Novel federal electronic health record: GOTS breakthroughs

The 2011 Health Reform Act has created financial incentives for rapid adoption of electronic health records (Ehr). A novel accelerated approach to ehr development at the Lovell FHCC has resulted in a breakthrough product now 90% operational. This multi-domain product (three domains) incorporates medical single sign on with context management, joint registration, and ancillary orders portability enabled by a two COTS enterprise service busses, and an agile development methodology to functionally integrate four existing DOD legacy ehr products. Advantages of product include scalable design, legacy archive retention and reasonable cost (10% of new single domain enterprise ehr like iehr). Disadvantages include complexity of network integration, possible prolonged latency and yet to be achieved pharmacy orders portability due to interagency cooperation business rule challenges on whose ehr is authoritative for pharmacy profile and allergy reconciliation

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