Differentiated synchronization plus FHIR a solution for EMR's Ecosystem

In many countries the health system consists of many organizations, both public and private, that must cooperate to achieve the common goal of population health. Even though in countries where public or private sector control most of the health centers, frequently each organization has a particular medical record format. This happens in Venezuela and in some South American countries. This medical record format diversity, makes it difficult to properly attend patients when they move from one health center to another. It also complicates decision-making processes related to public health policies and research, because the medical records can't be shared between organizations. Relevant medical record information is also difficult to combine. To address this problem, we propose a EMR's Ecosystem in which electronic medical records are centralized at the national level and local replicas are kept in every organization. This article is focused on a prototype of synchronization with priorities and on data sharing mechanisms proposed to implement this ecosystem.