Special Topic Interoperability and EHR: Combining openEHR, SNOMED, IHE, and Continua as approaches to interoperability on national eHealth

Beštek, Mate; Stanimirović, Dalibor

doi:10.4338/aci-2017-01-ra-0011

Cited by 15 publications

(5 citation statements)

References 22 publications

(21 reference statements)

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“…The CLIN-IK-LINKS platform permits the execution and configuration of medical data alteration workflows to adapt EHR data into EHR-semantic web standards. Hence, CLIN-IK-LINKS is a valued contributor to advancing the semantic interoperability of the mentioned EHR systems [47,48].…”

Section: Previous Framework That Have Been Implemented To Improve The...mentioning

confidence: 99%

Blockchain-Based Framework for Interoperable Electronic Health Records for an Improved Healthcare System

et al. 2023

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The healthcare industry has been transitioning from paper-based medical records to electronic health records (EHRs) in most healthcare facilities. However, the current EHR frameworks face challenges in secure data storage, credibility, and management. Interoperability and user control of personal data are also significant concerns in the healthcare sector. Although block chain technology has emerged as a powerful solution that can offer the properties of immutability, security, and user control on stored records, its potential application in EHR frameworks is not yet fully understood. To address this gap in knowledge, this research aims to provide an interoperable blockchain-based EHR framework that can fulfill the requirements defined by various national and international EHR standards such as HIPAA and HL7. The research method employed is a systematic literature review to explore the current state of the art in the field of EHRs, including blockchain-based implementations of EHRs. The study defines the interoperability issues in the existing blockchain-based EHR frameworks, reviews various national and international standards of EHR, and further defines the interoperability requirements based on these standards. The proposed framework can offer safer methods to interchange health information for the healthcare sector and can provide the properties of immutability, security, and user control on stored records without the need for centralized storage. The contributions of this work include enhancing the understanding of the potential application of blockchain technology in EHR frameworks and proposing an interoperable blockchain-based EHR framework that can fulfill the requirements defined by various national and international EHR standards. Overall, this study has significant implications for the healthcare sector, as it can enhance the secure sharing and storage of electronic health data while ensuring the confidentiality, privacy, and integrity of medical records.

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Section: Previous Framework That Have Been Implemented To Improve The...mentioning

confidence: 99%

Blockchain-Based Framework for Interoperable Electronic Health Records for an Improved Healthcare System

et al. 2023

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“…Interoperability between information systems has commonly been understood as a problem that needs to be solved using a common syntax and data semantics. While widely adopted standards like HL7 v2, HL7 FHIR and openEHR [1][2][3][4] mostly aim to solve interoperability for health care delivery processes, usually focusing on a single subject, a standard for supporting bio-medical research processes across organizational boundaries has not been established. These processes include feasibility studies (cross-organizational cohort size estimations), reviews and approvals of research proposals, consent checks, record linkage and pseudonymization, as well as the transfer of data and biomaterial between organizations and at times the return of research results or incidental findings.…”

Section: Introductionmentioning

confidence: 99%

Interoperability Is a Process – The Data Sharing Framework

Hund,

Wettstein,

Kurscheidt

et al. 2024

Studies in Health Technology and Informatics

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Common syntax and data semantics are core components of healthcare interoperability standards. However, interoperable data exchange processes are also needed to enable the integration of existing systems between organizations. While solutions for healthcare delivery processes are available and have been widely adopted, support for processes targeting bio-medical research is limited. Our Data Sharing Framework creates a platform to implement research processes like cohort size estimation, reviews and approvals of research proposals, consent checks, record linkage, pseudonymization and data sharing across organizations. The described framework implements a distributed business process engine for executing BPMN 2.0 processes with synchronization and data exchange using FHIR R4 resources. Our reference implementation has been rolled out to 38 organizations across three research consortia in Germany and is available as open source under the Apache 2.0 license.

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“…Interoperability, defined as ‘the ability for clinical data to be shared seamlessly between differing EHR systems without loss of context and for the data to be usable in a coordinated manner to facilitate patient care’ , has continued to be a growing challenge [ 7 , 11 , 12 ]. Due to the inherent technical complexity and nature of the clinical information involved, interoperability between existing systems varies greatly in both availability and sophistication [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…, Fast Healthcare Interoperability Resources (FHIR) or Health Level Seven (HL7)) for codifying data elements ( i.e. , content, terminology, and security to enable a shared understanding of clinical data) [ 7 , 12 , 15 ]. It should be noted, however, other definitions which stratify levels of interoperability in greater detail (such as technical, syntactic, pragmatic, dynamic, conceptual, structural, functional, and semantic interoperability), have also been proposed in recent years [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Perceptions of chief clinical information officers on the state of electronic health records systems interoperability in NHS England: a qualitative interview study

Li,

Lounsbury,

Clarke

et al. 2023

BMC Med Inform Decis Mak

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Background In the era of electronic health records (EHR), the ability to share clinical data is a key facilitator of healthcare delivery. Since the introduction of EHRs, this aspect has been extensively studied from the perspective of healthcare providers. Less often explored are the day-to-day challenges surrounding the procurement, deployment, maintenance, and use of interoperable EHR systems, from the perspective of healthcare administrators, such as chief clinical information officers (CCIOs). Objective Our study aims to capture the perceptions of CCIOs on the current state of EHR interoperability in the NHS, its impact on patient safety, the perceived facilitators and barriers to improving EHR interoperability, and what the future of EHR development in the NHS may entail. Methods Semi-structured interviews were conducted between November 2020 – October 2021. Convenience sampling was employed to recruit NHS England CCIOs. Interviews were digitally recorded and transcribed verbatim. A thematic analysis was performed by two independent researchers to identify emerging themes. Results Fifteen CCIOs participated in the study. Participants reported that limited EHR interoperability contributed to the inability to easily access and transfer data into a unified source, thus resulting in data fragmentation. The resulting lack of clarity on patients' health status negatively impacts patient safety through suboptimal care coordination, duplication of efforts, and more defensive practice. Facilitators to improving interoperability included the recognition of the need by clinicians, patient expectations, and the inherent centralised nature of the NHS. Barriers included systems usability difficulties, and institutional, data management, and financial-related challenges. Looking ahead, participants acknowledged that realising that vision across the NHS would require a renewed focus on mandating data standards, user-centred design, greater patient involvement, and encouraging inter-organisational collaboration. Conclusion Tackling poor interoperability will require solutions both at the technical level and in the wider policy context. This will involve demanding interoperability functionalities from the outset in procurement contracts, fostering greater inter-organisation cooperation on implementation strategies, and encouraging systems vendors to prioritise interoperability in their products. Only by comprehensively addressing these challenges would the full potential promised by the use of fully interoperable EHRs be realised.

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Special Topic Interoperability and EHR: Combining openEHR, SNOMED, IHE, and Continua as approaches to interoperability on national eHealth

Cited by 15 publications

References 22 publications

Blockchain-Based Framework for Interoperable Electronic Health Records for an Improved Healthcare System

Blockchain-Based Framework for Interoperable Electronic Health Records for an Improved Healthcare System

Interoperability Is a Process – The Data Sharing Framework

Perceptions of chief clinical information officers on the state of electronic health records systems interoperability in NHS England: a qualitative interview study

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