(FINAL) EHR Scorecard ENG

EHR-S Scorecard
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Product File
1. Basic product information
Product name
Long product description
Short description of the product
Destination URL with product information
Trial version access URL
Access URL to demo version
Others URLs of interest
2. Basic supplier information
Name
Country of your legal seat
Is it a national or international company?
Main certifications available to the supplier
3. General characteristics
Number of concurrent users supported
Is there a mobile version?
Is the web version responsive?
What are the available user interface language?
In which country is the data stored (if applicable)?
Is there geographic data redundancy?
Does the system have high availability mechanisms?
Are any of the WCAG accessibility standards met? Which?
4. Models of use
The solution is delivered in model:

Cloud, SaaS, WebInstalled: Windows, Mac, Linux, othersMobile: nativo iOS, nativo Android, Otros
Do you have a trial or demo?
Demo options: live, self-guided, video, etc.
5. Technology
List of component of the system architecture, technology that supports them and their versions
6. Support
Support availability

24/7 o no (working hours)Others modalities
Support type

OnlineNo offeredBy mailBy phoneBy chat
Support cost

Included in the statandard purchaseAdditional cost
Does the customer have a dedicated manager?
7. Integrations
Available integrations
Is an open api available?
Is there an ecosystem of partners that can carry out integrations?
Which?
In what regions?
8. Training
Training options

In personLive onlineWebinarsDocumentationNot offeredIs guardianship offered over users for implementation over a period of time? How long?
Training cost

Included with purchaseWith an additional cost/premium accounts
9. Price
Is there a free version?
Entry price
Payment frequency: a single payment, per month, per year
Does the price depend on the number of users?
Describe additional details about the price
10. References
List of main customers using the product
11. Media
Product image snapshots
Product videos

EHR
Cells marked by (*) define requirements that must be complied with the EHRS.
General Requirements

The profile distinguishes the different functions of professionals, e.g. doctor, nurse, administrative, etc. The role distinguishes the different tasks of a profile. For example, admission clerk and the radiology department clerk in charge of transcribing the department's medical reports. To answer in the affirmative, it is necessary that the system distinguishes access by both profiles and roles.

	Yes	No
Does the EHR control access by profiles and roles?

	Yes	No
Does the EHR allow for the identification and registration of the professionals who have accessed a particular patient's medical record?
Does the EHR allow the incorporation of files, structured and unstructured data, from others or from the same care provider, with clinical information about the patient?

The affirmative answer requires both the management of the request for consultation or exploration, and the report of the result. Both must be part of the EHRS, i.e. when the request or result requires access to another application, even if it is by clicking on the EHR, the response must be negative.

	Yes	No
Does the EHR allow for the management of referral and counter-referral processes in any care setting?

It is understood that the exchange of information is due to interoperability. If the exchange of information is by file transfer, e.g. Excel or similar, the answer should be negative.

	Sí	No
Does the EHR allow for information exchange with public health systems?

1. Patient and care data
1.1 Patient identification

A fragmented medical record is one that, while belonging to the same patient, presents records that are not connected to each other. A very classic case is the availability of independent patient records in different departments of the same hospital. It also refers to situations where departmental systems such as the laboratory are not integrated with the EHR, for example, because results are accessed through a viewer, or by accessing the laboratory system.

	Yes	No
Does the EHR have control mechanisms in place to prevent a patient's medical record from becoming fragmented?

Patient identification may use redundant procedures, such as the standardized care network identification code and the history number of each care facility. The question refers specifically to a personal identification code common to the entire care network. One question refers to the identification code within the health care network (provider organisation) and the other refers to the identification code of the entire health system, which includes all service providers.

	Yes	No
(*) Does the EHR use the individual patient ID code that has been standardized across the health care network and allows access to the EHR?
Does the EHR use the nationally standardized patient identification code that allows access to the EHR?

1.2 Patient affiliation (personal data)

	Yes	No
Does the EHR allow the following data to be recorded for each patient?
(*) Name and surname
(*) Unique patient identification code?
Date of birth?
Place of birth?
Sex?
Address?
Does the EHR allow to calculate the age of patients at any point in their care process (based on date of birth)?
Does the EHR allow connection to other databases for incorporation of demographic data?

2. Uniqueness and registration
2.1 Unique medical record

At any level or level of care, the doctor or nurse has a view of the patient's clinical information, even if it has been recorded in another facility or level of care (primary care, hospital or other facilities).

	Yes	No
Does the EHR have control mechanisms in place to prevent a patient's medical record from being fragmented between levels of care?

The electronic medical record (electronic health record) does not allow a patient to be assigned to two records. When a patient is discharged, before assigning a new ID code, the system makes certain that there is no other person with that identity. This check uses data such as surname and first name, father's and mother's first and last names, date and place of birth, among others. When a possible duplicity is detected, an alert is issued to verify the person's identity.

	Yes	No
Does the EHR have mechanisms in place to ensure that patients do not have their information fragmented?

3. Information registered in the MR
3.1 Prevention and education

Refers to the registration in each patient's EHR of colon and breast cancer screening results, among others.

