System Requirements

eHealth4U implements the prototype of the National integrated EHR system in Cyprus. As such, it should adequately describe all the potential medical aspects of human health. To manage that, the health data required by all the medical specializations (i.e. gynaecology, urology, pulmonology, etc.) should be analyzed and embraced by the EHR system. ​

However, Primary Care is considered the backbone of the nation’s healthcare system providing the framework of delivering care that best meets population needs, improving citizens’ health while reducing growth in costs and lowering inequality. ​

For that reason, the system requirements for the eHealth4U system were gathered through workshops held between the project’s business analysts and a medical team comprised by primary care doctors (i.e. general internal medicine, the general paediatrics and the family medicine).​

From the analysis of the requirements, we are separating the general components of the EHR system into two main categories, being ​

(a) the healthcare related and ​

(b) the administrative related requirements. ​

Healthcare related requirements

The healthcare related requirements are further split into 3 main sub-categories which reflects how the healthcare providers use this information in their routine workflows. Aided by the medical team, these are the: ​

  • Medical History
    Includes the total set of a citizen’s personal and health data which are captured during an interview between the citizen and the doctor. These data are further analyzed into the following sub-categories: Demographics, Family History, Vaccinations, History, Personal History, Epidemiological History, Gynaecological History, Social History and Systems Review.​
  • Clinical Examination
    Defines most of the possible clinical findings that might be observed by a doctor through a visit with a citizen. This category contains many sub-categories related to health, including vital signs, level of consciousness, the cardiovascular system, the musculoskeletal system, among others.​
  • Laboratory Results 
    The total findings from laboratory tests (e.g. chemistry, toxicology, etc.), imaging tests (e.g. MRI) and other instrumental diagnostic techniques. One example of such a scheme is shown in Figure below. ​
Fig. 1: A national integrated EHR is stored in a cloud-based Single electronic Health Records Bank (SeHRB). It keeps health data divided in three main categories which are further analyzed into further subcategories. An instance of the EHR structure showing route to the “Alerts” data is presented here. ​

Additionally, eHealth4U makes all the required provisions to facilitate integration of the national integrated EHR system with the cross-border services (a) Patient Summary and (b) ePrescription/eDispensation based on the functional requirements provided by eHealth Digital Service Infrastructure (eHDSI). ​

Administrative related requirements

The modules of scheduling and appointments were essentially required for the administration of the electronic encounters. They are designed to provide centralized services, connecting all citizens with all healthcare providers and enabling the efficient coordination of the required actions (e.g. encounters with doctors, visits to laboratory centers, etc.) for the promotion of the citizen’s well-being. ​

Additionally, to ensure data protection and complete alignment with GDPR and the Electronic Health Law of Cyprus (No. 59 (I) / 2019) a consent management component is also adopted by the eHealth4U system. In this manner, a consent will be acquired from citizens by the healthcare providers before obtaining access to their EHR data. This module allows the citizens to gain full control of their health data usage which will lead to the empowerment of citizen-ownership paving the way for the citizens to make informed choices for the benefit of their health status.​