William Grimson

A CORBA-based integration of distributed electronic healthcare records using the Synapses approach

The ability to exchange in a meaningful, secure, and simple fashion relevant healthcare data about patients is seen as vital in the context of efficient and cost-effective shared or team-based care. The electronic healthcare record (EHCR) lies at the heart of this information exchange, and it follows that there is an urgent need to address the ability to share EHCRs or parts of records between carers and across distributed health information systems. This paper presents the Synapses approach to sharing based on a standardized shared record, the Federated Healthcare Record, which is implemented in an open and flexible manner using the Common Object Request Broker Architecture (CORBA). The architecture of the Federated Healthcare Record is based on the architecture proposed by the Technical Committee 251 of the European Committee for Standardization.

Sharing health-care records over the Internet

Presents a novel approach to sharing electronic health-care records that leverages the Internet and the World Wide Web, developed as part of two European Commission-funded projects, Synapses and SynEx. The approach provides an integrated view of patient data from heterogeneous, distributed information systems and presents it to users electronically. Synapses and SynEx illustrate a generic approach in applying Internet technologies for viewing shared records, integrated with existing health computing environments. Prototypes have been validated in a variety of clinical domains and health-care settings.

Interoperability issues in sharing electronic healthcare records-the Synapses approach

This paper describes the approach to information sharing being adopted by Synapses, a pan-European project funded under the EU Health Telematics Programme. The emphasis in Synapses is on developing standards to enable sharing, in whole or in part, of electronic healthcare records between distributed healthcare providers and institutions. The current technological solutions available for data sharing, including federated database systems, gateways, data warehousing, messaging and the web are insufficient on their own to meet the needs of Synapses. Thus in Synapses several different, but complementary technologies are merged in an open, distributed object-oriented environment. Furthermore, in order to safeguard the legal, ethical and clinical integrity of the record, it is essential not only to preserve the meaning of the data being transferred, but also its context and structure. Synapses solves this problem by defining a standard architecture for the federated electronic healthcare record.

Remote instrument telemaintenance

In the past decade, great technological progress has been made in telemaintenance of mainframe and mini computers. As hardware technology is now available at an acceptable cost, computer aided trouble-shooting can be adapted to laboratory instrumentation in order to significantly improve repair time, avoid instrument downtime by taking advantage of predictive methods, and provide general diagnostic assistance. Depending on the size of the instrument, the telemaintenance facility can be dedicated to a single instrument or alternatively a telemaintenance server can manage multiple distributed small instruments through a Local Area Network. As complex failures can occur, the local diagnosis capabilities may be exceeded and automatic dialing for connection to computerized Remote Maintenance Centers is needed. The main advantages of such a centre, as compared to local diagnosis systems, are the increased access to more information and experience of failures from instrument installations, and consequently the provision of training data updates for Artificial Neural Networks and Knowledge Based Systems in general. When an abnormal situation is detected or anticipated by a diagnosis module, an automatic alert is given to the user, local diagnosis is activated, and for simple solutions, instructions are given to the operator. In the last resort, a human expert can be alerted who, with remote control tools, can attend to the failures. For both local and remote trouble-shooting, the data provided by the instrument and connected workstation is of paramount importance for the efficiency and accuracy of the diagnosis. Equally, the importance of standardization of telemaintenance communication protocols is addressed.

A new clinical laboratory information system architecture from the OpenLabs project offering advanced services for laboratory staff and users

The OpenLabs project aims to improve the efficiency and effectiveness of clinical laboratory services by integrating decision support systems with laboratory information systems and equipment. Standards for electronic data interchange between laboratories and other medical systems using the EUCLIDES/OpenLabs coding scheme and an open architecture for clinical laboratory information systems have been specified. This article gives an account of the proposed architecture and outlines new software applications being developed using the architecture which provide advanced services for ordering and reporting of laboratory tests, advanced instrument workstation and laboratory management services, including an OpenLabs Service Manager application which co-ordinates the available services.

A multimedia approach to raising awareness of information and communications technology amongst healthcare professionals.

This study is concerned with the application of advanced multimedia technology to the development of a programme aimed at raising awareness of information and communications technology (ICT) amongst health professionals in Ireland. The programme is delivered in the form of a symposium supplemented by a multimedia CD and associated web site. It examines how ICT can be used effectively in healthcare across all sectors - primary, secondary and tertiary - with a strong emphasis on supporting shared care. The aim is to empower users to make informed technological choices and to actively participate in the exploitation of ICT in the health sector. The programme was successfully completed and delivered to over 2300 health professionals across Ireland and follow-up activities include the active encouragement of leaders and champions within the sector. This will be supported by interactive web-based education and training material focused on specialised topics of particular interest within the broader context of continuing medical education (CME).

A select and annotated bibliography of philosophy in engineering education

The discussion of a philosophy of engineering and/or engineering education has encouraged the community to try and bring some coherence to the field. This select and annotated bibliography is one resource intended to enhance and continue the conversation. In conjunction with a preparatory review, this bibliography introduces the 2011 FIE special workshop on the subject of exploring the philosophies of engineering and engineering education. This work extends what has been done during the 2007, 2008, and 2009 FIE conferences. Focus is brought to bare on research and theoretical readings that discuss a philosophy of engineering education; the engineering identity crisis; differentiating engineering, science, and technology; engineering science verse engineering design, engineering epistemology, philosophy and practice of the engineering curriculum; philosophy in the engineering curriculum; engineering ethics; and engineering culture. Each of the focus areas is introduced with a list of annotated references that present current ideas, beliefs and findings related to these areas.

Specifying an open clinical laboratory information system

This paper presents an overview of the architectural infrastructure in which existing laboratory information systems can be made to interoperate with additional modules offering a range of advanced clinical laboratory functionalities. The infrastructure is based on an open distributed computing platform, and its specification is described using the open distributed processing reference model.

Health care in the information society: evolution or revolution?

This brief article is a commentary on the Haux et al. paper on Health Care in the Information Society: a prognosis for the year 2013. The commentary concentrates in particular on the underlying assumptions, which are at the core of the Haux et al. vision for healthcare in 2013. They assume that while there will be a shift towards increased patient-centred, community-based shared care, the underlying healthcare system will remain essentially the same. This commentary suggests that this is a conservative view and indeed questions its validity. Radical financial pressures to control costs as well as demands for equity fueled by more knowledgeable and better informed patients have the potential to bring about fundamental changes, with consequences for the way in which healthcare is delivered and in turn in how information and communications technologies are utilised.

OpenLabs advanced instrument workstation services

The advanced instrument workstation (AIW) is one of a number of system modules developed in the OpenLabs project, offering advanced services that complement the basic services available from laboratory information systems (LIS) in general. The AIW services relate to instrument interfacing, user interfacing, quality control, calibration verification, patient result validation, local and remote fault diagnosis and maintenance, and external quality assessment (EQA) by external organisations.