	Yes	No
Does the EHR have specific functionality for registration preventive activities for each patient?

This refers to the fact that there is a specific field to record the patient's ability to understand.

	Yes	No
Does the EHR have functionality to identify the patient's ability to understand information about their condition and care?

The positive response necessarily requires a field where the patient's instructions are recorded as to who, besides him/herself if he/she is able to understand it, will receive the information.

	Yes	No
Does the EHR have functionality to identify patient instructions on who receives information about their condition and care?

	Yes	No
Does the EHR have a functionality that allows the registration of information and training actions to properly perform self-care of your medical problem?

3.2 Vaccinations

	Yes	No
Does the EHR have an immunization schedule applicable to each patient?
(*) Does the EHR allow for the registration of vaccines administered to patients or refusal of administration?
Does the EHR allow registration of vaccine type, dose, manufacturer, and vaccine serial number?
Does the EHR record potential adverse events associated with vaccination?

Refers to interoperability with public health systems

	Yes	No
Does the EHR allow for the transmission of patient immunization-related data to public health authorities?

3.3 Social data

	Yes	No
Does the EHR allow for the registration of patients' social characteristics?

Interoperability between health and social services information systems is necessary to meet this requirement.

	Yes	No
Does the EHR allow for the capture of patients' social characteristics from social service-related sources?

The activity carried out in the care centres can give rise to information on the social characteristics of patients, which can be exchanged with other information systems (in the social sphere).

	Yes	No
Does the EHR allow for the exchange of information generated in this scope with other information systems?

3.4 Consultancies

	Yes	No
Does the EHR allow the patient's personal history to be recorded in relation to the current problem?

The EHR is a tool whose functions include registration clinical information. The information registration needs of different medical specialties are different. For example, primary care, Ophthalmology, ENT, Maxillofacial Surgery, etc. The EHR view and registration of information must be customised to these specific needs.

	Yes	No
Does the EHR allow for the completion of forms that allow for the collection of special characteristics of certain patient groups?

	Yes	No
Does the EHR allow for the identification of allergies or intolerances in consultations by incorporating tools that prevent patients from being administered these medications?
Can the EHR identify the drugs currently prescribed to the patient regardless of the source of the prescription?

The EHR allows for patient care based on a list of health problems that should be resolved, not on the basis of diseases or chronologically ordered medical information. The professional from basic data, history, examination and complementary studies builds a list of medical, psychological or social problems of the patient. For each health problem identified, a diagnostic plan, a therapeutic plan and a follow-up plan are produced. In this manner the information is better organized for better decision making.

	Yes	No
Does the EHR allow for the identification of the patient's structured problem list?

	Yes	No
(*) Does the EHR allow the registration of the development of the patient's process, identifying at each step the professional who has intervened?

The activity carried out in health care centres, in this case the outpatient clinic, can give rise to clinical information on patients, which can be exchanged with other information systems (in the health field).

	Yes	No
Does the EHR allow for the exchange of information generated in this scope with other information systems?

3.5 Active diagnoses and patient history

	Yes	No
Does the EHR allow the patient's family history to be recorded or captured from other sources?
Does the EHR allow you to define a list of the patient's medical history?
(*) Does the EHR allow you to define a list of active problems?

The activity carried out in health care centres can give rise to clinical information on patients, which can be exchanged with other information systems (in the health field).

	Yes	No
Does the EHR allow for the exchange of information generated in this scope with other systems?

3.6 Physiological parameters and assessment scales

	Yes	No
Does the EHR allow registration of patients' physiological parameters?

An affirmative answer to this question requires interoperability between the electro-medical devices and the EHR. the EHR. All the usual devices in the Intensive Care Unit must be interoperable.

	Yes	No
Does the EHR allow for the registration of vital signs obtained on a continuous basis in certain inpatient units?

	Yes	No
Does the EHR allow for graphical display of vital signs and vital signs?
Does the EHR allow parameterization of the units of measure?
Does the EHR allow for the calculation and registration of synthetic measures obtained from clinical constants obtained from patient contacts?
Does the EHR allow the incorporation of measurement scales with a diagnostic orientation or the establishment of evolution predictions?
Does the EHR incorporate the normality intervals defined for each of the variables and scales?

The activity carried out in health care centres can give rise to clinical information on patients, which can be exchanged with other information systems (in the health field).

	Yes	No
Does the EHR allow for the exchange of information generated in this scope with other systems?

3.7 Medical orders

The affirmative answer to this question requires that, both for the issuance of the most frequent medical orders and for the incorporation of the corresponding report, the paper is not necessary. The following orders, for example, are considered to be the most frequent: the care that the hospitalised patient must receive (feeding, checks, postural changes, etc.); the request for complementary examinations such as imaging, laboratories, etc.; the prescription, dispensing and administration of medicines when they take place in the same care centre; consultation with other services or other colleagues.

	Yes	No
Does the EHR allow for physician orders to be issued, renewed, changed or cancelled?

	Yes	No
Does the EHR define standardized procedures for physician order writing?

