Roehrs Alex, da Costa Cristiano André, da Rosa Righi Rodrigo
Programa de Pós-graduação em Computação Aplicada (PIPCA), Universidade do Vale do Rio dos Sinos - UNISINOS, Av. Unisinos, 950, 93022-750 São Leopoldo, RS, Brazil.
Programa de Pós-graduação em Computação Aplicada (PIPCA), Universidade do Vale do Rio dos Sinos - UNISINOS, Av. Unisinos, 950, 93022-750 São Leopoldo, RS, Brazil.
J Biomed Inform. 2017 Jul;71:70-81. doi: 10.1016/j.jbi.2017.05.012. Epub 2017 May 22.
The advances in the Information and Communications Technology (ICT) brought many benefits to the healthcare area, specially to digital storage of patients' health records. However, it is still a challenge to have a unified viewpoint of patients' health history, because typically health data is scattered among different health organizations. Furthermore, there are several standards for these records, some of them open and others proprietary. Usually health records are stored in databases within health organizations and rarely have external access. This situation applies mainly to cases where patients' data are maintained by healthcare providers, known as EHRs (Electronic Health Records). In case of PHRs (Personal Health Records), in which patients by definition can manage their health records, they usually have no control over their data stored in healthcare providers' databases. Thereby, we envision two main challenges regarding PHR context: first, how patients could have a unified view of their scattered health records, and second, how healthcare providers can access up-to-date data regarding their patients, even though changes occurred elsewhere. For addressing these issues, this work proposes a model named OmniPHR, a distributed model to integrate PHRs, for patients and healthcare providers use. The scientific contribution is to propose an architecture model to support a distributed PHR, where patients can maintain their health history in an unified viewpoint, from any device anywhere. Likewise, for healthcare providers, the possibility of having their patients data interconnected among health organizations. The evaluation demonstrates the feasibility of the model in maintaining health records distributed in an architecture model that promotes a unified view of PHR with elasticity and scalability of the solution.
信息与通信技术（ICT）的进步给医疗保健领域带来了诸多益处，特别是在患者健康记录的数字存储方面。然而，要对患者的健康史形成统一的观点仍然是一项挑战，因为通常健康数据分散在不同的医疗组织之间。此外，这些记录有多种标准，其中一些是开放的，另一些是专有的。健康记录通常存储在医疗组织内部的数据库中，很少有外部访问权限。这种情况主要适用于患者数据由医疗保健提供者维护的情况，即电子健康记录（EHRs）。在个人健康记录（PHRs）的情况下，根据定义患者可以管理自己的健康记录，但他们通常无法控制存储在医疗保健提供者数据库中的数据。因此，我们预想在PHR背景下存在两个主要挑战：第一，患者如何能够对其分散的健康记录有统一的视图；第二，即使在其他地方发生了变化，医疗保健提供者如何能够访问有关其患者的最新数据。为了解决这些问题，这项工作提出了一个名为OmniPHR的模型，这是一个用于集成PHR的分布式模型，供患者和医疗保健提供者使用。其科学贡献在于提出了一种支持分布式PHR的架构模型，患者可以从任何地方的任何设备以统一的视角维护自己 的健康史。同样，对于医疗保健提供者来说，有可能使他们患者的数据在不同医疗组织之间相互连接。评估表明该模型在维护分布于一种架构模型中的健康记录方面是可行的，该架构模型促进了具有弹性和可扩展性的PHR统一视图。
