EHR Architecture and Design

by Jerome Carter on March 25, 2013

**Updated August 26, 2014 **(Page is updated monthly on

the 26th. For more frequent resource alerts, follow** EHR Science on

Twitter:@ehrscience**.)

_The Architecture and Design page has been created to serve as a resource for those who are interested in building EHR

systems and/or understanding how they work. To that end, I have included links to EHR standards, open source projects,

and programming/technology information. Data exchange, decision support, and content-related materials (e.g. SNOMED,

LOINC) are included only if they directly address issues encountered when designing and building systems._

General

Books

Freeman E, Freeman E, Bates B, Sierra K, Robson E. _[Head First Design Patterns](http://www.amazon.com/First-Design-

Patterns-Elisabeth-Freeman/dp/0596007124)_. 2004

McLaughlin BD, Pollice G, West D. _[Head First Object-Oriented Analysis and Design](http://www.amazon.com/Head-First-

Object-Oriented-Analysis-Design/dp/0596008678/ref=sr_1_1?s=books&ie=UTF8&qid=1364182297&sr=1-

1&keywords=head+first+object+oriented+analysis+and+design)_. 2006

Microsoft Application Architecture Guide, Second Edition. 2009

Bass L, Clements P, Kazman R. _[Software Architecture in Practice](http://www.amazon.com/Software-Architecture-Practice-

3rd-Engineering/dp/0321815734/ref=sr_1_1?s=books&ie=UTF8&qid=1364182541&sr=1-1&keywords=software

+architecture+in+practice+3rd+edition)_, Third Edition. 2012

**Resource Pages

** EHR Data Quality

NoSQL and Relational Databases <span

style=“color: #ff0000;”>**

**

Websites

Object Mentor Resources - Great information on object-

oriented programminf and software design

Software Engineering Institute - Among other things, offers a range of resources on software

architecture

The Guide to the Software Engineering Body of Knowledge (SWEBOK) - Provides a

great overview of the main issues/areas of software engineering

**Reports

**AHRQ

A Robust Health Data Infrastructure, 2014 **<span

style=“color: #ff0000;”>

**

EHR Architecture and Design

EHR Standards

AHRQ

[Clinical Decision Support Initiative](http://healthit.ahrq.gov/portal/server.pt/community/ahrq-

funded_projects/654/clinical_decision_support_initiative/13665)

[Children’s Electronic Health Record Format]

(http://healthit.ahrq.gov/portal/server.pt/community/health_it_tools_and_resources/919/children

%92s_electronic_health_record_(ehr)_format/31456)

American Society of Testing Materials

E31 Standards

Food and Drug Administration

[Mobile Medical Applications – Guidance for Industry and Food and Drug Administration Staff]

(http://www.fda.gov/downloads/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/UCM263366.pdf), 2013 <span

style=“color: #ff0000;”>**

**

Health Level Seven

EHR Functional Profiles

International Standards Organization (ISO)

TC 25 Health Informatics Standards

ONC

[Health information technology: certification criteria, 2014 edition

](http://www.gpo.gov/fdsys/pkg/FR-2012-09-04/pdf/2012-20982.pdf)[2014 Certification Test Methods]

(http://www.healthit.gov/policy-researchers-implementers/2014-edition-final-test-method)

OpenEHR

Specification documents

Open Source Projects

FreeMED

GnuMED

Open EMR

Open MRS

**Tutorials **

Audit trails and data access – these posts discuss MU audit requirements and audit trail design.

[EHR Design, Timelines, and Audit Trails: Getting a Sense of What Has Happened

](http://ehrscience.com/2013/01/14/ehr-design-timelines-and-audit-trails-getting-a-sense-of-what-has-happened/ “EHR Design,

Timelines, and Audit Trails: Getting a Sense of What Has Happened”)[EHR Design Basics: Tracking Data Changes and Accesses]

(http://ehrscience.com/2013/01/28/ehr-design-basics-tracking-data-changes-and-accesses/ “EHR Design Basics: Tracking Data

Changes and Accesses”)

Representational State Transfer – the basics of REST

[Coming to REST, Part I: Complexity in EHR Systems

](http://ehrscience.com/2013/07/08/coming-to-rest-part-i-complexity-in-ehr-systems/ “Coming to REST, Part I: Complexity in

EHR Systems”)[Coming to REST, Part II: It’s All About Resources](http://ehrscience.com/2013/07/15/coming-to-rest-part-ii-

its-all-about-resources/ “Coming to REST, Part II: It’s All About Resources”)

**Posts

**General

[From Idea to System: A Story of Architecture and Design

](http://ehrscience.com/2013/02/18/from-idea-to-system-a-story-of-architecture-and-design/ “From Idea to System: A Story of

Architecture and Design”)[Coupling and Cohesion: A View of Software Design from the Inside Out

](http://ehrscience.com/2012/11/12/coupling-and-cohesion-a-view-of-software-design-from-the-inside-out-2/ “Coupling and

Cohesion: A View of Software Design from the Inside Out”)[Software Architecture and Design, First Steps

](http://ehrscience.com/2012/02/29/software-architecture-and-design-first-steps/ “Software Architecture and Design, First

Steps”)[Rethinking the Design of Electronic Health Record Systems

](http://ehrscience.com/2012/04/18/rethinking-the-design-of-electronic-health-record-systems/ “Rethinking the Design of

Electronic Health Record Systems”)[What If EHRs Were More Like Content Management Systems?

](http://ehrscience.com/2011/11/16/what-if-ehrs-were-more-like-content-management-systems/ “What If EHRs Were More Like

Content Management Systems?“)[Moving Beyond Paper-based Thinking in EHR Design

](http://ehrscience.com/2013/02/11/moving-beyond-paper-based-thinking-in-ehr-design/ “Moving Beyond Paper-based Thinking in

EHR Design”)[Requirements, Usability, and Petri Nets](http://ehrscience.com/2013/03/04/requirements-usability-and-petri-

nets/ “Requirements, Usability, and Petri Nets”)

Architecture and Design

Motifs in EHR Research

[The EHR As an Object Worthy of Study](http://ehrscience.com/2012/10/08/the-ehr-as-an-object-worthy-of-study/ “The EHR As

an Object Worthy of Study”)

[EHRs and Architectural Styles, Peeking Under the Hood](http://ehrscience.com/2012/06/27/ehrs-and-architectural-styles-

peeking-under-the-hood/ “EHRs and Architectural Styles, Peeking Under the Hood”)

[Investigating NoSQL for EHR Systems: MongoDB](http://ehrscience.com/2013/04/15/investigating-nosql-for-ehr-systems-

mongodb/ “Investigating NoSQL for EHR Systems: MongoDB”)

Exchanging Data with JSON

[SaaS EHRs, MVC, Flexibility and Innovation](http://ehrscience.com/2013/04/01/saas-ehrs-mvc-flexibility-and-innovation/

“SaaS EHRs, MVC, Flexibility and Innovation”)

Data Quality

[Wrestling with EHR Data Quality](http://ehrscience.com/2012/11/26/wrestling-with-ehr-data-quality/ “Wrestling with EHR

Data Quality”)

[EHR Data Accuracy—Should You Be Concerned?](http://ehrscience.com/2012/04/09/ehr-data-accuracy%e2%80%94should-you-be-

concerned/ “EHR Data Accuracy—Should You Be Concerned?“)

Clinical Algorithms and Data Structures

[From Data to Data + Processes: A Different Way of Thinking about EHR Software Design]

(http://ehrscience.com/2012/09/24/from-data-to-data-processes-a-different-way-of-thinking-about-ehr-design/ “From Data to

Data + Processes: A Different Way of Thinking about EHR Software Design”)

[The Informaticist-Programmer Interface: What Do You Mean By That…?](http://ehrscience.com/2012/07/30/the-informaticist-

programmer-interface-what-do-you-mean-by-that%e2%80%a6/ “The Informaticist-Programmer Interface: What Do You Mean By That…

?“)

[Making Clinical Concepts Computable](http://ehrscience.com/2012/05/16/making-clinical-concepts-computable/ “Making

Clinical Concepts Computable”)

[The Nuances of Clinical Data

](http://ehrscience.com/2012/01/30/the-nuances-of-clinical-data/ “The Nuances of Clinical Data”)[Null Codes: A Mechanism

for Understanding the Reasons for Missing EHR Data Values](http://ehrscience.com/2013/07/22/null-codes-a-mechanism-for-

understanding-the-reasons-for-missing-ehr-data-values/ “Null Codes: A Mechanism for Understanding the Reasons for Missing

EHR Data Values”)

