The Evolution of EHR-S Functionality for Care and Coordination

Abstract

The purpose of electronic health record systems (EHR-S) functionalities is to improve patient safety by reducing medical errors that lead to harm and to facilitate the measurement of care quality by providing access to process and outcomes data. Through collaborative standards development, the defi nition and translation of healthcare work into specifi c system functionalities for improving clinical data capture, communication and coordination has evolved from technical "wish lists" into commercially available products that meet the needs of multiple stakeholders: patients, clinicians, managers, systems developers, payers and regulatory agencies. Important technical drivers in the development and adoption of EHR-S functionalities have been: (a) progressive regulatory requirements for reporting quality measures and (b) lessons learned from deployment of EHR systems and other health information technology. A growing area of attention and challenge for health IT functionality development is in supporting longitudinal care coordination for patients with complex and chronic disease across time, providers and resources. Work in this domain has focused on (a) aligning and connecting Patient Centered Medical Homes and Medical Neighborhoods via data/communication standards to facilitate health information exchange (HIE) and (b) building the information infrastructures to facilitate the collection and reporting of quality measures related to care processes and outcomes.

Design and Implementation of a Collaborative Clinical Practice and Research Documentation System Using SNOMED-CT and HL7-CDA in the Context of a Pediatric Neurodevelopmental Unit

“…We performed functionality tests to ensure integration with other hospital EHR systems and objectively assessed the implementation of functionalities. Our tests focused on the functional components in EHR-S FM [ 23 , 24 ]. This model has been widely reviewed by healthcare providers, vendors, public health agencies, regulatory and accreditation bodies, professional societies, trade associations, researchers, and other stakeholders, and it expresses consistent EHR system functionality.…”

“…Additionally, a subset of standard functional components in HL7 EHR-S FM [ 23 , 24 ] was adopted in this study to ensure the quality of interoperability and EHR implementation standards ( Table 1 ). The HL7 EHR-S FM standard provides a well-defined functional profile for healthcare systems.…”

“…As a complex and highly interdisciplinary use case, we applied and developed the framework in close collaboration with UNDA. We assessed our approach following the main functionalities proposed in [ 23 , 24 ].…”