Stream: implementers
Topic: nationwide EHR
Siriman KONARE (Jun 09 2020 at 18:35):
Hello guys. I am new in FHIR. I find it very interesting. As long time I want to build a complet EHR for my country. I found that FHIR can help me to achieve it. My question is how can I build a complet EHR with FHIR?
Lloyd McKenzie (Jun 09 2020 at 18:41):
By "complete EHR" do you mean a registry that holds shared patient information for all your patients, or do you mean a proper EHR that allows clinicians to perform all of their regular workflow steps, book appointments, do billing, etc.? Both are significant amounts of work, but the latter is even harder because you have to worry about user interface, workflow, reporting, etc. If you're looking for cheap/free EMRs, have you looked at OpenMRS? They're an open source EMR targeting the developing world and they have a growing amount of FHIR support.
Siriman KONARE (Jun 09 2020 at 19:29):
@Lloyd McKenzie I am saying a registry that holds shared information about patient. This will enable practitioners(doctor, nurses, insurances company) to access patient health information.
Lloyd McKenzie (Jun 09 2020 at 19:56):
Ok, then you could theoretically start with one of the open source FHIR servers, but you'd have to add a lot of logic to manage access, consent, define profiles that guide what terminologies and elements need to be used for different types of data, work with data sources to push data and build interfaces to query data, etc. Generally there are lots of political considerations that will be bigger barriers than the technical steps.
Peter Jordan (Jun 09 2020 at 22:02):
Siriman KONARE said:
Lloyd McKenzie I am saying a registry that holds shared information about patient. This will enable practitioners(doctor, nurses, insurances company) to access patient health information.
Which country? As Lloyd says, political barriers may prove to be the biggest hurdle, not to mention security and privacy laws. The first up consideration is whether it's actually permissible within your regulatory environment - e.g. do you have national patient identifiers?
Siriman KONARE (Jun 09 2020 at 23:49):
@Peter Jordan It is for Senegal in Africa. I get your points, I will be face a lot of barriers I know. For security and access control I decide use a blockchain. About identifier, in Senegal this unique identifier does not exist yet
Lloyd McKenzie (Jun 10 2020 at 02:15):
I'd take a look at the #blockchain stream before you wed yourself too tightly to blockchain.
Please understand that we're not trying to discourage your initiative. National EHRs are wonderful things if you can get them up and running and well used. This community will absolutely help you however we can. We just want you to understand that what you're contemplating is a huge undertaking - so make sure that you're aware of that and have the right advocates in place who'll be able to help with the political barriers that inevitably arise.
I know Lithuania rolled out a national EHR based on FHIR STU1 - they may have some lessons to share. @Jan Jasinski?
Siriman KONARE (Jun 10 2020 at 07:49):
Thanks @Lloyd McKenzie for your advices. I will take my time to undertand very well my subjet and you will look also the polical barriers that you guys are saying. I will glad to take contact with @Jan Jasinski to have an idea on what is done in Lithuania
Last updated: Apr 12 2022 at 19:14 UTC