For example, the request for diabetic profile analysis, cardiovascular risk profile, etc.

	Yes	No
Does the EHR allow for the parameterization of standardized physician order forms applicable to pre-defined patient groups?

	Yes	No
Does the EHR ensure that each physician order is for only one patient?

In this case, the positive answer requires interoperability between systems. requires interoperability between systems.

	Sí	No
Does the EHR allow integration of medical orders with other systems, either as a receiver of the order or as a sender?

3.8 Identification of chronic or complex patients

A chronic patient is defined as a patient with one or more chronic diseases. In this sense, the World Health organisation (WHO) defines chronic diseases as "conditions of long duration" (more than 6 months) "with a generally slow progression", while a complex patient (complex chronic) is understood to be one who has progressive and limiting diseases, who is polymedicated and who presents some degree of functional deterioration.

	Yes	No
Does the EHR allow for specific identification of those patients who qualify for identification as chronic or complex patients?

Positive feedback requires interoperability between systems.

	Yes	No
Does the EHR allow for the exchange of information related to the patient's status as to whether the patient is classified as chronic or complex?

3.9 Pharmacological prescription

	Yes	No
Does the EHR allow the prescription to identify the active ingredient, dosage, route of administration, presentation, frequency (schedule) and expected duration of treatment?
Does the EHR allow the free registration of other non-standardized instructions or patient preferences?
Does the EHR allow the prescription to be for inpatient or outpatient use?
Does the EHR allow the calculation of doses when these are dependent on other variables?
Does the EHR allow for the issuance of an alert in the event that a prescription is made for a drug that is incompatible with the patient (allergy, etc.)?
Does the EHR allow for the issuance of an alert in the event that drugs are prescribed that interact with each other?
Does the EHR allow for an alert to be issued if the dose is above or below the therapeutic threshold?
Does the EHR allow for prescription prescription, facilitating proper registration of this validation?
Does the EHR allow for the registration of drug administration?
Does the EHR allow for the registration of incidents observed at the time of administration?
Does the EHR allow for the registration of potential adverse events following medication administration?

This requirement refers, for example, to the possibility of viewing prescriptions written for the patient at other providers at the same or another level of care.

	Yes	No
Does the EHR allow for the exchange of basic patient prescription information with other systems?

3.10 Laboratory

As a general rule, positive responses in this chapter require interoperability between the EHR and the laboratory information system.

	Yes	No
Does the EHR allow both inpatient and outpatient requests for hematology testing?
Does the EHR allow both inpatient and outpatient requests for biochemistry testing?
Does the EHR allow both inpatient and outpatient requests for immunology testing?
Does the EHR allow both inpatient and outpatient requests for microbiology testing?
Does the EHR allow both inpatient and outpatient requests for pathology testing?
Does the request allow for the inclusion of the patient's clinical orientation, as well as the reasons for which a certain analysis is requested?
Does the EHR provide the necessary instructions for the patient to take the test under optimal conditions (prior preparation, diet, etc.)?
Does it allow the parameterization of analytical profiles, e.g. diabetic profile, etc.?
(*) Does the EHR incorporate hematology results with your baseline levels?
(*) Does the EHR incorporate biochemistry results with your baseline levels?
(*) Does the EHR incorporate immunology results with your baseline levels?
Does the EHR incorporate microbiology results with your baseline levels?
Does the EHR incorporate pathology results?
Does the EHR allow receipt of requests for laboratory tests that are prescribed at other institutions?
Does the EHR allow lab results be displayed in a chronological manner that is understadable to the consulting physician
Does the EHR allow for the exchange of basic laboratory-related patient information with other systems?

3.11 Imaging

As a general rule, positive responses in this chapter require interoperability between the EHR and the radiology information system

	Yes	No
Does the EHR allow both inpatient and outpatient requests for imaging tests?
Does the EHR allow for the inclusion of the patient's clinical orientation, as well as the reasons why a particular test is requested?
Does the EHR allow for the necessary instructions to be provided at the time of prescription for the patient to undergo the test under optimal conditions?
(*) Does the EHR allow for the incorporation of imaging test reports displayed in a chronological order understandable to the consulting physician?
Does the EHR allow receipt of requests for imaging tests prescribed at other institutions?
Does the EHR allow for the exchange of basic patient information related to diagnostic imaging with other systems?

3.12 Image

	Yes	No
Does the EHR display the images obtained from the patient in a chronological manner that is understandable to the consulting physician?
Does the EHR show images with sufficient definition for a correct diagnosis?
Does the EHR show images obtained at other care facilities?

3.13 Other complementary tests (Except diagnostic imaging and laboratory)

As a general rule, the positive responses in this chapter require interoperability between the EHR and the information system of the departments or providers performing this testing.

	Yes	No
Does the EHR allow both inpatient and outpatient requests for supplemental testing?
Does the request for complementary tests include the clinical orientation of the patient, as well as the reasons for which a particular test is requested?
Are the necessary instructions provided at the time of prescription for the test to take place under optimal conditions?
Does the EHR incorporate the reports of complementary tests, displayed according to a chronological criterion understandable to the consulting physician?
In those cases in which complementary tests are associated with images or graphics, are they displayed in the EHR for the improvement of the physicians' diagnostic ability?
Does the EHR allow receipt of requests for supplemental tests prescribed at other institutions?
Does the EHR allow for the exchange of basic patient information related to ancillary tests with other systems?

