A Technological Framework for EHR Interoperability: Experiences from Italy

  • Mario Ciampi
  • Mario Sicuranza
  • Angelo Esposito
  • Roberto Guarasci
  • Giuseppe De Pietro
Conference paper
First Online:
Part of the Communications in Computer and Information Science book series (CCIS, volume 736)

Abstract

Electronic Health Records (EHRs) systems enable the construction of longitudinal collection of health information about individual patients, by integrating health data produced by the healthcare facilities. The advantags associated with the use of such systems are in terms of improvement of quality of care and cost reduction. An important barrier to the availability of exhaustive longitudinal collections of health data is represented by the lack of interoperability among EHR systems. In Italy, each region has been developing its own EHR systems according to the national guidelines and technical specifications compliant to the indications provided by a Italian Law issued in 2012 and updated in 2013. This paper describes the national technological framework designed from a National Technical Board for making interoperable the regional EHR systems each other, preserving the privacy of the patients. The framework, based on a System-of-Systems approach, enables healthcare professionals both to (i) consult health documents associated with a patient, even if they are produced in other regions, and (ii) register new health documents for patients assisted by other regions.

Keywords

Electronic health record Interoperability Framework Italy 
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Notes

Acknowledgements

The work presented in this paper has been partially supported by two joint projects between the Agency for Digital Italy and the National Research Council of Italy: Interventions to support the realization of the Electronic Health Record, prot. CNR 25751/2014, and Realization of services of the national interoperability infrastructure for the Electronic Health Record, det. AgID 61/2015.

References

  1. 1.
  2. 2.
  3. 3.
  4. 4.
  5. 5.
  6. 6.
  7. 7.
  8. 8.
  9. 9.
  10. 10.
  11. 11.
  12. 12.
  13. 13.
    Aminpour, F., Sadoughi, F., Ahamdi, M.: Utilization of open source electronic health record around the world: a systematic review. Off. J. Isfahan Univ. Med. Sci. 19(1), 57–64 (2014)Google Scholar
  14. 14.
    Beale, T.: Archetypes: constraint-based domain models for future-proof information systems. In: OOPSLA 2002 Workshop on Behavioural Semantics, vol. 105 (2002)Google Scholar
  15. 15.
    Black, A.D., Car, J., Pagliari, C., Anandan, C., Cresswell, K., Bokun, T., McKinstry, B., Procter, R., Majeed, A., Sheikh, A.: The impact of ehealth on the quality and safety of health care: a systematic overview. PLOS Med. 8(1), 1–16 (2011)CrossRefGoogle Scholar
  16. 16.
    Cantor, S., Kemp, I.J., Philpott, N.R., Maler, E.: Assertions and protocols for the oasis security assertion markup language v2.0. OASIS Standard (2005), March 2005 http://wiki.ihe.net/index.php/Cross-Enterprise_Document_Sharing
  17. 17.
    Chiaravalloti, M., Ciampi, M., Pasceri, E., Sicuranza, M., De Pietro, G., Guarasci, R.: A model for realizing interoperable EHR systems in Italy. In: International HL7 Interoperability Conference Proceedings, pp. 13–22. HL7 Conference 2015 (2015). http://ihic2015.hl7cr.eu/Proceedings-web.pdf
  18. 18.
    Ciampi, M., Esposito, A., Guarasci, R., De Pietro, G.: Towards interoperability of EHR systems: the case of Italy. In: Proceedings of the International Conference on Information and Communication Technologies for Ageing Well and e-Health, vol. 1, pp. 133–138. ICT4AWE (2016)Google Scholar
  19. 19.
    Ciampi, M., Pietro, G., Esposito, C., Sicuranza, M., Mori, P., Gebrehiwot, A., Donzelli, P.: On securing communications among federated health information systems. In: Ortmeier, F., Daniel, P. (eds.) SAFECOMP 2012. LNCS, vol. 7613, pp. 235–246. Springer, Heidelberg (2012). doi: 10.1007/978-3-642-33675-1_21 CrossRefGoogle Scholar
  20. 20.
    Dogac, A., Laleci, G.B., Aden, T., Eichelberg, M.: Enhancing IHE XDS for federated clinical affinity domain support. IEEE Trans. Inf. Technol. Biomed. 11(2), 213–221 (2007)CrossRefGoogle Scholar
  21. 21.
    Commission of the European Communities, E.C: Together for health: a strategic approach for the EU 2008–2013 (2007). http://ec.europa.eu/health/ph_overview/Documents/strategy_wp_en.pdf
  22. 22.
    Kalra, D., Blobel, B.: Semantic interoperability of EHR systems. Stud. Health Technol. Inf. 127, 231 (2007)Google Scholar
  23. 23.
    Lawrence, K., Sun, R.M., Nadalin, A., VeriSign, P.H.B.: Web services security: saml token profile 1.1. Terminology 5(3Usage), p. 7 (2002). https://www.oasis-open.org/committees/download.php/16768/wss-v1.1-spec-os-SAMLTokenProfile.pdf
  24. 24.
    Ludwick, D.A., Doucette, J.: Adopting electronic medical records in primary care: lessons learned from health information systems implementation experience in seven countries. Int. J. Med. Inf. 78(1), 22–31 (2009)CrossRefGoogle Scholar
  25. 25.
    Shekelle, P., Morton, S.C., Keeler, E.B.: Costs and benefits of health information technology (2006)Google Scholar
  26. 26.
    Sicuranza, M., Esposito, A.: An access control model for easy management of patient privacy in EHR systems. In: 2013 8th International Conference for Internet Technology and Secured Transactions (ICITST), pp. 463–470. IEEE (2013)Google Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Mario Ciampi
    • 1
  • Mario Sicuranza
    • 1
  • Angelo Esposito
    • 1
    • 2
  • Roberto Guarasci
    • 3
    • 4
  • Giuseppe De Pietro
    • 1
  1. 1.Institute for High Performance Computing and NetworkingNational Research Council of ItalyNaplesItaly
  2. 2.Department of EngineeringUniversity of Naples ParthenopeNaplesItaly
  3. 3.Institute for Informatics and TelematicsNational Research Council of ItalyRendeItaly
  4. 4.Department of LinguisticsUniversity of CalabriaRendeItaly

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