Υπηρεσιοστρεφείς αρχιτεκτονικές για την ανάπτυξη προσωπικών φακέλων υγείας
Κούφη, Βασιλική Ι.
SubjectΠληροφοριακά συστήματα -- Διοίκηση και οργάνωση ; Υγεία -- Πληροφοριακά συστήματα ; Αρχιτεκτονική ηλεκτρονικών υπολογιστών
The current PhD thesis contributes to the effort undertaken worldwide for the provision of shared and integrated care when and where needed. To this end, the implementation of pervasive, process-oriented HISs is proposed which can provide readily access to patient information anywhere, anytime and through almost any device. These systems may accrue from the evolution of already existing HISs or may be developed from scratch, embedding existing systems where possible. In particular, the current PhD thesis presents a service-oriented approach to the implementation of pervasive HISs. In this context, a number of prototype HISs have been built either by rendering the existing HISs interoperable or by using a Personal Health Record (PHR) System as their central component. In the first case, the service-oriented architecture has been implemented by means of web services and/or grid services which, in turn, were orchestrated in order to form healthcare process models. In the second case, web services have been used for the management of information being stored in the PHR system. PHR systems are autonomous and contain clinical as well as non-clinical data which are provided by patients themselves. The evaluation of these two alternative approaches has proven that PHR systems constitute a more suitable means for the communication, collaboration and coordination among members of medical staff involved in healthcare delivery, especially in cases where these members belong to geographically disparate healthcare organizations. Thus, decision making is enhanced and the efficiency and quality of healthcare is improved. Moreover, PHR systems can add tremendous value to emergency healthcare delivery where healthcare applications often have life-or-death dimensions as a patient’s life may hinge on the instant availability and accuracy of information. Hence, a PHR-based HIS has been developed which makes comprehensive and unified health information available at the point of care, thus contributing to the provision of optimal pre-hospital and in-hospital healthcare to patients. One important consideration in the development of the prototype HISs is to ensure confidentiality of patient medical data. To this end, suitable access control mechanisms have been developed which regulate access over processes, tasks and web services. These mechanisms meet the requirement of the least privilege principle which requires continuous adjustments of user permissions in order to adapt to the current situation. In systems where existing HIS have been used, the security mechanism forms an additional security layer on top of the security mechanisms and local security policies of each of the participating healthcare organization.