Data Exchange Engines for EHR Systems

One of the new areas of research for The Cromwell Workshop is in the area of electronic health record research. Orlova (2005) has a nice article on 21st Century Healthcare Systems at http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1560434 . The authors state in their abstract,

"An electronic health record - public health (EHR-PH) system prototype was developed to demonstrate the feasibility of electronic data transfer from a health care provider, i.e. hospital or ambulatory care settings, to multiple customized public health systems which include a Newborn Metabolic Screening Registry, a Newborn Hearing Screening Registry, an Immunization Registry and a Communicable Disease Registry, using HL7 messaging standards. Our EHR-PH system prototype can be considered a distributed EHR-based RHIE/RHIO model - a principal element for a potential technical architecture for a NHIN."

Their steps for an EHR-PH system protoype based on the HL-7 messaging standard involved tracking information from the hospital of birth to 4 public health programs:

Step 1. EHR-Birth Record
Step 2. Hearing Screening
Step 3. Newborn Screening
Step 4. Immunization
Step 5. Communicable Disease Reporting
Step 6. Healthcare Enterprise Viewer

They used a MVC framework in J2EE for their prototype. The openEHR foundation uses Java at http://www.openehr.org/downloads/publications/health_ict/Medinfo2007-openehr_java-ChenKlein.pdf for development. Wikipedia has a nice article on EHR at http://en.wikipedia.org/wiki/Electronic_health_record with open source software at http://en.wikipedia.org/wiki/List_of_open_source_healthcare_software.

In the course of consulting opportunities with GIS, SQL Server and .NET, another example is the South Carolina Birth Data Exchange Engine (BEE) Program which exchanges birth population data with users in both a timely and secure fashion. The “BEE” program builds on integrated/interoperable systems that permits multiple agencies and health care providers, i.e. for immunization and newborn screening, to directly share or access needed birth information for mission-critical public health practices.

This got me thinking about "How to select an EHR system" in 12 steps at http://www.aafp.org/fpm/20050200/55howt.html and with my degrees in economics, what is happening in medical economics at http://medicaleconomics.modernmedicine.com/memag/article/articleDetail.jsp?id=131518 . Furthermore, I looked at MediTech at http://www.meditech.com/Interoperability/ehrHome.htm with their interoperability and EHR initiatives. Finally, they have an interview on their Data Exchange engine at http://www.meditech.com/Interoperability/pages/1108fa_interview.htm .