3.14 Scheduling of activities

	Yes	No
Does the EHR allow for the scheduling of any care activities that are planned for the patient?

3.15 Last wills

	Yes	No
Does the EHR allow for the registration of patients' last wishes and preferences with their treatment or end of life?
Does the EHR allow for the exchange of basic information related to patients' last wishes and preferences with other systems?

3.16 Hospitalization of patients

	Yes	No
Does the EHR allow for structured registration of patient status?
Does the EHR allow for the completion of forms that allow for the collection of special characteristics of certain patient groups?
Does the EHR, in the inpatient setting, allow for the identification of allergies or intolerances by incorporating tools that prevent patients from being administered these medications?
Can the EHR identify the drugs currently prescribed to the patient regardless of the source of the prescription?

Patient care is based on a list of health problems to be resolved and not on the basis of diseases or chronologically ordered medical information. The professional, from basic data, history, examination and complementary studies builds a list of medical, psychological or social problems of the patient. For each health problem identified, a diagnostic plan, a therapeutic plan and a follow-up plan are produced. of the same. In this way the information is better organized for better decision making.

	Yes	No
¿Permite el EHR la identificación de la lista estructurada de problemas del paciente?

An affirmative response requires that the clinical protocol or guideline be part of the EHR. That is, if a patient is identified as meeting the criteria for a particular protocol, the EHR will suggest the steps that should be taken to care for that particular patient: tests to be requested at any given moment; care to be provided, prescription of medication, etc. Therefore, it is not only a matter of incorporating a PDF file or similar with the protocol to the EHR for consultation.

	Yes	No
Does the EHR allow for the incorporation of clinical practice guidelines and protocols that facilitate patient follow-up?

	Sí	No
Does the EHR allow the parameterization of the actions to be followed in certain groups of patients in order to facilitate the planning and monitoring of care processes?
(*) Does the EHR allow the registration of the development of the patient's process, identifying at each step the professional who has intervened?
Does the EHR allow the registration of the monitoring of variables that is performed in some special units (ICU, resuscitation...)?

The activity carried out in care centres, in this case hospitalization, can give rise to clinical information on patients, which can be exchanged with other information systems (in the health field), for which interoperability between systems is required.

	Yes	No
Does the EHR allow for the exchange of information generated in this scope with other systems?

3.17 Emergency care

An affirmative response requires the EHR to have a system in place to record the clinical information needed for triage and to calculate their degree of risk or priority for care. information needed for triage and calculates their level of risk or priority for care.

	Yes	No
Does the EHR incorporate the patient triage decision algorithm?

	Yes	No
Does the EHR allow the EHR to record the level of patient triage, along with the date and time it was performed?
Does the EHR allow the patient's personal history to be recorded in relation to the current problem?
Does the EHR allow adaptations to be made according to basic specialties that may require a very specific approach in emergencies (pediatrics, obstetrics, etc.)? Does this adaptation is done by creating specific forms?
Can the EHR identify known allergies or intolerances of patients, so that an alert is present at all times and visible to healthcare professionals?
Does the EHR allow for the identification of the medication that the patient takes on a regular basis regardless of the level of care at which it is prescribed?

Patient care based on a list of health problems to be resolved and not on the basis of diseases or medical information arranged in chronological order. The professional from basic data, history, examination and complementary studies builds a list of medical, psychological or social problems of the patient. For each health problem identified, a diagnostic plan, a therapeutic plan and a follow-up plan are produced. In this manner the information is better organized for better decision making.

	Yes	No
Does the EHR allow for the identification of the patient's problem list?

Interoperability between the EHR and laboratory information systems is required.

	Yes	No
Does the EHR allow for the ordering of all laboratory tests that can be ordered from the emergency department?
Does the EHR allow the viewing of lab results?

Interoperability between the EHR and the diagnostic imaging information system is required.

	Yes	No
Does the EHR support ordering all imaging tests that can be ordered from the emergency department?
Does the EHR allow viewing of reports of tests that have been performed for diagnostic imaging?
Does the EHR allow images from imaging tests that have been performed to be displayed in diagnostic quality?

	Yes	No
Does the EHR allow for pharmacological prescription in terms of active ingredient, dosage, route of administration, frequency (Pauta) and expected duration of treatment?
Does the EHR allow for the registration of the administration of prescribed drugs, as well as any eventualities that occur before or after administration?
Does the EHR allow for the registration of the evolution of patients throughout their care process within the emergency department, with the corresponding identification of the professional who intervened?
Does the EHR allow the EHR to track the patient's location along the care pathway (location within the emergency department, transfer to imaging, transfer to the inpatient scope, etc.)?
Does the EHR allow for the development and safekeeping of a summary of the careprovided ?

