The Design and Application of an Electronic Health Record System
for Digital Health Management
Li Li, Zhao Dongsheng
, Meng Haibin, Wang Huishu and Wu Feng
Institute of Health Service and Medical Information, Academy of Military Medical Sciences, Taiping Road, Beijing, China
Keywords: Electrical Health Record, Digital Health Management, Design, Application.
Abstract: To detailed elaborate the content and function of the Electrical Health Record system, this paper
respectively introduces its data model, function structure, user role, data collection process and deployment
model. And the present pilot work of the system is briefly described in 32 units of Guangdong area. The
summary in this paper offers a theoretical basis for the further improvement and application of the system,
and provides the theoretical basis and practical experience for the exploration of a new mode of digital
health management.
1 INTRODUCTION
With the rapid development of economy and the
improvement of people's living standard, the
implementation of health management (Sheppard et
al.,2012) in health promotion, health protection,
health and disease prevention as the main content
(Sijing et al., 2011), through the establishment of
electronic health records of residents throughout the
whole life process, has become one of the important
contents of national health world. EHR (ISO/TS
18308, 2004; Hoerbst1 et al., 2010) is a dynamic
electrical record to gather and store individual health
status. Integrated universal administration network
platform is individual health cantered, and initially
provides comprehensive and all-around health
management service for guarantee objects (Ball et
al.,
2006). Making use of this platform is a major
method to transit from traditional medical model to
digitalized health management model (Oliver , 2004).
This paper introduces data model, function
structure, user role, data collection process and
deployment model of the electronic health record
system. The pilot work of the system is briefly
described. The conclusion of the study is to
construct a new mode of health management health
records based on the theoretical and practical
foundation for next step.
2 SYSTEM DESIGN
2.1 Data Model
The system data contains two aspects, one is
electronic health record data, one is user data, data
dictionary, data security protection, system
management specification data, standard data etc.
The electronic health record data is the set of all
records of the residents' health service process. It
mainly includes 6 parts: basic information, health
promotion, disease prevention and control
information, the information of medical service
information, injury management information and
women's health information, a total of 33 types of
information (Figure 1). Compared with the national
electronic health records (Ministry of health of
China P.R, 2009), the electronic health records
reduces child module and increases the health
promoting module. Occupation disease prevention
and supervision, health hazards monitoring
information is added to the disease prevention and
control module. Pre hospital first aid and nursing
information is added to the medical service module.
Occupation disease, injury and oral disease
management information is added to the injury
management module.
2.2 System Function
To satisfy health management and guarantee
413
Li L., Dongsheng Z., Haibin M., Huishu W. and Feng W..
The Design and Application of an Electronic Health Record System for Digital Health Management.
DOI: 10.5220/0004902504130416
In Proceedings of the International Conference on Health Informatics (HEALTHINF-2014), pages 413-416
ISBN: 978-989-758-010-9
Copyright
c
2014 SCITEPRESS (Science and Technology Publications, Lda.)
Figure 1: The Electronic Health Record data Structure Diagram.
institutions of all levels, EHR system is divided into
health record business, health service business, and
system management system, and each one has two
categories (Li et al., 2011). Health record related
health service activities, including health service and
decision support activity come from all business
domain. Activities are implemented by different
health institutions, and detailed information is
recorded as business form. (Table 1).
Table 1: System Business Domain Classification.
No Level 1 categories Level 2 categories Business identifier
1 Health record business
001 Health records to establis
h
BA001
002 Health Librarianship BA002
2 Health services business
001 medical business BB001
002 Public health service BB002
003 Basic medical and health service BB003
004 Comprehensive health management BB004
005 self-care BB005
3
System management
business
001 The file data maintenance BC001
002 Support data maintenance BC002
003 system management service BC003
EHR has four functional modules: basic business,
share statistics, health management and system
management. Functions include health record file’s
establishment and management, data collection and
summarizing, information statistics and
demonstration, health status monitoring and risk
assessment, safeguard measure assessment and
promotion, health policy observation, etc. The
system gathers information of personal stamina,
intelligence and psychology, environment adaption
capability, disease, medical treatment, etc, through
data collection plug-in. Information is shared by
units of hospitals, sanatorium, CDC, etc by manual
input and output, electrical medical record’
automatic input in hospital network and business
data base capture. Personal ID is used as index.
Real-time data from every basic units and medical
departments are standardized disposed, encryption
transferred, and completely put in storage. User’s
function demand for authorization, identification,
and privacy protection is ensured by digital signature
and certificate, identity authentication and
timestamp service, identification plug-in (Figure 2).
Figure 2: EHR Function Structure.
2.3 User Role
Based on public service and health management, the
user role of this electronic health records system is
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divided into 5 categories, Including ordinary
residents, health management, health responsibility
of doctors, medical staff, organization management
etc.
Ordinary Residents can refer to all of their own
health information from the unified military
electronic health record system terminal, to
strengthen the self health management, develop self
disease prevention measures and improve the self
health level. In order to timely, accurate,
comprehensive grasp of community residents’ health
status and health risk factors, health management
staff is set. Using electronic health record
information, they carry out population health status
and health risk factors analysis, population health
risk assessment, disease surveillance and public
health emergencies early warning, environmental
health inspection, health maintenance and disease
management supervision. In order to make each
resident health attention falls to real point, health
responsibility doctor role is set. It is the key position
construction, electronic health record and health
management information system for the
management and use of the process and is
responsible for the security range construction of
electronic health records and health management.
