Where should electronic records for patients be stored?

International Journal of Medical Informatics(2012)

引用 21|浏览22
暂无评分
摘要
The importance of a nationwide health information infrastructure (NHII) is widely recognized. Patient data may be stored where it happens to be created (the distributed or institution-centric model) or in one place for a given patient (the centralized or patient-centric model). Minimal data is available regarding the performance implications of these alternative architectural choices.To help identify the architecture best suited for efficient and complete nationwide health information exchange based on the large-scale operational characteristics of these architectures.We used simulation to study the impact of health care record (data) fragmentation and probability of encounter on transaction volume and data retrieval failure rate as markers of performance for each of the above architectures.Data fragmentation and the probability of encounter directly correlate with transaction volume and are significantly higher for the distributed model when the number of data nodes >4 (p<0.0001). The number of data retrieval failures increases in proportion to fragmentation and is significantly higher for the distributed model when the number of data nodes ≥2 (p<0.0059).In simulation studies, the distributed model scaled poorly in terms of data availability and integrity with a higher failure rate when compared to the centralized model of data storage. Choice of architecture may have implications on the efficiency, usability, and effectiveness of the NHII at the point of care.
更多
查看译文
关键词
National Health Information Infrastructure,Electronic Medical Record,Health Information Exchange,Health Record Bank,Personal Health Record,Patient-Centered Medical Home
AI 理解论文
溯源树
样例
生成溯源树,研究论文发展脉络
Chat Paper
正在生成论文摘要