The activity carried out in health care centres, in this case emergencies, can give rise to clinical information on patients, which can be exchanged with other information systems (in the health field), for which interoperability between systems is required.

	Yes	No
Does the EHR allow for the exchange of information generated in this scope with other systems?

3.18 Informes de atención en la hospitalización

The affirmative answer requires the EHR to provide patient information that should be incorporated into the report for editing by the physician signing the report.

	Yes	No
Does the EHR allow for inpatient (or any other care setting) reporting?
(*) Does the EHR incorporate the hospitalization (or any other care setting) reports of patients according to a chronological criterion that is understandable to the consulting professional?

3.19 Informed consent

	Yes	No
Does the EHR allow for the registration of informed consents signed by the patient?

3.20 Surgical treatments

	Yes	No
Does the EHR allow registration of the surgical indication?
Does the EHR allow for the registration of surgical scheduling

In this case, the positive answer implies that the checklist is registered directly in the EHR, including the signature, without the need to provide other documents (pdf, etc.).

	Yes	No
Does the EHR allow for the registration of patient safety checklists?

	Yes	No
Does the EHR allow, through parameterizable forms, the registration of all patient variables that are relevant to the anaesthesiologist?
Does the EHR allow for the registration of all anaesthesia actions?
Does the EHR allow the registration of all drugs administered by the anaesthesiologist?
Does the EHR allow the anaesthesiologist to record the patient's vital signs and track them chronologically?
Does the EHR allow for the integration of information contained in other systems (register of constants)?

The affirmative answer requires the EHR to provide patient information that should be incorporated into the document for editing by the physician signing the report.

	Yes	No
Does the EHR allow for the creation and registration of the surgical chart?

	Yes	No
Does the EHR allow the registration of characteristics (Trademark, model, serial number, etc.)? of any device implanted in the surgical procedure?

Interoperability between the EHR and the anatomic pathology information system is required.

	Yes	No
Does the EHR allow the request for anatomic pathology?

3.21 Non-surgical treatments

	Yes	No
Does the EHR allow for the registration of treatment indication?
Does the EHR allow for the registration of patient scheduling
Does the EHR allow, through parameterizable forms, the registration of all patient variables that are relevant to the anesthesiologist?
Does the EHR allow for the registration of all anesthesia actions?
Does the EHR allow the registration of all drugs administered by the anesthesiologist?
Does the EHR allow the anesthesiologist to record the patient's vital signs and track them chronologically?
Does the EHR allow for the registration of the performance performed?

Interoperability between systems and devices with the EHR is required.

	Yes	No
Does the EHR allow for the integration of information contained in other systems (register of constants)?

	Yes	No
Does the EHR allow the registration of characteristics (Trademark, model, serial number, etc.)? of any device implanted in the surgical procedure or transfusion treatment?

Interoperability and standars
Cells marked by (*) define requirements taht must be complied with by the EHRS.
1. Standards

	Yes	No
Does the system have the capacity to receive information using semantic information exchange standards, which are specific to the system and not recognized by official international entities?

Does the system have the ability to receive information using semantic information exchange standards recognized by official international standards (SNOMED CT, LOINC, ICD-10, for example)?

	Yes	No
o CIE-9
o CIE-10
o SNOMED-CT
o LOINC
o DICOM
o CDA

	Yes	No
Does the system have the capacity to transmit information using semantic information exchange standards, which are specific to the system and not recognized by official international entities?

Does the system have the capacity to receive information using internationally recognized terminology and classification standards (SNOMEC CT, LOINC, ICD-10, for example)?

