Integrated Healthcare Enterprise (IHE) is an initiative by industry and healthcare professionals to improve knowledge sharing and interoperability between healthcare related enterprises. IHE publishes Integration Profiles on several Healthcare Fields to define how systems can use existing standards and technologies to execute a specific use case in healthcare. Cross Enterprise Document Sharing (XDS) is such a profile which defines the way of sharing Electronic Health Records (EHR) between healthcare enterprises. In this thesis, IHE Cross Enterprise User Authentication, IHE Node Authentication and Audit Trail, IHE Basic Patient Privacy Consent profiles are implemented based on the IHE XDSimplementation by National Institute of Standards, USA. Furthermore, some of the unspecified issues related with these profiles are clarified and new techniques are offered for their implementations. One of the contribution of the thesis is to use OASIS Extensible Access Control Markup Language (XACML) to define patient consent policies and manage access control. Other technologies and standards that are used in the implementation are as follows / OASIS Security Assertion Markup Language (SAML), XML Signature, Mutual Transport Layer Security (TLS), RFC 3195 Reliable Delivery for Syslog, RFC 3881 Security Audit and Access Accountability Message XML Data Definitions.

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.

Today, the healthcare IT vendors develop interfaces for their products to comply with the IHE Profiles and test them with other vendors in annual events, called IHE Connactathons which are one week events organized to perform interoperability testing. Network configuration including hostnames, IP addresses,port numbers for healthcare services and URLs for the various web services used in IHE profiles are stored on online databases accessible from the IHE website. When all companies register for participation to the connectathon, a default configuration is created in the database, assigning default values for healthcare service specific parameters. Afterwards, a company is expected to use the configuration parameters from that database during the connectathon. Except from the connectathons, the vendors could not test their products with other vendors&rsquo / . In this thesis, research on IHE Configuration Management Tool based on IHE profiles, ebXML ebBP, CPP and CPA specifications is presented. The intention behind developing such a tool is to automate the creation and exchange of configuration information between IHE Actors in a Virtual Connectathon Portal. The results of this research enable the IHE product vendors to test their products in interactions with other vendors through the web anytime/anywhere by automatic business service interface configuration. The research enables the healthcare systems to engage with many trading partners at the same time automatically. The work presented in this thesis is realized as a part of IST-027065 RIDE project funded by European Commission.

Made available in DSpace on 2016-12-23T14:33:39Z (GMT). No. of bitstreams: 1 dissertacao.pdf: 2082796 bytes, checksum: e50f1bc16d61a50d4c9fb2e41ecd3cd5 (MD5) Previous issue date: 2009-08-25 / No decorrer de sua vida, um paciente é atendido por várias instituições de saúde e é submetido a uma série de procedimentos. A quantidade de informações armazenadas sobre esse paciente é crescente, tanto em volume quanto em diversidade. Existem ainda diferentes identificações para um mesmo paciente, gerando alto custo com duplicação de procedimentos e colaborando com a imprecisão dos diagnósticos e tratamentos. Nesse sentido, o presente trabalho utiliza técnicas de Record Linkage e geração de MPI (Master Patient Index), combinadas com as especificações do perfil de integração PIX (Patient Identifier Cross-Referencing), para estabelecer uma identificação única de pacientes em diferentes sistemas de informação em saúde, que contenham fontes de dados heterogêneas e distribuídas. Com a utilização desses conceitos e tecnologias, foi especificado um projeto e desenvolvido um protótipo de um IHE (Integrating the Healthcare Enterprise)/PIX. Experimentos foram realizados em três cenários com dados reais.

