Affiliations: Department of Production and Management Engineering, Democritus University of Thrace, Xanthi, Greece
Correspondence:
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Corresponding author: Leonidas L. Fragidis, Department of Production and Management Engineering, Democritus University of Thrace, 12 Vas. Sofias Str., 67100 Xanthi, Greece. Tel.: +30 6945 237324; E-mail:lfrangid@pme.duth.gr
Abstract: BACKGROUND: The integration of heterogeneous electronic health records
systems by building an interoperable nationwide electronic health record
system provides undisputable benefits in health care, like superior health
information quality, medical errors prevention and cost saving.
OBJECTIVE: This paper proposes a semi-distributed system architecture approach for an
integrated national electronic health record system incorporating the
advantages of the two dominant approaches, the centralized architecture and
the distributed architecture.
METHODS: The high level design of the main
elements for the proposed architecture is provided along with diagrams of
execution and operation and data synchronization architecture for the proposed solution.
RESULTS: The proposed approach effectively handles issues related to redundancy,
consistency, security, privacy, availability, load balancing,
maintainability, complexity and interoperability of citizen's health data.
CONCLUSIONS:The proposed semi-distributed architecture offers a robust interoperability framework without healthcare providers to change their local EHR systems. It is a pragmatic approach taking into account the
characteristics of the Greek national healthcare system along with the
national public administration data communication network infrastructure, for achieving EHR integration with acceptable implementation cost.
Keywords: Electronic health records, system integration, interoperability, semi-distributed architecture, middleware, ehealth