	Yes	No
o CIE-9
o CIE-10
o SNOMED-CT
o LOINC
o DICOM
o CDA

	Yes	No
Does the system have the capability to receive information using messaging exchange standards, which are proprietary to the system and not recognized by official international entities?
Does the system have the capability to receive information using messaging exchange standards recognized by official international entities (e.g. HL7, FHIR)?
Does the system have the capability to transmit information using messaging exchange standards, which are proprietary to the system and not recognized by official international entities?
Does the system have the capability to transmit information using messaging exchange standards recognized by official international entities (HL7, FHIR, for example)?
(*) Does the system have the ability to operate with structured documents?
Does the system follow an internationally recognized standard for operating with structured documents, e.g. CDA?
Does the system have the ability to operate with images?
Does the system follow an internationally recognized standard for operating with images, DICOM for example?
Does the system follow a local or proprietary standard for operating with images?
Does the system have the ability to handle images in any type of PNG, JPG, etc. format?
Does the system have the ability to access diagnostic images stored in a PACS?
Does the system follow an internationally recognized standard for storing images, DICOM for example?
Does the system follow a local or proprietary standard for storing images?
Does the system have the ability to implement or configure policies for storing images according to time periods?
(*) Does the system have the ability to operate with structured messages?
Does the system follow an internationally recognized standard for operating with structured messages, HL7 for example?
Does the system follow a local or proprietary standard for operating with messages?
Does the system have a validation procedure for the structure/format of a message? (For example, XML validation v1.0/1.1)
Does the system have the capacity to receive information using exchange standards, which are specific to the system and not recognized by official international entities?
Does the system have the capacity to receive information using exchange standards recognized by official international entities?
Does the system have the capability to transmit information using exchange standards that are specific to the system and not recognized by official international entities?
Does the system have the capability to transmit information using exchange standards recognized by official international entities?
Does the system have the ability to use different versions of the standards at the same time?
Does the system have the ability to integrate with other systems using previously supported versions of an interoperability standard?
Does the manufacturer have an established policy of revising and incorporating new versions of standards in an agile and reliable manner?
Does the system offer the capability to manage data using different versions of terminologies (either local or standard)?
Does the system offer the capability to maintain terminologies (whether local or standard)?
Does the system maintain relationships between versions of a terminology to enable the preservation of interpretation over time?
Does the system provide the capability to receive and harmonize data and transmit data to other systems that use different known versions of a terminology standard while preserving the meaning of that data?
Does the system offer the capability to deprecate terminologies that become obsolete?
Does the system offer the capability to update individual codes within a terminology to an obsolete state?
Does the system provide the capability to update terms with their equivalent when terminology changes, when coded terminology content is embedded in clinical models (e.g., templates and custom forms)?
Does the system offer the capability to update standard terminologies used to enter clinical content (through templates, custom forms, etc.)?
Does the system provide the capability to maintain an audit trail or history of system changes at the individual code level, for versions used, dates implemented and updated to allow correct interpretation of historical data over time?
Does the system have described agreements and specifications for the exchange of information with third parties?
Does the system follow the standards set (if any) in the exchange agreement with a third party?
Does the system have the capability to manage data using terminology maps that can be provided by terminology mapping services (internal or external)?
Does the system have the capability to update terminology maps using standard terminology services (internal or external)?
Does the system have the capability to generate technical quality and data quality reports for a user to determine the validity of terminology mappings using approved mapping techniques?
Does the system have the capability for a user to maintain custom terminology maps using approved mapping techniques where formal standard terminology maps are not available?
Does the system have the capability for a user to maintain custom terminology maps in formal standard terminology maps to support the use of historical data?

2. Operation and monitoring

	Yes	No
When transformations are applied to source data, does the system retain the original, unedited version of the record?
Does the system maintain an identifiable and searchable record for each version/modification made to the data?
Does the system have a deferred message handling mechanism, a queuing system?
Does the system have an event planner for messaging queues?
Does the system have a volume control or message batches?
Does the system have a mechanism to manage and configure the rules for handling the flow of information?
Does the system have an alert and notification mechanism for events related to these rules and regulations?
Does the system have the ability to determine and update resource allocation and/or prioritize the information flow queue according to established rules and ad hoc needs that may arise?
(*) Does the system have the ability to determine whether information transmitted to another system has been successfully received by that other system?
(*) Does the system have the capacity to inform a third party when it has been unable to adequately process the information received from the third party?
Does the system have a record of each data exchange (transaction) stored when transmitting information with external systems?
Does the system have the ability to send information records to third parties keeping the original record unaltered, with its signatures, metadata, origin, etc.?
Does the system record the date, time, originating entity, message type, etc. of messaging transactions in the logs?
Does the system have an enabled mechanism for consulting and monitoring these logs?
Does the system have an alert mechanism in place to monitor the exchange of information with third parties?
Does the system have the possibility to configure the persistence time of these logs?
Is the log persistence time defined in the system longer than one month?
Does the system have an automatic periodic log cleaning mechanism enabled?
Does the system have the ability to exchange information with medical devices (APPs, measuring devices, etc.,)?
If so, does the system store a unique and unique identifier of the device it is communicating with?
Does the system have a built-in transversal monitoring tool for the application's "services", that is, for the different functional use cases of the application?
Does the system have a messaging repository where information is stored until communication between the systems is re-established?
If you have a queuing system, do the stored messages have an expiration date?
Is there a retry or reinstatement queuing system in place?
Does the system have a repository of undelivered messaging?
If the message was not delivered, does the solution include message reprocessing?
Does the system have mechanisms in place to report on indicators to monitor the effectiveness and quality of information exchange with third parties?
Are these reports available by default in the system?
Does the system have mechanisms in place to assess the quality of data exchanged through interoperability mechanisms?
Does the system have metrics in this regard?

Seguridad
Cells marked by (*) define requirements that must be complied the EHRS.
1. Identification and authentication

