| As China is going through a rapid nationwide informatization, various information systems came into existence, which accelerate the information construction of the healthcare systems greatly. However, we found a few problems in the information systems of the health care systems. The primary problem is the incompatibility among different systems. Our objective is to build a powerful healthcare platform which could interact among points and points as well as systems and systems. Therefore, the top priority is to solve the interoperability and integration of healthcare information systems.A series of healthcare information standards, with IHE as its representative, are aimed to solve these problems and their effects are recognized globally. This paper is to design a system that could share personal healthcare information based on integrating standards such as IHE PIX and XDS.This paper proposed that the healthcare information cooperation platform is based on general healthcare standards as well as the information systems of various hospitals that adopt PACS or HIS. The purpose is to share and transmit the information of patients and their medical images under the guidance of IHE. Compared with regular regional healthcare information systems, the healthcare information cooperation platform has the following advantages:(1) could be used more widely; (2) is compatible with the information systems that meet international healthcare standards; (3) put more emphasis on the cooperation among different organizations, standard workflow, information integration, transmission and sharing to fulfill healthcare information management and sharing.Personal identification technology is the basic work of Information Construction in Medical Institutions. To construct the exchange and sharing among heterogeneous personal medical information, the uniqueness identification issue of personal identity must be solved firstly, especially the issue that how to connect personal identification when the same person is hospitalized in different medical institutions and different medical information systems. This paper has analyzed the request to personal identification in the realization of personal medical information sharing and done comparative study of the current international personal identification methods and Identification technology. Then this paper has deep discussions about the integrated regulating technology framework and process design of IHE PIX.The function of IHE PIX regulating technology framework is to make the cross references among the patients identity from various business systems available. Domain A, Domain B and Domain C represent different patients' ID domains respectively. In each domain, the "source of patients ID" generates the only patient identification and submits the information of patients ID to PIX Manager. The PIX Manager is the core of entire framework, which is in charge of managing ID information between different ID domains and offers corresponding service of matching, cross references, etc.The technology framework of IHE PIX must consist of four functions:Patients ID Information Registration, Update Notification of Patients ID, Cross References of Patients ID Information and Matching of Patients ID Information. Patients ID Information Registration requires registration to PIX Manager after generating new patient ID information by the "source of patients ID" in a domain. Cross References of Patients ID Information refer to correspondence and conversion among patients ID from various domains in PIX Manager, which make the realization of relevant correspondence between domain and patients ID only with maintenance of patients identification in its domain available. Update Notification of Patients ID requires notification to PIX Manager when an ID domain detects change of patient ID information, and then notices other relevant domains by PIX Manager. Matching of Patients ID Information refers to judgment of whether the patients ID information which is correlative different Identification belong to the same patient. As the key function of judgment, Matching of Patients ID Information is the foundation to implement the entire IHE PIX technology framework. The specific algorithm of matching process fully depends on how to solve these problems:It is difficult to define the matching among paragraphs of ID information; the filled in information is not standard or incomplete; some long information fields are more difficult to match with. The patients ID information that Medical information system usually can gather includes:Special Information (ID number, global ID of the known PIX Manger, etc.), Fixed Information (Name, Sex, Birth Date, Nationality, Home Address, etc.) and Variable Information (Contact Information, Work Organization, etc.). According to the guidance of IHE PIX framework, it can be matched with the patients' information.Sharing of clinical document information is beneficial for patients to change hospitals, for doctors to speed up diagnostic efficiency and enhance diagnostic accuracy. In personal medical information, regardless of electronic medical records and personal medical file, it is usually stored as the form of clinical document information in each information system. In addition, clinical document information is the basic unit of data exchange in different information system and its electronic form can be all kinds of standard format. Therefore, sharing of clinical document information is the core of Personal Medical Information Sharing Service System.This paper compares two patterns of clinical document information sharing, which are RID and XDS. In RID pattern, displayer need submit patient's identification number when searching patients. It means that displayer must have some understanding about the use of patient's identification number before. If both the information source and displayer use the same Hospital Information System (HIS) as their common provider of patients' information, then the use of patients' identification number has no problems since all the information systems in this hospitals use this HIS to release patient admission, discharge, and patient information updates with HL7 information. However, if the information source and displayer use different HIS, PIX cross index must be applied together to position operated patients accurately in different systems, which means RID sharing pattern cannot be applied if mechanism of patients identification sharing does not exist among different medical institutions.XDS pattern is the joint application in the medical information coordination of E-commerce ebXML Standard, Medical Information Standard (HL7, CDA DICOM, etc.) and Internet Standard (HTTP, SOAP, PDF, JPEG, etc.), which offers solutions of sharing document which is not relevant with content and formats. During XDS's specific application, it can expand to some extend according to different types of sharing document, such as Cross—Enterprise Document Sharing for Imaging, XDS-Ⅰ. In XDS-Ⅰ, image data is not transferred to document database but stored in each medical institution's image server. Image data's quoted information is stored in "DICOM key selected object document" and this DICOM document will be stored in document database. When document users need some images, it will position the image server according to the "DICOM key object document" provided by document database and acquire images via WADA or Search/Extraction service defined by DICOM protocol. When applying XDS specifically, there are different realization strategies for document database. One is that placing document database in every independent medical institution to realize integration through the unique document registered point. The other is establishing a third-party document database for global use and all the medical institutions which participate in document sharing must store documents in these databases.In the construction of personal medical information sharing, the related domain of clinical document information must be crossing medical institutions. Therefore, during the construction, it will be more adaptable to select IHE XDS sharing pattern to realize clinical document information sharing.Finally, on the basis of the study above, this paper designs personal medical information sharing pattern based on IHE PIX and XDS integration standard. It describes scheme structures, data storage methods and work procedure in detail and provides examples of personal medical information sharing pattern to present a panoramic view of the design schemeBased on the increasing demand of regional medical information sharing, this paper studies and explores the research of heterogeneous medical information cooperation sharing on the basis of IHE integrated standard. It discusses selections and processes of personal information identification scheme of heterogeneous medical information sharing and medical information document sharing scheme in details. Besides, it also introduces the process and algorithm of cross reference based on IHE PIX. At last, on the basis of IHE PIX and XDS integration standard, the overall plan and process of personal medical information sharing are designed and detailed examples are also presented for the regional medical information sharing to make a preliminary exploration and propose research methods. And some initial achievements are obtained as well.This paper has innovative performance in the two aspects:Proposed the concept of medical information cooperation platform, constructed the platform for realizing personal medical information exchange and sharing, which have the certain innovation.Designed detailed organization framework of heterogeneous medical information crossover index based on PIX integrated standard, work procedure of each link and key technology algorithm for realizing specific PIX matching. So far, there hasn't references to describe detail matching algorithms or applications based on IHE PIX. Sometimes even though realization approaches and work procedures are involved, specific matching algorithms are not provided. So this paper has the certain innovation. |
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