Designing Next Generation EHR Applications using Metadata Driven Design

Posted by: Niket Gupta

According to industry reports, the global EHR market is growing at CAGR of 5.2% currently with an anticipated value worth USD 29.81 billion by 2020. On the basis of implementation, the EHR market is segmented into web or cloud-based and client-server based. Cloud-based EHR have the advantage over client-server based systems as they store information on external servers and web access is possible via a platform and a web service. Web-based EHR market is expected to significantly grow at a CAGR of 5% owing to the lucrative benefits of minimal implementation cost and time, seamless clinical integration, pay-per-use pricing model and configurability. Increased usage of tablets and smartphones have further augmented the demand of cloud-based EHRs.
Are existing EHR applications, even the modern ones that were built for Meaningful Use, doing good job in providing a holistic view of patients to all the collaborators in a patient’s care team across the care continuum? We believe the answer is ‘No’ because today’s reality of patient management is “disconnected care’’ leading to rising healthcare costs and poor outcomes. Current EHR applications are restricted to one legal entity (e.g. a single hospital or a hospital system or single ambulatory practice) which preclude integrated and coordinated care. Considering the post-reform transition from fee-for-service to value based reimbursement, shared savings initiatives, amount of measurements for quality reporting and new care delivery models such as ACOs, the next generation of EHRs should support secure, trusted, electronic collaboration between legal organizations (e.g. two hospitals or multiple clinics) as patients move across entities.

The next-generation of EHRs shall be designed with “multi-entity” or “multi-tenant” database models to accommodate more fluid workflows to handle with ease the complex multi-organization relationships, requirements and user communities that could change potentially daily or weekly based on the demands of new participants. One of the best approaches for such sort of needs has been to abstract implementation so that it can support dynamic business models with respect to legal boundaries. We term it as ‘Metadata Driven Design (MDD)‘. MDD can turn the idea of EHRs as true collaboration platforms a reality.

To know more about our MDD framework and how we have designed a next-generation EHR application using MDD, please visit our healthcare profile, or, write to us at healthcare@sourcefuse.com