Reducing fragmentation in sharing of information in e-medical recording systems: case of open Mrs and care2x

Abstract

Integration of the Electronic Medical Records (EMR) with clinical research systems has the potential to greatly enhance the efficiency, speed, and safety of medical research. New hypotheses could be generated through mining of EMR data, observational studies may be conducted more rapidly, and clinical trial recruitment and conduct could be greatly facilitated. Such enhancements will be accomplished through secondary use of EMR data for research and the development of automated decision support systems that rely on EMR data. In this study we defined the various types of EMR and clinical research data systems in use and described the goals and rationale for integrating these two types of systems to enhance research as well as quality of care. The various approaches and benefits to integrating EMR and clinical research systems are discussed and data integration was prototyped on Open MRS and Care2X health information systems. Medical Records Exchange System (MRES) prototype was developed for exchange of information on Open MRS and Care2x hospital information systems. While major benefits are conferred by such system integration, many challenges exist as well, such as the need for stringent data quality assurance, appropriate granularity, metadata and person index management, and extremely careful handling of data access and security issues. Furthermore, the movement toward the EMR within Tanzania has been slow to date, hampering these data integration efforts. However, recent legislation to incentivize the adoption of EMRs will make the feasibility and utility of EMR data integration to support clinical research more promising in the near future.