**Key Articles

**Sinsky CA, Beasley JW, Simmons GE, Baron RJ. [Electronic health records: design, implementation, and policy for higher-

value primary care.](http://annals.org/article.aspx?articleid=1872852) Ann Intern Med. 2014 May 20;160(10):727-8.**

**

Krist AH, Beasley JW, Crosson JC, Kibbe DC, et al. [Electronic health record functionality needed to better support primary

care.](http://www.ncbi.nlm.nih.gov/pubmed/24431335?dopt=Abstract) J Am Med Inform Assoc. 2014 Jan 15. [E] <span

style=“color: #ff0000;”>**

**

Hypp?nen H, Saranto K, Vuokko R, M?kel?-Bengs P, Doupi P, Lindqvist M, M?kel? M. [Impacts of structuring the electronic

health record: A systematic review protocol and results of previous reviews]

(http://www.sciencedirect.com/science/article/pii/S1386505613002475). Int J Med Inform. 2013 Dec 8. [E] <span

style=“color: #ff0000;”>**

**

Xiaomu Zhou, Kai Zheng, Mark Ackerman, and David Hanauer. 2012. [Cooperative documentation: the patient problem list as a

nexus in electronic health records.](http://web.eecs.umich.edu/~ackerm/pub/12b69/CSCW12-352-ProblemList.inpress.pdf) In

Proceedings of the ACM 2012 conference on Computer Supported Cooperative Work (CSCW ’12). ACM, New York, NY, USA,

911-920.

Bisbal J, Berry D. [An analysis framework for electronic health record systems. Interoperation and collaboration in shared

healthcare](http://www.dtic.upf.edu/~jbisbal/publications/me09-01-0002_Bisbal.pdf). Methods Inf Med. 2011;50

(2):1809.** **

Blobel B, Pharow P. [Analysis and evaluation of EHR approaches]

(http://person.hst.aau.dk/ska/MIE2008/ParalleSessions/PapersForDownloads/06.HIS&amp;EHR/SHTI136-0359.pdf). Methods Inf Med.

2009;48(2):162-9. **

**

Greenhalgh T, Potts HW, Wong G et al. (2009) . [Tensions and paradoxes in electronic patient record research: a systematic

literature review using the meta-narrative method](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2888022/). Milbank Q

vol. 87, (4) 729-788. **

**

Miller J. Cohesion and Coupling. MSDN Magazine. October 2008.**

**

H?yrinen K, Saranto K, Nyk?nen P. [Definition, structure, content, use and impacts of electronic health records: a review

of the research literature.](http://www.ijmijournal.com/article/S1386-5056(07)00168-2/abstract) Int J Med Inform. 2008

May;77(5):291-304. **

**

**Articles

****[New ** July 29 - August 26, 2014] [<span style=“color:

#ff0000;“>E**] = e-pub date

2014

**Bouaud J, Lamy JB. A 2014 medical informatics perspective on clinical decision support systems: do we hit the

ceiling of effectiveness? Yearb Med Inform. 2014 Aug 15;9(1):163-6.

Braun M, Brandt AU, Schulz S, Boeker M. Validating archetypes for the Multiple Sclerosis Functional Composite. BMC Med

Inform Decis Mak. 2014 Aug 3;14:64. 6.

Tastan S, Linch GC, Keenan GM, Stifter J, McKinney D, Fahey L, Lopez KD, Yao Y, Wilkie DJ. Evidence for the existing

American Nurses Association-recognized standardized nursing terminologies: a systematic review. Int J Nurs Stud. 2014

Aug;51(8):1160-70.

Liaw ST, Taggart J, Yu H, Lusignan SD, Kuziemsky C, Hayen A. Integrating electronic health record information to support

integrated care: Practical application of ontologies to improve the accuracy of diabetes disease registers. J Biomed

Inform. 2014 Aug 1. [E]

Kiah ML, Haiqi A, Zaidan BB, Zaidan AA. Open source EMR software: Profiling, insights and hands-on analysis. Comput Methods

Programs Biomed. 2014 Jul 17. [E]

Forrest CB, Margolis PA, Bailey LC, Marsolo K, Del Beccaro MA, Finkelstein JA, Milov DE, Vieland VJ, Wolf BA, Yu FB, Kahn

MG. PEDSnet: a National Pediatric Learning Health System. J Am Med Inform Assoc. 2014 Jul-Aug;21(4):602-6.

Yao Q, Han X, Ma XK, Xue YF, Chen YJ, Li JS. Cloud-based hospital information system as a service for grassroots

healthcare institutions. J Med Syst. 2014 Sep;38(9):104.

Jing X, Kay S, Marley T, Hardiker NR. Integration of an OWL-DL Knowledge Base with an EHR Prototype and Providing

Customized Information. J Med Syst. 2014 Sep;38(9):75.

Gazzarata R, Vergari F, Salmon Cinotti T, Giacomini M. A standardized SOA for clinical data interchange in a cardiac

telemonitoring environment. IEEE J Biomed Health Inform. 2014 Jul 1. [E]

Abbas A, Khan SU. A Review on the State-of-the-Art Privacy-Preserving Approaches in the e-Health Clouds. IEEE J Biomed

Health Inform. 2014 Jul;18(4):1431-41.

D’Amore JD, Mandel JC, Kreda DA, Swain A, Koromia GA, Sundareswaran S, Alschuler L, Dolin RH, Mandl KD, Kohane IS,

Ramoni RB. Are Meaningful Use Stage 2 certified EHRs ready for interoperability? Findings from the SMART C-CDA

Collaborative. J Am Med Inform Assoc. 2014 Jun 26. pii: amiajnl-2014-002883. [E].

G?eg KR, Chen R, H?jen AR, Elberg P. Content analysis of physical examination templates in electronic health records using

SNOMED CT. Int J Med Inform. 2014 Jun 17. [E]

Rasmussen LV, Thompson WK, Pacheco JA, Kho AN, Carrell DS, Pathak J, Peissig PL, Tromp G, Denny JC, Starren JB. Design

Patterns for the Development of Electronic Health Record-Driven Phenotype Extraction Algorithms. J Biomed Inform. 2014 Jun

21. [E]

Kush R, Goldman M. Fostering responsible data sharing through standards. N Engl J Med. 2014 Jun 5;370(23):2163-5.

Berges I, Bermudez J, Illarramendi A. Binding SNOMED CT Terms to Archetype Elements. Establishing a Baseline of Results.

Methods Inf Med. 2014 Jun 3;53(4). [E]

de Hoog CL, Portegijs PJ, Stoffers HE. Family history tools for primary care are not ready yet to be implemented. A

systematic review. Eur J Gen Pract. 2014 Jun;20(2):125-33.

Wongsapai M, Suebnukarn S, Rajchagool S, Beach D, Kawaguchi S. Health-oriented electronic oral health record: development

and evaluation. Health Informatics J. 2014 Jun;20(2):104-17.

Raebel MA, Haynes K, Woodworth TS, Saylor G, Cavagnaro E, Coughlin KO, Curtis LH, Weiner MG, Archdeacon P, Brown JS.

Electronic clinical laboratory test results data tables: lessons from Mini-Sentinel. Pharmacoepidemiol Drug Saf. 2014

Jun;23(6):609-18.

Laing GL, Bruce JL, Skinner DL, Allorto NL, Clarke DL, Aldous C. Development, implementation, and evaluation of a hybrid

electronic medical record system specifically designed for a developing world surgical service. World J Surg. 2014 Jun;38

(6):1388-97.

Sinsky CA, Beasley JW, Simmons GE, Baron RJ. Electronic health records: design, implementation, and policy for higher-value

primary care. Ann Intern Med. 2014 May 20;160(10):727-8.

Matui P, Wyatt JC, Pinnock H, Sheikh A, McLean S. Computer decision support systems for asthma: a systematic review. NPJ

Prim Care Respir Med. 2014 May 20;24:14005.

Asan O, D Smith P, Montague E. More screen time, less face time – implications for EHR design. J Eval Clin Pract. 2014 May

19. [E]

Trigo JD, Kohl CD, Eguzkiza A, Martinez-Espronceda M, Alesanco A, Serrano L, Garcia J, Knaup P. On the Seamless, Harmonized

Use of ISO/IEEE11073 and OpenEHR. IEEE J Biomed Health Inform. 2014 May;18(3):872-84.

Morrison Z, Fernando B, Kalra D, Cresswell K, Sheikh A. National evaluation of the benefits and risks of greater

structuring and coding of the electronic health record: exploratory qualitative investigation. J Am Med Inform Assoc. 2014

May-Jun;21(3):492-500.

