e-HealthExpert.org - Primum non nocere

The Artemis project is an European Commission funded project that aims to define a Semantic Web Service-based P2P Infrastructure for the Interoperability of Medical Information Systems.

Among its main purposes are:

• the ability to provide the interoperability of medical information systems through semantically enriched Web services (using a to phase process through, first a Message Ontology Mapping Process and then a Message Instance Mapping);
• to find and retrieve clinical information about a particular patient from different healthcare organizations where concrete sources are unknown.

The project started in 2004 and is a joint effort of Turkey, UK, Greece and Germany teams.

More information at the The Artemis Project home page.

The US Government published (2005.12.23) a list of the 20 messaging and vocabulary standards that from now on will be used at the US Government funded health care information systems.

“The portfolio of 20 adopted standards will be used in all federal agencies implementing new, and to the extent possible, in modifying existing health information technology systems, as well as related business processes”

These seem to be big news as this list has the potential to be the basis for further Health IT Interoperability initiatives.

The main adoptees are: HL7 2.x, DICOM, SNOMED CT, LOINC and HIPAA (Trans. and Code Sets).

The list may be freely downloaded from the US Gov. Printing Office.

(The e-HealthExpert.org members will have to log into the e-HealthExpert.org site to be able to download a copy by following the "attachment"/"fr23de05-78.pdf" link presented bellow these lines.)

This is the archive of software packages known by the e-HealthExpert.org members.

All entries should at least include:

1. Software name and version,
2. An abstract of what it does,
3. The type of license under which it is released,
4. The software homepage address,
5. A rating value from 1 to 5 [1 (lousy), 2 (mediocre), 3 (average), 4 (good), 5 (very good)],
6. Submission author's name.

This new area of e-HealthExpert.org site is also meant to be a repository of the most relevant software that appears at our [sw-hw] mailing list.

The [sw-hw] mailing list is an open forum in which any member can freely review, evaluate and talk about any subject related to systems architecture, software, hardware and, more in general the usage of IT technology to support all the activities of a Healthcare Organization. List guidelines and subscription application forms are available from: [sw-hw] mailing list usage guidelines.

Standards are a critical subject in any activity. Healthcare has been pestered for years by a Babel tower of proto-standards and lousy standardization efforts.

It seems that a long time offender - HL7 - is showing some activity at the (long dued) effort of moving from the fuzzy and profit centered HL7 2.x to a more up to date Web Age XML-based and Clinically-Centered standardization effort (HL7 3.x).

At the HL7 organization's web site you may find a recent update (2005.03.23) of the: Clinical Document Architecture (CDA) Ver. 2.0 proposal.

But, for anyone that has been following the HL7 soap opera from 1987, a thought come to mind:
How much of this is "the true standard" and how much of it is "more of the same", just to cope with the USA market and with the recent US Government HIPPA enforcement?

A heterogeneous group of people from the MIT, Tufts NEMC, Childrens Hospital (Boston) has been working in a very interesting project named the Guardian Angel Personal Lifelong Active Medical Assistant.
The BMJ has an 2001 article from that group named Public standards and patients control how to keep electronic medical records accessible but private, which is freely available for download, in .pdf format, from: Public standards and patients control.
The "Guardian Angel" project has threee main areas of development: PING (Personal Internetworked Notary and Guardian), HealthConnect and W3-EMRS (World Wide Web based Electronic Medical Record System).

The European Interoperability Framework (EIF) is the reference interoperability document for the development and delivery of e-government services (including e-Health and Health IT related services) at pan-European level. The EIF provides:

• a set of guidelines and recommendations to enable interoperability of government systems and processes with a view to delivering pan-European e-Government services (PEGS),
• identifies a number of general principles that should be considered for any e-government service to be set up at a pan-European level: accessibility, multilingualism, security, privacy, subsidiarity, use of open standards (adopted and maintained by an open not-for-profit organization and freely available on a royalty-free basis), assessing the benefits of Open Source Software, and use of multilateral (or 'many-to-many') solutions.

Based on these principles, the EIF addresses three distinct interoperability levels that need to be considered: organisational interoperability, semantic interoperability, and technical interoperability.
For each of these levels, the EIF provides a number of recommendations.

You may download the full specification at: European Interoperability Framework

Collection of norms, specifications and various data tables of general interest to the development, management or control of Health IT Systems (HIS).

David A. Wheeler presents in his site Why Open Source Software a thorough analysis on why you should seriously consider to use Open Source Software in your organization.