Posted on: 7.12.2009 3:47:34 PM Posted by Deborah Kohn
Over the years, many prominent healthcare informaticists agreed that an electronic health record (EHR) system is not one or even two or more "products." Rather, an EHR is a construct that consists of a number of integrated, (hopefully) interoperable, feature/function and technical-based "component" (or "service-based") systems and technologies. For example, picture archiving and communication systems (PACS), medical device systems, even voice/text/speech systems are some of these key feature/function-based "component" EHR systems and technologies, and single sign-on, clinical messaging, and intranets are some of these key technical-based "component" EHR systems and technologies that, in general, are NOT and never will be included in one EHR "product."
Despite the fact that the 21st century market trend has been toward the provision of most or all of the EHR technology by one vendor or service provider, primarily because hospital CIOs have struggled to integrate "best of breed" components and clinician office IT Directors had even less success assembling their own technology from pieces, a healthcare provider organization still will NOT have 100% of its EHR from one vendor or service provider. In fact, newer systems and technologies based on the latest technical approaches suggest that feature/function and technical components--not products--must be the focus of EHR certification efforts.
For example, today's useful systems are increasingly created by assembling reliable software/service components to meet specific needs. As such, certification of feature/function and technical components will need to assure that identities cannot be stolen and used to access protected health information, that data are transmitted and presented reliably, that communications are secure, that transactions are inexpensively audited, etc. Also, a component-based approach to certification would provide innovators with a greater opportunity to develop products suited to specific clinical needs.
Even though there remains a lack of standards for how components interconnect and share data, healthcare information technology professionals must strive for certification evolving to address a componentized world, and not a product world.
