO/TR 20514:2005. Health informatics - Electronic health record - Definition, scope and context. Tech. rep. TR 20514. International Organization for Standardization, Geneva, Switzerland.
ISO/TS 18308:2004. Health informatics - Requirements for an electronic health record architecture. Tech. spec. TS 18308. International Organization for Standardization, Geneva, Switzerland
Kalra, D.: Clinical foundations and information architecture for the implementation of a federated health record service. Disertation, Univ. London (2003)
Ong, K.R.: Medical Informatics, An Executive Primer. HIMSS, Chicago (2007)
Logic and Ontology (Stanford Encyclopedia of Philosophy), http://plato.stanford.edu/entries/logic-ontology (accessed April 2012)
National Committee on Vital and Health Statistics, Uniform Data Standards for Patient Medical Record Information: Report to the Secretary of the US Department of Health and Human Services. US Department of Health and Human Services (July 2000)
QREC "European Quality Labelling and Certification of Electronic Health Record systems (EHRs)", http://www.eurorec.org/RD/pastProject_Q-REC.cfm (accessed: May 2012)
Rector, A.L., Brandt, S.: Why do it the hard way? The case for an expressive description logic for SNOMED. J. Am. Med. Inform. Assoc. 15(6), 744–751 (2008)
Rector, A., et al.: WP6: Ontologies and Terminologies. Background, Findings & Recommendations (2008), http://www.semantichealth.org/PUBLIC/MIE2008-Semantic-EHR-Session_1_Rector_Terminologies.pdf (accessed May 2012 )
RIDE "A Roadmap for Interoperability of eHealth Systems in Support of COM 356 with Special Emphasis on Semantic Interoperability", http://www.eurorec.org/RD/pastProject_RIDE.cfm (accessed April 2012)
Slee, V.N., Slee, D., Schmidt, H.J.: The Tyranny of the Diagnosis Code. NC Med. J. 66(5) (2005)
Smolij, K., Dun, K.: Patient Health Information Management: Searching for the Right Model. Perspectives in Health Information Management (2006)
SNOMED - Clinical Terms, http://www.ihtsdo.org/snomed-ct (accessed April 2012)
State of the EHR: The Vendor Perspective, AHIMA (2004)
Stenzhorn, H.: Automatic mapping of Clinical documentation to SNOMED CT. In: Adlassnig, K.P., et al. (eds.) Medical Informatics in a United and Healthy Europe. IOS Press, Amsterdam (2009)
Unified Medical Language System (UMLS), http://www.nlm.nih.gov/research/umls (accessed March 2012)
Waegemann, C.P.: The principles of going paperless. After decades of debate it is time to take action on electronic health records. Mod. Healthc. 34(20), 24 (2004)
Zeng, Q., Cimino, J.J., Zhou, Z.K.: Providing Concept-oriented Views for Clinical Data Using a Knowledge-based System: An Evaluation. J. Am. Med. Inform. Assoc. 9(3), 294–305 (2002)
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Focsa, M., Mihalas, G.I. (2013). EHR Ecosystem. In: Mukhopadhyay, S., Postolache, O. (eds) Pervasive and Mobile Sensing and Computing for Healthcare. Smart Sensors, Measurement and Instrumentation, vol 2. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-32538-0_12
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DOI: https://doi.org/10.1007/978-3-642-32538-0_12
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