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An infrastructure for Integrated Electronic Health Record services: the role of XML (Extensible Markup Language).

Katehakis DG, Sfakianakis S, Tsiknakis M, Orphanoudakis SC - J. Med. Internet Res. (2001 Jan-Mar)

Bottom Line: In addition, due to the greater mobility of the population, national and international healthcare networks are increasingly used to facilitate the sharing of healthcare-related information among the various actors of the field.Since documents are much more easily accessible rather than data inside a database, Extensible Markup Language has the potential of becoming a very cheap technology provided, of course, that the underlying Healthcare Information Infrastructure exists.XML can be introduced incrementally and its implementation is completely transparent to the end user.

View Article: PubMed Central - HTML - PubMed

Affiliation: Center of Medical Informatics and Health Telematics Applications (CMI-HTA), Institute of Computer Science (ICS), Foundation for Research and Technology, Heraklion, Crete, Greece. katehaki@ics.forth.gr

ABSTRACT

Background: The sharing of information resources is generally accepted as the key to substantial improvements in productivity and better quality of care. In addition, due to the greater mobility of the population, national and international healthcare networks are increasingly used to facilitate the sharing of healthcare-related information among the various actors of the field. In the context of HYGEIAnet, the regional health telematics network of Crete, an Integrated Electronic Health Record environment has been developed to provide integrated access to online clinical information, accessible throughout the island.

Objectives: To make available comprehensive medical information about a patient by means of incorporating all the distributed and heterogeneous health record segments into an Integrated Electronic Health Record that can be viewed on-line through a unified user interface and visualization environment.

Methods: The technological approach for implementing this Integrated Electronic Health Record environment is based on the HYGEIAnet Reference Architecture, which provides the necessary framework for the reuse of services, components, and interfaces. Seamless presentation of information is achieved by means of the Extensible Markup Language (XML), while its underlying capabilities allow for dynamic navigation according to personalized end-user preferences and authorities.

Results: The Integrated Electronic Health Record environment developed in HYGEIAnet provides the basis for consistent and authenticated access to primary information over the Internet in order to support decision-making. Primary information is always kept at the place where it has been produced, and is maintained by the most appropriate clinical information system, contrasting traditional store and forward techniques, or centralized clinical data repositories.

Conclusions: Since documents are much more easily accessible rather than data inside a database, Extensible Markup Language has the potential of becoming a very cheap technology provided, of course, that the underlying Healthcare Information Infrastructure exists. XML can be introduced incrementally and its implementation is completely transparent to the end user.

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Related in: MedlinePlus

Example of database schema mapping to the COAS observation structure
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figure2: Example of database schema mapping to the COAS observation structure

Mentions: In this context, a generic mapping between observations and attributes of database tables has been deployed. Composite observations have been mapped to database views while atomic observations have been mapped to attributes. The composite observations contain other observations, and this composition in the database is implemented through links and references from one table to another (Figure 2). Observations that are contained or related to another observation are, in turn, views that reference other tables and so forth. This recursion ends when an atomic observation is found and, if this is the case, the value of an attribute is retrieved. There is a specific mapping for each type of clinical information source, and each mapping follows a coding scheme accessible through a terminology server so that a client can "understand" the semantics of the information returned to it. The actual COAS implementation is the same for all information systems as long as they store their information in a relational database system. When moving from an information source to another, the actual implementation remains the same and the only thing that changes is the mapping from internal database relations to observations, provided that these information sources store their data in relational databases.


An infrastructure for Integrated Electronic Health Record services: the role of XML (Extensible Markup Language).

Katehakis DG, Sfakianakis S, Tsiknakis M, Orphanoudakis SC - J. Med. Internet Res. (2001 Jan-Mar)

Example of database schema mapping to the COAS observation structure
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC1761885&req=5

figure2: Example of database schema mapping to the COAS observation structure
Mentions: In this context, a generic mapping between observations and attributes of database tables has been deployed. Composite observations have been mapped to database views while atomic observations have been mapped to attributes. The composite observations contain other observations, and this composition in the database is implemented through links and references from one table to another (Figure 2). Observations that are contained or related to another observation are, in turn, views that reference other tables and so forth. This recursion ends when an atomic observation is found and, if this is the case, the value of an attribute is retrieved. There is a specific mapping for each type of clinical information source, and each mapping follows a coding scheme accessible through a terminology server so that a client can "understand" the semantics of the information returned to it. The actual COAS implementation is the same for all information systems as long as they store their information in a relational database system. When moving from an information source to another, the actual implementation remains the same and the only thing that changes is the mapping from internal database relations to observations, provided that these information sources store their data in relational databases.

Bottom Line: In addition, due to the greater mobility of the population, national and international healthcare networks are increasingly used to facilitate the sharing of healthcare-related information among the various actors of the field.Since documents are much more easily accessible rather than data inside a database, Extensible Markup Language has the potential of becoming a very cheap technology provided, of course, that the underlying Healthcare Information Infrastructure exists.XML can be introduced incrementally and its implementation is completely transparent to the end user.

View Article: PubMed Central - HTML - PubMed

Affiliation: Center of Medical Informatics and Health Telematics Applications (CMI-HTA), Institute of Computer Science (ICS), Foundation for Research and Technology, Heraklion, Crete, Greece. katehaki@ics.forth.gr

ABSTRACT

Background: The sharing of information resources is generally accepted as the key to substantial improvements in productivity and better quality of care. In addition, due to the greater mobility of the population, national and international healthcare networks are increasingly used to facilitate the sharing of healthcare-related information among the various actors of the field. In the context of HYGEIAnet, the regional health telematics network of Crete, an Integrated Electronic Health Record environment has been developed to provide integrated access to online clinical information, accessible throughout the island.

Objectives: To make available comprehensive medical information about a patient by means of incorporating all the distributed and heterogeneous health record segments into an Integrated Electronic Health Record that can be viewed on-line through a unified user interface and visualization environment.

Methods: The technological approach for implementing this Integrated Electronic Health Record environment is based on the HYGEIAnet Reference Architecture, which provides the necessary framework for the reuse of services, components, and interfaces. Seamless presentation of information is achieved by means of the Extensible Markup Language (XML), while its underlying capabilities allow for dynamic navigation according to personalized end-user preferences and authorities.

Results: The Integrated Electronic Health Record environment developed in HYGEIAnet provides the basis for consistent and authenticated access to primary information over the Internet in order to support decision-making. Primary information is always kept at the place where it has been produced, and is maintained by the most appropriate clinical information system, contrasting traditional store and forward techniques, or centralized clinical data repositories.

Conclusions: Since documents are much more easily accessible rather than data inside a database, Extensible Markup Language has the potential of becoming a very cheap technology provided, of course, that the underlying Healthcare Information Infrastructure exists. XML can be introduced incrementally and its implementation is completely transparent to the end user.

Show MeSH
Related in: MedlinePlus