Thinking of building a Healthcare “e-Hub”?

constructionIf you are thinking of developing a healthcare e-Hub, this is not something that can be designed on the back of an envelope and implemented in a few days, weeks or months. As usual, the devil is in the details and one way to avoid a long drawn-out development / implementation cycle is to enter into a Private Label arrangement with an established e-Hub software manufacturer.

Private Label allows you to brand software under your company/product name. You pay a one-time license fee plus re-mastering charges as and when you upgrade to newer versions of the software, as these become available from the manufacturer.

For more information on private label options from Civerex call 800 529 5355 and ask for Walter Keirstead.

Background Information

There are two broad options under private labeling agreements. If the nature of the software product is such that it is “configurable” as opposed to requiring “customization”, you do not need to acquire a copy of the source code. This is the option to go for as the cost is significantly lower than outright purchase of source code.  Financing can usually be arranged.

The initial consideration, of course, re e-Hubs is “What is an e-Hub and what is the market for e-Hubs”?

The term e-Hub refers to an advanced form of Electronic Health Record (EHR).  It is still early days for e-Hubs – I did an Internet search and got back “e-Hub is not available in the medical dictionary”.  

Basically, an e-Hub consolidates patient data and provides interoperability. Beyond this, unless you look under the hood, the terms e-Hub and EHR are interchangeable.

Most EHRs are repositories. Subscribers log in and are able to browse summary demographics relating to individual patients. They may be able to download data and, if the consolidated data is available at the EHR in a standard healthcare data format (e.g. Continuity of Care Document), they can import the data to their individual patient record software systems or EMRs.

e-Hubs, on the other hand, allow subscribers to gain access to summary demographics plus gain access to posted unstructured data (doc/PDF files, notes, images, dashboards, even video/audio recordings) typically found in clinic EMRs.

Increasingly, structured data relating to a patient can account for, in some cases, as little as 10% of all data for that patient.

The differences between EHRs and EMRs, by the way, are not generally well understood.

Electronic Medical Records (EMRs) are longitudinal repositories for individual patient healthcare information that provide decision support to clinicians in respect of the rendering of health care services to individual patients and, in some implementations, provide in-line governance that accommodates excursions away from “best practices” templates that may be present in the environment.  EMRs that support “interoperability” are a source of statistical data for long term outcomes assessments studies.

The term EHR is often used to describe EMRs, but the common meaning of EHR is that of a repository of healthcare data across a large number of patients, with the various reasons for having an EHR left to the imagination.

One practical example of the use of an EHR is to facilitate the transfer of healthcare information relating to an individual patient when he/she relocates out of one regional healthcare system to another.

Another is to allow members of a specific healthcare group (clinics, hospitals, lab test facilities) to consolidate and share information relating to a patient.

Managed Care Companies look to EHRs to be able to download data relating to specific patient populations for the purposes of carrying out data analyses that lead to developing and improving “best practices” and, here, the concept of “e-hubs” appears to be taking root.

Civerex predicts that with Affordable Healthcare, private and public healthcare services delivery organizations are going to have to pull up their socks.  As patients become empowered, healthcare organizations will need to become customer-centric in order to retain these consumers, increase efficiency, increase effectiveness and plan for increased patient volumes.

e-Hubs can facilitate the transition.

Civerex’s CIVER-MED™ e-Hub and CIVER-PSYCH e-Hub software suite for healthcare comprises a generic data exchanger (CiverExchange™) for import of non-standard data, plus a direct data import capability for “flat” data files and Continuity of Care (CCD) files. Parsers can be provided to carve up different flavors of incoming multiple HL7 and XML file formats for import of data to CIVER-MED™.

At e-hub sites, the organization hosting the e-Hub service can either allow subscribers to access consolidated data at patient records on a need-to-know basis, or allow subscribers to access the organization’s secure FTP site to download encapsulations of data for patients being seen at a subscriber location.

For cross-patient statistical / tabular data mining and reporting, CIVER-MED™ /CIVER-PSYCH e-Hub effects an automatic re-export of all incoming patient data to the hosting organization’s Data Warehouse via CIVER-EXCHANGE™.

Optional modules to the CIVER-MED™/CIVER-PSYCH e-Hub software suite include CiverOrders™ (a graphic workflow development environment) and CIVER-MANAGE™ (a 3-D graphic cross-patient knowledgebase that accommodates free-form data searches).


Management consultant and process control engineer (MSc EE) with a focus on bridging the gap between operations and strategy in the areas of critical infrastructure protection, connect-the-dots law enforcement investigations, healthcare services delivery, job shop manufacturing and b2b/b2c/b2d transactions. (C) 2010-2018 Karl Walter Keirstead, P. Eng. All rights reserved. The opinions expressed here are those of the author, and are not connected with Jay-Kell Technologies Inc, Civerex Systems Inc. (Canada), Civerex Systems Inc. (USA) or CvX Productions.
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