Bruun-Rasmussen Morten, Bernstein Knut, Chronaki Catherine
Danish Centre for Health Telematics, Rugaardsvej 15, Odense C 5000, Denmark.
Int J Med Inform. 2003 Jul;70(2-3):205-14. doi: 10.1016/s1386-5056(03)00037-6.
During the past 10-15 years, Regional Health Care Networks (RHCN) have been established in many regions throughout the world. RHCN build on well-known techniques, methodologies and appropriate standards. Most of the European Countries today have set up IT strategic plans that focus on the establishment of RHCN. The benefits of having access to all relevant information are tremendous and contribute to cost-effective and coherent health services. By the rapid spread and use of Internet, technology has made it possible to interconnect all kinds of applications. In 2000, the most experienced regions in Europe joined PICNIC, a European project to develop the Next Generation Regional Health Care Networks and to support their new ways of providing health and social care. The previous generation of Regional Health Care Networks supported the interconnection of applications by transfer of messages. Messaging is an effective means of integration for isolated high-specialised systems that only need to exchange data. This service will continue to be one of the most important services in the future health care networks. However, tighter coupling may be desirable in some instances to avoid replicating the same functionality in several applications. In other words, certain services can be common and used by a number of applications instead of building that service inside each application. These common services are called middleware services. In PICNIC (http://www.medcom.dk/picnic), a new middleware Collaboration IT service has been identified and developed. This service allows the end users to perform real-time clinical collaboration, with exchange of text, structured data, voice and images across the limits of a single region. A clinical collaboration is associated with the shared clinical context to provide a record of relevant clinical information and facilitates synchronous as well as asynchronous collaboration. This new IT service builds on the increasing popularity of instance messaging and presence systems that facilitate smooth transition between synchronous and asynchronous interaction. The new Collaboration IT service is expected to have a strong impact on the practice of health care in the next generation of Regional Health Care Networks.
在过去的10到15年里，区域医疗保健网络（RHCN）已在世界许多地区建立起来。RHCN建立在知名技术、方法和适当标准的基础之上。如今，大多数欧洲国家都制定了以建立RHCN为重点的信息技术战略计划。获取所有相关信息的益处是巨大的，有助于实现具有成本效益且连贯一致的医疗服务。随着互联网的迅速普及和应用，技术已使各种应用程序之间的互连成为可能。2000年，欧洲最具经验的地区加入了PICNIC，这是一个旨在开发下一代区域医疗保健网络并支持其提供健康和社会护理新方式的欧洲项目。上一代区域医疗保健网络通过消息传递来支持应用程序之间的互连。消息传递是孤立的高度专业化系统之间进行集成的有效手段，这些系统只需交换数据。这项服务在未来的医疗保健网络中仍将是最重要的服务之一。然而，在某些情况下，可能需要更紧密的耦合，以避免在多个应用程序中重复相同的功能。换句话说，某些服务可以是通用的，并由多个应用程序使用，而不是在每个应用程序中构建该服务。这些通用服务被称为中间件服务。在PICNIC（http://www.medcom.dk/picnic）项目中，一种新的中间件协作信息技术服务已被识别并开发出来。这项服务允许终端用户进行实时临床协作，跨越单个区域的界限交换文本、结构化数据、语音和图像。临床协作与共享的临床背景相关联，以提供相关临床信息的记录，并促进同步和异步协作。这项新的信息技术服务建立在日益流行的即时消息传递和在线状态系统的基础之上，这些系统有助于在同步和异步交互之间实现平稳过渡。预计这项新的协作信息技术服务将对下一代区域医疗保健网络中的医疗实践产生重大影响。
