Advanced EHR Architectures–Promises or Reality

Summary Objectives: Forming the informational reflection of the patients and their care, the Electronic Health Record (EHR) is the core application of any complex health information system or health network. Such an ideally lifelong history file must be reliable, flexible, adaptable to new concepts and technologies, and robust, to allow for sharing knowledge over its lifetime. A sophisticated architecture must be chosen for meeting this challenge. Methods: An advanced EHR architecture for designing and implementing future-proof EHR systems must be a model of generic properties required for any Electronic Patient Record to provide communicable, comprehensive, useful, effective, and legally binding records that preserve their integrity over the time, independent of platforms and systems as well as of national special-ties. The resulting approach is based on the ISO Reference Model – Open Distributed Processing. Results: Based on advanced architectural principles introduced in the paper, a new generation of EHR systems has been designed and implemented for demonstrating the feasibility of the approach. This result is presented and evaluated regarding the achievements and problems using the component-based paradigm of model-driven health information system architectures. Conclusions: The future-proof EHR approach that has been established has been shortly evaluated. Advantages regarding flexibility, reliability, and portability of policy-driven, highly secure, role-dependent applications have to be considered in the light of performance as well as of the availability of network and application services.

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The Navy Mental Health Information System (NAMHIS): An Overview

PsycEXTRA Dataset ◽

10.1037/e527962009-001 ◽

2013 ◽

Author(s):

R. B. Chaffee ◽

G. D. Baker ◽

D. Kolb

Keyword(s):

Mental Health ◽

Information System ◽

Health Information ◽

Health Information System ◽

Mental Health Information ◽

Mental Health Information System

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The Vision for a Person-Centered Health Information System

NAM Perspectives ◽

10.31478/201810a ◽

2018 ◽

Vol 8 (10) ◽

Cited By ~ 2

Author(s):

Keith Horvath ◽

◽

Patricia Sengstack ◽

Frank Opelka ◽

Andrea Borondy Kitts ◽

...

Keyword(s):

Information System ◽

Health Information ◽

Health Information System

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Implementation of a Health Information System to Support the Screening and Surveillance of Suicidal Behaviours

Proceedings of the 4th International Conference on Medical and Health Informatics ◽

10.1145/3418094.3418108 ◽

2020 ◽

Author(s):

Juan Martínez-Miranda ◽

Fernando López-Flores ◽

Antonio Palacios-Isaac ◽

Liliana Jiménez ◽

Luis García Medina ◽

...

Keyword(s):

Information System ◽

Health Information ◽

Health Information System ◽

Screening And Surveillance

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A proposed Integrated Medicine Management System Tool based on System, Utilization and Evidence Based Theory for Malaysian Health Information System Optimization

2021 International Congress of Advanced Technology and Engineering (ICOTEN) ◽

10.1109/icoten52080.2021.9493457 ◽

2021 ◽

Author(s):

Rabbia Alamdar ◽

Allan Mathews ◽

Sharanjit Kaur

Keyword(s):

Information System ◽

Health Information ◽

Management System ◽

Health Information System ◽

System Optimization ◽

Evidence Based ◽

Integrated Medicine ◽

Medicine Management ◽

System Utilization

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Impact of Perioperative Tachydysrhythmias on Mortality and Length of Stay in Complete Repair of Tetralogy of Fallot: A Multicenter Retrospective Cohort Study from the Pediatric Health Information System

Cardiology ◽

10.1159/000512777 ◽

2021 ◽

pp. 1-7

Author(s):

Aziez Ahmed ◽

Parthak Prodhan ◽

Beverly J. Spray ◽

Elijah H. Bolin

Keyword(s):

Information System ◽

Length Of Stay ◽

Health Information ◽

Tetralogy Of Fallot ◽

Health Information System ◽

Inpatient Mortality ◽

Pediatric Health ◽

Mortality And Morbidity ◽

Multiple Risk Factors ◽

Complete Repair

Introduction: Tachydysrhythmias (TDS) frequently occur after complete repair of tetralogy of Fallot (TOF). However, not much is known about the effect of TDS on morbidity and mortality after TOF repair. We sought to assess the associations between TDS and mortality and morbidity after repair of TOF using a multicentre database. Materials and Methods: We identified all children aged 0–5 years in the Pediatric Health Information System who underwent TOF repair between 2004 and 2015. Codes for TDS were used to identify cases. Outcome variables were inpatient mortality and total length of stay (LOS). Univariate and multiple logistic and linear regression analyses were used to identify the effects of multiple risk factors, including TDS, on mortality and LOS. Results: A total of 7,749 patients met inclusion criteria, of which 1,493 (19%) had codes for TDS. There was no association between TDS and inpatient mortality. However, TDS were associated with 1.1 days longer LOS and accounted for 2% of the variation observed in LOS. Conclusion: After complete repair of TOF, TDS were not associated with mortality and appeared to have only a modest effect on LOS.

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Diagnosis of Auditory Neuropathy Spectrum Disorder in the Neonatal Intensive Care Unit Population

Otolaryngology ◽

10.1177/01945998211029836 ◽

2021 ◽

pp. 019459982110298

Author(s):

Chengetai Mahomva ◽

Yi-Chun Carol Liu ◽

Nikhila Raol ◽

Samantha Anne

Keyword(s):

Intensive Care Unit ◽

Information System ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Health Information ◽

Neonatal Intensive Care ◽

Health Information System ◽

Auditory Neuropathy ◽

Spectrum Disorder ◽

Nicu Admission

Objective To determine the incidence of auditory neuropathy spectrum disorder (ANSD) and its risk factors among the neonatal intensive care unit (NICU) population from 2009 to 2018 in the Pediatric Health Information System database. Study Design Retrospective national database review. Setting Population-based study. Methods The Pediatric Health Information System database was queried to identify patients ≤18 years old with NICU admission and ANSD diagnosis. Patient demographics, jaundice diagnosis, use of mechanical ventilation, extracorporeal membrane oxygenation, furosemide, and/or aminoglycosides were extracted. Multivariable linear regression was used to assess trends in incidence. Chi-square analysis was used to assess differences between patients with and without ANSD. Logistic regression was used to assess factors associated with ANSD. Results From 2009 to 2018, there was an increase in (1) NICU admissions from 14,079 to 24,851 ( P < .001), (2) total ANSD diagnoses from 92 to 1847 ( P = .001), and (3) annual total number of patients with ANSD and NICU admission increased from 4 to 16 ( P = .005). There was strong correlation between the increases in total number of NICU admissions and total ANSD diagnoses over time ( R = 0.76). The average ANSD incidence was 0.052% with no statistically significant change over 10 years. When compared with all NICU admissions, children with ANSD had a higher association with use of furosemide ( P < .001) and ventilator ( P < .001). Conclusion Despite a statistically significant increase in NICU admissions and total ANSD diagnosis, the incidence of ANSD in the NICU population has not increased from 2009 to 2018. Furosemide and mechanical ventilator use were associated with increased likelihood of ANSD.

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