{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T04:53:45Z","timestamp":1773291225317,"version":"3.50.1"},"reference-count":24,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2020,10,5]],"date-time":"2020-10-05T00:00:00Z","timestamp":1601856000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Informatics"],"abstract":"<jats:p>While efforts are underway to create a sound system of electronic health records in Palestinian health institutions, there remain obstacles and challenges. Given modern day demands on health systems, we propose a federated electronic health system based on the clinical document architecture (CDA) that is compliant within the Palestine context. This architecture also brings a normalized electronic health record and a structure of blockchain to enhance interoperability with scalability, fault tolerance, privacy, and security. The new architecture and technologies will enhance services by allowing health care players, patients, and others to have the opportunity to obtain improved access and control of their health services. This may also serve as a useful model for other low-middle income countries.<\/jats:p>","DOI":"10.3390\/informatics7040041","type":"journal-article","created":{"date-parts":[[2020,10,6]],"date-time":"2020-10-06T10:46:17Z","timestamp":1601981177000},"page":"41","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Towards a New Paradigm of Federated Electronic Health Records in Palestine"],"prefix":"10.3390","volume":"7","author":[{"given":"Carol","family":"El Jabari","sequence":"first","affiliation":[{"name":"College of Nursing, Hebron University, Hebron, Palestine"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4145-7301","authenticated-orcid":false,"given":"Mario","family":"Macedo","sequence":"additional","affiliation":[{"name":"VALORIZA\u2014Research Center for Endogenous Resource Valorization Management Sciences, 7300 Portalegre, Portugal"},{"name":"School of Management Sciences, Health, IT and Engineering, Atlantica University,\r\n2730-036 Barcarena, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1527-9839","authenticated-orcid":false,"given":"Mohanad O.","family":"Al-jabari","sequence":"additional","affiliation":[{"name":"College of Information Technology, Hebron University, Hebron, Palestine"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,5]]},"reference":[{"key":"ref_1","unstructured":"WHO (2020, August 22). Global Health Observatory (GHO) Data. Available online: https:\/\/www.who.int\/gho\/goe\/electronic_health_records\/en\/."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Laher, I. (2019). Health informatics in the Arab world. Handbook of Healthcare in the Arab World, Springer.","DOI":"10.1007\/978-3-319-74365-3"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"89","DOI":"10.4258\/hir.2019.25.2.89","article-title":"Comparison of Open-Source Electronic Health Record Systems Based on Functional and User Performance Criteria","volume":"25","author":"Purkayastha","year":"2019","journal-title":"Heal. Informatics Res."},{"key":"ref_4","unstructured":"World Health Assembly (2019). Health Conditions in the Occupied Palestinian Territory, Including East Jerusalem, and in the Occupied Syrian Golan: Report by the Director-General, World Health Organization. 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