Goossen W, Langford LH. Exchanging care records using HL7 V3 care provision messages. J Am Med Inform Assoc. 2014 Apr 19.

[E]

V. Curcin, S. Miles, R. Danger, Y. Chen, R. Bache, and A. Taweel. 2014. Implementing interoperable provenance in biomedical

research. Future Gener. Comput. Syst. 34 (May 2014), 1-16.

Fernando B, Morrison Z, Kalra D, Cresswell K, Sheikh A. Approaches to recording drug allergies in electronic health

records: qualitative study. PLoS One. 2014 Apr 16;9(4)

Kerstin A. Kessel, Christian Bohn, Uwe Engelmann, Dieter Oetzel, Nina Bougatf, Rolf Bendl, Jürgen Debus, and Stephanie E.

Combs. 2014. Five-year experience with setup and implementation of an integrated database system for clinical documentation

and research.Comput. Methods Prog. Biomed. 114, 2 (April 2014)

Poba-Nzaou, Placide; Marsan, Josianne; Pare, Guy; Raymond, Louis, “Governance of Open Source Electronic Health Record

Projects: A Successful Case of a Hybrid Model,” _System Sciences (HICSS), 2014 47th Hawaii International Conference

on_ , vol., no., pp.2798,2807, 6-9 Jan. 2014

Steininger, Katharina; Stiglbauer, Barbara; Baumgartner, Bernd; Engleder, Bernhard, “Factors Explaining

Physicians’ Acceptance of Electronic Health Records,” System Sciences (HICSS), 2014 47th Hawaii International

Conference on , vol., no., pp.2768,2777, 6-9 Jan. 2014

Gan, Qiwei; Cao, Qing, “Adoption of Electronic Health Record System: Multiple Theoretical Perspectives,”

System Sciences (HICSS), 2014 47th Hawaii International Conference on , vol., no., pp.2716,2724, 6-9 Jan. 2014

Noteboom, Cherie; Dempsey, Kathryn; Fruhling, Ann, “Recognizing Patient Safety Importance through Instrument

Validation on Physicians’ Assessment of an EHR,” _System Sciences (HICSS), 2014 47th Hawaii International

Conference on_ , vol., no., pp.2828,2837, 6-9 Jan. 2014

Grabenbauer, Lisa A.; Fruhling, Ann L.; Windle, John R., “Towards a Cardiology/EHR Interaction Workflow Usability

Evaluation Method,” System Sciences (HICSS), 2014 47th Hawaii International Conference on , vol., no.,

pp.2626,2635, 6-9 Jan. 2014

Mansoori B, Rosipko B, Erhard KK, Sunshine JL. Design and Implementation of Disaster Recovery and Business Continuity

Solution for Radiology PACS. J Digit Imaging. 2014 Feb;27(1):19-25.

Thyvalikakath TP, Dziabiak MP, Johnson R, Torres-Urquidy MH, Acharya A, Yabes J, Schleyer TK. Advancing cognitive

engineering methods to support user interface design for electronic health records. Int J Med Inform. 2014 Jan 20. [E]

M. Poulymenopoulou, F. Malamateniou, and G. Vassilacopoulos. 2014. E-EPR: a workflow-based electronic emergency patient

record. Personal Ubiquitous Comput. 18, 1 (January 2014), 91-100.

Doods J, Botteri F, Dugas M, Fritz F; EHR4CR WP7. A European inventory of common electronic health record data elements for

clinical trial feasibility.Trials. 2014 Jan 10;15:18.

Kathleen H. Pine and Melissa Mazmanian. 2014. Institutional logics of the EMR and the problem of ‘perfect’ but

inaccurate accounts. In Proceedings of the 17th ACM conference on Computer supported cooperative work & social

computing (CSCW ’14). ACM, New York, NY, USA, 283-294

Krist AH, Beasley JW, Crosson JC, Kibbe DC, Klinkman MS, Lehmann CU, Fox CH, Mitchell JM, Mold JW, Pace WD, Peterson KA,

Phillips RL, Post R, Puro J, Raddock M, Simkus R, Waldren SE. Electronic health record functionality needed to better

support primary care. J Am Med Inform Assoc. 2014 Jan 15. [E]

Zargaran E, Schuurman N, Nicol AJ, Matzopoulos R, Cinnamon J, Taulu T, Ricker B, Garbutt Brown DR, Navsaria P, Hameed SM.

The electronic trauma health record: design and usability of a novel tablet-based tool for trauma care and injury

surveillance in low resource settings. J Am Coll Surg. 2014 Jan;218(1):41-50.

**2013

**Klann JG, Szolovits P, Downs SM, Schadow G. Decision support from local data: Creating adaptive order menus from

past clinician behavior. J Biomed Inform. 2013 Dec 16. [E]

Duke JD, Morea J, Mamlin B, Martin DK, Simonaitis L, Takesue BY, Dixon BE, Dexter PR. Regenstrief Institute’s Medical

Gopher: A next-generation homegrown electronic medical record system. Int J Med Inform. 2013 Dec 14 [E]

Austin T, Sun S, Hassan T, Kalra D. Evaluation of ISO EN 13606 as a result of its implementation in XML. Health

Informatics J. 2013 Dec;19(4):264-80.

Duftschmid G, Rinner C, Kohler M, Huebner-Bloder G, Saboor S, Ammenwerth E. The EHR-ARCHE project: Satisfying clinical

information needs in a Shared Electronic Health Record System based on IHE XDS and Archetypes. Int J Med Inform. 2013

Dec;82(12):1195-207.

Acharya A, Hernandez P, Thyvalikakath T, Ye H, Song M, Schleyer T. Development and initial validation of a content taxonomy

for patient records in general dentistry. Int J Med Inform. 2013 Dec;82(12):1171-82.

Bache R, Miles S, Taweel A. An adaptable architecture for patient cohort identification from diverse data sources. J Am Med

Inform Assoc. 2013 Dec;20(e2):e327-33.

Yilmaz O, Erdur RC, Türksever M. SAMS – A Systems Architecture for Developing Intelligent Health Information

Systems. J Med Syst. 2013 Dec;37(6):9989.

Xin Zhang; Tingting Zhang, “Achieving scalability in a distributed electronic health record system,” Science

and Information Conference (SAI), 2013 , vol., no., pp.68,77, 7-9 Oct. 2013

Deblieck C, Laflamme AF, Rivard MJ, Monsen KA. Standardizing Documentation for Postoperative Nausea and Vomiting in the

Electronic Health Record. AORN J. 2013 Oct;98(4):370-80.

Kho AN, Rasmussen LV, Connolly JJ, Peissig PL, Starren J, Hakonarson H, Hayes MG. Practical challenges in integrating

genomic data into the electronic health record. Genet Med. 2013 Oct;15(10):772-8.

Tarczy-Hornoch P, Amendola L, Aronson SJ, Garraway L, Gray S, Grundmeier RW, Hindorff LA, Jarvik G, Karavite D, Lebo M,

Plon SE, Van Allen E, Weck KE, White PS, Yang Y. A survey of informatics approaches to whole-exome and whole-genome

clinical reporting in the electronic health record. Genet Med. 2013 Oct;15(10):824-32.

Peterson JF, Bowton E, Field JR, Beller M, Mitchell J, Schildcrout J, Gregg W, Johnson K, Jirjis JN, Roden DM, Pulley JM,

Denny JC. Electronic health record design and implementation for pharmacogenomics: a local perspective. Genet Med. 2013

Oct;15(10):833-41.

Rothman MJ, Rothman SI, Beals J 4th. Development and validation of a continuous measure of patient condition using the

Electronic Medical Record. J Biomed Inform. 2013 Oct;46(5):837-48.

Sinaci AA, Laleci Erturkmen GB. A federated semantic metadata registry framework for enabling interoperability across

clinical research and care domains. J Biomed Inform. 2013 Oct;46(5):784-94.

Baskaran LN, Greco PJ, Kaelber DC. Case report medical eponyms: an applied clinical informatics opportunity. Appl Clin

Inform. 2012 Sep 19;3(3):349-55.

Katzer R, Barton DJ, Adelman S, Clark S, Seaman EL, Hudson KB. Impact of implementing an EMR on physical exam documentation

by ambulance personnel. Appl Clin Inform. 2012 Jul 25;3(3):301-8.

Bahga, A.; Madisetti, V.K., “A Cloud-based Approach for Interoperable Electronic Health Records (EHRs), Biomedical

and Health Informatics, IEEE Journal of , vol.17, no.5, pp.894,906, Sept. 2013.

