Atalag Koray
National Institute for Health Innovation (NIHI), University of Auckland.
Stud Health Technol Inform. 2013;193:282-96.
This chapter describes a middle-out approach to eHealth interoperability, with strong oversight on public health and health research, enabled by a uniform and shared content model to which all health information exchange conforms. As described in New Zealand's Interoperability Reference Architecture, the content model borrows its top level organization from the Continuity of Care Record (CCR) standard and is underpinned by the openEHR formalism. This provides a canonical model for representing a variety of clinical information, and serves as reference when determining payload in health information exchange. The main premise of this approach is that since all exchanged data conforms to the same model, interoperability of clinical information can readily be achieved. Use of Archetypes ensures preservation of clinical context which is critical for secondary use. The content model is envisaged to grow incrementally by adding new or specialised archetypes as finer details are needed in real projects. The consistency and long term viability of this approach critically depends on effective governance which requires new models of collaboration, decision making and appropriate tooling to support the process.
本章描述了一种电子健康互操作性的由中间向外的方法，该方法对公共卫生和健康研究进行严格监督，由所有健康信息交换都遵循的统一且共享的内容模型来实现。如新西兰互操作性参考架构中所述，该内容模型从连续护理记录（CCR）标准借鉴其顶级组织方式，并以openEHR形式主义为基础。这为表示各种临床信息提供了一个规范模型，并在确定健康信息交换中的有效载荷时作为参考。此方法的主要前提是，由于所有交换的数据都符合相同的模型，临床信息的互操作性能够轻易实现。使用原型确保了临床上下文的保留，这对二次使用至关重要。随着实际项目中需要更详细的信息，内容模型设想通过添加新的或专门的原型来逐步扩展。这种方法的一致性和长期可行性严重依赖于有效的治理，而这需要新的协作、决策模型以及适当的工具来支持该过程。
