Cloud architecture for electronic health record systems interoperability.

BACKGROUND Current Electronic Health Record (EHR) systems are built using different data representation and information models, which makes difficult achieving information exchange. OBJECTIVE Our aim was to propose a scalable architecture that allows the integration of information from different EHR systems. METHODS A cloud-based EHR interoperable architecture is proposed through the standardization and integration of patient electronic health records. The data is stored in a cloud repository with high availability features. Stakeholders can retrieve the patient EHR by requesting only to the integrated data repository. The OpenEHR two-level approach is applied according to the HL7-FHIR standards. We validated our architecture by comparing it with 5 different works (CHISTAR, ARIEN, DIRAYA, LLPHR and INEHRIS) using a set of selected axes and a scoring method. RESULTS The problem was reduced to a single point of communication between each EHR system and the integrated data repository. By combining cloud computing paradigm with selected health informatics standards, we obtained a generic and scalable architecture that complies 100% with interoperability requisites according to the evaluation framework applied. CONCLUSIONS The architecture allowed the integration of several EHR systems, adapting them with the use of standards and ensuring the availability thanks to cloud computing features.