Makam AN, Lanham HJ, Batchelor K, Moran B, Howell-Stampley T, Kirk L, Cherukuri M, Samal L, Santini N, Leykum LK, Halm EA.

The good, the bad and the early adopters: providers’ attitudes about a common, commercial EHR. J Eval Clin Pract.

2013 Aug 20. [E]

Fernández-Breis JT, Maldonado JA, Marcos M, Legaz-García MD, Moner D, Torres-Sospedra J, Esteban-Gil A, Martínez-Salvador

B, Robles M. Leveraging electronic healthcare record standards and semantic web technologies for the identification of

patient cohorts. J Am Med Inform Assoc. 2013 Aug 9. [E]

Brown JS, Kahn M, Toh S. Data quality assessment for comparative effectiveness research in distributed data networks. Med

Care. 2013 Aug;51(8 Suppl 3):S22-9.

Kuqi K, Eveleigh T, Holzer T, Sarkani S, Levin JE, Crowley RS. Design of electronic medical record user interfaces: a

matrix-based method for improving usability. J Healthc Eng. 2013;4(3):427-52.

Kushniruk A, Nohr C, Jensen S, Borycki EM. From Usability Testing to Clinical Simulations: Bringing Context into the Design

and Evaluation of Usable and Safe Health Information Technologies. Contribution of the IMIA Human Factors Engineering for

Healthcare Informatics Working Group. Yearb Med Inform.2013;8(1):78-85.

Majeed RW, St?hr MR, R?hrig R. Architecture of a Prehospital Emergency Patient Care Report System (PEPRS). Stud Health

Technol Inform. 2013;192:1151.

Del Fiol G, Curtis C, Cimino JJ, Iskander A, Kalluri AS, Jing X, Hulse NC, Long J, Overby CL, Schardt C, Douglas DM.

Disseminating Context-Specific Access to Online Knowledge Resources within Electronic Health Record Systems. Stud Health

Technol Inform. 2013;192:672-6.

Janzek-Hawlat S, Ammenwerth E, Dorda W, Duftschmid G, Hackl W, H?rbst A, Jung M, Woertz K, Gall W. The Austrian e-

Medikation Pilot Evaluation: Lessons Learned from a National Medication List. Stud Health Technol Inform. 2013;192:347-51.

Mansoori B, Rosipko B, Erhard KK, Sunshine JL. Design and Implementation of Disaster Recovery and Business Continuity

Solution for Radiology PACS. J Digit Imaging. 2013 Aug 6. [E]

Park JY, Lee G, Shin SY, Kim JH, Han HW, Kwon TW, Kim WS, Lee JH. Lessons Learned from the Development of Health

Applications in a Tertiary Hospital. Telemed J E Health. 2013 Aug 2. [E]

Alabdulatif, A.; Khalil, I.; Mai, V., “Protection of electronic health records (EHRs) in cloud,” Engineering in

Medicine and Biology Society (EMBC), 2013 35th Annual International Conference of the IEEE , vol., no., pp.4191,4194, 3-7

July 2013.

Vreeman DJ, Richoz C. Possibilities and Implications of Using the ICF and Other Vocabulary Standards in Electronic Health

Records. Physiother Res Int. 2013 Jul 30. [E]

Aljarullah A, El-Masri S. A novel system architecture for the national integration of electronic health records: a semi-

centralized approach. J Med Syst. 2013 Aug;37(4):9953.

Sahoo SS, Zhang GQ, Lhatoo SD. Epilepsy informatics and an ontology-driven infrastructure for large database research and

patient care in epilepsy. Epilepsia. 2013 Aug;54(8):1335-41.

Morton P, Petersen C, Chard R, Kleiner C. Validation of the Data Elements for the Health System Domain of the PNDS. AORN J.

2013 Jul;98(1):39-48.

Bacelar-Silva, G.M.; Cesar, H.; Braga, P.; Guimaraes, R., “OpenEHR-based pervasive health information system for

primary care: First Brazilian experience for public care,” Computer-Based Medical Systems (CBMS), 2013 IEEE 26th

International Symposium on , vol., no., pp.572,873, 20-22 June 2013.

Santos, B.; Rodrigues, P.; Cruz-Correia, R., “An automatic clinical document importance estimator for an existing

electronic patient record — Architecture and implementation,” Computer-Based Medical Systems (CBMS), 2013 IEEE 26th

International Symposium on , vol., no., pp.537,539, 20-22 June 2013.

Shoenbill K, Fost N, Tachinardi U, Mendonca EA. Genetic data and electronic health records: a discussion of ethical,

logistical and technological considerations. J Am Med Inform Assoc. 2013 Jun 14. [E]

Post AR, Kurc T, Cholleti S, Gao J, Lin X, Bornstein W, Cantrell D, Levine D, Hohmann S, Saltz JH. The Analytic

Information Warehouse (AIW): A platform for analytics using electronic health record data. J Biomed Inform. 2013 Jun;46

(3):410-24.

Byrne MD. Redesign of electronic health records for perianesthesia nursing. J Perianesth Nurs. 2013 Jun;28(3):163-8.

Gupta A, Sharda R. 2013. Improving the science of healthcare delivery and informatics using modeling approaches. _Decis.

Support Syst._ 55, 2 (May 2013), 423-427.

Klann JG, McCoy AB, Wright A, Wattanasin N, Sittig DF, Murphy SN. Health care transformation through collaboration on

open-source informatics projects: integrating a medical applications platform, research data repository, and patient

summarization. Interact J Med Res. 2013 May 30;2(1):e11.

Sundvall E, Nystr?m M, Karlsson D, Eneling M, Chen R, Orman H. Applying representational state transfer (REST) architecture

to archetype-based electronic health record systems. BMC Med Inform Decis Mak. 2013 May 9;13(1):57. [E]

Anderson HV, Weintraub WS, Radford MJ, Kremers MS, Roe MT, Shaw RE, Pinchotti DM, Tcheng JE. Standardized cardiovascular

data for clinical research, registries, and patient care: a report from the data standards workgroup of the national

cardiovascular research infrastructure project. J Am Coll Cardiol. 2013 May 7;61(18):1835-46.

Yoo S, Kim S, Lee S, Lee KH, Baek RM, Hwang H. A study of user requests regarding the fully electronic health record system

at Seoul National University Bundang Hospital: Challenges for future electronic health record systems. Int J Med Inform.

2013 May;82(5):387-97.

Yunan Chen, “Towards collaborative-oriented health IT systems design,” Collaboration Technologies and Systems

(CTS), 2013 International Conference on , vol., no., pp.479,480, 20-24 May 2013.

Brasil, L.; Oliveria, E.; Elpi?dio, F.; Neto, A.; Tahmasebi, R.; Mendon?a, H.; Puttini, R., “Information architecture

and services of the Electronic Health Record (EHR) definition of Brazil – GT information architecture,” Health

Care Exchanges (PAHCE), 2013 Pan American , vol., no., pp.1,1, April 29 2013-May 4 2013.

Bahga, A.; Madisetti, V.K.. A Cloud-Based Approach to Interoperable EHRs. Biomedical and Health Informatics, IEEE Journal

of , vol 17 no.99. April 2013

Menárguez-Tortosa M, Fernández-Breis JT.OWL-based reasoning methods for validating archetypes.J Biomed Inform. 2013 Apr;46

(2):304-17.

Lee KK, Tang WC, Choi KS. Alternatives to relational database: comparison of NoSQL and XML approaches for clinical data

storage.Comput Methods Programs Biomed. 2013 Apr;110(1):99-109.

Ngouongo SM, L?be M, Stausberg J.The ISO/IEC 11179 norm for metadata registries: Does it cover healthcare standards in

empirical research?J Biomed Inform. 2013 Apr;46(2):318-27.

K?pcke F, Trinczek B, Majeed RW, Schreiweis B, Wenk J, Leusch T, Ganslandt T, Ohmann C, Bergh B, R?hrig R, Dugas M,

Prokosch HU.Evaluation of data completeness in the electronic health record for the purpose of patient recruitment into

clinical trials: a retrospective analysis of element presence.BMC Med Inform Decis Mak. 2013 Mar 21;13:37.

Atkins D, Cullen T. The future of health information technology: implications for research. Med Care. 2013 Mar;51 Suppl:S1

-3.

Calvillo J, Rom I, Rivas S, and Roa LM. 2013. Easing the development of healthcare architectures following RM-ODP

principles and healthcare standards. Comput. Stand. Interfaces 35, 3 (March 2013), 329-337.

