EMR (Electronic Medical Record) standard record format?

Question

A few associates and myself are starting an EMR project (Electronic Medical Records). I have heard talk in the past - and more so lately - about a standard record format - to facilitate the transferring of records when appropriate (HIPAA) from one facility to another. Has anyone seen any information on this?

Answer 1

You can look to HL7 for interoperability between systems (http://www.hl7.org/). Patient demographic information and textual notes can be passed. I've been out of the EMR space too long to know if any standards groups have done anything interesting of late. A standard format that maintains semantic meaning is a really, really difficult problem. See SnoMed (http://www.nlm.nih.gov/research/umls/Snomed/snomed_main.html) for one long-running ontology effort -- barely the start of a rich interchange format.

A word of warning from someone who spent several years with an upstart EMR vendor...This is a very hard business to be in. Sales cycles for large health systems literally can take years, and the amount of hand-holding required for smaller medical practices can quickly erode margins. Integration with existing practice management systems is non-standard, even if those vendors claim otherwise. More and more issues abound. I'm not sure that it's a wise space for an unfunded start-up to enter.

Answer 2

If you want to go outside HL7 thinking and are looking for an comprehensive EMR or EHR with a specified record format rather than a record extract message interchange format, then have a look at openEHR, http://www.openehr.org/. The ISO 13606 extract standard is (almost) a subset of openEHR. You will also find open source reference libraries and openEHR implementations of different maturity available in Java, .NET, Ruby, Python, Groovy etc.

Some organisations are also producing HL7 artifacts like CDA as output from openEHR based EHR/EMR systems.