Abstract
One of the problems of the Spanish Public Health National System is the lack of interoperability in the implemented Electronic Health Records (EHRs) systems in primary and specialty care. There is a deficiency in the electronic health systems that store the data of primary care patients, so one of the basic problems that prevent that every hospital and health center working on the same method is that deficiency. In this paper we research on this problem and to give expression to a series of solutions to it. Bibliographic material in this work has been obtained mainly from MEDLINE source. Additionally, due to the lack of information and privacy about the different EHRs systems, we have resorted to making direct contact with the organizations that have implemented those systems and technological providers. Two solutions have been propounded given several aspects for a feasibility study. The first solution is based upon in the execution of backups in different EHRs databases, which implies a huge economical and infrastructure development. The second of these solutions so that due to the creation of protocols by means of Cloud Computing Technologies. It is crucial the need to reach a homogeneity concerning to the storage of patients clinical data. On the results achieved we can emphasize that maybe the main problems are not the economical handicaps or the large technological development needed, but, as for Health each Region manages its own competences, each one governs with independent policies and decisions.


Similar content being viewed by others
References
De la Torre, I., González, S., and López-Coronado, M., Analysis of the EHR Systems in Spanish Primary Public Health System: The Lack of Interoperability. J. Med. Syst. 36(5):3273–3281, 2012.
Garde, S., Knaup, P., Hovenga, E. J. S., and Heard, S., Towards semantic interoperability for electronic health records. Methods Inform. Med. 46:332–343, 2007.
Lenz, R., Beyer, M., and Kuhn, K. A., Semantic integration in healthcare networks. Int. J. Med. Inform. 76(2–3):201–207, 2007.
European Commission. Information Society and Media. The conceptual framework of interoperable electronic health record and ePrescribing systems, Version 1.0, April 2008; http://www.ehr-impact.eu/downloads/documents/EHRI_D1_2_Conceptual_framework_v1_0.pdf. Accessed 31 May 2012.
Sonoda, T., Evolution of Electronic Medical Record solutions. Fujitsu Sci. Tech. 47(1):19–27, 2011.
HIMSS Analytics Europe. First German, Spanish and Swedish hospitals win EMRAM awards at eHealth week, 2011; http://www.himssanalytics.eu. Accessed 31 May 2012.
Saleem, T., Implementation of EHR/EPR in England a model for developing countries. JHIDC. 3(1):9–12, 2009.
Bashur, R., and Shannon, G. W., National Telemedicine Initiating essencial to healthcare reform. J. Telemed. eHealth 15:600–273, 2009.
Colera, E., Building a National Heath IT System from the middle out. J. Am. Med. Inform. Assoc. 16:271–273, 2009.
Hoerbst, A., Kohl, C., Knaup, P., and Ammenweth, E., Attitudes and behaviors related to rhe introduction of electronic health record among Austrian and German citizens. Int. J. Med. Inform. 79:81–89, 2010.
Gunter, T. D., and Terry, N. P., The emergence of national Electronic Health Record architectures in the United States and Australia: models, cost and questions. J. Med. Internet Res. 7(1):e3, 2005.
Showel, C. M., Citizens, patients and policy: a challenge for Australia’s national electronic health record. Health Inform. Manag. J. 40(2):39–43, 2011.
Takemura, T., Araki, K., Arita, K., Suzuki, T., Okamoto, K., Kume, N., Kudora, T., Takada, A., and Yoshihara, H., Development of fundamental Infrastructure for nationwide EHR in Japan. J. Med. Syst. 36(4):2213–2218, 2012.
Xu, W., Guan, Z., Cao, H., Zhang, H., Lu, M., and Li, T., Analysis and evaluation of Electronic Health Record Standard in China: A Comparison with the American National Standard ASTME 1384. Int. J. Med. Inform. 80:555–561, 2011.
Ginn, M. et al., Comparison of user groups’ perspectives of barriers and facilitators to implementing electronic health records: A systematic review. BMC Med. 9(46):1–10, 2011.
Fernández-Cardeñosa, G., De la Torre-Díez, I., López-Coronado, M., Rodrigues, J. P. C., Analysis of cloud-based solutions on EHRs systems in different scenarios. J. Med. Syst. 36(6):3777–3782, 2012.
Health Level Seven International. Introduction to HL7 Standards; http://www.hl7.org/implement/standards/index.cfm?ref=nav. Accessed 11 May 2012.
Acknowledgments
The authors want to express our gratitude to the organizations that have implemented the EHR systems in Spain for answering our questions.
This research has been partially supported by the Spanish Social Security Administration Body (IMSERSO) under the project 85/2010.
Conflict of interest
The authors declare that there is no conflict of interest with the contents of this manuscript.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
de la Torre-Díez, I., González, S. & López-Coronado, M. EHR Systems in the Spanish Public Health National System: The Lack of Interoperability between Primary and Specialty Care. J Med Syst 37, 9914 (2013). https://doi.org/10.1007/s10916-012-9914-3
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s10916-012-9914-3