Towards a universal patient-centric health record sharing platform

Objectives: This paper provides a practical approach to evaluate health record sharing platforms in terms of their ability to deliver interoperable healthcare of quality at a systems level. We use our previously published interoperability evaluation framework to evaluate our proposed System-level Record Sharing (SLRS) platform against four other common categories of health record sharing platforms in Canada, the United States, and Norway. Methods: In this paper, we compare the SLRS platform architecture that we previously developed against 4 health record sharing platform categories. We conducted this comparative evaluation of 5 categories of healthcare platforms: SLRS, Commercial-Multi (CM), Commercial-Independent (CI), Governmental-Multi (GM), and Governmental-Independent (GI) using our proposed evaluation framework that is built upon quadruple aim, triple aim and Canadian Institute for Health Information (CIHI) health platform evaluation frameworks. Results: SLRS and platforms managed by government organizations that provide a technology-independent or compatible platform were the most effective in terms of satisfying data interoperability, providing meaningful and effective information exchange, being compliant with health privacy regulations across a range of contexts, and having many of the costs paid for at a central level. All platforms struggled with context and process interoperability requirements, as well as providing evidence-based information across an entire health system. Conclusion: To optimize health management, both clinicians and patients need sharing of personal health information (PHI) across applications. Our findings indicate that commercial platforms in this study need to improve their governance structure and employ a consistent ontology that can be adopted by all EHR applications across a health system. Our proposed SLRS platform can support the sharing of health data across multiple health care organizations at a system-level, allowing clinicians to access patient health data to inform treatment and care decisions. Public interest abstract: Healthcare organizations face barriers when exchanging information across their boundaries. Many obstacles are caused by varying technical requirements of the EHR applications they have, and their contextual regulations. Most healthcare organizations have a portal in which the patients can view their care history. However, the breadth of the information provided limits to the number of healthcare providers subscribed to that specific platform. Viewing the full history across the entire health system, requires maintaining multiple accounts. In this paper we refer to a new framework for sharing health information and its prototyped platform (SLRS) that we have previously developed in our lab. In this paper we report on how we evaluated the SLRS platform against four prominent practices of Health Information Exchange. We used our interoperability evaluation framework that was developed based on well-acknowledged criteria from literature and practice. We found areas of improvement for existing health information platforms so they can share their records across an entire health system.