Hospitals in Denmark as well as in other parts of the world are in a process
of replacing paper-based medical records with electronic patient records (EPR).
There are several obvious advantages of the electronic record as compared to the
paper-based one in terms of accessibility, quality of data, overview, sharing
across time and space, etc. These advantages are well documented. However, looking
at how healthcare professionals work and use the paper-based medical records there
are two aspects of its use, which apparently seems incompatible with the classic
client-server architecture used as a foundation for the electronic patient records.
Firstly, a medical record is used heavily in cooperation among a wide range of
different persons within and outside a hospital, and secondly clinical personnel
rarely sit down at a desk.
Hence, the PC-based technology used in the current versions of Danish EPR seems
to be inadequate because this technology take for granted that the clinical personnel
approach a desktop PC running the EPR instead of having the record ready at hand
when needed in a clinical situation – e.g. when seeing a patient or consulting
a fellow physician. Furthermore, the inherent cooperative aspect of a paper-based
record needs to be incorporated in the electronic one as well – e.g. the
ability to share medical notes and use these as a basis for a teleconference.
It is therefore of high interest – clinical, scientific as well as commercial
– to investigate how the EPR can maintain the paper-based records’
mobile and cooperative characteristics. This is the aim of this project.
Aarhus County is the first county in Denmark to design, develop, and implement
an EPR for all the hospitals in the whole county. Hence, it is very interesting
for everybody involved to study and learn from this grand-scale implementation
of a public computer system. Furthermore, it is of great interest for the suppliers,
like Systematic, to maintain their leadership in the design and development of
EPRs. Hence, product enhancement in terms of adding mobile and pervasive access
to the EPR is of high interest for the suppliers. In these years, Aarhus is to
a large extend becoming the central place in Denmark where knowledge about the
design, development, and implementation of EPRs is concentrated.