A Healthcare Information Infrastructure to Support Integrated Services over Regional Health Telematics Networks

Information and Communication Technologies (ICT) provide today a unique opportunity for a more efficient delivery of quality care and improved access to healthcare resources and information. ICT can undoubtedly improve the use of information by healthcare professionals in day-to-day patient care. However, there must be an equally strong focus on the practical use and communication of information to provide direct benefits to patients in their use of healthcare services at the point of need. In order to achieve the provision of integrated, user-oriented, health telematics services, which will eventually ensure prompt and secure access to information resources, several complex issues ought to be resolved. They are related to fragmented domain data, to platform and service heterogeneity requirements, to complicated protection and authorization policies, and to the multiplicity of existing standards for interoperability and information exchange. Therefore, the issue of developing an open, scalable and evolvable Healthcare Information Infrastructure (HII), based on a reference architecture, which is capable of supporting the seamless integration of existing information sources as well as new applications and services, is of strategic importance. Introduction Healthcare is usually delivered within certain organizational boundaries and information produced at each site is managed by isolated autonomous clinical information systems. In some cases point-to-point communication is enabled by telemedicine sessions that facilitate communication of information. In contrast, integrated regional health telematics networks enable accessibility to information and services without visible organizational boundaries, to provide decentralized healthcare through integrated services for seamless and personalized information delivery [1]. This has the advantage of enabling informed citizens to have an impact on the healthcare system and to be more concerned and care for their own health. The current vision comprises affordable access to healthcare resources and services for all citizens, thus making medical expertise a shared resource wherever and whenever needed. Important areas in which information society technologies are likely to have a significant impact include those of pre-hospital health emergencies, remote monitoring of patients with chronic conditions, and medical collaboration through sharing of health-related information resources. Current trends in the provision of healthcare services call for integrated user-oriented telematics services, which ensure prompt and secure access to information resources, provided proper authorization is available. This requires the cooperation of healthcare facilities that offer complementary set of services and involves dealing with complex issues mainly related to patient data confidentiality, semantic heterogeneity, and the diversity of systems and services requirements. This further urges for the creation and/ or adoption of certain interopera* Dimitrios G. Katehakis, Stelios C. Orphanoudakis, Manolis Tsiknakis, A Healthcare Information Infrastructure to Support Integrated Services over Regional Health Telematics Networks, Health IT Advisory Report, Medical Records Institute, Vol. 4, No. 1, Dec. 2001 Jan. 2002, pp. 15-18.