The doctors collect and adjust the basic health
information, physical fitness test, environment
monitoring and other information. They are
responsible for the liability management range
residents health consultation, risk assessment,
guidance and supervision information supplement,
special disease (chronic) information acquisition and
management etc..In the process of diagnosis and
treatment, the medical staff access to electronic
health records of patients and view the information
of diagnosis and treatment, to the maximum extent
possible to avoid misdiagnosis and missed diagnosis,
to choose the best treatment and improve the
accuracy of diagnosis. Through regular analysis of
data, the results can be used to provide data support
for the health assessment and early warning of
disease. Through this system, government
management can invoke the required statistical
information and decision support to help managers
more direct, effective, comprehensive, systematic
grasp the overall situation. First, they can assess the
grass-roots health management performance. Second,
they carry out a statistical analysis of the data, from
the overall index (such as the incidence rate of
hospitalization, outpatient, morbidity, position) to
groups of health, to judge the health work attention
key. Third, they predict emergencies to improve the
timeliness of emergency response.
2.4 Data Collection Process
Application process of EHR system is: collecting
personal relevant health data from existing
information system and other relevant health service
record; then transfer to EHR data center for storage
after standardizing and packing data (Feng et al.,
2010). Afterwards data extracting is implemented
according to relevant principles, and then shaped
EHR is used for health information sharing and
utilization, medical service collaboration, health
operation linkage, health management aid decision
making and personal health administration through
extracting and utilize data. Every authorized agency
and person can have access to health record through
the system, which realizes health information
sharing and utilization, medical service collaboration,
health operation linkage, health management aid
decision making and personal health administration.
(Figure 3).
Figure 3: Application Process of EHR System.
3 DEPLOYMENT AND
APPLICATION
3.1 System Deployment
EHR supports the architecture model of multistage
platform vertical deploy, and realizes three-level
platform architecture from headquarters to
grassroots unit in the whole country. The 1st and
2nd levels of health record data center are built, and
large-scale data base Oracle and document library is
deployed. Information is sourcing from business
TheDesignandApplicationofanElectronicHealthRecordSystemforDigitalHealthManagement
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system data in system hospitals, grassroots units and
health administrative authority. Health record
abstract and prime index information is stored, and
health record data is exchanged and shared. Health
managers could make use of the data base to
strengthen various data’s gathering, collection and
analyzing, and support accurate data for decision-
making departments to complete health management
service system and making health management
policy. Individuals could view all of his health
information from the data base service website to
strengthen personal health care management, and to
take self-precautionary measures.
Mix (group and distribution) structure is used in
the deployment of the system. Stable exchange and
effective connection of users’ EHR data is realized
among users of hospitals, clinics, CDC, and
grassroots units, etc, through various network
accesses like satellite communication network,
wired and wireless network, etc, to reach the
purpose of real-time access and effective utilization
for every guaranteed object. (Figure 4)
Figure 4: EHR System Deployment Model.
3.2 Application
At present, the pilot work of the system is underway
in 32 units of Guangdong area, involving more than
37000 residents. We have been collecting outpatient,
hospital, sanatorium, infectious diseases, and
medical information more than 250000 data
document. The establishment of more than 22000
resident’s electronic health records has been
completed.
4 CONCLUSIONS
Construction of this system achieves various health
data integration, completes health evaluation
criterion, enforces standard health management
process, and makes full use of information and
health resource. But there are many theoretical and
practical problems that remain to be researched and
solved, such as optimization of system structure,
perfection of business function, unity of standard
and system, etc.
Next, based on the improvement of electronic
health records the basic theory and the platform
function, we will improve the health standards,
Standardized health management process, create a
new model of health management to provide a
systematic, individual, real-time health assessment,
disease prevention, health services and management
for the residents and to better safeguard residents
Omni-directional health.
REFERENCES
Sheppard, J. W., et al., 2012. IEEE Standards for
Prognostics and Health Management. Aerospace and
Electronic Systems Magazine. 24(9):23-41.
Sijing W., et al., 2011. Status and barriers of application of
electronic health records at home and abroad. CGP
Chinese General Practice. 14(1):226-228.
ISO/TS 18308, 2004. Health informatics - Requirements
for an electronic health record architecture.
Hoerbst1, A., et al., 2010. Electronic Health Records.
Methods Inf Med. 4:320-336.
Ball M., et al., 2006. Personal Health
Records:Empowering Consumers. Journal of
HealthcareInformation Management. 21 (1): 76–86.
Ministry of health of China P.R , 2009. The regional
health information platform construction technology
solution based on health records.
Oliver, J. B., 2004. The Electronic Health Record:
Standardization and Implementation. 2nd OpenECG
Workshop.
Li, L., et al., 2011. Business process analysis and system
architecture design of military electronic health record
system. Med J Chin PAPF. 22(12):1046-1049.
Feng, W., et al., 2010. The idea of establishing Army’s
electronic health records. People’s Military Surgeon.
55(1):98-100.
HER Level 1 Data Center
HER Level 1 Data Center
Integrated information
network
Primary user
Client Manager
Data
storage
blades
Wireless
network
Wired
network
Network user
Mobile client
Intranet user
Hospital
CDC Policlinic
Grassroots
unit
Data server WEB server
Application
server
Relational
data base
Document
Data
Base
Index
Database
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