Affiliations: Nucleus of Research and Technological Development, Polytechnic Faculty, National University of Asuncion, San Lorenzo, Paraguay
Correspondence:
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Corresponding author: Cynthia Villalba, Nucleus of Research and Technological Development, Polytechnic Faculty, National University of Asuncion, Mariscal Lopez Avenue, San Lorenzo, Paraguay. E-mail: cvillalba@pol.una.py.
Abstract: BACKGROUND: Current Electronic Health Record (EHR) systems are built using different data representation and information models, which makes difficult achieving information exchange. OBJECTIVE: Our aim was to propose a scalable architecture that allows the integration of information from different EHR systems. METHODS: A cloud-based EHR interoperable architecture is proposed through the standardization and integration of patient electronic health records. The data is stored in a cloud repository with high availability features. Stakeholders can retrieve the patient EHR by requesting only to the integrated data repository. The OpenEHR two-level approach is applied according to the HL7-FHIR standards. We validated our architecture by comparing it with 5 different works (CHISTAR, ARIEN, DIRAYA, LLPHR and INEHRIS) using a set of selected axes and a scoring method. RESULTS: The problem was reduced to a single point of communication between each EHR system and the integrated data repository. By combining cloud computing paradigm with selected health informatics standards, we obtained a generic and scalable architecture that complies 100% with interoperability requisites according to the evaluation framework applied. CONCLUSIONS: The architecture allowed the integration of several EHR systems, adapting them with the use of standards and ensuring the availability thanks to cloud computing features.
Keywords: Electronic health records, Cloud EHR, interoperability, health informatics standards, HL7 FHIR, OpenEHR
