Medical Data GRIDs as approach towards secure cross enterprise document sharing (based on IHE XDS).

Quality and efficiency of health care services is expected to be improved by the electronic processing and trans-institutional availability of medical data. A prototype architecture based on the IHE-XDS profile is currently being developed. Due to legal and organizational requirements specific adaptations to the IHE-XDS profile have been made. In this work the services of the health@net reference architecture are described in details, which have been developed with focus on compliance to both, the IHE-XDS profile and the legal situation in Austria. We expect to gain knowledge about the development of a shared electronic health record using Medical Data Grids as an Open Source reference implementation and how proprietary Hospital Information systems can be integrated in this environment.

E-health approach to link-up actors in the health care system of Austria.

"Electronic health services are important" the EU commission stated in the E-Health action plan. By these means access to health care can be improved and the quality and effect of the offered medical services can be increased. By introducing the e-card in Austria, an overall link-up of nearly all health service providers of the external sector (e.g. family doctors) was achieved. In 2005 the Austrian E-Health Initiative (EHI) of the Austrian Federal Ministry for Health and Women mapped out a strategy to organise the development of the health system towards an integrated patient-centred. Hereby the electronic health record (EHR) plays a decisive role. The aim of this study is to analyse requirements for a virtual, cross-institutional and patient-centred electronic health record from the point of view of the exemplary main actors (Doctor and Patient), to define conditions, and then to evaluate the thus derived, specific concept of implementation. Aside from the two main actors regarding medical acts, namely the institution treating a patient (e.g. doctor, paramedic or nurse) and the patient receiving treatment, a row of other actors could be identified. Group assessment techniques with representatives of these actors resulted in an overview of required functions of an EHR. As a proof-of-concept an information system architecture conformable to the IHE XDS architecture for cross enterprise document sharing is currently being constructed and evaluated in the course of a pilot-project. If the core architecture fulfils the expectations, then a further extension to other hospitals and resident doctors, and subsequently also to the other actors of the health system, is planned. Since both legal and socio-technical requirements are presently not yet entirely met, and since there are also deficits from a methodical viewpoint, a complete implementation and widespread introduction will be a long term goal.