Marco Eichelberg
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Abstract
Medical information systems today store clinical information about patients in all kinds of proprietary formats. To address the resulting interoperability problems, several Electronic Healthcare Record standards that structure the clinical content for the purpose of exchange are currently under development. In this article, we present a survey of the most relevant Electronic Healthcare Record standards, examine the level of interoperability they provide, and assess their functionality in terms of content structure, access services, multimedia support, and security. We further investigate the complementarity of the standards and assess their market relevance.
- Aden, T. and Eichelberg, M. 2005. Cross-enterprise search and access to clinical information based on IHE Retrieve Information for Display. In Proceedings of Computer Assisted Radiology and Surgery (CARS'05). Elsevier, 986--991.Google Scholar
- Aden, T., Eichelberg, M., and Thoben, W. 2004. A fault-tolerant cryptographic protocol for patient record requests. In Proceedings of EuroPACS-MIR 2004 in the Enlarged Europe. EuroPACS, 103--106.Google Scholar
- ANSI. American National Standards Institute. http://www.ansi.org/.Google Scholar
- Araki, K., Ohashi, K., Yamazaki, S., Hirose, Y., Yamashita, Y., Yamamoto, R., Minagawa, K., Sakamoto, N., and Yoshihara, H. 2000. Medical Markup Language (MML) for XML-based hospital information interchange. J. Medical Syst. 24, 3, 195--211. Google Scholar
- ARTEMIS. The ARTEMIS Project. http://www.srdc.metu.edu.tr/webpage/projects/artemis.Google Scholar
- Beale, T. 2002. Archetypes: Constraint-based domain models for future-proof information systems. In Workshop on Behavioural Semantics (OOPSLA'02). http://www.deepthought.com.au/it/archetypes/arche-types_new.pdf.Google Scholar
- Beale, T. 2005. The openEHR integration information model, rev. 0.5. openEHR Reference Model. The openEHR Foundation.Google Scholar
- Beale, T. and Heard, S. Archetype definitions and principles. http://www.openehr.org/repositories/spec-dev/latest/publishing/architecture/archety-pes/principles/REV_HIST.html.Google Scholar
- Beale, T. and Heard, S. 2003. The openEHR EHR service model, rev. 0.2. openEHR Reference Model. The openEHR Foundation.Google Scholar
- Beale, T. and Heard, S. 2005. Archetype Definition Language (ADL), Rev. 2.0rc1 (Release 1.0 draft). The openEHR Foundation. openEHR Specification.Google Scholar
- Beale, T., Heard, S., Kalra, D., and Lloyd, D. 2004. The openEHR EHR_EXTRACT information model, Rev. 1.3.5. openEHR Reference Model. The openEHR Foundation.Google Scholar
- Beale, T., Heard, S., Kalra, D., and Lloyd, D. 2005a. The openEHR common information model Rev. 2.0rc1 (Release 1.0 draft). openEHR Reference Model. The openEHR Foundation.Google Scholar
- Beale, T., Heard, S., Kalra, D., and Lloyd, D. 2005b. The openEHR data types information model Rev. 1.9.1. openEHR Reference Model. The openEHR Foundation.Google Scholar
- Beale, T., Heard, S., Kalra, D., and Lloyd, D. 2005c. The openEHR demographic information model, Rev. 1.4.7. openEHR Reference Model. The openEHR Foundation.Google Scholar
- Beale, T., Heard, S., Kalra, D., and Lloyd, D. 2005d. The openEHR EHR information model Rev. 5.0rc1 (Release 1.0 draft). openEHR Reference Model. The openEHR Foundation.Google Scholar
- Beale, T., Heard, S., Kalra, D., and Lloyd, D. 2005e. The openEHR support information model Rev. 1.5rc1 (Release 1.0 draft). openEHR Reference Model. The openEHR Foundation.Google Scholar
- Beale, T., Heard, S., Kalra, D., and Lloyd, D. 2005f. The openEHR data structures information model Rev. 1.6rc1 (Release 1.0 draft). openEHR Reference Model. The openEHR Foundation.Google Scholar
- Bicer, V., Kilic, O., Dogac, A., and Laleci, G. B. 2005. Archetype-based semantic interoperability of Web service messages in the healthcare domain. Inte. J. Semantic Web Informat. Syst. 1, 4, 1--23.Google Scholar
