Healthcare information architecture: elements of a new paradigm

  • Authors:
  • Daniel J. Essin;Thomas L. Lincoln

  • Affiliations:
  • University of Southern California;University of Southern California, The RAND Corporation

  • Venue:
  • NSPW '94 Proceedings of the 1994 workshop on New security paradigms
  • Year:
  • 1994

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Abstract

An Electronic Medical Record (EMR) must provide a secure, permanent archive for an individual's medical records and also function as a multi-purpose database that supports the complex, varied activities of patient care. Meeting these objectives requires unusual flexibility in how data are retrieved and processed. Semantic and referential integrity must preserved both over time and as chunks of information are exchanged with other systems. Relationships between data entries must determined dynamically based on actual events, rather than statically through application design. Distributed data requires that new forms of system security be incorporated into an EMR at a structural level, with an emphasis on the labeling of elements to be secured behind a security barrier, with audit trails to document necessary overrides and monitor for suspicious use. A modular information architecture is proposed that integrates requirements for structure, content, processing and security.