January 5th, 2006
Easily sharing medical information
Because of a lack of integration between proprietary health information systems, it’s not easy today to exchange medical data about patients even in a single medical institution. And it’s obviously worse between different hospitals or different countries. But, according to IST Results, this healthcare interoperability problem is about to be solved by Artemis, a EU-funded project. This system is using Web services on top of existing standards to exchange messages and medical records. A prototype should be demonstrated next month in San Diego.
First, what are the major interoperability problems encountered today?
"The healthcare interoperability problem can be investigated in two categories: interoperability of the healthcare messages exchanged and interoperability of electronic healthcare records [EHRs]," says Professor Asuman Dogac, Director of the Software Research & Development Center in Turkey, and coordinator of the IST-funded Artemis project.
Standards exist to define these messages, but they have no explicit information model, so proprietary systems are using only the parts of interest to them.
Artemis provides the required interoperability between medical information systems through semantically-enriched Web services that use defined meanings of individual pieces of parameters. Artemis uses existing standards, such as HL7, as a basis for defining both the service action semantics and the message semantics.
There is an even bigger problem: the lack of unique identifiers for patients, especially when they’re not in their countries.
A protocol is needed that allows the identification of patients by means of non-unique patient-related attributes. Artemis developed a ‘Patient Identification Process’ (PIP) Protocol’. PIP provides a solution for continuity of care by locating and accessing prior clinical records and provides comprehensive security and privacy protection mechanisms.
But Artemis goes further and has extended this protocol to allow for access to patient-related clinical information, even if no Master Patient Index is available.
So how does this work? Below is a diagram showing an Artemis pilot application deployed by healthcare providers located in two European countries (Credit: Artemis project). "The pilot application includes healthcare providers South East Belfast Healthcare Trust (SEBT) in Belfast, Northern Ireland and Hacettepe Hospital in Ankara, Turkey. Each healthcare provider operates within distinct legislative domains and has different healthcare information systems to support patient care."
For more information about this project, here is a short selection of technical papers.
- Deploying Semantically Enriched Web Services in the Healthcare Domain (PDF format, 30 pages, 247 KB)
- Semantic Interoperability of Exchanged Messages in the Healthcare Domain (PDF format, 8 pages, 308 KB)
- Towards a Secure Interoperability Infrastructure for Healthcare Information Systems (MS Word format, 10 pages, 137 KB), from which the above diagram was extracted
So what’s next? A demo will be organized next month in San Diego, simulating the arrival of a patient in an hospital after an accident.
"The patient will be admitted before the ambulance arrives at the hospital, via a mobile device. The hospital admissions service will then automatically seek out any relevant healthcare records of the patient in the ARTEMIS P2P network, and presents them to the doctor, although the hospitals discovered may not be using interoperable standards with each other," says Dr Dogac.
Let’s hope that these automatic exchanges will be generalized in a few years from now.
Sources: IST Results, January 3, 2006; and various web sites
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