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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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Objective
• Compare database architectures employed by various vendor applications, for fulfilling different user purposes
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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
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What is an Electronic Health Record (EHR)?
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Sample EHR Architecture
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EHR Hardware Platform
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EHR Hardware Platform (cont.)
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Example EHR Hardware Configuration Using Citrix
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EHR Software Platform
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Databases
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Relational Databases
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Hypothetical Relational Database Model
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Hierarchical Databases
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Hypothetical Hierarchical Database Model
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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
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HIMSS Online Buyer’s Guide
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KLAS Research, LLC
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Epic
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Epic (cont.)
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Epic (cont.)
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Eclipsys
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Eclipsys (cont.)
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Quadramed CPR
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NextGen EMR
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eClinicalWorks EHR (ECW)
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eClinicalWorks Small Practice Technical Requirements
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Monitoring the EHR
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Security
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Recommended EHR Security Features
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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
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Who Reads Whose Notes?
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System PerformancePrototype dashboard for real-time monitoring of EHR system use and performanceCourtesy of Roger Corman, Corman Technologies, Inc.
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