Background: Electronic Health Record Systems (EHRS) and Personal Health Record Systems (PHRS) are core components of infrastructure needed to run any health system. Objectives: As health systems undergo paradigm changes, EHRS and PHRS have to advance as well to meet the related interoperability challenges. Methods: The paper discusses EHR types, implementations and standards, starting with different requirements specifications, systems and systems architectures, standards and solutions. Results: Existing standards and specifications are compared with changing requirements, presenting weaknesses and defining the advancement of EHRS, architectures and related services, embedded in advanced infrastructure systems. Conclusion: Future EHR systems are components in a layered architecture with open interfaces. The need of verifying data models at business domains level is specifically highlighted. Such approach is enabled by the ISO Interoperability Reference Architecture of a systemoriented, architecture-centric, ontology-based, policy- driven approach, meeting good modeling best practices.
This paper first looks at the several definitions of the word interoperability. Next, the paper addresses several of the distinct components that are factors in accomplishing interoperability: semantic interoperability, functional interoperability, stakeholder interoperability, consumer interoperability, business interoperability, privacy and security interoperability, and international interoperability. This paper discusses each of these components in terms of their current state relating to interoperability and suggests what changes might be made to achieve interoperability.