- Bicer, V., Laleci, G., Dogac, A., and Kabak, Y. 2005a. Artemis message exchange framework: Semantic interoperability of exchanged messages in the healthcare domain. ACM Sigmod Record 34, 3 (Sept.). Google Scholar
- Bicer, V., Laleci, G. B., Dogac, A., and Kabak, Y. 2005b. Providing semantic interoperability in the healthcare domain through ontology mapping. In Proceedings of eChallenges 2005. Ljubljana, Slovenia.Google Scholar
- Boniface, M. and Wilken, P. 2005. ARTEMIS: Towards a secure interoperability infrastructure for healthcare information systems. In Studies in Health Technology and Informatics---From Grid to Healthgrid: Proceedings of Healthgrid 2005. T. Solomonides, R. McClatchey, V. Breton, Y. Legré, and S. Nørager, Eds. Vol. 112. IOS Press, 181--189.Google Scholar
- Brown, N. and Reynolds, M. 2000. Strategy for production and maintenance of standards for interoperability within and between service departments and other healthcare domains. Short Strategic Study CEN/TC 251/N00-047, CEN/TC 251 Health Informatics. Brussels, Belgium.Google Scholar
- Canada Health Infoway. http://www.canadahealthinfoway.com/.Google Scholar
- CBC Archetype. Complete blood count archetype ADL definition. http://www.openehr.org/repositories/archetype-dev/adl_1.1/adl/archety-pes/openehr/ehr/entry/openehr-ehr-observation.haematology-cbc.draft.adl.html.Google Scholar
- CEN ENV 12265. 1997. Medical informatics--Electronic healthcare record architecture. European Prestandard ENV 12265, European Committee for Standardization. Brussels, Belgium.Google Scholar
- CEN ENV 13606. 2000. Medical informatics---Electronic healthcare record communication. European Prestandard ENV 13606, European Committee for Standardization. Brussels, Belgium.Google Scholar
- CEN prEN 13606-1. 2004. Health informatics--Electronic health record communication--Part 1: Reference model. Draft European Standard for CEN Enquiry prEN 13606-1, European Committee for Standardization. Brussels, Belgium.Google Scholar
- CEN prEN 14822-1. 2003. General purpose information components. Draft European Standard prEN 14822-1, European Committee for Standardization. Brussels, Belgium.Google Scholar
- CEN TS 14796. 2003. Health informatics---Data types. Technical Specification TS 14796, European Committee for Standardization. Brussels, Belgium.Google Scholar
- CEN/TC 251. European Committee for Standardization---Technical Committee on Health Informatics. http://www.centc251.org/.Google Scholar
- Channin, D. S., Siegel, E. L., Carr, C., Sensmeier, J., Henderson, M., Behlen, F. M., Parisot, C., and Siegel, E. L. 2001. Integrating the healthcare enterprise: A primer. Part 4--5. Radiographics 21, 6 (Nov--Dec), 1597--1608.Google Scholar
- Channin, D. S., Siegel, E. L., Parisot, C., Wanchoo, V., and Leontiev, A. 2001. Integrating the healthcare enterprise: A primer. Part 1--3. Radiographics 21, 5 (Sept--Oct), 1339--1358.Google Scholar
- Clunie, D. A. 2000. DICOM Structured Reporting, 1st ED. PixelMed Publishing, Bangor PA.Google Scholar
- DICOM. 2004. Digital imaging and communications in medicine. NEMA Standards Publication PS 3. National Electrical Manufacturers Association, Rosslyn VA.Google Scholar
- DICOM Supplement 104 2005. DICOM encapsulation of PDF documents. DICOM Standards Committee, Working Group 6, Final Text. ftp://medical.nema.org/medical/dicom/final/sup104_ft.pdf.Google Scholar
- DICOM Supplement 42 2004. MPEG2 transfer syntax. DICOM Standards Committee, Working Group 13. Visible light, final text. ftp://medical.nema.org/medical/dicom/final/sup42_ft. pdf.Google Scholar
- DICOM Supplement 85 2004. Web access to DICOM persistent objects (WADO). Joint DICOM Standards Committee/ISO TC215 Ad Hoc Working Group on WADO. Final text. ftp://medical.nema.org/medical/dicom/final/sup85_ft. pdf.Google Scholar
- DICOM Supplement 99 2005. Extended negotiation of user identity. DICOM Standards Committee, Working Group 14. Final text. ftp://medical.nema.org/medical/dicom/final/sup99_ft. pdf.Google Scholar
