An Environment for the Creation of an Integrated Electronic Health Record in HYGEIAnet, the Regional Health Telematics Network of Crete (original) (raw)
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2000
National and international healthcare networks are increasingly used to facilitate the sharing of health -related information and meet the healthcare needs of an increasingly mobile population. In this context, the vision of the Integrated Electronic Health Record (I-EHR) enables autonomous healthcare facilities to operate in a cooperative working environment and the delivery of seamless care. The Patient Clinical Data Directory (PCDD), as a central element of the overall architecture is a middleware component that provides clinical information on the distributed EHR segments maintained by autonomous information systems in a regional health-telematics network such as HYGEIAnet, the regional health-telematics network of the island of Crete. The PCDD maintains a distributed registry of feeder systems, patient key demographics, and references to clinical objects (medical encounters) inside patient EHR segments. Feeder systems, supporting diverse access methods ranging from human-mediat...
Studies in health technology and informatics
A fundamental requirement for achieving continuity of care is the seamless sharing of multi-clinical information. Several different technological approaches can be followed to enable the sharing of health record segments. In all cases interoperability between systems is a prerequisite and this requires presently a major technological challenge. Inter-operability can be achieved either through messages or through a more advanced approach based on a federation of autonomous systems. Message based integration is centered mainly on the exchange of HL7 and DICOM messages for achieving the functional integration of clinical information systems (CIS) at institutional or regional level. The federated approach is principally used for facilitating the virtual view of the Integrated Electronic Health Record (I-EHR), without having to replicate unnecessary information. Within the context of HYGEIAnet, which is the regional health telematics network of Crete, both approaches have been utilized f...
An open, component-based information infrastructure for integrated health information networks
International Journal of Medical Informatics, 2002
A fundamental requirement for achieving continuity of care is the seamless sharing of multimedia clinical information. Different technological approaches can be adopted for enabling the communication and sharing of health record segments. In the context of the emerging global information society, the creation of and access to the integrated electronic health record (I-EHR) of a citizen has been assigned high priority in many countries. This requirement is complementary to an overall requirement for the creation of a health information infrastructure (HII) to support the provision of a variety of health telematics and e-health services. In developing a regional or national HII, the components or building blocks that make up the overall information system ought to be defined and an appropriate component architecture specified. This paper discusses current international priorities and trends in developing the HII. It presents technological challenges and alternative approaches towards the creation of an I-EHR, being the aggregation of health data created during all interactions of an individual with the healthcare system. It also presents results from an ongoing Research and Development (R&D) effort towards the implementation of the HII in HYGEIAnet, the regional health information network of Crete, Greece, using a component-based software engineering approach. Critical design decisions and related trade-offs, involved in the process of component specification and development, are also discussed and the current state of development of an I-EHR service is presented. Finally, Human Computer Interaction (HCI) and security issues, which are important for the deployment and use of any I-EHR service, are considered. #
Design, Architecture, Standards and Protocols for Patient Information Systems
library.uettaxila.edu.pk
Electronic Medical Record (EMR) (sometimes also referred to as Electronic Health Record (HER) or Patient Information System (PIS)) systems are emerging as an essential part of the modern healthcare framework. EMR systems have now become an integrated, enterprise-wide providing access to patient healthcare data. EMR systems also serve as a core component of Clinical Decision Support System (CDSS). EMR systems promise to facilitate healthcare professionals with the necessary information to improve patient care efficiently and effectively. Though there has not been a great deal of research to provide a guideline for successful EMR systems implementation. This review paper provides a literature review of EMR from an architectural perspective and also lists some global EMR standards and protocols widely used in the development of EMR systems.
A fundamental requirement for achieving continuity of care is the seamless sharing of multi-clinical information. Several dif- ferent technological approaches can be followed to enable the sharing of health record segments. In all cases interoperability between systems is a prerequisite and this requires presently a major technological challenge. Interoperability can be achieved either through messages or through a more advanced approach based on a federation of autonomous systems. Mes- sage based integration is centered mainly on the exchange of HL7 and DICOM messages for achieving the functional inte- gration of clinical information systems (CIS) at institutional or regional level. The federated approach is principally used for facilitating the virtual view of the Integrated Electronic Health Record (I-EHR), without having to replicate unnecessary in- formation. Within the context of HYGEIAnet, which is the regional health telematics network of Crete, both approaches have been uti...
2002
Information and Communication Technologies (ICT) provide today a unique opportunity for a more efficient delivery of quality care and improved access to healthcare resources and information. ICT can undoubtedly improve the use of information by healthcare professionals in day-to-day patient care. However, there must be an equally strong focus on the practical use and communication of information to provide direct benefits to patients in their use of healthcare services at the point of need. In order to achieve the provision of integrated, user-oriented, health telematics services, which will eventually ensure prompt and secure access to information resources, several complex issues ought to be resolved. They are related to fragmented domain data, to platform and service heterogeneity requirements, to complicated protection and authorization policies, and to the multiplicity of existing standards for interoperability and information exchange. Therefore, the issue of developing an ope...
2001 Conference Proceedings of the 23rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 2001
The Integrated Electronic Health Record (I-EHR) is a term used to describe the whole set of information that exists in electronic form and is related to the personal health of an individual. Any approach towards I-EHR focuses on the needs of professionals or citizens who want a uniform way of accessing parts of personal health record information that is physically located in disparate information sources. Any I-EHR end-user environment must provide fast, secure and authorized access to the distributed fragments of the electronic patient record (EPR) originating at multiple clinical information systems, and to deliver them in a multitude of formats. The importance of such an environment becomes apparent when used in conjunction with a number of advanced telematic services, such as medical collaboration, home care monitoring, and/ or health emergency services, to provide seamless care without visible organizational boundaries.
Distributed Information System Architecture For Primary Health Care
We present a distributed architectural framework for Primary Health Care (PHC) Cent res. Distribution is handled through the introduction of the Roaming Electronic Health Care Record (R-EHCR) and the use of local caching and incremental update of a global index. The proposed architecture is designed to accommodate a specific PHC workflow model. Finally, we discuss a pilot implementation in progress, which is based on CORBA and web-based user interfaces. However, the conceptual architecture is generic and open to other middleware approaches like the DHE or HL7.