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Comp 14 - Special Topics in Vendor- Specific Systems Unit 5 - System and Database Architectures Used in Commercial EHRs This material was developed by Columbia University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number 1U24OC000003.

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Page 1: Comp 14 - Special Topics in Vendor- Specific Systems Unit 5 - System and Database Architectures Used in Commercial EHRs This material was developed by

Comp 14 - Special Topics in Vendor- Specific Systems

Unit 5 - System and Database Architectures Used in

Commercial EHRs

This material was developed by Columbia University, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number 1U24OC000003.

Page 2: Comp 14 - Special Topics in Vendor- Specific Systems Unit 5 - System and Database Architectures Used in Commercial EHRs This material was developed by

Objective

• Compare database architectures employed by various vendor applications, for fulfilling different user purposes

Comp 14/Unit 5Health IT Workforce Curriculum

Version 2.0/Spring 20112

Page 3: Comp 14 - Special Topics in Vendor- Specific Systems Unit 5 - System and Database Architectures Used in Commercial EHRs This material was developed by

After this completing this unit, you should be able to:

• Demonstrate concept knowledge of system and database architectures used in commercial EHRs

• Describe the health information systems landscape, including how EHRs exchange information with ancillary systems such as Pharmacy, Laboratory, etc.

• Identify the differences between thick and thin-client EHR deployments

• Compare different operating systems and databases used by EHRs

• Explain how database architecture can impact performance and extensibility

• Articulate how system and database architectures impact security, auditing and performance monitoring

Comp 14/Unit 5Health IT Workforce Curriculum

Version 2.0/Spring 20113

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What is an Electronic Health Record (EHR)?

Comp 14/Unit 5Health IT Workforce Curriculum

Version 2.0/Spring 20114

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Sample EHR Architecture

Comp 14/Unit 5Health IT Workforce Curriculum

Version 2.0/Spring 20115

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EHR Hardware Platform

Comp 14/Unit 5Health IT Workforce Curriculum

Version 2.0/Spring 20116

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EHR Hardware Platform (cont.)

Comp 14/Unit 5Health IT Workforce Curriculum

Version 2.0/Spring 20117

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Example EHR Hardware Configuration Using Citrix

Comp 14/Unit 5Health IT Workforce Curriculum

Version 2.0/Spring 20118

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EHR Software Platform

Comp 14/Unit 5Health IT Workforce Curriculum

Version 2.0/Spring 20119

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Databases

Comp 14/Unit 5Health IT Workforce Curriculum

Version 2.0/Spring 201110

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Relational Databases

Comp 14/Unit 5Health IT Workforce Curriculum

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Hypothetical Relational Database Model

Comp 14/Unit 5Health IT Workforce Curriculum

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Hierarchical Databases

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Hypothetical Hierarchical Database Model

Comp 14/Unit 5Health IT Workforce Curriculum

Version 2.0/Spring 201114

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Vendor Comparison of System Architectures

• Inpatient EHR– Epic, Eclipsys, Quadramed

• Ambulatory EHR– NextGen, eClinicalWorks

• http://onlinebuyersguide.himss.org/

• http://www.klasresearch.com/Search/Browse.aspx?t=2

Comp 14/Unit 5Health IT Workforce Curriculum

Version 2.0/Spring 201115

http://onlinebuyersguide.himss.org/
http://www.klasresearch.com/Search/Browse.aspx?t=2
http://www.klasresearch.com/Search/Browse.aspx?t=2
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HIMSS Online Buyer’s Guide

Comp 14/Unit 5Health IT Workforce Curriculum

Version 2.0/Spring 201116

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KLAS Research, LLC

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Epic

Comp 14/Unit 5Health IT Workforce Curriculum

Version 2.0/Spring 201118

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Epic (cont.)

Comp 14/Unit 5Health IT Workforce Curriculum

Version 2.0/Spring 201119

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Epic (cont.)

Comp 14/Unit 5Health IT Workforce Curriculum

Version 2.0/Spring 201120

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Eclipsys

Comp 14/Unit 5Health IT Workforce Curriculum

Version 2.0/Spring 201121

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Eclipsys (cont.)

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Version 2.0/Spring 201122

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Quadramed CPR

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NextGen EMR

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eClinicalWorks EHR (ECW)

Comp 14/Unit 5Health IT Workforce Curriculum

Version 2.0/Spring 201125

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eClinicalWorks Small Practice Technical Requirements

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Monitoring the EHR

Comp 14/Unit 5Health IT Workforce Curriculum

Version 2.0/Spring 201127

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Security

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Recommended EHR Security Features

Comp 14/Unit 5Health IT Workforce Curriculum

Version 2.0/Spring 201129

AHIMA e-HIM Work Group on Security of Personal Health Information. "Ensuring Security of High-Risk Information in EHRs" Journal of AHIMA 79, no.9 (September 2008): 67-71.

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System Use

Comp 14/Unit 5Health IT Workforce Curriculum

Version 2.0/Spring 201130

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Who Reads Whose Notes?

Comp 14/Unit 5Health IT Workforce Curriculum

Version 2.0/Spring 201131

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System PerformancePrototype dashboard for real-time monitoring of EHR system use and performanceCourtesy of Roger Corman, Corman Technologies, Inc.

Comp 14/Unit 5Health IT Workforce Curriculum

Version 2.0/Spring 201132


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