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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Lapsia, Vijay Lamb, Kenneth Yasnoff, William A. |
| Description | Country affiliation: United States Author Affiliation: Lapsia V ( Department of Medicine, Mount Sinai School of Medicine, New York, United States. vijay.lapsia@mssm.edu) |
| Abstract | INTRODUCTION: The importance of a nationwide health information infrastructure (NHII) is widely recognized. Patient data may be stored where it happens to be created (the distributed or institution-centric model) or in one place for a given patient (the centralized or patient-centric model). Minimal data is available regarding the performance implications of these alternative architectural choices. OBJECTIVE: To help identify the architecture best suited for efficient and complete nationwide health information exchange based on the large-scale operational characteristics of these architectures. DESIGN: We used simulation to study the impact of health care record (data) fragmentation and probability of encounter on transaction volume and data retrieval failure rate as markers of performance for each of the above architectures. RESULTS: Data fragmentation and the probability of encounter directly correlate with transaction volume and are significantly higher for the distributed model when the number of data nodes >4 (p<0.0001). The number of data retrieval failures increases in proportion to fragmentation and is significantly higher for the distributed model when the number of data nodes ≥2 (p<0.0059). CONCLUSION: In simulation studies, the distributed model scaled poorly in terms of data availability and integrity with a higher failure rate when compared to the centralized model of data storage. Choice of architecture may have implications on the efficiency, usability, and effectiveness of the NHII at the point of care. |
| File Format | HTM / HTML |
| ISSN | 13865056 |
| Issue Number | 12 |
| Volume Number | 81 |
| e-ISSN | 18728243 |
| Journal | International Journal of Medical Informatics |
| Language | English |
| Publisher | Elsevier |
| Publisher Date | 2012-12-01 |
| Publisher Place | Ireland |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Discipline Medical Informatics Computer Communication Networks Information Storage And Retrieval Medical Record Linkage Methods Medical Records Systems, Computerized Models, Theoretical Computer Simulation Humans Journal Article |
| Content Type | Text |
| Resource Type | Article |
| Subject | Health Informatics |
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