A Standardized SOA for Clinical Data Sharing to Support Acute Care, Telemedicine and Clinical Trials

Background: Developed countries are planning the creation of national EHR (Electronic Health Record) systems to modernize the healthcare field and improve its quality, security and efficiency. Objectives: To support clinical data sharing, it is important that an EHR is designed to be integrated within an appropriate architectural context aimed to satisfy the needs of all actors involved in this information management by adding and integrating new functionalities to existing solutions. Methods: SOA (Service Oriented Architecture) provides a good approach to promote the easy integration and alignment of a new and existing solution into a cohesive architecture. The HSSP (Healthcare Service Specification Program) was formed to adopt the SOA approach to guarantee interoperability between applications and distributed and heterogeneous devices, by providing a set of standards to design and develop specific services. Results: The authors present a landscape architecture to support the collaboration between actors involved in the treatment of chronic diseases. The core of this architecture consists of services compliant to HSSP standards. Among these, the authors developed: Health Record Management Services, Health Terminology Services and Health Identity Services. The proposed architecture and these services have already been adopted in different systems: a tele-monitoring system to support the continuity of care of CHF (Congestive Heart Failure) patients, two systems to share clinical data to manage clinical trials in both infectivology and ophthalmology. Conclusions: The main advantage of the proposed architecture is its flexibility that allows it to be adapted over time and to be adopted in all health care scenarios.