	Yes	No
(*) Does the system have an access control mechanism for accessing protected information based on username and password (username password)? (username/password)?
Does the System have an access control mechanism for accessing protected information based on a digital certificate?
Does the System have an access control mechanism for accessing protected information based on a secure token?
Does the System have an access control mechanism for accessing protected information based on biometric information?
(*) Does the system offer the user the possibility to change their password?
Does the system offer the user the possibility to generate a new password when he/she has forgotten it?
(*) Does the system have a procedure and procedure and mechanism to uniquely identify a patient? For example, to distinguish between people who have similar first and last names that may lead to confusion. In these cases, other identification data, e.g. date and place of birth and parents' names, must be confirmed.
Does the system have the ability to manage more than one ID code for each patient? For example, health facility medical record number, health care network identification code, and national identification code.
Does the system have a connection to a local MPI?
Does the system have a connection to an external PFI within the organisation, but not at the national level?
Does the system have a connection to a national external PPM?
Does the system have an authentication mechanism for accessing protected information that is accredited to international authentication standards (e.g. SAML, WS-Trust, Kerberos)?
(*) ¿Does the system have mechanisms to manage digital identities (accounts, keys, tokens) throughout their lifecycle, from registration to termination?
Does the system have layers of Hardware/Software where AAA (authentication, authorization and accounting) validation protocol applies?
Does the system have an authorization mechanism that enforces lockout time limits in case of login error and default minimum privileges?
Does the system have a logout mechanism for inactivity of the logged in user?
Does the system have a password management mechanism that follows current security standards (NIST SP 800-57 or similar)?
Does the system employ specific measures to protect remote access services?
Does the system have token generation mechanisms?
Does the system have a mechanism to identify and authenticate patients when one patient is a proxy for another? (minors, wards...)

2. Permissions and roles of actors

	Yes	No
Does the system have an access control policy for authorizing and revoking access rights to information systems?
Does the system have the ability to easily configure these access rules?
Does the system have a process for granting and revoking appropriate user access?
Does the system have procedures in place to periodically review user access to ensure that only necessary privileges are applied?
Does the system have an authentication system that applies higher levels of authentication to protect resources with higher levels of sensitivity?
Does the system have an established usage guide for mobile computing devices (regardless of ownership) that store, process or transmit system data?
Does the system have mechanisms to enable user stories and roles to contain functional safety constraints? For example, that certain profiles (or roles) can only (or roles) can only access information about patients with whom they have a healthcare relationship. For example, patients in my department, or in my basic health scope, or radiology patients..
Does the system have mechanisms to ensure that access control is attribute or feature based whereby code verifies user authorization for a feature / data element rather than just its function?

3. Traceability of actions

	Yes	No
(*) Does the system have the ability to generate an audit trail for any authentication action/Login (successful or unsuccessful), or password change performed by the user?
Does this user audit log have all the information regarding who, what, when, where?
Does the system have the ability to generate an audit trail for any actions taken by the user against sensitive data or functionality?
Does this user audit log have all the information regarding who, what, when, where?
Does the system have the capability to generate an audit trail against actions of the system itself that affect sensitive data? That is, internal actions that the system performs on its own, without the intervention of a logged user, such as cleaning or archiving old information from a history, synchronization of information, etc.
Does this internal system process audit trail have all the information regarding who, what, when, where?
Does the system have the ability to generate an audit log with standard tools?
Does the system keep these audit trails accessible for consultation for more than 6 months?

4. Information integrity, availability and confidentiality

	Yes	No
Does the system use appropriate or proven encryption methods to protect sensitive data in transit?
Are communications between application components, including APIs, middleware, and data layers authenticated?
Does the system have policies in place that indicate when encryption should be used (e.g., at rest, in transit, with sensitive or confidential data, etc.)?
Are the security regulations and data protection compliance that apply at the national level of the country where the system is to be implemented taken into account?
Does the system employ technologies to block or restrict unencrypted sensitive information from traveling to untrusted networks?
Do secure databases use database encryption levels?
Does the system require encryption on mobile computing devices (i.e. laptops, tablets, etc.)?
Does the system have logical access restrictions to internal system components?
Does the communication between systems count with identification between parties by means of a Digital Certificate?
Has the system identified and classified sensitive data into levels of protection?
Does the system have the ability to rectify a user's data when it is wrongly associated?
Does the system have change management features?
Does the system have sensitive data identification policies?
Does the system have specific mechanisms for handling and storing sensitive data in an anonymised form?

5. Risk Management

	Yes	No
Does the system have a person or group with responsibility for an ongoing process of assessing the likelihood of known threats exploiting vulnerabilities and, as a result, the impact on valuable assets?
Does the system have a process to identify and assess reasonably foreseeable internal and external risks to the security, confidentiality and/or integrity of any electronic, paper or other records containing sensitive information?
Are routine risk assessments conducted on the system to identify key objectives to be supported by the information security program?
Is risk documentation carried out?
Does the system have protection mechanisms for your web application (e.g. WAF, port restrictions and DDoS protections)?

6. Standards and regulatory monitoring

	Yes	No
Are the standards for key management documented and used?
Does the system use secure communication standards (TLS 1?3, SSL v3, etc.)?
Does the system use SHA 1024 or similar level of communication encryption?
Does the system have standards for isolating sensitive data and procedures and technologies to protect them from unauthorized access and tampering?

Under which data protection, dissemination and authorisation regulations are they governed?

ISO 27002GDPR o equivalentOWASPCEWNIST

	Yes	No
Does the system provider participate with local, national or international security groups, associations and agencies?

