, Volume 18, Issue 1, pp 91-100
Date: 25 Nov 2012

E-EPR: a workflow-based electronic emergency patient record

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Emergency care is, politically and socially, one of the highest priorities in society today. Increasing patient expectations and the advancement of scientific and medical knowledge has had a dramatic effect on the provision of emergency care. Emergency medical services (EMSs) perform pre-hospital and in-hospital emergency care activities, operate 24 h a day/7 days a week and constitute an important link between the community (primary care) and the hospital (secondary and tertiary care). Managing emergency care involves assessing individual needs to create a coordinated plan of care that is consistent with agreed priorities and is designed to bring optimal outcomes using cost-effective care. Emergency care is vital for avoiding death and chronic suffering by the elderly and the homeless, but its overall positive effect on the long-term health and overall well-being of these people can only be improved significantly by applying holistic principles, going beyond basic medical care to offer psychological and social support as far as possible. Thus, creating appropriate emergency care plans requires collaboration and coordination among EMS and social care providers, giving rise to a more holistic approach to emergency care management. In turn, this requires the availability of integrated patient information to authorized individuals of health and social care providers when and where needed. On these grounds, the development of a workflow-based electronic patient record (E-EPR) for emergency care is described which is provided as a service on a cloud. The E-EPR aims at supporting the execution of EMS workflows by providing integrated patient information to EMS process participants and to make this information shareable to health and social care professionals. Due to the heterogeneity of the participating organizations’ information systems, the E-EPR is built on top of an Integrating the Healthcare Enterprise (IHE)-based collaborative network consisting of EMS agencies and health and social care providers who share patient documents using IHE-based profiles. An experimental implementation of the E-EPR is also described.