Tsiknakis Manolis, Katehakis Dimitrios G, Orphanoudakis Stelios C
Center for Medical Informatics and Health Telematics Applications (CMI-HTA), Institute of Computer Science (ICS), Foundation for Research and Technology-Hellas (FORTH), Vassilika Vouton, Heraklion, Crete, Greece.
Int J Med Inform. 2002 Dec 18;68(1-3):3-26. doi: 10.1016/s1386-5056(02)00060-6.
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.
实现医疗连续性的一项基本要求是多媒体临床信息的无缝共享。可以采用不同的技术方法来实现健康记录片段的通信和共享。在新兴的全球信息社会背景下，许多国家都高度重视创建公民的综合电子健康记录（I-EHR）并实现对其的访问。这一要求与创建健康信息基础设施（HII）以支持提供各种健康远程信息处理和电子健康服务的总体要求相辅相成。在开发区域或国家HII时，应定义构成整体信息系统的组件或构建模块，并指定适当的组件架构。本文讨论了当前国际上在开发HII方面的优先事项和趋势。它提出了创建I-EHR所面临的技术挑战和替代方法，I-EHR是个人与医疗保健系统所有交互过程中产生的健康数据的汇总。它还展示了正在进行的一项研发工作的成果，该工作采用基于组件的软件工程方法，在希腊克里特岛的区域健康信息网络HYGEIAnet中实施HII。文中还讨论了组件规范和开发过程中涉及的关键设计决策及相关权衡，并介绍了I-EHR服务的当前开发状态。最后，考虑了对任何I-EHR服务的部署和使用都很重要的人机交互（HCI）和安全问题。
