pacoispaco / ehr-ng

A new approach to EHR-systems

About EHR-ng

EHR-ng is a new approach to EHR-systems.

There is no code yet. Just ideas!

Current problems of EHR-systems

In no particluar order of seriousness:

• Monolithic systems.
• Data hoarding systems. No simple export or import of data.
• Bad or poor API:s. Poor support for systems integration.
• Expensive licenses. Customers pay for both licenses and development.
• Huge and complex standards that are difficult and seldome fully implemented.
• Tight integration of health care process data and features with EHR data and features.
• No clear separation of communication between health care professionals and EHR data. Communication often stored in EHR.
• Based on the assumption that the healthcare provider "owns" the EHR, not the patient.
• No modern UX and usability design.

Some principles for a new EHR system

The core principles:

• The patient owns the EHR-data.
• EHR-data is the most valuable asset of the system.
• Separate the EHR-data from health care process data, and communication between health care professionals.
• EHR-data should be seen as a time log of events; a journal.
• Conserve integrety and traceability of changes to EHR-data.

Note: By health care process data is meant, among other things, information on health care units and organisation, status of patient treatment in health care flow, bookings, invoices etc.

Technical principles:

• Data-centric design.
• Distributed by design.
• No technical or data dependencies between different peoples EHR-data.
• Separate persistance and integrity of EHR-data from presentation of and features on EHR-data.
• Standards used must be open, free, simple and have open-source reference implementations.
• It should be easy for third party providers to develop and provide tools and servcies for manipulating EHR-data.

Some technologies that are relevant

• Blockchain.
• C API for accessing EHR-data.
• Command line tools for accessing and manipulating EHR-data.
• Mobile app
• Webb app
• Microservices for core data sets

EHR-data: some core data sets

Note: All data should be seen as being entered on a time line; a journal!

• Personal core characteristics; birth date, weight, length, sex, blood type, etc.
• Personal characteristics; allergies, etc.
• Personal comments on health.
• Measurement based data and calculated characteristics; age, BMI, blood pressure, etc.
• Medication data.
• Vaccination data.
• Lab-based data and calculated characteristics; blood samples, renal clearance, etc.
• Image based data; radiography, magnetic resonance imaging, ultrasound, photoacoustic imaging, magnetic particle imaging, etc.
• Diagnostics by medical professionals.
• Comments by medicial professionals.
• Recommended treatment and instructions by medical professionals.