Lumir: The EHR-S In The Basilicata Region

The Lucania – Medici in Rete (LuMiR) project aims to support the changing environment in the Italian National Health Systems, embodying a shift from organisation-centric to patient-centric healthcare service delivery in the Basilicata Region. The project main objective is to foster collaborative, cross-organizational and patient-centric healthcare processes, with a suite of shared e-services supporting the interoperability of active stakeholders’ IT applications and the exchange of patient related clinical information. In the paper the LuMiR project approach and its aim to overcome some limitations of the EHR-S national recommendation are discussed. The methodology adopted in the design and development of the LuMiR system to comply with institutional constraints and to better support a gradual change in the daily working practice of healthcare professionals is described, together with details on the LuMiR system architecture and remarks on the interventions scheduled to cope with possible hindrances for the large scale adoption of the LuMiR system itself

A medical device domain analysis model based on HL7 RIM

Clinical investigations (CIs) are carried out to demonstrate safety and efficacy of new Medical Devices (MDs). The presence of many stakeholders participating in CIs makes it necessary to develop a common standard language to achieve semantic interoperability among systems and organizations. In Italy the National Research Council is carrying out a project supported by Ministry of Health aiming to develop an information system (MEDIS) that manages MD clinical investigations. In order to develop a flexible and interoperable system, MEDIS design has been based on the application of HL7 (Health Level 7) v.3 standards. This paper presents the results of the MEDIS design: the MD DAM based on HL7 RIM

Holistic health: Predicting our data future (from inter-operability among systems to co-operability among people)

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The LITIS Conceptual Framework: Measuring eHealth Readiness and Adoption dynamics across the Healthcare Organizations

The Italian Federation of Healthcare Trusts and Municipalities promoted a national initiative, named LITIS, on the levels of technological innovation in healthcare, to assist its members in the governance of the eHealth phenomenon. The result is a toolkit (i) to compare the policies among HealthCare Organizations (HCOs) within a jurisdiction; (ii) to help negotiate and monitor the balanced evolution of eHealth solutions within and across the HCOs, and (iii) to facilitate the collaboration among HCOs to face common topics. The primary achievement is a Conceptual Framework, spanning over the complete spectrum of the support to care and administrative processes, assuming two perspectives: the Functions F (services for citizens, social/ healthcare professionals, managers, administrative staff) and the Enabling Components C (prerequisites to deploy the Functions and handle the change). The framework entails a taxonomy of indicators to assess the eHealth readiness and adoption in the HCOs: at first the raw data – from a survey that involved nearly two thirds of the Italian HCOs—were transformed to yield a lower layer of 145 micro-indicators, then the micro-indicators were aggregated at an intermediate layer for two different purposes, either as 36 topics or as 12 sectors; the upmost layer was made of 3 macro-area indexes and a global index, named “ICLI”. The ontological structure behind the framework allows to adapt the set of microindicators to the context of any particular jurisdiction. The global index was used to classify each HCO into one out of five “Classes of Innovation” of increasing functional completeness. The lessons learned on presentation and interpretation of results are described

The macrophage at the intersection of immunity and metabolism in obesity

Obesity is a worldwide pandemic representing one of the major challenges that societies face around the globe. Identifying the mechanisms involved in its development and propagation will help the development of preventative and therapeutic strategies that may help control its rising rates