Effective chronic disease management ensures better treatment and reduces medical costs. Representing knowledge through building an ontology for Electronic Medical Records (EMRs) is important to achieve semantic interoperability among healthcare information systems and to better execute decision support systems. In this thesis, an ontology-based EMR focusing on Chronic Disease Management is proposed. The W3C Computer-based Patient Record ontology [32] is customized and augmented with concepts and attributes from the Western Health Infostructure Canada chronic disease management model [27] and the American Society for Testing and Materials International EHR. The result is an EMR ontology capable of representing knowledge about chronic disease. All of the clinical actions of the proposed ontology were found to map to HL7 RIM classes. Such an EMR ontology for chronic disease management can support reasoning for clinical decision support systems as well as act as a switching language from one EMR standard to another for chronic disease knowledge.

That is not the secret that most of health insuranse institutions are still using hand-documentation methods for information helding, processing and transmission. The research shows that about 70% of international medical transactions are accompished with the help of the telephony, fax or paper. For example, only in Lithuania this percent is the whole 100. Only in very special cases medical information exchange invokes current technical solutions. KMU centre of heart disease can be said is the beginner of the idea…The project started had to be extended to invoke all the medical Lithuanian institutions. With the help of KTU faculty of informatics the prototype for medical documents interchange was created. Having the solution of medical documentation interchange, I defined the problem area as medical information security problems. The data security problem is not the new one in the world of computer science. But this problem is very important and the new one in the world of medicine. The only one medical information fault in medicine can reason the human’s tragedy. The first my step is to define medical information security strategy. This will be accomplished by the analyzing main information security services. Having the defined strategy I will choose security technologies and will design the medical documentation security implementation. This work can be find in the analytical part of the current document. Design part of the document will show the solution of medical... [to full text]

Rapid development in information technology (IT) has substantially affected the hospital world and will continue to be important. This research presents an IT infrastructure and a set of IT capabilities for medical referral in a hospital setting. This includes the introduction of the networking, communication standards, software and hardware, IT capability, and medical referral process as a whole in an electronic environment. The results of this research provide a great knowledge in IT infrastructure and capability for hospitals to implement medical referral. Based on this finding, hospitals can implement electronic medical referral easily.

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro Tecnológico, Programa de Pós-Graduação em Ciência da Computação, Florianópolis, 2009. / Made available in DSpace on 2012-10-24T21:29:32Z (GMT). No. of bitstreams: 1 268024.pdf: 2833334 bytes, checksum: a92f3959a3c6eb025059fc6a431bf87d (MD5) / Com a finalidade de reduzir a demanda de trabalho resultante da integração e atualização de sistemas legados de saúde heterogêneos que compartilham uma mesma base de dados propõe-se um modelo em camadas denominado HL7Middleware. O HL7Middleware utiliza a semântica fornecida pelas mensagens do padrão HL7 para que sistemas de saúde e equipamentos médicos possam acessar um banco de dados de forma homogênea e estruturada. Para validar o desempenho do modelo em camadas foram realizados testes de performance com e sem o uso do HL7Middleware, e com diferentes configurações de largura de banda. O resultado mostrou que o desempenho do HL7Middleware é superior, se comparado com o acesso direto ao banco de dados para maiores volumes de dados e quando a largura de banda do usuário é inferior à largura de banda da conexão com o banco de dados. Para validar o HL7Middleware quanto ao esforço de desenvolvimento de sistemas legados foi monitorado o tempo de desenvolvimento de wrappers, biblioteca e sistema com HL7 nativo. O custo de desenvolvimento resultante foi considerado baixo e com grau alto de reusabilidade sugerindo redução progressiva do esforço de desenvolvimento para implantação de serviços adicionais.

Medical data exchange between medicine institutions is very important subject. In Lithuania at this time hasn’t installed united medical system which allows doctors to check patient’s case-history from all hospitals. For example abroad, in Canada for example has united medical system in all country hospitals. Canada hospitals has a lot of different medical data store systems installed, and to exchange data between them, they need to accept one united standard, which allows to get and perceive accepted data in all the country. They accepted to use HL7 standard for medical data exchange. I will try to research, can we use Canada practice in Lithuania, some data and other’s research. Our object to create HL7 system which will send HL7 message answers to HL7 message queries. All queries and answers must follow the requirements of HL7 standard. We will use KMU Heart center database which is in operation for data capture. The fact that database is in operation, adds additional data analysing. Analyzing involves how data met, the HL7 requirements and there they must be put in HL7 message. The data coding in HL7 message is defined in HL7 standard, so this part is clear. But the data exchange and events processing part lets user to take his own decisions. In the analytical part of our work we will try to touch questions about data capture from database and coding it to HL7 message. Also we will touch questions about data exchange methods, what tools or solutions must be used to... [to full text]