Laleci, G.B.; Yuksel, M.; Dogac, A., “Providing Semantic Interoperability Between Clinical Care and Clinical Research

Domains,” Biomedical and Health Informatics, IEEE Journal of , vol.17, no.2, pp.356,369, March 2013

Li-Min Liu. 2013. A new software development methodology for clinical trial systems. Adv. Soft. Eng. 2013, (January

2013).

2012

de la Torre-Díez I, López-Coronado M, Rodrigues JJ. How to measure the QoS of a web-based EHRs system: development of an

instrument. J Med Syst. 2012 Dec;36(6):3725-31.

Sun S, Austin T, Kalra D. A data types profile suitable for use with ISO EN 13606. J Med Syst. 2012 Dec;36(6):3621-35.

Anoshiravani A, Gaskin GL, Groshek MR, Kuelbs C, Longhurst CA. Special requirements for electronic medical records in

adolescent medicine. J Adolesc Health. 2012 Nov;51(5):409-14.

Antoniades, A.; Georgousopoulos, C.; Forgo, N.; Aristodimou, A.; Tozzi, F.; Hasapis, P.; Perakis, K.; Bouras, T.;

Alexandrou, D.; Kamateri, E.; Panopoulou, E.; Tarabanis, K.; Pattichis, C., “Linked2Safety: A secure linked data

medical information space for semantically-interconnecting EHRs advancing patients’ safety in medical

research,” Bioinformatics & Bioengineering (BIBE), 2012 IEEE 12th International Conference on , vol., no.,

pp.517,522, 11-13 Nov. 2012

Yu, W.D.; Panova, A., “An architectural design framework for an Electronic Health Record system with hospice

application,” e-Health Networking, Applications and Services (Healthcom), 2012 IEEE 14th International Conference on

, vol., no., pp.367,370, 10-13 Oct. 2012

Menárguez-Tortosa M, Martínez-Costa C, Fernández-Breis JT. A generative tool for building health applications driven by ISO

13606 archetypes. J Med Syst. 2012 Oct;36(5):3063-75.

Cui Tao; Guoqian Jiang; Oniki, T.A.; Freimuth, R.R.; Pathak, J.; Qian Zhu; Sharma, D.; Huff, S.M.; Chute, C.G., “A

Semantic-Web Oriented Representation of Clinical Element Model for Secondary Use of Electronic Healthcare Data,”

Healthcare Informatics, Imaging and Systems Biology (HISB), 2012 IEEE Second International Conference on , vol., no.,

pp.133,133, 27-28 Sept. 2012

Jie Huang; Sharaf, M.; Chin-Tser Huang, “A Hierarchical Framework for Secure and Scalable EHR Sharing and Access

Control in Multi-cloud,” Parallel Processing Workshops (ICPPW), 2012 41st International Conference on , vol., no.,

pp.279,287, 10-13 Sept. 2012

Srur, B.L.; Drew, S., “Challenges in designing a successful e-health system for Australia,” Information

Technology in Medicine and Education (ITME), 2012 International Symposium on , vol.1, no., p.480,484, 3-5 Aug. 2012

Yu HY, Li JS, Zhang XG, Tian Y, Suzuki M, Araki K. Performance assessment of EMR systems based on post-relational database.

J Med Syst. 2012 Aug;36(4):2421-30.

Seto B, Friedman C. Moving toward multimedia electronic health records: how do we get there? J Am Med Inform Assoc. 2012

Jul-Aug;19(4):503-5.

Zhiwei Yu; Thomborson, C.; Chaokun Wang; Jianmin Wang; Rui Li, “A cloud-based watermarking method for health data

security,” High Performance Computing and Simulation (HPCS), 2012 International Conference on , vol., no.,

pp.642,647, 2-6 July 2012

Rodriguez-Martinez, M.; Valdivia, H.; Rivera, J.; Seguel, J.; Greer, M., “MedBook: A Cloud-Based Healthcare Billing

and Record Management System,” Cloud Computing (CLOUD), 2012 IEEE 5th International Conference on , vol., no.,

pp.899,905, 24-29 June

Ati, M.; Omar, W.; Hussain, A., “Knowledge based system framework for managing chronic diseases based on service

oriented architecture,” Information Science and Digital Content Technology (ICIDT), 2012 8th International Conference

on , vol.1, no., pp.20,23, 26-28 June 2012

Jing X, Kay S, Marley T, Hardiker NR, Cimino JJ. Incorporating personalized gene sequence variants, molecular genetics

knowledge, and health knowledge into an EHR prototype based on the Continuity of Care Record standard. J Biomed Inform.

2012 Feb;45(1):82-92.

Chen W, Shih CC. Architecture of portable electronic medical records system integrated with streaming media. J Med Syst.

2012 Feb;36(1):25-31.

Park HA, Min YH, Jeon E, Kim Y, Km HY. Development of an electronic nursing records system based on information models and

clinical practice guidelines. Stud Health Technol Inform. 2012;180:1206-8.

Al Jarullah A, El-Masri S. Proposal of an architecture for the national integration of Electronic Health Records: a semi-

centralized approach. Stud Health Technol Inform. 2012;180:917-21.

Stausberg J, Pritzkuleit R, Schmidt CO, Schrader T, Nonnemacher M. Indicators of data quality: revision of a guideline for

networked medical research. Stud Health Technol Inform. 2012;180:711-5.

Veseli H, Kopanitsa G, Demski H. Standardized EHR interoperability -preliminary results of a German pilot project using the

archetype methodology. Stud Health Technol Inform. 2012;180:646-50.

Ouagne D, Hussain S, Sadou E, Jaulent MC, Daniel C. The Electronic Healthcare Record for Clinical Research (EHR4CR)

information model and terminology. Stud Health Technol Inform. 2012;180:534-8. Ahlbrandt J, Henrich M, Hartmann BA,

Bundschuh BB, Schwarz J, Klasen J, R?hrig R. Small cause – big effect: improvement in interface design results in

improved data quality – a multicenter crossover study. Stud Health Technol Inform. 2012;180:393-7.

Kalra D, Tapuria A, Austin T, De Moor G. Quality requirements for EHR archetypes. Stud Health Technol Inform. 2012;180:48-

Mouleeswaran, S. K.; Rangaswamy, A.; Rauf, H.A., “Harnessing and securing cloud in patient health monitoring,”

Computer Communication and Informatics (ICCCI), 2012 International Conference on , vol., no., pp.1,5, 10-12 Jan. 2012

2011

Wade TD, Hum RC, Murphy JR. A Dimensional Bus model for integrating clinical and research data. J Am Med Inform Assoc.

2011 Dec;18 Suppl 1:i96-102.

Batley NJ, Osman HO, Kazzi AA, Musallam KM. Implementation of an emergency department computer system: design features that

users value. J Emerg Med. 2011 Dec;41(6):693-700.

Abd Ghani, M.K.; Lee Chew Wen, “The design of flexible Pervasive Electronic Health Record PEHR),” Humanities,

Science and Engineering (CHUSER), 2011 IEEE Colloquium on , vol., no., pp.249,254, 5-6 Dec. 2011

Yang Jin; Tang Deyu; Zhou Yi, “A Distributed Storage Model for EHR Based on HBase,” Information Management,

Innovation Management and Industrial Engineering (ICIII), 2011 International Conference on , vol.2, no., pp.369,372, 26-27

Nov. 2011

Saleem JJ, Haggstrom DA, Militello LG, Flanagan M, Kiess CL, Arbuckle N, Doebbeling BN. Redesign of a computerized clinical

reminder for colorectal cancer screening: a human-computer interaction evaluation. BMC Med Inform Decis Mak. 2011 Nov

29;11:74.

Weiwei Jiang; Haishun Wang; Xiaomei Xu; Chun Peng, “Individual Self-Service Electronic Health Records: Architecture,

Key Technologies and Prototype System,” Cyber-Enabled Distributed Computing and Knowledge Discovery (CyberC), 2011

International Conference on , vol., no., pp.574,579, 10-12 Oct. 2011.

Dias RD, Cook TW, Freire SM. Modeling healthcare authorization and claim submissions using the openEHR dual-model approach.

BMC Med Inform Decis Mak. 2011 Oct 12;11:60.

Acker B, Bronnert J, Brown T, Clark JS, Dunagan B, Elmer T, Goodell S, Green K, Heller P, Holmes C, Imel M, Johnson K,

Kallem C, Loucks M, Patel S, Reed DA, Scichilone R, Tegen AL. Problem list guidance in the EHR. J AHIMA. 2011 Sep;82(9):52

-8.

