RESUMO
The aim of this paper is to present Cyprus' initiative for the design and the implementation of the prototype of the integrated electronic health record at a national level that will establish the foundations of the country's broader eHealth ecosystem. The latter, requires an interdisciplinary approach and scientific collaboration among various fields, including medicine, information and communication technologies, management, and finance, among others. The objective, is to design the system architecture, specify the requirements in terms of clinical content as well as the hardware infrastructure, but also implement European and national legislation with respect to privacy and security that govern sensitive medical data manipulation. The present study summarizes the outcomes of the 1st phase of this initiative, which comprises of the healthcare as well as the administrative requirements, user stories, data-flows and associated functionality. Moreover, leveraging the HL7 Fast Healthcare Interoperability Resources (FHIR) standard we highlight the concluded interoperability framework that allows genuine cross-system communication and defines third-party systems connectivity.Clinical Relevance- This work is strongly correlated with medicine since it describes the system requirements and the architecture of a national integrated electronic health records system.
Assuntos
Registros Eletrônicos de Saúde , Telemedicina , Chipre , SoftwareRESUMO
The European Union (EU)'s keen concern about citizens' health and well-being advancement has been expressed at all levels. It has been understood that at present, these can only be achieved through coordinated actions at the individual member states' level based on EU directives, as well as through promoting and funding R&D and expanding the use of eHealth technologies. Despite the diversities and particularities among member states, common values such as universal access to good quality healthcare, equity, and solidarity have been widely accepted across EU. That demanded the adoption of policies and follow directives, which streamlined actions to bridge healthcare gaps, and facilitate cross-border healthcare. This paper articulates a framework for deriving a national healthcare system, based on interoperable Electronic Health Record (EHR) with safeguarding healthcare quality, enabling quadruple helix (Public, Academia, Industry, NGOs) driven R&D and guided by a patient-centered approach. A methodology to develop an integrated EHR at National level is proposed as a prerequisite for eHealth and put into perspective. Recommendations are given for the steps needed, from the managerial, legal, technical, and financial concerns in developing an open access, patient-centered national healthcare system based on the context and constraints of a country. The example of a small country to apply the proposed methodology is demonstrated. Stakeholders, including citizens, healthcare professionals, academia, and the industry are mobilized, enabled, and incentivized for implementing the methodology. Experiences are aspired to be offered as lessons learned for other countries to adapt on their environment.
Assuntos
Registros Eletrônicos de Saúde , Informática Médica , Programas Nacionais de Saúde , Telemedicina , Computação em Nuvem , União Europeia , Humanos , Saúde PúblicaRESUMO
BACKGROUND: Medical practice and patient-doctor relationship will continue improving while technology is integrated in our everyday life. In recent years the term eHealth landmarked a new era with improved health provider's skills and knowledge, and increased patient participation in medical care activities. OBJECTIVE: To show why the design and implementation of a healthcare system needs to follow a specific philosophy dictated by the level of eHealth maturity of a country and its citizens. METHODS: Based on the maturity level, an adaptable framework for implementing an Electronic Health System at national level is derived, guided by the Patient Centered Philosophy as defined and introduced by the EU directives. Implementation prerequisites are analyzed together with guiding principles for identifying the maturity level of an organization or country. RESULTS: Cyprus being a small EU country, it can be used as pilot site for the whole Europe, was chosen for this study and its maturity level analysis is presented. Recommendations that determine general steps needed to prepare the ground for an adequate patient-centered national healthcare system are accompanied. CONCLUSION: The implementation of an integrated Electronic Health Record at National level, as a prerequisite for a patient-centered eHealth environment is evidently demonstrated.
Assuntos
Registros Eletrônicos de Saúde/organização & administração , Participação do Paciente , Assistência Centrada no Paciente/organização & administração , Relações Médico-Paciente , Telemedicina/organização & administração , Europa (Continente) , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Armazenamento e Recuperação da Informação , Internacionalidade , Acesso dos Pacientes aos RegistrosRESUMO
This paper presents an electronic registry system for the purposes of the eENERCA for rare congenital conditions that require lifelong follow up and treatment. The main objective of the eENERCA project focusses on the prevention of major rare anaemias (RAs) by facilitating the access, at a European level, to the best genetic counselling, diagnosis and clinical management of the patients with RA independently of their country of origin. This can be achieved by promoting an extension of the full Electronic Health Record system and specifically the electronic registries for RAs, across Europe for the purposes stated hence promoting service development for the benefit of patients. The proposed eRegistry will serve as an epidemiological tool to improve the management of patient services and ultimately improve patient care.
Assuntos
Anormalidades Congênitas/diagnóstico por imagem , Anormalidades Congênitas/terapia , Doenças Raras/diagnóstico , Doenças Raras/terapia , Sistema de Registros , Anemia/diagnóstico , Anemia/terapia , Anormalidades Congênitas/epidemiologia , Europa (Continente) , Humanos , Doenças Raras/epidemiologia , Fatores SocioeconômicosRESUMO
eHealth has attained significant importance as a new mechanism for health management and medical practice. However, the technological growth of eHealth is still limited by technical expertise needed to develop appropriate products. Researchers are constantly in a process of developing and testing new software for building and handling Clinical Medical Records, being renamed to Electronic Health Record (EHR) systems; EHRs take full advantage of the technological developments and at the same time provide increased diagnostic and treatment capabilities to doctors. A step to be considered for facilitating this aim is to involve more actively the doctor in building the fundamental steps for creating the EHR system and database. A global clinical patient record database management system can be electronically created by simulating real life medical practice health record taking and utilizing, analyzing the recorded parameters. This proposed approach demonstrates the effective implementation of a universal classic medical record in electronic form, a procedure by which, clinicians are led to utilize algorithms and intelligent systems for their differential diagnosis, final diagnosis and treatment strategies.
Assuntos
Sistemas de Gerenciamento de Base de Dados/normas , Registros Eletrônicos de Saúde/organização & administração , Integração de Sistemas , Registros Eletrônicos de Saúde/normas , Humanos , Design de SoftwareRESUMO
The design and implementation of a healthcare system needs to follow a specific philosophy regarding its operational structure and must be adapted gradually with one step at a time, depending on the level of maturity of a country on certain key issues. The main goal of this paper is to present an overall recommendations framework for implementing an Electronic Health System at national level, guided by the Patient Centered Philosophy. Certain prerequisites for implementing such systems are analyzed together with guiding principles for identifying the maturity level of an organization or country. The maturity level analysis for Cyprus is presented and is accompanied by some recommendations that determine the steps needed to prepare the ground for a complete patient centered national healthcare system.