A Research For The Construction Of Medical Image Coordinating System Based On IHE For Sharing

The constitution of regional healthcare information system is a large-scaled, multi-system integration research, which is involved in all of the integration technologies and standards. In recent years, the new generation of information technologies, typically, the Internet, has wildly and deeply touched every corner of people's daily life. The interoperability of various kinds of information has been the focus of all industries and service departments. Healthcare service industries, as the biggest and primary domain of world economic system, is facing the challenges from the modern lifestyle. Comparing with other information-intensive industries, such as bank financial, engineering communications, media, merchandise sales, the degree of information in healthcare industry always falls behind them. In recent years, studies show that both domestic and foreign experts agreed that with the massive increase of the healthcare information, we should widespread adoption electronic medical records at the core of modern medical information technology, to meet the demand of the information interoperability in different system. To reach the goal for information share, the new healthcare network should be built on the common information standards. Then the data between heterogeneous systems can be exchange and reused based on the communication. This contributes to the regional healthcare services to achieve. In addition, these methods help the healthcare reform policy in our national, especially for the realization of healthcare services in an orderly manner and the solution for the structural imbalance between healthcare resources and patients.With the development of IT technology, now it can support the integration of applications from various industries. Middleware technology and HIS integration technology have been introduced in healthcare industry. DICOM and HL7 have solve a problem about connection between heterogeneous systems in the Internet, but there are still more problems to realize interoperability. Due to the difference between the standard and data processing objects, so the integration for the systems against image and text will be more trouble. Integrating the Healthcare Enterprise (IHE) is an initiative designed to stimulate the integration of the information systems that support modern healthcare institutions. It was stared in 1999 by RSNA and HIMSS. Its fundamental objective is to ensure that in the care of patients all required information for medical decisions is both correct and available to healthcare professionals. The approach employed in the IHE initiative is to support the use of existing standards, e.g HL7, ASTM, DICOM, ISO, IETF, OASIS and others as appropriate, rather than to define new standards. Especially, it defines several profiles for the implementation of established messaging standards to achieve interoperability in 2004, which mainly includes XDS, XDS-I. The effect of IHE is recognized around the world. In Many international countries and regions, the design of regional healthcare systems be considered to comply with IHE.The research on IHE and the sharing of healthcare information in China is lagging behind other countries for many reasons. First, the developing of healthcare information is Lack of organizational. There is no long-term perspective to consider the issue of patients' information sharing. Second, although the products of healthcare information are numerous, but just a few of them was designed by standards inadequately, which ignores the need of information systems integration and data sharing in the future. Third, the absence of a standardization framework to guide the information sharing processes leads to 'information islands'. Fourth, decision-makers for medical institutions pay not enough attention to the sharing of healthcare information. They believe that information is just a replace of 'manual process' on computer and refuse to communicate with other healthcare institutes. This research aims to achieve healthcare information sharing and medical business workflow optimization by reference to IHE. We put forward the methods to sharing healthcare information suited to the medical business characteristics in china. The patterns of healthcare information development is discussed in the current healthcare reform trends. Medical imaging is one of an important basis for the diagnosis of patients, so the PACS acts as an important role in medical business. When a patient transfers to different hospital, the Clinicians desires to access all of the patient's healthcare intonations including the document outside there own hospital. They hope to connect the RIS/PACS in different institutions to improve the rate of diagnostic accuracy .But it is difficult to do for heterogeneous systems and heterogeneous data formats. With the development of regional healthcare information, information sharing between medical institutions has become an inevitable trend. So medical images as the raw data for diagnosis are required to share at any time when clinicians need. It is worth to do efforts on this research. We analysis the use of HIT in other countries in the course of study and hope to learn from the successful experience of foreign countries to avoid the errors they have done.This paper proposes the means to construct a medical image coordinating system based on IHE for information sharing. We hope that through a third-party platform we can organize a collaborative network of medical imaging medical Union in accordance with IHE. The healthcare institutions admit to the union and share resources to break through the limitations of geographical location by network. Then we will reach the goal of information sharing and interoperability by internet. Simultaneously the system can provide medical education service and medical imaging-related research service based the data sharing. Compared with regional PACS carried out in many cities of china., it is widely used and allows heterogeneous systems to participate. In the other hand, it gives more attention on the collaboration in the union which aims to data integration.This paper summarizes the characters of medical imaging environment, and builds a radiology workflow model under the IHE technical framework in accordance with the actual process of local hospital in china. What's more, the key issues of interoperability between different applications are discussed and used on the system to some extend. If the RIS/PACS have been highly integrated, it will easy the realization of interoperability in the medical image coordinating system. This approach is related to many legacy hospital systems. These systems usually take private protocol and C/S architecture. Then many problems emerge when we require to share the data from them, such as Openness, interoperability and scalability. With the development of software engineering, Web service-based SOA architecture has been mature and good enough to give a help to HIT for its advantages such as scalable, interoperable, reusable. In fact, a series of potential advantages and innovations can be identified for such an approach. (1)The use of patient identifier cross-referencing. The patient ID cross-referencing is the basic of the document sharing of the system. But the IDs are different in hospitals for the same person. So it is significant to identify the patient and mach the information. (2)The system is based on .NET and web service-base SOA. In terms of tele-diagnostics of medical imaging, this way is much better than the legacy systems. (3) by the use of MTOM, we promote the performance of medical image files transmission on web and share the medical image and related documents seamlessly.