Ray, S.; Dogra, D.; Bhattacharya, S.; Saha, B.; Biswas, A.; Majumdar, A.; Mukherjee, J.; Majumdar, B.; Singh, A.; Paria,

A.; Mukherjee, S.; Bhattacharya, S.D., “A Web Enabled Health Information System for the Neonatal Intensive Care Unit

(NICU),” Services (SERVICES), 2011 IEEE World Congress on , vol., no., pp.451,458, 4-9 July 2011

de Smet, K., “The Dutch Nationwide Electronic Health Record: Why the Centralised Services Architecture?,”

Software Architecture (WICSA), 2011 9th Working IEEE/IFIP Conference on , vol., no., pp.181,186, 20-24 June 2011

Xu W, Guan Z, Cao H, Zhang H, Lu M, Li T. Analysis and evaluation of the Electronic Health Record standard in China: a

comparison with the American national standard ASTM E 1384. Int J Med Inform. 2011 Aug;80(8):555-61.

Yang TH, Sun YS, Lai F. A scalable healthcare information system based on a service-oriented architecture. J Med Syst. 2011

Jun;35(3):391-407.

Soares dos Santos, E.; Martins, H.G., “Usability and impact of Electronic Health Records for Primary Care Units in

Portugal,” Information Systems and Technologies (CISTI), 2011 6th Iberian Conference on , vol., no., pp.1,3, 15-18

June 2011

Chiasera, A.; Toai, T.J.; Bogoni, L.P.; Armellin, G.; Jara, J.J., “Federated EHR: How to improve data quality

maintaining privacy,” IST-Africa Conference Proceedings, 2011 , vol., no., pp.1,8, 11-13 May 2011

Huser V, Rasmussen LV, Oberg R, Starren JB. Implementation of workflow engine technology to deliver basic clinical decision

support functionality. BMC Med Res Methodol. 2011 Apr 10;11:43.

Brzeziski, J.; Czajka, S.; Kobusi?ski, J.; Piernik, M., “Healthcare Integration Platform,” Medical Information

& Communication Technology (ISMICT), 2011 5th International Symposium on , vol., no., pp.52,55, 27-30 March 2011

Cheong YC, Bird L, Tun NN, Brooks C. Using a logical information model-driven design process in healthcare. Stud Health

Technol Inform. 2011;169:804-8.

de la Cruz E, Lopez DM, Uribe G, Gonzalez C, Blobel B. A reference architecture for integrated EHR in Colombia. Stud Health

Technol Inform. 2011;169:305-9.

Chevrier R, Jaques D, Lovis C. Architecture of a decision support system to improve clinicians’ interpretation of

abnormal liver function tests. Stud Health Technol Inform. 2011;169:195-9.

Eccher C, Piras EM, Stenico M. TreC – a REST-based regional PHR. Stud Health Technol Inform. 2011;169:108-12.

Tuomainen M, Mykk?nen J. Reference architecture of application services for personal wellbeing information management. Stud

Health Technol Inform. 2011;169:98-102.

Rinner C, Kohler M, Hübner-Bloder G, Saboor S, Ammenwerth E, Duftschmid G. Creating ISO/EN 13606 archetypes based on

clinical information needs. Stud Health Technol Inform. 2011;165:43-8.

Sullivan-Taylor P, Flanagan T, Harrison T, Webster G. Development of a draft pan-Canadian primary health care electronic

medical record content standard. Stud Health Technol Inform. 2011;164:385-91.

2010

Pavalam, S. M.; Jawahar, M.; Akorli, F.K., “Data warehouse based Architecture for Electronic Health Records for

Rwanda,” Education and Management Technology (ICEMT), 2010 International Conference on , vol., no., pp.253,255, 2-4

Nov. 2010

Liang Xiao; ChunZhi Wang; YiXiang Chen; Cousins, G.; Hederman, L.; Fahey, T.; Dimitrov, B., “Developing an EHR for

methadone treatment recording and decision support,” Computer Application and System Modeling (ICCASM), 2010

International Conference on , vol.14, no., pp.V14-189,V14-193, 22-24 Oct. 2010

Liang Xiao; Cousins, G.; Hederman, L.; Fahey, T.; Dimitrov, B., “The design of an EHR for clinical decision

support,” Biomedical Engineering and Informatics (BMEI), 2010 3rd International Conference on , vol.6, no.,

pp.2525,2531, 16-18 Oct. 2010

Jiye An; Zhe Wu; Hushan Chen; Xudong Lu; Huilong Duan, “Level of detail navigation and visualization of electronic

health records,” Biomedical Engineering and Informatics (BMEI), 2010 3rd International Conference on , vol.6, no.,

pp.2516,2519, 16-18 Oct. 2010

Percival, J.; McGregor, C.; Percival, N.; Kamaleswaran, R.; Tuuha, S., “A framework for nursing documentation

enabling integration with EHR and real-time patient monitoring,” Computer-Based Medical Systems (CBMS), 2010 IEEE

23rd International Symposium on , vol., no., pp.468,473, 12-15 Oct. 2010

Malaviya AN, Gogia SB. Development, implementation and benefits of a rheumatology-specific electronic medical record

application with automated display of outcome measures. Int J Rheum Dis. 2010 Oct;13(4):347-60.

Flores Zuniga AE, Win KT, Susilo W. Functionalities of free and open electronic health record systems. Int J Technol Assess

Health Care. 2010 Oct;26(4):382-9.

Bach A, Singer MB, Bach M. The perfect electronic medical record system. J Am Osteopath Assoc. 2010 Oct;110(10):614-5.

Bates GW. Special requirements of electronic medical record systems in obstetrics and gynecology. Obstet Gynecol. 2010

Oct;116(4):994.

Sutcliffe A, Thew S, De Bruijn O, Buchan I, Jarvis P, McNaught J, Procter R. User engagement by user-centred design in e-

Health. Philos Transact A Math Phys Eng Sci. 2010 Sep 13;368(1926):4209-24.

Tychalas, D.; Kakarountas, A., “Planning and Development of an Electronic Health Record Client Based on the Android

Platform,” Informatics (PCI), 2010 14th Panhellenic Conference on , vol., no., pp.3,6, 10-12 Sept. 2010

Cho I, Kim J, Kim JH, Kim HY, Kim Y. Design and implementation of a standards-based interoperable clinical decision support

architecture in the context of the Korean EHR. Int J Med Inform. 2010 Sep;79(9):611-22.

Duftschmid G, Wrba T, Rinner C. Extraction of standardized archetyped data from Electronic Health Record systems based on

the Entity-Attribute-Value Model. Int J Med Inform. 2010 Aug;79(8):585-97.

McCoy MJ, Diamond AM, Strunk AL; American Congress of Obstetricians and Gynecologists’ Committee on Ambulatory

Practice Operations. Special requirements of electronic medical record systems in obstetrics and gynecology. Obstet

Gynecol. 2010 Jul;116(1):140-3.

Frank, L.; Andersen, S.K., “Evaluation of different database designs for integration of heterogeneous distributed

Electronic Health Records,” Complex Medical Engineering (CME), 2010 IEEE/ICME International Conference on , vol.,

no., pp.204,209, 13-15 July

Ken Qing Yang, “Secure and efficient data replay in distributed eHealthcare information system,” Information

Society (i-Society), 2010 International Conference on , vol., no., pp.634,639, 28-30 June 2010

Jinyuan Sun; Yuguang Fang, “Cross-Domain Data Sharing in Distributed Electronic Health Record Systems,”

Parallel and Distributed Systems, IEEE Transactions on , vol.21, no.6, pp.754,764, June 2010

Riedl, B.; Grascher, V., “Assuring integrity and confidentiality for pseudonymized health data,” Electrical

Engineering/Electronics Computer Telecommunications and Information Technology (ECTI-CON), 2010 International Conference on

, vol., no., pp.473,477, 19-21 May 2010

Niès J, Pelayo S. From users involvement to users’ needs understanding: a case study. Int J Med Inform. 2010 Apr;79

(4):e76-82.

Arzt NH. Service-oriented architecture in public health. J Healthc Inf Manag. 2010 Spring;24(2):45-52. Ryan A, Eklund P.

The Health Service Bus: an architecture and case study in achieving interoperability in healthcare. Stud Health Technol

Inform. 2010;160(Pt2):922-6.

Lober WB, Revere D, Hills R. A Lab-EMR interoperability profile as an eHealth architecture component for resource-

constrained settings. Stud Health Technol Inform. 2010;160(Pt 1):257-61.

Walderhaug S, Hartvigsen G, Stav E. Model-driven traceability in healthcare information systems development. Stud Health

Technol Inform. 2010;160(Pt 1):242-6.

Santos MR, Bax MP, Kalra D. Building a logical EHR architecture based on ISO 13606 standard and semantic web technologies.

