The shift towards electronic medical records is no longer a matter of debate. In the current era of digital transformation, the healthcare sector must stay current and harness the latest digital advancements, as articulated in the article “Digitalization of Medical Records.”
The real question is what type of electronic medical record (EMR) system an organisation should aspire to have. In an ideal scenario, EMRs would operate on a unified national platform, albeit one that would likely be massive and fraught with inherent risks. Alternatively, a more pragmatic approach is to adopt a generic EMR platform as the primary communication and functional hub, complemented by separate sub-speciality platforms designed to address specific objectives.
To guide the development of these EMR platforms, the International Organization for Standardization (ISO) and the International Electrotechnical Commission (IEC) have jointly produced the ISO/IEC 25010 document, outlining the essential software quality characteristics. Whether it’s a purpose-built or generic EMR platform, adhering to these quality standards is crucial to meeting the needs of stakeholders. Nevertheless, it’s worth noting that these quality attributes may vary between platforms, prompting us to conduct a theoretical comparison between purpose-built and generic EMR systems.
Functional suitability:
Functional suitability encompasses attributes like functional completeness, correctness, and appropriateness. A generic EMR platform offers greater functional completeness than a standalone sub-specialty platform because it addresses all facets of healthcare provision. Nevertheless, the pursuit of completeness can render it a substantial, intricate platform susceptible to errors, making it less suitable for the specific requirements of sub-specialities.
Performance efficiency:
Performance efficiency concerns resource utilisation and can be categorised into three primary aspects: time behaviour, resource utilisation, and capacity. In the case of a purpose-built sub-speciality platform, it typically excels in terms of response and processing times because it handles fewer commands concurrently. Additionally, such a platform tends to exhibit lower resource utilisation and a greater capacity to cater to the specific needs of its sub-speciality. However, it’s worth noting that when numerous purpose-built platforms are deployed, overall resource utilisation may increase, potentially leading to suboptimal time behaviour.
Compatibility:
Whether a purpose-built sub-specialty or a generic EMR platform, it should prioritise compatibility with other existing systems to facilitate coexistence and interoperability.
Usability:
A purpose-built sub-speciality platform offers ease of operation and mastery advantages due to its streamlined command structure. Users have the flexibility to customise the interface according to their needs. Additionally, implementing error firewalls is more straightforward on such platforms. On the other hand, a generic EMR platform, ideally on a national scale, provides superior accessibility with a broad spectrum of features and capabilities.
Reliability:
A purpose-built sub-speciality platform is comparatively easier to develop and refine and is likely to excel in performing specific tasks due to its focused design. Its smaller scale also enhances resilience and facilitates smoother recovery processes. Conversely, a generic platform provides a broader range of functionalities and interconnectivity, enabling more versatile operations in generic settings.
Security:
Confidentiality in healthcare is essential for all operations, with patient confidentiality being paramount to all stakeholders. Regardless of the platform, stringent minimum security standards should be in place. A purpose-built sub-specialty platform can enhance confidentiality and integrity by restricting user access. It also simplifies user and activity tracking, improving non-repudiation, accountability, and authenticity.
Maintainability:
A purpose-built sub-specialty platform provides greater modularity. Such a platform can and should be tailored to meet the specific needs of stakeholders, making it easier to customise. Additionally, regardless of the platform type, analysability and testability are essential prerequisites to ensure functionality and reliability.
Portability:
Given its specialised focus and tailored design, a purpose-built sub-speciality platform will likely offer ease of installation, troubleshooting, and adaptability advantages.
In conclusion, the desired Electronic Medical Record (EMR) system must align with the objectives of its stakeholders. The optimal solution involves a combination of a generic EMR platform capable of handling various functions and users and specialised purpose-built platforms designed to meet the specific objectives of different sub-specialties within healthcare. These platforms’ co-existence and seamless interoperability are essential to ensure comprehensive and effective healthcare data management.
By Dr Omar Aldalati, MD, PhD
Medical Notes Solutions media team
