Background: Electronic Health Record Systems (EHRS)
and Personal Health Record Systems (PHRS) are core components of infrastructure needed to run any health system.
Objectives: As health systems undergo paradigm changes,
EHRS and PHRS have to advance as well to meet the related
interoperability challenges.
Methods: The paper discusses EHR types, implementations
and standards, starting with different requirements
specifications, systems and systems architectures, standards
and solutions.
Results: Existing standards and specifications are compared
with changing requirements, presenting weaknesses
and defining the advancement of EHRS, architectures and
related services, embedded in advanced infrastructure systems.
Conclusion: Future EHR systems are components in
a layered architecture with open interfaces. The need
of verifying data models at business domains level is
specifically highlighted. Such approach is enabled by the
ISO Interoperability Reference Architecture of a systemoriented, architecture-centric, ontology-based, policy- driven approach, meeting good modeling best practices.