<p>Uppsatsen tar upp tretton bilder som<em> Hilma af Klint </em>målade under tidsperioden 1906-1915. Bilderna ingår i en svit som kallas för <em>Bilderna till Templet</em><strong> </strong>som omfattar nästan 190 målningar. Under hennes livstid var hennes livsverk okänt för hennes samtid. Hon målade abstrakta, geometriska former och använde klara färger flera år före sina samtida konstnärskollegor. Inom ett hermeneutiskt arbetssätt ingår det olika moment som tolkning, beskrivning och analys av bilder. Uppsatsen vill belysa och ta upp hennes formspråk ur symbolisk synvinkel med hjälp av den hermeneutiska arbetsmodellen. Dels genom att göra hennes bildspråk mer begripligt och dels för att hitta gemensamma nämnare som ökar förståelsen för hennes målningar. Enligt författarens mening hade hon svårt för att förstå innehållet i bilderna, men hade en klar tanke om att bilderna speglade evolutionstanken i Skapelsen.</p> / <p>The essay includes thirteen pictures by <em>Hilma af Klint,</em> who painted these between 1906-1915. The pictures is a part ofa suite namned <em>The Paintings</em> <em>to The Temple</em> which extent almost 190 paintings. During her lifetime her life's work was unknown to her own period. She painted abstractical, geometrical forms and used bright colours many years before her contemporary artistcolleagues. Within a hermeneutical method includes different moments like, interpretation, description and analysis of pictures. The essay wants to illuminate and to lind her idiom out of a symbolic visual angle with help from the hermeneutical workrnodell. Partly making her pictorial language more clear and partly to find common factors which increase the understanding for her paintings. The author of this essay means that Hilma af Klint had some difficulties to understand the contents of her own paintings, but she had a clear thought that the pictures reflected the evolution thought in the Creation.</p>

Uppsatsen tar upp tretton bilder som Hilma af Klint målade under tidsperioden 1906-1915. Bilderna ingår i en svit som kallas för Bilderna till Templet som omfattar nästan 190 målningar. Under hennes livstid var hennes livsverk okänt för hennes samtid. Hon målade abstrakta, geometriska former och använde klara färger flera år före sina samtida konstnärskollegor. Inom ett hermeneutiskt arbetssätt ingår det olika moment som tolkning, beskrivning och analys av bilder. Uppsatsen vill belysa och ta upp hennes formspråk ur symbolisk synvinkel med hjälp av den hermeneutiska arbetsmodellen. Dels genom att göra hennes bildspråk mer begripligt och dels för att hitta gemensamma nämnare som ökar förståelsen för hennes målningar. Enligt författarens mening hade hon svårt för att förstå innehållet i bilderna, men hade en klar tanke om att bilderna speglade evolutionstanken i Skapelsen. / The essay includes thirteen pictures by Hilma af Klint, who painted these between 1906-1915. The pictures is a part ofa suite namned The Paintings to The Temple which extent almost 190 paintings. During her lifetime her life's work was unknown to her own period. She painted abstractical, geometrical forms and used bright colours many years before her contemporary artistcolleagues. Within a hermeneutical method includes different moments like, interpretation, description and analysis of pictures. The essay wants to illuminate and to lind her idiom out of a symbolic visual angle with help from the hermeneutical workrnodell. Partly making her pictorial language more clear and partly to find common factors which increase the understanding for her paintings. The author of this essay means that Hilma af Klint had some difficulties to understand the contents of her own paintings, but she had a clear thought that the pictures reflected the evolution thought in the Creation.

The delivery of quality healthcare to all citizens at reasonable costs is an important challenge. With the increase in the aging population, the costs of managing chronic diseases increase. Today, healthcare services tend to shift from recovery to prevention. Remote healthcare monitoring is crucial for prevention and monitoring of chronic diseases since they require continuous and long-term monitoring. The advances in networking, mobile communications and medical device technologies offer a great potential to realize remote healthcare monitoring. However, seamless integration of multi-modal medical devices to the existing healthcare information systems is necessary for the automated use of medical device observations in related applications. The thesis addresses the automatic acquisition and use of multi-modal medical device observations in healthcare information systems. The interoperability of medical devices with healthcare information systems requires both physical connectivity and application level interoperability. Therefore, the thesis concentrates on both the medical device domain and the interoperability efforts on the existing healthcare information systems. It provides an interoperability solution based on ISO/IEEE 11073 and HL7 standards. This work is also realized the automatic acquisition and use of multi-modal medical device observations in an intelligent healthcare monitoring and decision support system which is developed as a part of the IST-027074 SAPHIRE project funded by the European Commission.

Die zentrale Aufgabe von Informationssystemen im Gesundheitswesen ist die Unterstützung einer bestmöglichen Patientenversorgung zu geringstnötigen Kosten durch effektive und zugleich effiziente Informationsprozesse. Diese Aufgabe repräsentiert zum einen die Motivation für das Erreichen einer hohen Qualität der Informationsverarbeitung und gibt zugleich die Anforderungen vor, denen bei allen Entscheidungen bezüglich der Entwicklung eines Informationssystems Rechnung getragen werden muss.

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