Blobel B
eHealth Competence Center, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany.
Methods Inf Med. 2010;49(2):123-34. doi: 10.3414/ME9308. Epub 2010 Feb 5.
For improving safety and quality of care as well as efficiency of health delivery under the well-known burdens, health services become specialized, distributed, and therefore collaborative, thereby changing the health service paradigm from organization-centered over process-controlled to personal health (pHealth).
Personalized eHealth services provided independent of time and location have to be based on advanced technical paradigms of mobile, pervasive and autonomous computing, enabling ubiquitous health services. Personalized eHealth systems require a multidisciplinary approach including medicine, informatics, biomedical engineering, bioinformatics and the omics disciplines but also legal and regulatory affairs, administration, security, privacy and ethics, etc. Interoperability between different components of the intended system must be provided through an architecture-centric, model-driven, formalized process.
In order to analyze, design, specify, implement and maintain such an interactive environment impacted by so many different domains, a formal and unified methodology for system analysis and design has been developed and deployed, based on an overall architectural framework. The paper introduces the underlying paradigms, requirements, architectural reference models, modeling and formalization principles as well as development processes for comprehensive service-oriented personalized eHealth interoperability chains, thereby exploiting all interoperability levels up to service interoperability. A special focus is put on ontologies and knowledge representation in the context of eHealth and pHealth solutions. Furthermore, EHR solutions, security requirements, existing and emerging standards, and educational challenges for realizing personalized pHealth are briefly discussed.
For personal health, bridging between disciplines including ontology coordination is the crucial demand. All aspects of the design and development process have to be considered from an architectural viewpoint.
在众所周知的负担之下,为提高医疗服务的安全性、质量以及效率,医疗服务变得专业化、分散化,进而需要协作,由此将医疗服务模式从以组织为中心、过程控制转变为个人健康(pHealth)模式。
独立于时间和地点提供的个性化电子健康服务必须基于移动、普适和自主计算的先进技术模式,以实现无处不在的健康服务。个性化电子健康系统需要多学科方法,包括医学、信息学、生物医学工程、生物信息学和组学学科,还包括法律和监管事务、管理、安全、隐私和伦理等。必须通过以架构为中心、模型驱动、形式化的过程来提供预期系统不同组件之间的互操作性。
为了分析、设计、指定、实现和维护这样一个受众多不同领域影响的交互式环境,基于一个总体架构框架,开发并部署了一种用于系统分析和设计的形式化且统一的方法。本文介绍了面向全面服务的个性化电子健康互操作性链的基础模式、要求、架构参考模型、建模和形式化原则以及开发过程,从而利用直至服务互操作性的所有互操作性级别。特别关注电子健康和个人健康解决方案背景下的本体和知识表示。此外,还简要讨论了电子健康记录(EHR)解决方案、安全要求、现有和新兴标准以及实现个性化个人健康的教育挑战。
对于个人健康而言,跨学科的桥梁搭建,包括本体协调,是关键需求。设计和开发过程的所有方面都必须从架构角度加以考虑。