Stud Health Technol Inform. 2010;160(Pt 1):161-5.

Rosenbeck KH, Randorff Rasmussen A, Elberg PB, Andersen SK. Balancing centralised and decentralised EHR approaches to

manage standardisation. Stud Health Technol Inform. 2010;160(Pt 1):151-5. Webster C, Copenhaver M. Process-aware EHR BPM

systems: two prototypes and a conceptual framework. Stud Health Technol Inform. 2010;160(Pt 1):106-10.

Bansler JP, Havn EC, M?nsted T. Designing shared electronic records for chronic care. Stud Health Technol Inform.

2010;157:53-8.

Botin L. How to dwell in an EHR. The question concerning architecture EHR. Stud Health Technol Inform. 2010;157:38-43.

Koppel R, Kreda DA. Healthcare IT usability and suitability for clinical needs: challenges of design, workflow, and

contractual relations. Stud Health Technol Inform. 2010;157:7-14.

Katt B, Trojer T, Breu R, Schabetsberger T, Wozak F. Meeting EHR security requirements: SeAAS approach. Stud Health Technol

Inform. 2010;155:85-91.

2009

Hoerbst, A.; Ammenwerth, E., “A structural model for quality requirements regarding Electronic Health Records –

State of the art and first concepts,” Software Engineering in Health Care, 2009. SEHC ’09. ICSE Workshop on ,

vol., no., pp.34,41, 18-19 May 2009

Weng C, Levine BA, Mun SK. Software architecture and engineering for patient records: current and future. Mil Med. 2009

May;174(5 Suppl):27-34. Review.

Arguello, M.; Des, J.; Perez, R.; Fernandez-Prieto, M. J.; Paniagua, H., “Electronic Health Records (EHRs) Standards

and the Semantic Edge: A Case Study of Visualising Clinical Information from EHRs,” Computer Modelling and

Simulation, 2009. UKSIM ’09. 11th International Conference on , vol., no., pp.485,490, 25-27 March 2009

Jian-Cheng Dong; Dong Zhou; Xin-Ping Hu; Zhi-Mei Zhang; Kui Jiang, “Analysis and Design on Standard System of

Electronic Health Records,” Education Technology and Computer Science, 2009. ETCS ’09. First International

Workshop on , vol.1, no., pp.980,982, 7-8 March 2009

Senathirajah Y, Bakken S. Architectural and usability considerations in the development of a Web 2.0-based EHR. Stud Health

Technol Inform. 2009;143:315-21.

Armstrong B, Kushniruk A, Joe R, Borycki E. Technical and architectural issues in deploying electronic health records

(EHRs) over the WWW. Stud Health Technol Inform. 2009;143:93-8.

2008

Kim H, Harris MR, Savova GK, Chute CG. The first step toward data reuse: disambiguating concept representation of the

locally developed ICU nursing flowsheets. Comput Inform Nurs. 2008 Sep-Oct;26(5):282-9.

Martins SB, Shahar Y, Goren-Bar D, Galperin M, Kaizer H, Basso LV, McNaughton D, Goldstein MK. Evaluation of an

architecture for intelligent query and exploration of time-oriented clinical data. Artif Intell Med. 2008 May;43(1):17-34.

H?yrinen K, Saranto K, Nyk?nen P. Definition, structure, content, use and impacts of electronic health records: a review of

the research literature. Int J Med Inform. 2008 May;77(5):291-304.

Leslie H. International developments in openEHR archetypes and templates. HIM J. 2008;37(1):38-9.

Yoo SK, Kim DK, Kim JC, Park YJ, Chang BC. Implementation of a large-scale hospital information infrastructure for multi-

unit health-care services. J Telemed Telecare. 2008;14(3):164-6.

Massaut J, Reper P. Open source electronic health record and patient data management system for intensive care. Stud Health

Technol Inform. 2008;141:139-45.

Pomares A, Roncancio C, Abásolo J. Virtual objects in large scale health information systems. Stud Health Technol Inform.

2008;138:80-9.

Massari P, Pereira S, Thirion B, Derville A, Darmoni SJ. Use of super-concepts to customize electronic medical records data

display. Stud Health Technol Inform. 2008;136:845-50.

It?l? T, Ukkola J, Virtanen A, Mykk?nen J. SOA approach for integration of departmental systems. Stud Health Technol

Inform. 2008;136:723-8.

Wong MC, Turner P, Yee KC. Involving clinicians in the development of an electronic clinical handover system –

thinking systems not just technology. Stud Health Technol Inform. 2008;136:490-5.

Carrajo L, Penas A, Melcón R, González FJ, Couto E. From documents on paper to electronic medical records. Stud Health

Technol Inform. 2008;136:395-400.

Blobel BG, Pharow P. Analysis and evaluation of EHR approaches. Stud Health Technol Inform. 2008;136:359-64.

Khajouei R, Jaspers MW. CPOE system design aspects and their qualitative effect on usability. Stud Health Technol Inform.

2008;136:309-14. Review.

Jaspers MW, Peute LW, Lauteslager A, Bakker PJ. Pre-post evaluation of physicians’ satisfaction with a redesigned

electronic medical record system. Stud Health Technol Inform. 2008;136:303-8.

Martinez, I.; Fernandez, J.; Galarraga, M.; Serrano, L.; de Toledo, P.; Jimenez-Fernandez, S.; Led, S.; Martfnez-

Espronceda, M.; Garcia, J., “Implementation of an end-to-end standard-based patient monitoring

solution,”Communications, IET , vol.2, no.2, pp.181,191, February 2008

Riedl, B.; Grascher, V.; Fenz, S.; Neubauer, T., “Pseudonymization for improving the Privacy in E-Health

Applications,” Hawaii International Conference on System Sciences, Proceedings of the 41st Annual , vol., no.,

pp.255,255, 7-10 Jan. 2008.

2007

Riedl, B.; Grascher, V.; Neubauer, T., “Applying a Threshold Scheme to the Pseudonymization of Health Data,”

Dependable Computing, 2007. PRDC 2007. 13th Pacific Rim International Symposium on , vol., no., pp.397,400, 17-19 Dec.

Katehakis, D.G.; Sfakianakis, S.G.; Kavlentakis, G.; Anthoulakis, D.N.; Tsiknakis, M., “Delivering a Lifelong

Integrated Electronic Health Record Based on a Service Oriented Architecture,” Information Technology in Biomedicine,

IEEE Transactions on , vol.11, no.6, pp.639,650, Nov. 2007

Li HaoMin; Duan Huilong; Lu XuDong; Huang Zhengxing, “A Clinical Document Repository for CDA Documents,”

Bioinformatics and Biomedical Engineering, 2007. ICBBE 2007. The 1st International Conference on , vol., no., pp.1084,1087,

6-8 July 2007

Jian WS, Hsu CY, Hao TH, Wen HC, Hsu MH, Lee YL, Li YC, Chang P. Building a portable data and information interoperability

infrastructure-framework for a standard Taiwan Electronic Medical Record Template. Comput Methods Programs Biomed. 2007

Nov;88(2):102-11.

Katehakis DG, Sfakianakis SG, Kavlentakis G, Anthoulakis DN, Tsiknakis M. Delivering a lifelong integrated electronic

health record based on a service oriented architecture. IEEE Trans Inf Technol Biomed. 2007 Nov;11(6):639-50.

Chelico JD, Wilcox A, Wajngurt D. Architectural design of a data warehouse to support operational and analytical queries

across disparate clinical databases. AMIA Annu Symp Proc. 2007 Oct 11:901..

Murphy SN, Mendis M, Hackett K, Kuttan R, Pan W, Phillips LC, Gainer V, Berkowicz D, Glaser JP, Kohane I, Chueh HC.

Architecture of the open-source clinical research chart from Informatics for Integrating Biology and the Bedside. AMIA Annu

Symp Proc. 2007 Oct 11:548-52

Sumita Y, Takata M, Ishitsuka K, Tominaga Y, Ohe K. Building a reference functional model for EHR systems. Int J Med

Inform. 2007 Sep;76(9):688-700.

McMurry AJ, Gilbert CA, Reis BY, Chueh HC, Kohane IS, Mandl KD. A self-scaling, distributed information architecture for

public health, research, and clinical care. J Am Med Inform Assoc. 2007 Jul-Aug;14(4):527-33.

Morales Rodriguez M, Casper G, Brennan PF. Patient-centered design. The potential of user-centered design in personal

health records. J AHIMA. 2007 Apr;78(4):44-6; quiz 49-50.

