journal of biomedical informatics
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Interoperable EHR Systems - Challenges, Standards and Solutions

Author(s): Bernd Blobel*

Background: Electronic Health Record Systems (EHRS) and Personal Health Record Systems (PHRS) are core components of infrastructure needed to run any health system.

Objectives: As health systems undergo paradigm changes, EHRS and PHRS have to advance as well to meet the related interoperability challenges.

Methods: The paper discusses EHR types, implementations and standards, starting with different requirements specifications, systems and systems architectures, standards and solutions.

Results: Existing standards and specifications are compared with changing requirements, presenting weaknesses and defining the advancement of EHRS, architectures and related services, embedded in advanced infrastructure systems.

Conclusion: Future EHR systems are components in a layered architecture with open interfaces. The need of verifying data models at business domains level is specifically highlighted. Such approach is enabled by the ISO Interoperability Reference Architecture of a systemoriented, architecture-centric, ontology-based, policy- driven approach, meeting good modeling best practices.