Unlocking the value of clinical information: What you need to do now to enjoy the benefits in the future

Abstract

Electronic communication and connectivity are among the core functionalities of an Electronic Health Record (EHR) infrastructure with comprehensive life-long records. But clinical data is still mostly locked up in disjoint data silos, and often stored in non-standard formats. This paper elucidates the opportunities and drawbacks of using the HL7 Clinical Document Architecture (CDA) as a standard for storing clinical information for computer decision support and knowledge management. As EHR document standards are continually being improved, we argue that the ease in upgrading to new standards should be a significant factor in the design of an EHR infrastructure. To achieve this upgradeability, we need to decouple a document's data from the standards used to represent the data. We argue that this separation between data and form can be achieved using a technique called compilable templates, which was recently developed by the authors in a Personal Health Record (PHR) project. Web services offer a compelling means of implementing such templates owing to their language and platform neutrality. Finally we show that some software that one would typically expect to find in a knowledge management context can be automatically generated from a compilable template, saving time and money while reducing the possibility of error. © Springer-Verlag Berlin Heidelberg 2005.