Nagrinėjama skirtingais medicinos informatikos standartais ar jų skirtingomis versijomis sąveikaujančių asmens sveikatos priežiūros įstaigos informacinių sistemių integracija. Pagal Kauno Dainavos poliklinikos informacinių sistemų integracijos uždavinius pasirinktas artimiausias teorinis integracijos modelis. Jo pagrindu parengti tarpinio (integracinio) IS sluoksnio/modulio funkciniai reikalavimai, užtikrinantys vienareikšmius paciento sąryšius su jo sveikatos duomenimis, esančiais skirtingose sistemose. Panaudojant medicinos informatikos standarto HL7 bibliotekas 2-ai ir 3-iai versijoms, sukurtas ir sėkmingai išbandytas tarpinio (integracinio) IS sluoksnio/modulio prototipas, leidžiantis automatiškai formuoti procedūrų užsakymo identifikatorius ir, jų pagrindu, nuorodas į duomenų archyvą. Integralumas tarp 2-os ir 3-os versijos sutampančių komponentų užtikrinamas trigeriais: įterpiant, keičiant bei trinant įrašus iš vietos versijos komponento, jis bus atitinkamai modifikuotas ir kitoje versijoje. Toks duomenų sluoksnio realizavimas leidžia sumažinti verslo logikos sluoksnio sudėtingumą, kai naudojama trijų lygių architektūra, bei pačių duomenų transformacijų skaičių. / The research is devoted to an integration of health information systems, when the interoperability should be utilised using different health informatics standards or their versions. To meet the integration goals, the theoretical model, closest to a particular situation of the Dainava outpatient clinic in Kaunas, had been chosen. Based on the model, the functional requirements for the middleware (integration) layer had been defined in order to ensure unambiguous links between patient data, stored in different systems. The middleware software prototype had been developed using messaging libraries for the HL7 versions v2 and v3. The middleware was successfully tested for automatic generation of orders for procedures and links to the procedure result data in the archive. The integration of the HL7 v2 and v3 coincidental components is achieved using trigger events for synchronous data manipulations. Such rules, implemented at the data layer, leads to less complex logics at business process layer and to lower number of data transformations. After automatic orders generation from referrals model implementation, we had to produce Worklist management system prototype to ensure full control of coming patient examinations. In this scenario DICOM based data models and terms had been chosen to use.

La gestion de l'acheminement de messages d'e-santé en environnement ubiquitaire soulève plusieurs défis majeurs liés à la diversité et à la spécificité des cas d'usage et des acteurs, à l'évolutivité des contextes médical, social, logistique, environnemental...Nous proposons une méthode originale d'orchestration autonome et auto-adaptative de services visant à optimiser le flux des messages et à personnaliser la qualité de transmission, en les adressant aux destinataires les plus appropriés dans les délais requis. Notre solution est une architecture générique dirigée par des modèles du domaine d'information considéré et des données contextuelles, basés sur l'identification des besoins et des contraintes soulevées par notre problématique.Notre approche consiste en la composition de services de fusion et de gestion dynamique en temps réel d'informations hétérogènes provenant des écosystèmes source, cible et message, pilotés par des méthodes d'intelligence artificielle pour l'aide à la prise de décision de routage. Le but est de garantir une communication fiable, personnalisable et sensible à l'évolution du contexte, quel que soit le scénario et le type de message (alarme, technique, etc.). Notre architecture, applicable à divers domaines, a été consolidée par une modélisation des processus métiers (BPM) explicitant le fonctionnement des services qui la composent.Le cadriciel proposé est basé sur des ontologies et est compatible avec le standard HL7 V3. L'auto-adaptation du processus décisionnel d'acheminement est assurée par un réseau bayésien dynamique et la supervision du statut des messages par une modélisation mathématique utilisant des réseaux de Petri temporels / Routing policy management of eHealth messages in ubiquitous environment leads to address several key issues, such as taking into account the diversity and specificity of the different use cases and actors, as well as the dynamicity of the medical, social, logistic and environmental contexts.We propose an original, autonomous and adaptive service orchestration methodology aiming at optimizing message flow and personalizing transmission quality by timely sending the messages to the appropriate recipients. Our solution consists in a generic, model-driven architecture where domain information and context models were designed according to user needs and requirements. Our approach consists in composing, in real time, services for dynamic fusion and management of heterogeneous information from source, target and message ecosystems, driven by artificial intelligence methods for routing decision support. The aim is to ensure reliable, personalized and dynamic context-aware communication, whatever the scenario and the message type (alarm, technical, etc.). Our architecture is applicable to various domains, and has been strengthened by business process modeling (BPM) to make explicit the services operation.The proposed framework is based on ontologies and is compatible with the HL7 V3 standard. Self-adaptation of the routing decision process is performed by means of a dynamic Bayesian network and the messages status supervision is based on timed Petri nets

