Enhancing a Commercial EMR with an Open, Standards-Based Publish-Subscribe Infrastructure

Area of Science:

• Health Informatics
• Computer Science

Background:

• Electronic Medical Records (EMR) systems often have limitations in supporting external applications and services.
• Event processing is crucial for real-time data access and workflow automation in healthcare.

Purpose of the Study:

• To describe the design and implementation of a publish-subscribe (PubSub) infrastructure at Intermountain Healthcare.
• To demonstrate how this PubSub infrastructure can extend the capabilities of a commercial EMR.
• To highlight the benefits of a PubSub paradigm for healthcare event processing.

Main Methods:

• Design and implementation of a novel PubSub architecture.
• Integration of the PubSub system with a commercial EMR.
• Development of use cases for health information exchange, public health reporting, and pulmonary embolism diagnosis.

Main Results:

• The PubSub infrastructure successfully supports essential event processing workflows.
• The system enables external applications to access triggering events within the EMR.
• The PubSub system provides enhanced event handling functionality beyond the commercial EMR's capabilities.

Conclusions:

• The developed PubSub infrastructure effectively supports critical event processing and enhances EMR functionality.
• The open, standards-based design facilitates adoption by other organizations.
• This approach improves health information exchange and supports advanced clinical applications.