PHR AND EHR SEMANTIC INTEROPERABILITY

Basheer Dillsi, Emily Prumers, Ethan Clark

Department of English, Washington State University
ENGLISH 402: Technical & Prof Writing
Professor: Megan Lobnitz
7/18/2021
Letter of Transmittal
The name of the report, PHR and EHR Semantic Interoperability, has been agreed by the
members of team 1, as of July 14, 2021.
The purpose of the report is to provide our audience with a complete view of the flaws in the
system being used for medical records. The report will contain a concise summary of the
proposal of an app made to efficiently serve as a medium for medical record communication for
patients and health care providers. Research methods, results, and recommendations will be
included. How the system will serve as a new technology in an aged environment will be
thoroughly explained.

We would greatly appreciate any questions, comments, or concerns.

Your consideration of our proposal is welcomed, thank you for taking the time to read.

Basheer Dillsi
Emily Prumers
Ethan Clark

Executive Summary
This report includes an introduction explaining the necessity of a PHR system, MyHealth, and
the importance of interoperability with EHR systems. Research methods, results and tasks are
listed and recommendations and conclusions follow.

Introduction
Patients lack easy access to their own medical records and an efficient way to share their medical
records between health care providers. The offices of health care providers transfer medical
records between themselves, a process that can take days and can be somewhat incomplete. A
database/application (PHR system) that patients can receive and send their medical records to
and from is needed. Patients would have 24/7 immediate access to their health records and be
able to share and receive them from their smart devices. Communication between the solution
(PHR) and the individual systems that health care providers use (EHR) needs to be researched
and developed to accommodate Health Care Portability and Accountability (HIPAA) laws. Both
patients and health care providers will benefit from this solution. Patients can easily access their
records and test results and share those documents with health care providers as needed. The
general public and medical professionals are the primary audience. Caretakers and retirement
homes are also a focus, as is anyone with a smart device. Security surrounding the PHR is the
primary concern, and how the data would be transferred between the PHR and EHR systems.
Furthermore, on the heels of the COVID-19 global pandemic “telemedicine”, meeting with a
health care provider via a live video connection, was vital during the pandemic and has
continued to increase in popularity. Medical records are an essential part of health care. The
importance of health care providers to be able to share medical records electronically, both
amongst themselves and with patients, has increased alongside telemedicine and is arguably
more important now than has been in the past.

Research Methods and Tasks

Research Methods – Health Care Provider Census Description
The Health Care Provider EHR Census of 2021 is an official survey sent to numerous health care
facilities asking four questions:
(1) Are you currently using an EHR system? If yes, what EHR system are you currently using?
(2) How do you define your health care institution?
(3) Approximately how many patients do you see a year?
(4) What is your preferred incentive for installing/upgrading to an EHR system?
Using this Census results and conclusions can be made supporting the feasibility of an
application that the consumer could interact with to obtain their personal medical records with
ease. For an application to be a functional solution to the disorganization of medical records, the
first step is to implement a compatible EHR system. To summarize; the use of the Health Care
Provider EHR Census of 2021 is to determine the customer base for a consumer-friendly
interface where patients can easily access their personal medical records.
Task #1 – Determining a Customer Base
As for customer base for MyHealth; 3.15% of the responding institutions with existing EHR
systems will have to move to a different EHR system to work with the PHR software. The
incentive for them to move to the compatible EHR would be consumer satisfaction in service.
The overall 37.59% of facilities that do not have an EHR system in place would not be a
consumer of this application software as they do not meet the base level requirements to be
compatible.
Task #2 – Application Development
Most mobile applications are developed on a programing language called C# for windows-based
phones or Swift for IOS and other Apple products. Apple dominates the smartphone industry in
the United States with a 55% market share. Due to this fact the initial development of MyHealth
should be through the Swift programing language.
Task #3 – Request for Quotes
The average cost for a basic application is around $40,000 to $60,000. If some more complex
features within an application are involved the price can easily make its way up to $61,000-
$120,000. Ongoing updates are required future costs that will be added on to the existing
developmental costs. Maintenance costs are usually about 15-20% of what the app cost to
develop initially.

Results and Tasks

The product, an app titled MyHealth, is a complete system used to efficiently process and
communicate medical records for patients and health care providers. The app will be one of the
most useful tools in the health care industry. A major decrease in wait times, processing times,
and a supplemental increase in private citizens ability to access their health records. Provided in
the appendix is a small infographic containing information about the app and it’s major upgrade
of accessibility for the entire industry.
The results provided from the Provider EHR Census of 2021 are attached in the appendix and
provided below. There is a clear result showing that an upgrade to the system would be
beneficial if a tax rebate or cash rebate was involved. This is a monetary gain for hospitals while
the private citizen is able to benefit from a seamless and efficient transition to an advanced
system for communicating medical records.

Conclusions
MyHealth would be a feasible product for healthcare institutions. MyHealth should initially be
developed for Apple products quickly followed by development for Windows devices using C#
programming language. For the costs of production complexity of the application would need to
be determined. The developmental costs would most likely be handled by obtaining private
investors and initial bank loans. MyHealth would in fact be of use to the majority of healthcare
providers greatly reducing the incompetent paper systems, transferability of medical records and
increasing ease of access for the patient.

Recommendations
#1 Engaging with Apple to add MyHealth to the Apple store.
#2 Advertising on social media for PHR system MyHealth
#3 Advertising on social media and TV commercials for tax credit for health care providers
switching to compatible EHR systems

Appendices
Attached is our repurposed product, an infographic containing information about the app,
MyHealth.
The results of the survey used in research method 1, The Health Care Provider EHR Census of 2021,
is provided below:

Health Care Provider EHR Census 2021 - Results

(1) Are you currently using an EHR System?
Yes: 62.41%
No: 37.59%
If Yes, What EHR System are you currently using?
Allscripts: 36.20% Epic: 12.36%
Cerner: 24.52% NextGen: 6.52%
eClinicalWorks: 17.25% Other: 3.15%
(2) How do you define your health care instituion?
Ambulatory Surgical Center: 12.65% Hospital: 26.20%
Birth Center: 2.56% Imaging/Radiology Center: 1.30%
Blood Bank: 1.18% Mental Health/Addiction Treatment Center: 1.02%
Clinic/Medical Office: 36.52% Nursing Home: 2.52%
Diabetes Education Center: 0.09% Orthopedic/Rehabilitation Center: 1.09%
Dialysis Center: 1.20% Urgent Care: 3.91%
Hospice Home: 9.75% Telehealth: 0.01%
(3) Approximately how many patients do you see a year?
Under 500: 0.20% 3000-6000: 49.59%
500-1500: 1.56% Over 6000: 2.44%
1500-3000: 46.21%
(4) What is your prefered incentive for installing/upgrading to an EHR System?
Cash Rebate: 37.68%
Tax Credit: 45.96%
Other: 16.36%