Letter to Editor (Response from author): Toward a universal electronic health record system.

Health information exchange (HIE) has mostly emerged as centralized data hubs that can pass data requests from one subscribing healthcare institution to another. Using traditional health information systems (HISs) with different technologies in hospitals leads to usability and incompatibility issues because of islands of information. This paper discusses shifting from HIE into an integrated universal health information infrastructure. Migration to such integrated universal electronic health records architecture could support real-time HIE and advanced modern big data analytics. However, there are various standards and technologies to facilitate HIS integration, a significant amount of efforts is still needed.