A Reference Architecture for Sharing CDA Documents in Colombia

Abstract

Background: The Colombian health system is complex. There are more than 3200 healthcare service providers aiming at offering quality of care to more than 48 million citizens. Unfortunately, health services are not integrated, a citizen has a fraction of its health record in the different health services provider organizations without a chance for integration. Objective: The objective of this paper is to propose a reference architecture for an integrated Electronic Health Record System in Colombia based on the ISO/HL7 CDA standard. Methods: A formal system architecture is defined based on the Health Information Systems Development Framework (HIS-DF). Results: The architecture is described as platform independent architecture expressed by three different models: The enterprise model describing business process and policies, the information model describing dynamic and static information flows, and the computational model, describing the systems components and interrelations, based on software engineering architectural styles and patterns. Conclusions: The proposed architecture has been compared with traditional architectural models for Integrated Electronic Health Record Systems. The architecture was evaluated through a case study in dental care were the availability, chronology, completeness and timeliness of the EHR stored in the system were considered high. Also perceived quality was high as evaluated by the users.