Hypermedata to exchange heterogeneous multimedia patient records between hospitals

Sankt Augustin 26 May 1998 The need for a universally accessible patient record increases, as people are getting more mobile than ever in both their professional career and their leisure time. If they are hospitalized, they often are moved from one health care facility to another, which turns the electronic medical record into an indispensable tool for accurate information exchange between the hospitals. Every medical information system is different, so the health care record has to be compatible with any imaginable local computer system. Since the patient record consists of complex data, including text, images, tables, formulae, graphics, and maybe even sounds, the challenge seems enormous. At the ERCIM Health and Information Technology Workshop last May, Professor Keith Jeffery presented the Hypermedata project, a truly promising solution for the smooth exchange of multimedia patient data.

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The need for a universally accessible patient record increases, as people are getting more mobile than ever in both their professional career and their leisure time. If they are hospitalized, they often are moved from one health care facility to another, which turns the electronic medical record into an indispensable tool for accurate information exchange between the hospitals. Every medical information system is different, so the health care record has to be compatible with any imaginable local computer system. Since the patient record consists of complex data, including text, images, tables, formulae, graphics, and maybe even sounds, the challenge seems enormous. At the ERCIM Health and Information Technology Workshop last May, Professor Keith Jeffery presented the Hypermedata project, a truly promising solution for the smooth exchange of multimedia patient data.

In collaboration with Professor Jana Kohoutkova from the Masaryk University in Brno, Professor Jeffery, who is working at the Central Laboratory for the Research Councils (CLRC) in the United Kingdom, has developed a set of information technology tools to optimize the integration of data, coming from heterogeneous distributed sources. The information is being represented by means of hyperlinked multimedia for user-friendly purposes. The project participants have preferred to make use of standards in the distributed database, as well as in the hyperdocument areas, in order to facilitate in- and output activities by the end-users.

The Hypermedata project already started in 1995 and will end this year. It has run in three phases. First, the exact requirements have been studied to match them with the design of the software. As a result, the necessary tools were developed, according to the design, and finally, the end-users will have to evaluate the quality of the information exchange process. If all is well, the Small and Medium sized Enterprises (SMEs) can start the production of the systems incorporating the hypermedia exchange solution, to provide the hospitals with a powerful tool for direct consultation and updating of the electronic patient record.

The Hypermedata technology is based on the conversion of data by means of a graph theory. Initially, the researchers take the native data structures of two hospital information systems (HIS) A and B. Both A and B data are converted to Hypermedata Graph Language, respectively the HISa gateway interface and the HISb gateway interface (gi). HISagi and HISbgi are compared to each other, in order to generate a canonical schema, referred to as Common Gateway Interface (CGI). The next step is to create appropriate conversion functions in Hypermedata Graph Language and to load the convertors in HISa and HISb with them. As a result, the multimedia data stream runs from HISae(xchange) over HISage to Cge over HISbge to HISbe and vice versa.

The nice thing about this project is that it works with the usual, commercial browsers, equipped with Java add-ons, in the by now familiar World Wide Web based environment. Ideally, in addition to the convertors, the two HIS structures should equally be provided with analysers but this can only be realized if the research team has the time and the money available to further complete the project. In any case, Hypermedata allows the health care facilities to go on using the HIS that best suits their needs while staying able to interoperate with other HIS constellations for the exchange of medical data. For more Hypermedata information, please consult the CLRC and the Masaryk University Web sites, as well as the ERCIM Health and Information Technology Workshop site.


Leslie Versweyveld

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