Proposal of an architecture for the national integration of Electronic Health Records: a semi-centralized approach

This paper proposes a novel architecture for the national integration of Electronic Health Records (EHRs), the semi-centralized approach, in which summarized EHRs are maintained centrally at a nation-wide system with references to their comprehensive versions at their original locations on the various healthcare providers' databases. The idea is to allow the clinicians to have an idea of what is included inside the patient's EHRs at each healthcare provider's database and to have a general view of the patient's medical history, and when needed to retrieve the complete EHR of the patient from a remote healthcare providers' systems. A high level system architecture needed to integrate EHRs from various sources on a nation-wide basis using the proposed semi-centralized approach is described. Best practices and essential requirements are the central to the evolution of the approach taken.