iCARDEA: Practical Data Integration for the Follow-up of Cardiovascular Implantable Electronic Device Patients in Cardiology Departments

Abstrac

Providing Interoperability of eHealth Communities Through Peer-to-Peer Networks

Providing an interoperability infrastructure for Electronic Healthcare Records (EHRs) is on the agenda of many national and regional eHealth initiatives. Two important integration profiles have been specified for this purpose, namely, the "Integrating the Healthcare Enterprise (IHE) Cross-enterprise Document Sharing (XDS)" and the "IHE Cross Community Access (XCA)." IHE XDS describes how to share EHRs in a community of healthcare enterprises and IHE XCA describes how EHRs are shared across communities. However, the current version of the IHE XCA integration profile does not address some of the important challenges of cross-community exchange environments. The first challenge is scalability. If every community that joins the network needs to connect to every other community, i.e., a pure peer-to-peer network, this solution will not scale. Furthermore, each community may use a different coding vocabulary for the same metadata attribute, in which case, the target community cannot interpret the query involving such an attribute. Yet another important challenge is that each community may (and typically will) have a different patient identifier domain. Querying for the patient identifiers in the target community using patient demographic data may create patient privacy concerns. In this paper, we address each of these challenges and show how they can be handled effectively in a superpeer-based peer-to-peer architecture

Patient Identification based on Control Numbers 3 A Distributed Patient Identification Protocol based on Control Numbers with Semantic Annotation

One important problem of information systems in healthcare is the localisation and access to electronic patient records across healthcare institute boundaries, especially in an international setting. The complexity of the problem is increased by the absence of a globally accepted standard for electronic healthcare records, the absence of unique patient identifiers in most countries and the strict data protection requirements that apply to clinical documents. This article describes a protocol that allows to identify locations of patient records for a given patient and to access these records if granted, under consideration of the legal and technical requirements. The protocol combines cryptographic techniques with semantic annotation and mediation and presents a simple, web service based access to clinical documents