González-García Juan, Estupiñán-Romero Francisco, Tellería-Orriols Carlos, González-Galindo Javier, Palmieri Luigi, Faragalli Andrea, Pristās Ivan, Vuković Jakov, Misinš Janis, Zile Irisa, Bernal-Delgado Enrique
Biocomputing Unit, Institute for Health Sciences in Aragon (IACS), Zaragoza, Spain.
Data Sciences for Health Services and Policy Research, Institute for Health Sciences in Aragon (IACS), Zaragoza, Spain.
Arch Public Health. 2021 Dec 9;79(1):221. doi: 10.1186/s13690-021-00731-z.
Information for Action! is a Joint Action (JA-InfAct) on Health Information promoted by the EU Member States and funded by the European Commission within the Third EU Health Programme (2014-2020) to create and develop solid sustainable infrastructure on EU health information. The main objective of this the JA-InfAct is to build an EU health information system infrastructure and strengthen its core elements by a) establishing a sustainable research infrastructure to support population health and health system performance assessment, b) enhancing the European health information and knowledge bases, as well as health information research capacities to reduce health information inequalities, and c) supporting health information interoperability and innovative health information tools and data sources.
Following a federated analysis approach, JA-InfAct developed an ad hoc federated infrastructure based on distributing a well-defined process-mining analysis methodology to be deployed at each participating partners' systems to reproduce the analysis and pool the aggregated results from the analyses. To overcome the legal interoperability issues on international data sharing, data linkage and management, partners (EU regions) participating in the case studies worked coordinately to query their real-world healthcare data sources complying with a common data model, executed the process-mining analysis pipeline on their premises, and shared the results enabling international comparison and the identification of best practices on stroke care.
The ad hoc federated infrastructure was designed and built upon open source technologies, providing partners with the capacity to exploit their data and generate dashboards exploring the stroke care pathways. These dashboards can be shared among the participating partners or to a coordination hub without legal issues, enabling the comparative evaluation of the caregiving activities for acute stroke across regions. Nonetheless, the approach is not free of a number of challenges that have been solved, and new challenges that should be addressed in the eventual case of scaling up. For that eventual case, 12 recommendations considering the different layers of interoperability have been provided.
The proposed approach, when successfully deployed as a federated analysis infrastructure, such as the one developed within the JA-InfAct, can concisely tackle all levels of the interoperability requirements from organisational to technical interoperability, supported by the close collaboration of the partners participating in the study. Any proposal for extension, should require further thinking on how to deal with new challenges on interoperability.
“信息促行动！”是一项由欧盟成员国推动、由欧盟委员会在第三个欧盟卫生计划（2014 - 2020年）下资助的关于健康信息的联合行动（JA - InfAct），旨在创建和发展坚实的可持续欧盟健康信息基础设施。该联合行动的主要目标是通过以下方式构建欧盟健康信息系统基础设施并加强其核心要素：a）建立可持续的研究基础设施以支持人群健康和卫生系统绩效评估；b）加强欧洲健康信息和知识库以及健康信息研究能力，以减少健康信息不平等现象；c）支持健康信息互操作性以及创新的健康信息工具和数据源。
遵循联合分析方法，“信息促行动！”开发了一个临时联合基础设施，该基础设施基于将一种定义明确的流程挖掘分析方法分发到每个参与伙伴的系统中，以便在各系统中重现分析过程并汇总分析的聚合结果。为克服国际数据共享、数据链接和管理方面的法律互操作性问题，参与案例研究的伙伴（欧盟地区）协同工作，根据通用数据模型查询其真实世界的医疗保健数据源，在本地执行流程挖掘分析流程，并共享结果以实现国际比较并确定中风护理的最佳实践。
临时联合基础设施基于开源技术进行设计和构建，使伙伴们有能力利用其数据并生成探索中风护理路径的仪表板。这些仪表板可以在参与伙伴之间或共享到协调中心，且不存在法律问题，从而能够对各地区急性中风的护理活动进行比较评估。尽管如此，该方法并非没有一些已解决的挑战以及在最终扩大规模时应解决的新挑战。针对最终扩大规模的情况，已提供了12条考虑不同互操作性层面的建议。
所提议的方法在成功部署为联合分析基础设施（如“信息促行动！”中开发的基础设施）时，能够在参与研究的伙伴密切协作的支持下，简洁地解决从组织互操作性到技术互操作性的所有层面的互操作性要求。任何扩展提议都应进一步思考如何应对互操作性方面的新挑战。
