Int J Comput Assist Radiol Surg - Grid-based implementation of XDS-I as part of image-enabled EHR for regional healthcare in Shanghai.

Tópicos

{ ehr(2073) health(1662) electron(1139) }
{ implement(1333) system(1263) develop(1122) }
{ health(3367) inform(1360) care(1135) }
{ method(984) reconstruct(947) comput(926) }
{ case(1353) use(1143) diagnosi(1136) }
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Resumo

RPOSE: Due to the rapid growth of Shanghai city to 20 million residents, the balance between healthcare supply and demand has become an important issue. The local government hopes to ameliorate this problem by developing an image-enabled electronic healthcare record (EHR) sharing mechanism between certain hospitals. This system is designed to enable healthcare collaboration and reduce healthcare costs by allowing review of prior examination data obtained at other hospitals. Here, we present a design method and implementation solution of image-enabled EHRs (i-EHRs) and describe the implementation of i-EHRs in four hospitals and one regional healthcare information center, as well as their preliminary operating results.METHODS: We designed the i-EHRs with service-oriented architecture (SOA) and combined the grid-based image management and distribution capability, which are compliant with IHE XDS-I integration profile. There are seven major components and common services included in the i-EHRs. In order to achieve quick response for image retrieving in low-bandwidth network environments, we use a JPEG2000 interactive protocol and progressive display technique to transmit images from a Grid Agent as Imaging Source Actor to the PACS workstation as Imaging Consumer Actor.RESULTS: The first phase of pilot testing of our image-enabled EHR was implemented in the Zhabei district of Shanghai for imaging document sharing and collaborative diagnostic purposes. The pilot testing began in October 2009; there have been more than 50 examinations daily transferred between the City North Hospital and the three community hospitals for collaborative diagnosis. The feedback from users at all hospitals is very positive, with respondents stating the system to be easy to use and reporting no interference with their normal radiology diagnostic operation.CONCLUSIONS: The i-EHR system can provide event-driven automatic image delivery for collaborative imaging diagnosis across multiple hospitals based on work flow requirements. This project demonstrated that the grid-based implementation of IHE XDS-I for image-enabled EHR could scale effectively to serve a regional healthcare solution with collaborative imaging services. The feedback from users of community hospitals and large hospital is very positive.

Resumo Limpo

rpose due rapid growth shanghai citi million resid balanc healthcar suppli demand becom import issu local govern hope amelior problem develop imageen electron healthcar record ehr share mechan certain hospit system design enabl healthcar collabor reduc healthcar cost allow review prior examin data obtain hospit present design method implement solut imageen ehr iehr describ implement iehr four hospit one region healthcar inform center well preliminari oper resultsmethod design iehr serviceori architectur soa combin gridbas imag manag distribut capabl compliant ihe xdsi integr profil seven major compon common servic includ iehr order achiev quick respons imag retriev lowbandwidth network environ use jpeg interact protocol progress display techniqu transmit imag grid agent imag sourc actor pac workstat imag consum actorresult first phase pilot test imageen ehr implement zhabei district shanghai imag document share collabor diagnost purpos pilot test began octob examin daili transfer citi north hospit three communiti hospit collabor diagnosi feedback user hospit posit respond state system easi use report interfer normal radiolog diagnost operationconclus iehr system can provid eventdriven automat imag deliveri collabor imag diagnosi across multipl hospit base work flow requir project demonstr gridbas implement ihe xdsi imageen ehr scale effect serv region healthcar solut collabor imag servic feedback user communiti hospit larg hospit posit

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