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Architecture for Electronic Health Recording - Essay Example

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From the paper "Architecture for Electronic Health Recording " it is clear that a good architecture for an Electronic Health Recording system has to ensure that the system manages the consistency of all transactions within the health service organization…
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Architecture for Electronic Health Recording
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? Architecture for HER Develop the architecture for an EHR that satisfies the following requirements Implementation of essential features of practice management such as billing, scheduling appointments, etc. A good architecture for an Electronic Health Recording system has to ensure that the system manages the consistency of all transactions within the health service organization (Busch, 2008). The architecture keeps track of information from the entry point of the patient at the reception, to the diagnosis and to the treatment then to the billing point. At the billing point, the system ensures that all segments of the medical bill are consolidated into an aggregate summary. It also keeps a multiple secure back up at various point. The architecture presents the system as the central link between all departments. The figure below shows sample architectural design of the EHR system. The main server is the host for the HER system, from which all other terminals access its services. Figure 1: An architecture for HER System The integration of all the departmental functions and processes is done through a common database and the network. In the appointment booking, the system confirms the time usage from the database, whereby it generates a record of booked hours and free hours. It then uses decision support system to allocate the free hours for new appointments. The backup system is stationed a distance away from the main server area and the local area network because of disaster management strategy. 2. Implementation of decision support by providing lab tests performed on the patient and and patient family history Decision support is essential for the HER in many ways. First, it enables the appointment-booking module to allocate free time to the new appointments and processes. It also assists in the diagnosis in the sense that the medical professionals can use them detect the likelihood of presence a disease or infection affecting a patient. After the diagnosis, the decision support module offers recommendations for treatment. Depending on the magnitude of the disease as read from the symptoms, the decision support system recommends appropriate medical intervention. The risk is that the system can confuse between two diseases that share symptoms. Solution to such inconsistency in system behavior is remedied through modification and customization of the knowledge base of the system. The other area that requires decision support is the billing module. In this module, the system prompts the user to select the choice of payment method, and then presents the available options. The system combines the parameters including historical records of a patient in judging diseases using a logical model in which conditions have direct implications. For example, in a lab test, a disease A is characterized by various symptoms 1, 2 and 3. If symptom 1, symptom 2 and Symptom 3 is detected, then the lab test is positive for disease A otherwise, it is negative. The lab test must find all the three symptoms to confirm the results. In a second instance, the three symptoms are combined with the historical records bearing similar symptoms or positive test results. In this case, the lab test does not have all the three symptoms but the available symptoms match an earlier test result (Melvin, 2010). The system suggests a possibility of the patient having the same disease. The decision support system simply suggests the results and leaves the decision to the system users. It simply matches the data in the knowledge base and presents predictive results to the system users to implement the actual judgment and decision-making. The figure bellow shows an illustration of the functioning decision support mechanism for the HER in Diagnosis. Figure 2: Lab Test and Decision Support 3. Secure backup of patient data The Electronic Health Record System must have a secure data for all patients’ data as illustrated in the architectural structure. The backup centers can be more than one for the security of the data to be ensured. This is because of disaster management techniques for secure data backup strategy. In case one backup record is destroyed, there are other backups for recovery. The size of the backup device matters a lot in this exercise. This is in consideration of the growing sizes of data for patients, and the many times a patient can receive treatment in the same health service institution (Carter, 2008). It is possible that the patients’ records can run to billions of data records as data entry proceeds. The backup storage devices can be selected to be of large capacities such as terabytes. There has to be a maximum security provided for the backup servers and the devices from access by unauthorized entities (Walker et al., 2006). There are other risks facing the safety of back up patient data. These include the destruction by fire, floods, earthquakes and bomb explosions. This is why back up centers must be spread widely apart from each other to minimize the exposure to critical risks. The project document must provide the following details: a) Screenshots of the above mentioned features b) Essential diagrams such as flow charts detailing the details of the processes involved The data flow diagram for the activities for the processes involved in the laboratory test is shown below. There are two decision points demonstrated in the diagram: The detection of the disease from the symptoms and the history of the patient The Billing function where the patient is discharged once he or she settles the Bills. The “if” and “else” condition is iterative. It can be tested as many times as possible until the conditions are satisfied, that is the condition is Yes. . Figure 3: Data Flow Diagram for the Lab test The second data flow diagram shows the processes involved in making appointments. Figure 4: Data Flow Diagram for Booking Appointments The appointment Booking Module checks if the patients’ conditions require him or her to meet with the doctor. If it proves necessary, the system checks the availability of the doctor to attend to the patients (Melvin, 2010). If the doctor is available, it books appointment and marks the time on the electronic calendar with label B meaning “Booked” or “Busy”. The next task that requires appointment particularly for the booked Doctor will not be able because it busy unless he or she changes time, doctor, or both. References Busch, R. S. (2008). Electronic Health Records: An Audit and Internal Control Guide. New York: John Wiley & Sons. Carter, J. H. (2008). Electronic Health Records: A Guide for Clinicians and Administrators. New York: ACP Press. Melvin, A. C. (2010). Electronic Health Records: Program Office Improvements Needed to Strengthen Management of VA and DoD Efforts to Achieve Full Interoperability: Congressional Testimony. New York: DIANE Publishing. Melvin, V. C. (2010). Electronic Health Records: DoD and VA Efforts to Achieve Full Interoperability are Ongoing; Program Office Management Needs Improvement. New York: DIANE Publishing. Walker, J. M., Bieber, E. J., Richards, F., and Buckley, S. (2006). Implementing an Electronic Health Record System. New York: Springer. c) Information on the type of equipments that would be used with the system The equipment that will be required for this system include hardware components of an information system such as personal computers, system server machines, printers, network cables, Phones, Smart Card reading Machine., Point of Sale devices, Back Up devices and network boosters. It will also require software applications. These include Operating System for the server and the clients. The Operating system for the server, machine terminals can be either UNIX server or Windows Server of the latest generations. The client computer terminals can use ordinary operating system such as Windows XP professional or Windows 7. Apart from the Operating system, the HER system will require other applications such as Microsoft office applications, the Latest version of the Office being of release 2013. The other applications are specific to the particular health information system. Fundamentally, the Health Organization requires an installation of the Electronic Health Recording System. This is the Core Information System. The electronic Health System is the interface through which all departments and service points link in the entire organization. For the sake of data security, the system will require to run on a secure network database. This includes Oracle Database or SQL Server System. It also requires security features such as access control through passwords. Since the data in the database are at risk of virus attack, there is need for installation of Antivirus. Preferably, the system administrator can consider ESET NOD 32 version 3.0. This is because the company will need to be updating the virus frequently by accessing update license, files and credentials from the internet. Read More
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