Interoperation and Collaboration in Shared Healthcare

concepts, which were referred to as the Synapses Object Model (SynOM). The SynOM also included a set of constraints, in the form of aggregation rules, that described how its (eight) classes could be rightfully aggregated in order to build a health record organized in a specific way. Therefore, each caregiver could organize his/her healthcare record as better suited his/her specific needs. These organizations were all valid instances of the SynOM, and collectively were referred to as the Synapses Object Dictionary (SynOD). As a result, Synapses was the first two-level-modeled EHR system that had been proposed, as referred to in Section 3.2.1, and had a neutral organization as of Section 3.2.6. A Synapses-based EHR was originally designed as a federated EHR system, as described in Section 3.2.2. One of the classes in the SynOM described how to access relevant clinical data from their original sources (e.g. relational database, proprietary API) to be included in a patient’s EHR. Some implementations of the Synapses approach [21] exploited this design principle so that the system could be used without changes to the underlying (legacy) databases; therefore an EHR could be introduced in a healthcare organization with minimal disruption to its daily activities.