Katehakis D G, Kostomanolakis S, Tsiknakis M, Orphanoudakis S C
Center of Medical Informatics and Health Telematics Applications (CMI-HTA), Institute of Computer Science (ICS), Foundation for Research and Technology Hellas (FORTH), Heraklion, Crete, Greece.
Stud Health Technol Inform. 2001;84(Pt 1):18-22.
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 for providing end users with seamless access to clinical information. Both are based on an open architecture, which provides the framework for the reuse of standardized common components and public interfaces. This work presents the experiences related to the implementation of "messaging" and "federating" in HYGEIAnet, which are used complementary to each other. A comparison of the two parallel approaches, together with their strengths and weaknesses is described, and evaluation is given from the technological as well as the end users' perspective. Emphasis is given on the technological challenges in developing open, component-based information infra-structure to support integrated service delivery.
实现连续护理的一个基本要求是多临床信息的无缝共享。可以采用几种不同的技术方法来实现健康记录片段的共享。在所有情况下，系统之间的互操作性是一个先决条件，而目前这是一项重大的技术挑战。互操作性可以通过消息实现，也可以通过基于自治系统联盟的更先进方法实现。基于消息的集成主要集中在HL7和DICOM消息的交换上，以在机构或区域层面实现临床信息系统（CIS）的功能集成。联合方法主要用于促进综合电子健康记录（I-EHR）的虚拟视图，而不必复制不必要的信息。在克里特岛的区域健康远程信息网络HYGEIAnet的背景下，这两种方法都被用于为最终用户提供对临床信息的无缝访问。两者都基于开放架构，该架构为标准化通用组件和公共接口的重用提供了框架。本文介绍了HYGEIAnet中与“消息传递”和“联合”实施相关的经验，这两种方法相互补充。描述了两种并行方法的比较及其优缺点，并从技术和最终用户的角度进行了评估。重点介绍了开发开放的、基于组件的信息基础设施以支持综合服务交付方面的技术挑战。
