Abstract
Information and communication technologies have already become an inseparable part of healthcare sector activities. In the chapter, the authors discuss the issues of standardization and interoperability that are crucial for correct interconnection of medical and other devices and information systems. Their previous work in the area has led to the conclusion that successful integration of partial solutions is strongly dependent on the issue of interoperability of medical devices and information systems. It comprises problems of standardization of data acquisition, communication, processing, and storage, and the connected problem: correct data mapping between different ICT applications. They present several examples of partial solutions of communication and data format definition in dedicated areas.
TopIntroduction
Information and communication technologies have become inevitable and almost inseparable parts of our lives. They have also penetrated many application areas, including medicine. In that way new term “eHealth” has appeared. It represents those activities in healthcare practice that are supported by electronic processes and communication. The term encompasses rather wide range of systems being at the edge of healthcare and information technology. The systems include electronic health records; telemedicine; consumer health infromatics; health knowledge management; medical decision support systems; mHealth (use of mobile devices for different applications in healthcare).
With boom of smart phones, iPhones and similar devices, mHealth has become an attractive application area. The mobile devices can be used for many different functions in healthcare. Let us mention the most frequently cited: collecting health data; delivery of healthcare information to clinicians, researchers and patients; real-time monitoring of patient vital signs; and direct provision of care (using tools of telemedicine). This technology obviously provides greater access to medical information, larger segments of population in developing countries, improving the capacity of health systems in such countries to provide quality healthcare. Many before mentioned functions of mHealth can contribute to better awareness of care for one own health, teleconsultancy, sending data about one’s health to the doctor, informing people e.g. about air pollution and warning them of the situation. Gradually there appear new areas of interest in mHealth: emergency response systems (e.g., road traffic accidents, emergency obstetric care); human resources coordination, management, and supervision (e.g. natural disasters); mobile synchronous (voice) and asynchronous (SMS) telemedicine diagnostic and decision support to remote clinicians; clinician-focused, evidence-based formulary, database and decision support information available at the point-of-care; pharmaceutical supply chain integrity & patient safety systems; clinical care and remote patient monitoring; health extension services; health services monitoring and reporting; training and continuing professional development for health care workers; health promotion and community mobilization. Recently there have appeared additional application areas on the edge of medicine, social care, and technology, namely assistive technologies and ambient assisted living.
Integrating information deriving from different sources and implementing it with knowledge discovery techniques allows medical and social actions to be appropriately performed with reliable information, in order to improve quality of life of patients and caregivers.
Currently the mobile technologies, sensors and other devices enable collecting vast amount of data of individuals. This multi-parametric data may include physiological measurements, genetic data, medical images, laboratory examinations, and other measurements related to a person's activity, lifestyle and surrounding environment. There will be increased demand on processing and interpreting such data for accurate alerting and signalling of risks and for supporting healthcare professionals in their decision-making, informing family members, and the person himself/herself.
Recent development in ICT (Bernstein, 2009; Kaplan, 2005) shows that it is almost impossible to design and implement a complex system as fixed to certain hardware, operating system, and infrastructure. Thus it is necessary to develop such architectures that will be easily extensible and modifiable. For easy extensibility the basic requirement is to understand data exchanged between individual parts of the system. That means not only to recognize data syntax, but also semantic content of the data.
The following section describes technological trends towards mobile devices, including devices measuring physiological parameters; broadband communication; advanced sensor technology; and software development utilizing distributed approach. Next section is focused on the issue of electronic health record and approaches to its standardization. Then we present a brief overview of standards and recommendations for interconnection of medical devices and health care information systems. The conclusion summarizes the chapter and suggests briefly future directions.
Key Terms in this Chapter
Medical Device: A product, which is used for medical purposes in patients – in diagnosis, monitoring, surgery, or therapy. It acts by physical, mechanical, thermal, psysico-chemical or chemical means.
Ontology: High-level knowledge and data representation structure. Ontologies provide a formal frame to represent the knowledge related with a complex domain, as a qualitative model of the system. Ontologies can be used to represent the structure of a domain by means of defining concepts and properties that relate them.
Interoperability: Property referring to the ability of diverse systems and organizations to work together (inter-operate); the ability of two or more systems to exchange information and to use the information that has been exchanged (in other words ability to understand the semantic content of the exchanged information).
Standardization: Formulation, publication, and implementation of guidelines, rules, methods, procedures and specifications for common and repeateds use, aimed at achieving optimum degree of order or uniformity in given context, discipline, or field; standards are most frequently developed on international level; there exist national standardization bodies cooperating with international bodies; standards can be either legally binding or de facto standards followed by informal convention or voluntary standards (recommendations).
Electronic Health Record: An evolving concept defined as a systematic collection of electronic health information about individual patients or populations. It is a record in digital format that is capable of being shared across different health care settings, by being embedded in network-connected enterprise-wide information systems. Such records may include a whole range of data in comprehensive or summary form, including medical history, medication and allergies, laboratory test results, radiology images, vital signs, personal stats like age and weight, and billing information.
Information System: An integrated set of components for collecting, storing, processing, and communicating information.
EHealth: Healthcare practice supported by electronic processes and communication; it can encompass a range of services or systems that are at the edge of medicine/healthcare and information technology.