Abstract

The current paper presents several interoperability features applied to a local distributed
information system, CardioNET, meant to improve quality of healthcare services, through the use
of the latest medical and IT&C technologies. Modern healthcare systems require a patient-centric
vision, where patients must receive medical attention or treatment anytime, regardless of their
physical location. The eHealth distributed system we present – CardioNET is based on a SOA
producer-consumer model taking a patient centric approach where every hardware, software and
medical activities become “services”. The system offers tools for remote interactions between
patients, doctors, medical entities (e.g. hospitals, labs) and authorities. Based on international
standards (IDC10, LOINC, HL7), the system assures interoperability and data exchange in widely
accepted XML formats. A logical domain bus, called Pervasive Health Service Bus-pHSB,
exchanges HL7 compliant data messages between the integrated elements of the platform, through
high level protocols (SOAP/HL7). The paper addresses interoperability problems between medical
informational platforms proposing an eHealth architecture composed of: - production systems
(nodes): General Practitioner, Analysis Laboratories, Clinics, Hospitals, Home Health Care Units
(H-HCU);- portal with specialized web services, registries and shared data repositories – distributed,
boundary-less environment for decision support, research and educational activities.
Keywords: Hospital Information Systems; Knowledge bases; Information storage and retrieval;

Introduction

Over the last years, the Internet has become the backbone of the information processing
environments, but at the same time offers insufficient levels of reliability, safety and security for
industrial quality services (ex: for health information needs). On the other hand: „Healthcare is
inherently fractal. The more closely you look, the more complexity you find” [1]. Furthermore,
health domain information and associated data structures are very complex and formalized with
different methods and by different institutions. Given these aspects it becomes more and more
difficult when patients suffering of multiple problems are being treated by several specialists in
Mircea RUSU, Gavril SAPLACAN, Gheorghe SEBESTYEN, Nicolae TODOR, Lorand KRUCZ, and Cristian LELUTIU
2 Appl Med Inform 27(3) September / 2010 jurisdictionally different locations.
The solutions rely on domain standards and interoperability among health systems.
In this context, our work tries to cover the lacks in healthcare communities, enabling
communication between domain specialized networked environments, through a set of generic
tools built in a framework. We present here an enterprise-cross border service-oriented approach:
CardioNET distributed information system, a HL7&IHE, [2,3] based framework. The currently
implemented standards require extension beyond their definitions, in order to be used among
separate systems, for enterprises cross-borders observations, reports in medical domains (trials,
claims, infectious disease reports, patient summaries), or across jurisdictional (national or regional) borders.
Interoperability is another prerequisite for the process of standalone Health Information
Systems (HIS) reengineering that will reduce the costs, errors, delays, and development repetition
efforts. The transformation of health care depends critically on interoperability, enabling computers
to automatically share and deliver information from where it originates to where it is needed.
When interoperability will be a commonplace, patients, clinicians, managers, and researchers will
enjoy secure access to the right information at the right time and at the right place, leading to better
patient outcomes and fewer mistakes.

Background