Bergmann J, Bott OJ, Pretschner DP, Haux R. An e-consent-based shared HER system architecture for integrated healthcare

networks. Int J Med Inform. 2007 Feb-Mar;76(2-3):130-6.

Blobel B, Pharow P. A model driven approach for the German health telematics architectural framework and security

infrastructure. Int J Med Inform. 2007 Feb-Mar;76(2-3):169-75.

Yang Y, Ahtinen A, Lahteenmaki J, Nyman P, Paajanen H, Peltoniemi T, Quiroz C. A service platform architecture design

towards a light integration of heterogeneous systems in the wellbeing domain. Conf Proc IEEE Eng Med Biol Soc.

2007;2007:5865-8.

Stacey M, McGregor C, Tracy M. An architecture for multi-dimensional temporal abstraction and its application to support

neonatal intensive care. Conf Proc IEEE Eng Med Biol Soc. 2007;2007:3752-6.

Raghupathi W, Gao W. An Eclipse-based development approach to health information technology. Int J Electron Healthc.

2007;3(4):433-52.

Mu?oz A, Somolinos R, Pascual M, Fragua JA, González MA, Monteagudo JL, Salvador CH. Proof-of-concept design and

development of an EN13606-based electronic health care record service. J Am Med Inform Assoc. 2007 Jan-Feb;14(1):118-29.

Corwin J, Silberschatz A, Miller PL, Marenco L. Dynamic tables: an architecture for managing evolving, heterogeneous

biomedical data in relational database management systems. J Am Med Inform Assoc. 2007 Jan-Feb;14(1):86-93.

Klimov D, Shahar Y. Intelligent querying and exploration of multiple time-oriented medical records. Stud Health Technol

Inform. 2007;129(Pt 2):1314-8.

Boye N, Eberholst F, Farlie R, S?rensen LB, Lyng KM. User driven, evidence based experimental design; a new method for

interface design used to develop an interface for clinical overview of patient records. Stud Health Technol Inform.

2007;129(Pt 2):1053-7.

Beale T, Heard S. An ontology-based model of clinical information. Stud Health Technol Inform. 2007;129(Pt 1):760-4.

Ginsburg, M., “Pediatric Electronic Health Record Interface Design: The PedOne System,” System Sciences, 2007.

HICSS 2007. 40th Annual Hawaii International Conference on , vol., no., pp.139,139, Jan. 2007

2006

Al-zharani, S.; Sarasvady, S.; Chandra, H.; Pichappan, P., “Controlled EHR access in secured health information

system,” Digital Information Management, 2006 1st International Conference on , vol., no., pp.63,68, 6-6 Dec. 2006

Shanmugam, M.; Thiruvengadam, S.; Khurat, A.; Maglogiannis, I., “Enabling Secure Mobile Access for Electronic Health

Care Applications,” Pervasive Health Conference and Workshops, 2006 , vol., no., pp.1,8, Nov. 29 2006-Dec. 1 2006

Ferranti JM, Musser RC, Kawamoto K, Hammond WE. The clinical document architecture and the continuity of care record: a

critical analysis. J Am Med Inform Assoc. 2006 May-Jun;13(3):245-52.

Stoicu-Tivadar L, Stoicu-Tivadar V. Human-computer interaction reflected in the design of user interfaces for general

practitioners. Int J Med Inform. 2006 Mar-Apr;75(3-4):335-42.

Blobel B. Advanced and secure architectural EHR approaches. Int J Med Inform. 2006 Mar-Apr;75(3-4):185-90.

Seo HJ, Youn ST, Hwang KT, Kim JH. Defining structural constraints for the development of structured operation note for

breast cancer based on Clinical Document Architecture. AMIA Annu Symp Proc. 2006:1089.

Murphy SN, Mendis ME, Berkowitz DA, Kohane I, Chueh HC. Integration of clinical and genetic data in the i2b2 architecture.

AMIA Annu Symp Proc. 2006:1040.

Massey T, Gao T, Welsh M, Sharp JH, Sarrafzadeh M. The design of a decentralized electronic triage system. AMIA Annu Symp

Proc. 2006:544-8.

Moner D, Maldonado JA, Bosca D, Fernandez JT, Angulo C, Crespo P, Vivancos PJ, Robles M. Archetype-based semantic

integration and standardization of clinical data. Conf Proc IEEE Eng Med Biol Soc. 2006;1:5141-4.

Nace GS, Graumlich JF, Aldag JC. Software design to facilitate information transfer at hospital discharge. Inform Prim

Care. 2006;14(2):109-19.

Blobel BG, Engel K, Pharow P. Semantic interoperability–HL7 Version 3 compared to advanced architecture standards.

Methods Inf Med. 2006;45(4):343-53.

Blobel BG. Advanced EHR architectures–promises or reality. Methods Inf Med. 2006;45(1):95-101.

2005

Zhang J. Human-centered computing in health information systems part 2: evaluation. J Biomed Inform. 2005 Jun;38(3):173-5.

Yun-Sik Kwak, “International standards for building Electronic Health Record (EHR),” Enterprise networking and

Computing in Healthcare Industry, 2005. HEALTHCOM 2005. Proceedings of 7th International Workshop on , vol., no., pp.18,23,

23-25 June 2005

Hanzlicek P, Spidlen J, Heroutova H, Nagy M. User interface of MUDR electronic health record. Int J Med Inform. 2005

Mar;74(2-4):221-7.

Johnson CM, Johnson TR, Zhang J. A user-centered framework for redesigning health care interfaces. J Biomed Inform. 2005

Feb;38(1):75-87.

Samaras GM, Horst RL. A systems engineering perspective on the human-centered design of health information systems. J

Biomed Inform. 2005 Feb;38(1):61-74.

Rose AF, Schnipper JL, Park ER, Poon EG, Li Q, Middleton B. Using qualitative studies to improve the usability of an EMR. J

Biomed Inform. 2005 Feb;38(1):51-60.

Zhang J. Human-centered computing in health information systems. Part 1: analysis and design. J Biomed Inform. 2005 Feb;38

(1):1-3.

Orlova AO, Dunnagan M, Finitzo T, Higgins M, Watkins T, Tien A, Beales S. Electronic health record – public health

(EHR-PH) system prototype for interoperability in 21st century healthcare systems. AMIA Annu Symp Proc. 2005:575-9.

2004

Marcheschi, P.; Mazzarisi, A.; Dalmiani, S.; Benassi, A., “HL7 clinical document architecture to share cardiological

images and structured data in next generation infrastructure,” Computers in Cardiology, 2004 , vol., no., pp.617,620,

19-22 Sept. 2004

Blobel B, Pharow P. Implementing MDA-based distributed, interoperable, flexible, scalable, portable, and secure EHR

systems. Stud Health Technol Inform. 2004;103:394-9.

Hanzlicek P, Spidlen J, Nagy M. Universal electronic health record MUDR. Stud Health Technol Inform. 2004;105:190-201.

Barretto, S.A.; Warren, J.; Goodchild, A., “Designing guideline-based workflow-enabled electronic health

records,” System Sciences, 2004. Proceedings of the 37th Annual Hawaii International Conference on , vol., no., pp.10

pp.,, 5-8 Jan. 2004

2003

Zheng L, Wetzel AW, Gilbertson J, Becich MJ. Design and analysis of a content-based pathology image retrieval system. IEEE

Trans Inf Technol Biomed. 2003 Dec;7(4):249-55.

Mahoney ME. A nontraditional day in the life. Software development: from conception to implementation. J AHIMA. 2003

Oct;74(9):32-3.

Blobel B. Architecture and tools for open, interoperable and portable EHRs. Stud Health Technol Inform. 2003;97:25-33.

Berler, A.; Konnis, G.; Pavlopoulos, S.; Karkalis, G.; Sakka, E.; Koutsouris, D., “Use of XML technology in a virtual

patient record infrastructure,” Information Technology Applications in Biomedicine, 2003. 4th International IEEE EMBS

Special Topic Conference on , vol., no., pp.118,121, 24-26 April 2003

2002

Berler, A.; Pavlopoulos, S.; Karkalis, G.; Sakka, E.; Konnis, G.; Koutsouris, D., “Implementation of a novel virtual

patient record architecture,” Engineering in Medicine and Biology, 2002. 24th Annual Conference and the Annual Fall

Meeting of the Biomedical Engineering Society EMBS/BMES Conference, 2002. Proceedings of the Second Joint , vol.3, no.,

pp.1936,1937 vol.3, 23-26 Oct. 2002

Blobel B. Comparing concepts for electronic health record architectures. Stud Health Technol Inform. 2002;90:209-14.