- Dierks, T. and Allen, C. 1999. The TLS (Transport Layer Security) protocol. IETF Specification RFC 2246. Internet Engineering Task Force. http://www.ietf.org/rfc/rfc2246.txt.Google Scholar
- Dogac, A., Laleci, G., Kirbas, S., Kabak, Y., Sinir, S., Yildiz, A., and Gurcan, Y. 2005. Artemis: deploying semantically enriched web services in the healthcare domain. Informat. Syst. J. (Special Issue on Semantic Web and Web Services). To appear. Google Scholar
- Dogac, A., Laleci, G. B., Kabak, Y., Unal, S., Beale, T., Heard, S., Elkin, P., Najmi, F., Mattocks, C., and Webber, D. 2004. Exploiting ebXML registry semantic constructs for handling archetype metadata in healthcare informatics. Int. J. Metadata, Semantics Ontologies. To appear. Google Scholar
- ebRIM. ebXML Registry Information Model v2.5. http://www.oasis-open.org/committees/regrep/documents/2.5/specs/ebrim-2.5.pdf.Google Scholar
- ebRS. ebXML Registry Services Specification v2.5. http://www.oasis-open.org/committees/regrep/documents/2.5/specs/ebrs-2.5.pdf.Google Scholar
- Eichelberg, M., Poiseau, E., B.Wein, B., and Riesmeier, J. 2003. IHE Europe: extending the IHE initiative to the European healthcare market. In Medical Imaging 2003: PACS and Integrated Medical Information Systems: Design and Evaluation. H. K. Huang and O. M. Ratib, EDS. Vol. 5033. SPIE, 1--10.Google Scholar
- freebXML. (OMAR) implementation. http://ebxmlrr.sourceforge.net/3.0/index.html.Google Scholar
- Guo, J., Takada, A., Tanaka, K., Sato, J., Suzuki, M., Suzuki, T., Nakashima, Y., Araki, K., and Yoshihara, H. 2004. The development of MML (Medical Markup Language) version 3.0 as a medical document exchange format for HL7 messages. J. Medical Syst. 28, 6, 523--533. Google Scholar
- HIMSS. Healthcare Information and Management Systems Society. http://www.himss.org/.Google Scholar
- HL7. Health Level 7 (HL7). http://www.hl7.org/.Google Scholar
- HL7 2.5 2000. HL7, Application Protocol for Electronic Data Exchange in Healthcare Environments, Version 2.5, ANSI Standard. Ann Arbor MI.Google Scholar
- HL7 CCOW. Clinical context object workgroup standard. http://www.hl7.org.au/CCOW.htm.Google Scholar
- HL7 CDA Implementations. HL7 Clinical document architecture implementations. http://www.hl7.org.au/CDA.htm.Google Scholar
- HL7 CDA Release 1.0 2000. The HL7 Version 3 Standard: Clinical Data Architecture. Release 1.0. ANSI Standard.Google Scholar
- HL7 CDA Release 2.0 2005. The HL7 Version 3 Standard: Clinical Data Architecture. Release 2.0. ANSI Standard.Google Scholar
- HL7 RIM. HL7 reference information model. http://www.hl7.org/library/data-model/RIM/modelpage_non.htm.Google Scholar
- HL7 V3. HL7 version 3 message development framework. http://www.hl7.org/library/mdf99/mdf99.pdf.Google Scholar
- Hussein, R., Engelmann, U., Schröter, A., and Meinzer, H.-P. 2004a. DICOM structured reporting: Part 1. Overview and characteristics. Radiographics 24, 3 (May--June), 891--96.Google Scholar
- Hussein, R., Engelmann, U., Schröter, A., and Meinzer, H.-P. 2004b. DICOM structured reporting: Part 2. Problems and challenges in implementation for PACS workstations. Radiographics 24, 3 (May--June), 897--909.Google Scholar
- Iakovidis, I. 1998. Towards personal health records: Current situation, obstacles and trends in implementation of Electronic Healthcare Records in Europe. Int. J. Medical Informatics 52, 128, 105--117.Google Scholar
- IHE. Integrating the healthcare enterprise. http://www.ihe.net/.Google Scholar
- IHE. 2005a. Cross-enterprise Document Sharing for Imaging (XDS-I). IHE Radiology Technical Framework, Supplement 2005--2006. Trial Implementation, Integrating the Healthcare Enterprise. http://www.ihe.net/Technical_Framework/upload/IHE_RAD-TF_Suppl_XDSI_TI_2005-08-15.pdf.Google Scholar