Usability
1. Simplicity in the navigation and organisation of the contents

	Yes	No
Does the system's user interface show precisely and completely what content or services are offered?
Is any mechanism provided for contacting the Help Desk, or support for credential issues, detected errors, etc.?
Is the EHR patient-centreed? (patient-centreed means that all patient information is linked to that patient and it is not necessary to access different places (at least not the user) to have the information and record it). For example, to access an RX report I do not have to go to the RIS, it is in the history, the same as for the prescription of medicines, I do not have to go to the electronic prescription, or to access a clinical analysis report I do not have to go to the LIS.
Is the EHR view oriented to the user's profile?
Are the contents organized in an intuitive way? Are the contents organised according to the care processes that are the object of the user's activity?
Is the title of the screens clear and can the user easily know what information they will find on the screens?
Does the navigation menu always stay in the same place throughout the navigation through the different screens of the user interface and does it behave in the same way?
Are the links easily recognizable as such? Does its characterization indicate its status (visited, active...)?
Are there navigation elements that guide the user the user about where they are and how to undo their navigation (such as breadcrumbs, links to the home page, a wizard, etc.)?
Are the lists of values clear and unambiguous?

2. Effective interaction

	Yes	No
In general terms, can the number of clicks the user has to make to access each task from the start be considered excessive considering the logical steps for the action to be performed?
Does the system offer frequently used navigation options, shortcuts to more relevant content or for more advanced users?
Does the navigation in the system minimize user movements, such as paging, scrolling to get to content, or frequently switching between entering data and clicking the mouse?

3. Design

	Yes	No
Does the design remain consistent and uniform (structures, colours, typography...) on all screens?
Is it a simple interface, with the necessary information for the user to perform the task without noise or visual distractions?
Does the design include the necessary elements to highlight relevant content, shortcuts, actions, etc.? For clear and understandable icons, banners or images are used to attract the user's attention, etc.
Graph of constants or other parameters

4. Consistency

	Yes	No
Is the EHR in the same language or does it use local jargon concepts that are familiar from where it is implemented?
Do you use clear and concise clear and concise?
Are the terms used consistently (do they always mean the same thing on different screens)?
Are the various design elements of the application or system treated consistently across all screens? They are always in the same place, mean the same thing on every screen, etc.

5. Help and error prevention

	Yes	No
The link to the Help section Is it placed in a visible and "standard" scope?
Is help offered in understanding the contents and actions to be performed such as tool tips, help texts or information texts?
Is contextual contextual help in complex tasks? For example, it helps with coding
Are the error messages clear and descriptive so that the user can understand without doubt what was the reason for the error, what erroneous action causes it?
Does the EHR system have a feature that checks for certain information to prevent errors? For example, medication dosage, duplicate identification elements (surname and first name and ID number, or other), administration check with dispensing and with prescription of medication, with patient. Five correct: Patient, medication, dosage, route, time.

6. Feed-back and analytical information (Control and feedback)

	Yes	No
Is the user constantly informed about what is happening?
When an error appears is the user informed in a clear and not in an exaggerated alarmist manner of what happened and how to solve the reported error?
Can the user cancel or edit their actions when it makes sense to allow it?
Does the user have analysis tools for their own information?
Is the tracking information provided to the user?
Is this information presented in easily understandable graphs?
Is this information provided by dynamic graphics?

7. Minimizing the need for user interpretation

	Yes	No
Is the information needed to perform a particular action or function presented on a single screen and is it not necessary for the user to navigate and recall information presented on multiple screens?
Are the alerts presented to the user concise with clear actions and are they appropriate in number and when they are presented to the user?
For simple calculations, does the application perform them automatically so that the user does not have to do them?

Should be Empty:

EHR-S Scorecard

Product File

1. Basic product information

2. Basic supplier information

3. General characteristics

4. Models of use

5. Technology

6. Support

7. Integrations

8. Training

9. Price

10. References

11. Media

EHR

General Requirements

1. Patient and care data

1.1 Patient identification

1.2 Patient affiliation (personal data)

2. Uniqueness and registration

2.1 Unique medical record

3. Information registered in the MR

3.1 Prevention and education

3.2 Vaccinations

3.3 Social data

3.4 Consultancies

3.5 Active diagnoses and patient history

3.6 Physiological parameters and assessment scales

3.7 Medical orders

3.8 Identification of chronic or complex patients

3.9 Pharmacological prescription

3.10 Laboratory

3.11 Imaging

3.12 Image

3.13 Other complementary tests (Except diagnostic imaging and laboratory)

3.14 Scheduling of activities

3.15 Last wills

3.16 Hospitalization of patients

3.17 Emergency care

3.18 Informes de atención en la hospitalización

3.19 Informed consent

3.20 Surgical treatments

3.21 Non-surgical treatments

Interoperability and standars

1. Standards

2. Operation and monitoring

Seguridad

1. Identification and authentication

2. Permissions and roles of actors

3. Traceability of actions

4. Information integrity, availability and confidentiality

5. Risk Management

6. Standards and regulatory monitoring

Usability

1. Simplicity in the navigation and organisation of the contents

2. Effective interaction

3. Design

4. Consistency

5. Help and error prevention

6. Feed-back and analytical information (Control and feedback)

7. Minimizing the need for user interpretation