There are many challenges in the design, development and implementation of Electronic Health Record that facilitates sharing of personal information and personal health information across the province of Ontario, Canada.
As a starting point, here is a quick list of the challenges:
- Governance model. Governance refers to the structure and process to make strategic decisions for the lifecycle of the EHR. The governance model deals with fundamental by critical questions such as who has the control of the data, who is accountable to the use of the data, who makes corrections if requested by the patient.
- Benefit model. The EHR is not just a repository of clinical data; it is the solution to realize clinical benefit. Without clearly identified and agreed-upon benefit model managed throughout the lifecycle of the project, EHR won’t be a successful project that delivers the value as expected by various stakeholders.
- Consent management model. Each party (healthcare organization) in EHR has its own consent management model that supports the lifecycle of patient’s consent directive – collections, recording, registration, enforcement, override.
- Access control model. There are many access control model, such as role-based access control, policy-based access control, mandatory access control, discretionary access control, context-based access control. It is very challenging to determine the appropriate access control model that meets the privacy and security requirements and expectations from the stakeholders, and in the mean time, practically possible to implementation and support with the limitation of operational resource and budget.
The list will continue to be updated; detailed explanation of each challenge will be published soon. Please come back again.