Information Technology Reference
In-Depth Information
23
Electronic Health Records Interoperability
by Archetype Based Contexts
Belén Prados-Suárez, Carlos Molina,
Miguel Prados de Reyes, and Carmen Peña-Yañez
23.1
Introduction
The use of Electronic Health Records (EHR) has become a reality in the everyday
practice of most of the hospitals, so it is possible to find in the literature a great
variety of proposals to implement the EHR in different specialities like pediatrics,
nursery, family care, emergencies, radiology, elder care or outpatient consultation
(as can be seen in [14, 20, 22, 25, 36, 46] and [54], respectively); and also, un-
der different regulations depending on the country, like in the Korean or the Czech
medical systems (in [13] and [39], respectively).
In the last decades the necessity to improve the access to these systems and the
communication between them have arose as important issues to be solved. The last
one has been called
Interoperability
and a lot of efforts is applied to solve it. We
claim that both problems have to be solve together.
However in most of these proposals, as well as in other studies regarding the sat-
isfaction of the users about the implantation of the EHR like [38, 48, 51, 54] and
[52]; or even about the comparison of different EHR systems as [4] and [21], there
is a remarked problem: the great amount of information that is accumulating in the
EHRs is making arise problems of access. Since all the information is always avail-
able, it is becoming really difficult to access a concrete information item required,
even in relatively simple situations. It becomes really serious for situations like the
urgencies, where the decisions must be taken within seconds and the relevant infor-
mation for the concrete case should be immediately available to support them. Even
more, the problem will get worse due to the increasing use of new medical machines
and devices like PACs, that automatically generate documents to be included in the
EHRs [43, 44].
To solve this situation the storage and access can't be restricted only to informa-
tion with high clinical value, since depending on the assistance act the information
needed may change. This problem is so relatively recent, that up to this moment it
