Which country is responsible for Singapore's train system and design?

How to pull data from an EMR/EHR records from hospital? Is there a direct API to access them? I'm trying to design a diagnostic app which needs information from EHR? Which EMR/EHR vendor has a good eco system?

• Answer:

  The first step in pulling data from a hospital EMR is passing muster with the hospital's IRB, CMO, CIO, CMIO (if they have one) and HIPAA privacy officer. I have not seen a direct API for a hospital EMR; instead, the hospital-based EMRs that I've worked with support an HL7  interface as an alternative to a direct API to the physical data layer. (HL7 support is a core requirement of every inpatient EMR RFP that I've reviewed.) Two examples: (1) Cerner runs on Oracle and provides both HL7 support and an API to an abstract data layer, but not to the Oracle base tables, and (2) Epic runs on a M/MUMPS backend, provides HL7 support, but does not allow direct access to the M/MUMPS globals. Once you have the proper permissions and authorizations in place, work with the hospital's IT staff to coordinate real-time HL7 connections between your system and the hospital's EMR. You'll need their help in decoding the structure and contents of certain HL7 messages, the definition of which varies from vendor to vendor. If you are fortunate, the hospital EMR supports XML-encoded HL7 v3, which provides store and forward data transfers over public networks, and a robust approach to data encoding. But don't count on it. Capture the incoming HL7 messages into an OLAP database. Develop software that parses the EMR data from the HL7 messages, transforms the EMR data for loading into a fully normalized (5NF) clinical datawarehouse, then loads the data into the CDW. With certain EMRs, you may discover that your incoming HL7 data stream has certain update anomolies that prevent the data from being loaded into the normalized CDW, requiring you to develop heuristics for deciding which clinical data is correct, without discarding incoming data.