- IHE. 2005b. Cross-Enterprise user authentication (XUA) integration profile. IHE IT Infrastructure Technical Framework, Supplement 2005--2006. Public Comment II Version, Integrating the Healthcare Enterprise. http://www.ihe.net/Technical_Framework/upload/IHE_ITI_TF-Supplement_Cross-Ent_User_Authentication_PC-2_2005-07-28.pdf.Google Scholar
- IHE. 2005c. Document digital signature content profile. IHE IT Infrastructure Technical Framework, Supplement 2005-2006. Trial Implementation, Integrating the Healthcare Enterprise. http://www.ihe.net/Technical_Framework/upload/IHE_ITI_TF-Supplement_Digital_Signature-TI_2005-08-15.pdf.Google Scholar
- IHE. 2005d. IT infrastructure technical framework Rev. 2.0. Tech. rep., Integrating the Healthcare Enterprise. http://www.ihe.net/Technical_Framework/index.cfm.Google Scholar
- ISO 17432. 2004. Health Informatics---Messages and Communication---Web Access to DICOM Persistent Objects. International Standard IS 17432, International Organization for Standardization, Geneva, Switzerland.Google Scholar
- ISO/TR 18307. 2001. Health informatics---Interoperability and compatibility in messaging and communication standards---Key characteristics. Tech. rep. TR 18307. International Organization for Standardization, Geneva, Switzerland.Google Scholar
- ISO/TR 20514. 2005. Health informatics---Electronic health record---Definition, scope and context. Tech. rep. TR 20514. International Organization for Standardization, Geneva, Switzerland.Google Scholar
- ISO/TS 18308. 2004. Health informatics---Requirements for an electronic health record architecture. Tech. speci. TS 18308. International Organization for Standardization, Geneva, Switzerland.Google Scholar
- Kalra, D. 2004. CEN prEN 13606, draft standard for Electronic Health Record Communication and its introduction to ISO TC/215. Document CEN/TC 251/WG I/N04-52, CEN/TC 251. Health Informatics, Brussels, Belgium.Google Scholar
- Kerberos. Kerberos: The network authentication protocol. http://web.mit.edu/kerberos/www/.Google Scholar
- Klein, G. and Beeler, G. 2000. Memorandum of understanding on Intensifying the collaboration between CEN/TC 251 and HL7. Document CEN/TC 251/N00-022, CEN/TC 251. Health Informatics, Brussels, Belgium.Google Scholar
- LOINC. Logical observation identifiers names and codes (LOINC). http://www.loinc.org/.Google Scholar
- MML 2003. Medical Markup Language (MML) Specification Version 3.0. MedXML Consortium. http://www.medxml.net/E_mml30/.Google Scholar
- NAICS. North American Industrial Classification Scheme (NAICS) Codes. http://www.naics.com/.Google Scholar
- NEMA. National Electrical Manufacturers Association (NEMA). http://www.nema.org/.Google Scholar
- OpenEHR. openEHR Community. http://www.openehr.org/.Google Scholar
- OpenGALEN. OpenGALEN Foundation. http://www.opengalen.org/.Google Scholar
- RSNA. Radiological Society of North America. http://www.rsna.org/.Google Scholar
- SAML 2005. Security Assertion Markup Language (SAML) 2.0. Tech. Overview, Working Draft 06. http://www.oasis-open.org/committees/download.php/12938/sstc-saml-tech-overview-2.0-draft-06.pdf.Google Scholar
- SAML Profiles 2005. Profiles for the OASIS Security Assertion Markup Language (SAML) Version 2.0. OASIS Standard. http://docs.oasis-open.org/security/saml/v2.0/saml-profiles-2.0-os.pdf.Google Scholar
- SNOMED. SNOMED (The Systematized Nomenclature of Medicine) Clinical Terms. http://www.snomed.org/snomedct_txt.html.Google Scholar
- Trombert-Paviot, B., Rodrigues, J. M., Rogers, J. E., Baud, R., van der Haring, E., Rassinoux, A. M., Abrial, V., Clavel, L., and Idir, H. 2000. GALEN: A third generation terminology tool to support a multipurpose national coding system for surgical procedures. Int. J. Medical Informatics 58--59, 71--85.Google Scholar
- UNSPSC. Universal Standard Products and Services Classification (UNSPSC). http://eccma.org/unspsc.Google Scholar
- WSDL. Web Service Description Language. http://www.w3.org/TR/wsdl.Google Scholar
Index Terms
- A survey and analysis of Electronic Healthcare Record standards
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