Information Technology Reference
In-Depth Information
Retrospective Access Data Base (RADB) . The number of records stored in the
RADB is in the order of hundreds of millions.
We support the work proposed here on the registers of this data base since, as we
will see next, their analysis allows to know which information has been acceded and
the related context.
23.3
Interoperability
In the last decades, the EHR has been developed in most of the hospitals but without
any coordination. Now the problem of communicating the systems has arisen and
there are some proposals to solve it. All of them are based on the communications
of the systems (machine-to-machine) so theEHRsystemshavetobeadaptedto
understand an unified language. These solution are based on the use of archetypes
as the information unit to be transmitted and languages to represent them.
In Europe, a regulation has been proposal for this problem. In next sections we
briefly present the proposal.
23.3.1
CEN/ISO ISO 13606
As mentioned above, the ISO 13606 [28] regulation proposes a dual model where
the first model is the reference model and the second one is the archetypes model.
The proposal tries to define a general structure for EHR system interfaces. So, the
proposal is only for interoperability but not for the internal structure of the system.
The ISO13606 propose an hierarchical object structure to classify and stored the
medical concepts (e.g. diseases, reports, etc.) and the use of archetypes for each of
these concepts. It is based on others proposals as Open-EHR and the requirement by
companies related to health. The ISO proposes to use messages using HL 7 version
3 to communicate the systems. The agent implicated in these messages are not only
EHR system but also other middleware services such as security components, work-
flow systems, alerting and decision support services and other medical knowledge
agents.
Reference Model
The reference model is proposed to structure the data. It establishes a basic structure
using an object-oriented paradigm. It defines the main classes with the character-
istics to store for each one. The classes are structured in a hierarchical manner
considering from a set of documents (folder) to each value on an single analysis.
It is based on a class called “structure” that gives rise to the following hierarchy of
members:
Folder: It represents the divisions at the highest level inside the extracts of the
clinical history.
Composition: It is the set of annotations related to a unique given clinical session
or document.
 
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