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Harmonizing patient-centric requirements for secure digital health services in heterogeneous settings
Stockholm Univ, Dept Comp & Syst Sci, S-16425 Kista, Sweden.
KTH, School of Industrial Engineering and Management (ITM), Learning, Digital Learning. Stockholm Univ, Dept Comp & Syst Sci, S-16425 Kista, Sweden.ORCID iD: 0000-0002-6854-785x
Stockholm Univ, Dept Comp & Syst Sci, S-16425 Kista, Sweden.;Mid Sweden Univ, Forum Digitalisat, S-85170 Sundsvall, Sweden.
2025 (English)In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 25, no 1, article id 235Article in journal (Refereed) Published
Abstract [en]

Implementing electronic health services with a patient-centric focus while adapting to the know-how of local contexts is a challenge. This paper addresses this challenge by establishing a template of modular requirements for designing a viable Electronic Health Record (EHR) system that enables transmission and sharing of patient data across primary, secondary, and specialized care, ensuring versatility in diverse healthcare environments and across varying socio-economic landscapes. The research is anchored in design science and employs an action research strategy, using northern Brazil as empirical case. The approach builds on generic requirements from standards established by the European Union, Fast Healthcare Interoperability Resources (FHIR), and the Swedish ePrescription journal system. These requirements are refined and adapted to the Brazilian context through a participatory method, considering development disparities across municipalities and aligning with national policy. A key feature is the integration of knowledge graphs, which, when combined with fieldwork iterations involving healthcare professionals and patient association representatives, facilitated the extraction of patient-centric requirements. Strategies from Brazilian healthcare policies targeting chronic kidney disease, selected as a significant challenge for specialized healthcare in emergent areas, were incorporated to generalize the design of EHR modules aimed at prevention and monitoring of population at risk. Results support that harmonization towards legacy system is strongly advised and discourage the introduction of systems designed from scratch.

Place, publisher, year, edition, pages
Springer Nature , 2025. Vol. 25, no 1, article id 235
Keywords [en]
Patient-centric care, Under-served areas, Harmonization requirements, Electronic journal systems, Knowledge graphs
National Category
Information Systems
Identifiers
URN: urn:nbn:se:kth:diva-360433DOI: 10.1186/s12913-024-11978-xISI: 001418244200007PubMedID: 39934816Scopus ID: 2-s2.0-85218481576OAI: oai:DiVA.org:kth-360433DiVA, id: diva2:1940398
Note

QC 20250303

Available from: 2025-02-26 Created: 2025-02-26 Last updated: 2025-03-05Bibliographically approved

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Karunaratne, Thashmee

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