The report considers eHealth foundations built through policy development, funding approaches and capacity building in eHealth through the training of students and professionals. It then observes specific eHealth applications such as mHealth, telehealth, electronic health records systems and eLearning and how these contribute to the goals of UHC.

Of interest is the extent to which legal frameworks protect patient privacy in EHRs as health care systems move towards to delivering safer, more efficient, and more accessible health care. Finally the rapidly emerging areas of social media for health care as well as big data for research and planning are reported. This report complements the Atlas of eH

Highlights

• Private vendors׳ involvement does not depend on who has the responsibility of the EHR system development.
• Private vendors׳ involvement can be found in all phases of the EHR system development.
• Indicates the necessity of more efforts to be made for the integration of Standards, for enhancing interoperability.
• Identifies which Standards supported by EHR system in operation worldwide.

Abstract:

The primary aim of this research is to capture the existing experience from countries where nationwide EHR systems have already been implemented or the development is in a mature phase. To capture the necessary information, an international survey has been conducted with expert participants from 13 countries. The results of this research show that private vendors׳ involvement in most of the system development lifecycle phases is inevitable. However, the phase where most private vendors are involved in during the development of an EHR system is System Design. Interestingly, their involvement does not depend on who has the responsibility of the EHR system development (either a national organization or a private vendor).

Finally, examining the supported standards by EHR systems and their interoperability with other information systems, in respect to both technical and semantic interoperability, it is found that more efforts should be made for the integration of the most widely supported standards, and the enhancement of interoperability among health information systems, which will lead to the successful integration of a NEHR system.

From a national level to give Internet technology support, the Nationwide Integrated Healthcare System in Uruguay requires a model of Information Systems Architecture. This system has multiple healthcare providers (public and private), and a strong component of supplementary services. Thus, the data processing system should have an architecture that considers this fact, while integrating the central services provided by the Ministry of Public Health. The national electronic health record, as well as other related data processing systems, should be based on this architecture.

The architecture model described here conceptualizes a federated framework of electronic health record systems, according to the IHE affinity model, HL7 standards, local standards on interoperability and security, as well as technical advice provided by AGESIC. It is the outcome of the research done by AGESIC and Systems Integration Laboratory (LINS) on the development and use of the e-Government Platform since 2008, as well as the research done by the team Salud.uy since 2013.