Design and Development of a Standards-Based Holistic Electronic Health Record Application for Integrated Hospital Clinical Workflows

The rapid advancement of digital technology has accelerated the adoption of Electronic Health Record (EHR) application as essential tools for improving healthcare quality, patient safety, and clinical efficiency. However, many existing EHR implementations remain fragmented, focusing on specific services or diseases rather than representing the full complexity of hospital workflows. This study aims to design and develop a holistic EHR application capable of integrating comprehensive medical service processes within a general hospital environment using standardized datasets and real-world clinical requirements. The research employed a multi-stage development methodology consisting of requirements analysis, system design, iterative construction, and implementation with evaluation. Requirements were derived from actual hospital service processes and aligned with the national EHR minimum dataset and data model standards to ensure structural consistency and interoperability. The resulting system integrates 5 major clinical workflow process encompassing 21 subprocesses, including patient registration, multidisciplinary assessment, supporting examinations, prescription management, and final reporting. The application architecture was designed to support collaboration among healthcare professionals such as physicians, nurses, medical record staff, pharmacists, nutritionists, and laboratory personnel. Evaluation was conducted through Expert Judgement involving 8 healthcare professional representing diverse professional roles. Results indicate strong overall acceptance, with 6 of 8 evaluators assigning scores above 85%, highlighting strengths in usability, interface design, system performance, and data model reliability. Highest ratings were provided by medical record professionals, confirming structural robustness and data integrity. Overall, the study demonstrates that a standards-based, holistic EHR application can effectively operationalize complex hospital clinical workflows within a unified digital platform. The findings contribute empirical evidence supporting the feasibility of integrated EHR architectures for real-world clinical implementation and provide a practical foundation for future enhancements, scalability, and interoperability across healthcare institutions.

Electronic health record application, Standard-based health information system, Clinical data model, System Evaluation

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