Healthc Inform Res.  2010 Dec;16(4):281-289. 10.4258/hir.2010.16.4.281.

Implementation of Medical Information Exchange System Based on EHR Standard

• Han SH
• Lee MH
• Kim SG
• Jeong JY
• Lee BN
• Choi MS
• Kim IK
• Park WS
• Ha K
• Cho E
• Kim Y
• Bae JB

• KMID: 2284541
• DOI: http://doi.org/10.4258/hir.2010.16.4.281

Abstract

OBJECTIVES
To develop effective ways of sharing patients' medical information, we developed a new medical information exchange system (MIES) based on a registry server, which enabled us to exchange different types of data generated by various systems.
METHODS
To assure that patient's medical information can be effectively exchanged under different system environments, we adopted the standardized data transfer methods and terminologies suggested by the Center for Interoperable Electronic Healthcare Record (CIEHR) of Korea in order to guarantee interoperability. Regarding information security, MIES followed the security guidelines suggested by the CIEHR of Korea. This study aimed to develop essential security systems for the implementation of online services, such as encryption of communication, server security, database security, protection against hacking, contents, and network security.
RESULTS
The registry server managed information exchange as well as the registration information of the clinical document architecture (CDA) documents, and the CDA Transfer Server was used to locate and transmit the proper CDA document from the relevant repository. The CDA viewer showed the CDA documents via connection with the information systems of related hospitals.
CONCLUSIONS
This research chooses transfer items and defines document standards that follow CDA standards, such that exchange of CDA documents between different systems became possible through ebXML. The proposed MIES was designed as an independent central registry server model in order to guarantee the essential security of patients' medical information.

Keyword

Electronic Health Record; VPN; Web Service Security Enhanced; Health Level 7 Standard; CDA R2

MeSH Terms

Delivery of Health Care
Electronic Health Records
Electronics
Electrons
Information Systems
Korea

Figure

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  Figure 1 Referral process from physician's clinic to general hospital through medical information exchange system (MIES). CDA: clinical document architecture.

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  Figure 2 Medical information exchange system architecture. EMR: electronic medical record, CDA: clinical document architecture, EHR: electronic health record.

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  Figure 3 Service architecture of cal information exchange system (MIES). CDA: clinical document architecture.

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  Figure 4 Clinical document extensible markup language (XML) format for diagnosis applying clinical document architecture (CDA) standard.

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  Figure 5 Document registry framework (DRF). CDA: clinical document architecture.

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  Figure 6 Example of applying standard terminology to diagnosis.

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  Figure 7 Example of applying standard terminology to medication.

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  Figure 8 Clinical document architecture (CDA) Viewer.

Reference

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