The Vision for eHealth infers that Sweden should be best in the world to utilize the opportunities of the digitization by 2025. One of three particularly important areas of action to realize the vision is standardization of e.g. exchange of information. HL7 FHIR is a modern standard for interoperability within e-health. HL7 FHIR enables the exchange of information between different healthcare information systems in an easy way. The basic building blocks in HL7 FHIR are called resources. These represent healthcare entities of some kind, e.g. Patient, Medication, Care plan, and Device. A base set of resources should either together, or by themselves, be able to satisfy the most common use cases in healthcare. A set of rules about a resource's content is called a profile, which is used for defining extensions and constraints on a resource. Profiles can be used to customize the standard to everything from a small local use-case to characteristics common for a whole country, so-called national profiles. This master thesis project sought to investigate the opportunities and restrictions with HL7 FHIR profiling by mapping the outlook of e-health stakeholders in Sweden. The project conducted a mixed method approach. Surveys were sent out to regions, county councils and private caregivers and interviews were held with national stakeholders, industry suppliers, HL7 Sweden and subject experts. The qualitative data was processed through a thematic analysis and the quantitative data was processed through a descriptive analysis. The results showed that there were positive views on governing and maintaining HL7 FHIR and FHIR profiling on a national level and to the establishment of national FHIR profiles. However, questions remain on how it shold be done. Among caregivers there were in general positive attitudes towards HL7 FHIR as a standard for interoperability and towards a possible implementation. However, the implementation level was low and specific knowledge of HL7 FHIR profiles is yet needed. / Vision e-Hälsa 2025 innebär att Sverige ska vara bäst i världen på att utnyttja möjligheterna med digitaliseringen år 2025. Ett av tre särskilt viktiga handlingsområden för att förverkliga visionen är standardisering, t.ex. av utbyte av information. HL7 FHIR är en modern standard för interoperabilitet inom e-hälsa och möjliggör utbyte av information mellan olika hälsoinformationssystem på ett enkelt sätt. De grundläggande byggstenarna i HL7 FHIR kallas resurser. Dessa representerar hälso- och sjukvårdsentiteter av något slag, t.ex. Patient, Medicin, Vårdplan och Apparat. En basuppsättning av resurser ska antingen tillsammans eller i sig själva kunna tillgodose de vanligaste användningsfallen inom hälso- och sjukvård. En uppsättning regler om en resurs innehåll kallas för profil och används för att definiera tillägg och begränsningar på en resurs. Profiler kan användas för att anpassa standarden till allt från ett litet lokalt användningsfall till egenskaper som är gemensamma för ett helt land, så kallade nationella profiler. Detta masterexamensarbete ämnade undersöka möjligheter och begränsningar med HL7 FHIR-profilering genom att kartlägga utsikterna för ehälso-aktörer i Sverige. I projektet genomfördes en mixad metodinriktning, i vilken enkäter skickades ut till regioner, landsting och privata vårdgivare och intervjuer hölls med nationella intressenter, leverantörer, HL7 Sverige och ämnesexperter. Kvalitativ data genomgick en tematisk analys och kvantitativ data genomgick en deskriptiv analys. Resultatet visade på en generellt positiv attityd gentemot ett framtagande och förvaltande av HL7 FHIR och FHIR-profiler på nationell nivå och införande av nationella FHIR-profiler. Däremot kvarstår frågor om hur det ska realiseras. Bland vårdgivare var det generellt positiva attityder gentemot HL7 FHIR som en standard för interoperabilitet och en eventuell implementation. Däremot var den generella implementationsnivån låg och ytterligare kunskap om HL7 FHIR-profiler behövs.

[pt] Este trabalho apresenta uma proposta de implementação de uma blockchain privada gerenciada por agentes de software para armazenar dados de sáude. A tecnologia blockchain está mudando a maneira com que dados privados são armazenados. Agora é possível compartilhar informações sem revelar quem é o dono da informação. Este trabalho apresenta um sistema que permite que usuários armazenagem dados de saúde em uma blockchain gerenciada por agentes de software. Pesquisas revelaram que dados de saúde devem ser armazenado em blockchains privadas, pois são privadas e não devem ser acessíveis para qualquer pessoa como em blockchains públicas. Técnicas de engenharia de software foram utilizadas para desenvolver a arquitetura proposta. O resultado é uma blockchain privada capaz de manipular dados no padrão HL7 e armazena-los de forma anônima e privada. Agentes de software foram utilizados para realizar todo o processo de recebimento, validação e inserção de dados no blockchain. / [en] This paper presents an implementation approach for a private blockchain that is managed by software agents for healthcare data storage. Blockchain technology is changing the way we store private information. Now, it is possible to share private information while not revealing its owner s identity. This paper presents a solution, which enables users to store medical data by using blockchains along with software agents. Further research work has shown that healthcare data, as sensitive information, should be stored in private blockchains through the use of appropriate methods. Software engineering techniques have been used to achieve the proposed solution. The result is a private blockchain that is suitable for manipulating HL7 data, ensuring anonymity and privacy. This can be achieved through software agents that act as regulatory controls for the private blockchains.

Hospitals are the largest and most complex organizations where health care is provided. Safe and effective patient care services in hospitals depend on the efficient decisions made by hospital executives. The main task of hospital executives is to ensure the hospital can provide high quality patient care and services. “Android Mobile Application For Hospital Executives” is an Android application used for displaying hospital performance metrics on a daily basis. This application allows hospital executives to review and monitor hospital operational data with ease of access and in a portable manner. Thus, reducing the effort of the hospital executives to perform their tasks.