A Model for an Electronic Health Information Management System with Structural Interoperability in Heterogeneous Environments for continued Health Care

Abstract

Electronic Health Records (EHR) Systems have over the recent years become an integral part of any effective Health Care System. Volumes of data is kept in heterogeneous systems and though continued health care highly depends on knowledge acquired from medical history captured at various points, this information is usually not readily available. This is caused by lack of interoperability and use of standards. Usually, interoperability has been targeted at health systems communicating amongst themselves and not with other supporting systems such as administrative systems that may be directly affected by healthcare systems or may themselves affect healthcare systems. The University of Zambia (UNZA) Clinic EHR does not interoperate with administrative systems systems. This study proposes a model to improve the efficiency of healthcare at UNZA Clinic by introducing an EHR system that applies interoperability with the University’s Human Resource and Student Information Systems at as less a cost a possible. The study was guided by two (2) objectives. A baseline study was conducted to evaluate the performance of the currently implemented modules of the Electronic System at UNZA Clinic to address objective number (1). 200 questionnaires were distributed during clinic visits with 150 of them being used to collect data from within University community. Of these, 50 were given to members of staff that benefit from the health services, 75 to students and 50 to the healthcare providers.  The remaining 25 questionnaires were shared amongst staff dependents and the community outside the University. Our results show that there is potential to improve on patient delay time. Many respondents suggested that automating the processes and securely sharing electronic records amongst the offices that attend to them would better the service. A model has been proposed to address objective 2 for the design of a prototype that adheres to HL7 EHR Standards. In order to achieve an interoperable eHealth Records System, we have investigated and proposed a Web Service architecture.