A technological framework for EHR interoperability: Experiences from Italy

Electronic Health Records (EHRs) systems enable the construction of longitudinal collection of health information about individual patients, by integrating health data produced by the healthcare facilities. The advantags associated with the use of such systems are in terms of improvement of quality of care and cost reduction. An important barrier to the availability of exhaustive longitudinal collections of health data is represented by the lack of interoperability among EHR systems. In Italy, each region has been developing its own EHR systems according to the national guidelines and technical specifications compliant to the indications provided by a Italian Law issued in 2012 and updated in 2013. This paper describes the national technological framework designed from a National Technical Board for making interoperable the regional EHR systems each other, preserving the privacy of the patients. The framework, based on a System-of-Systems approach, enables healthcare professionals both to (i) consult health documents associated with a patient, even if they are produced in other regions, and (ii) register new health documents for patients assisted by other regions.