A simulation-based performance analysis of a National Electronic Health Record System

This paper addresses through simulation experiments a number of technical issues which are raised during the development and operation of a National Electronic Health Record System (NEHRS). The simulation experiments represent the NEHRS performance for a variety of technological infrastructures, within the context of a realistic scenario. The scenario includes the estimation of the delays created in queues during the exchange of Electronic Patient Records (EPR) between different health service points. It is essential to clarify the delays derive from LAN and Internet technologies, the EPR encryption/decryption, the HL7 message generation/parsing, and the databases. The results of this study identify how a number of technical aspects influence the NEHRS development and operation.