Summary
Objectives: EHR systems are core applications in any eHealth/pHealth environment and represent
basic services for health telematics platforms. Standards Developing Organizations
as well as national programs define EHR architectures as well as related design, implementation,
and deployment processes. Claiming to meet the challenge for semantic interoperability
and to offer a sustainable pathway, the resulting documents and specifications are
sometimes controversial and even inconsistent.
Methods: Based on long-term experiences from national and international EHR projects, inputs
from related academic groups, and active involvement at CEN, ISO, HL7, an analysis
and evaluation study has been performed. Using the Generic Component Model (GCM) reference
architecture, the characteristics for advanced and sustainable EHR architectures have
been investigated. The dimensions of such an architectural reference model have been
described, including basic principles of the underlying formal logical framework.
Results: Strengths and weaknesses of the different standards, specifications, and approaches
have been studied and summarized. Migration pathways for re-using and harmonizing
the available materials as well as for formally defining standards development roadmaps
can be derived.
Conclusions: For providing interoperable and sustainable EHR systems, an EHR architecture reflecting
all paradigms of the GCM is absolutely necessary. The resulting EHR solution represents
a services architecture of distributed components. The development process shall be
completely model-driven and tool-based with formalized specifications of all domains’
aspects.
Keywords
EHR - architecture - models - semantic interoperability - standards
