Framework di architettura di servizi per la sanita'

The Project
Project Team
The training course
    The Project

The research project, co-financed by MIUR under the “Programma Operativo Nazionale (PON) Ricerca e Competitività 2007-2013” (National Operational Programme for Research and Competitiveness), aims, through research and testing, to implement a framework of plug-and-play services, based on the SOA paradigm and comply with international standards HSSP for the new generation of distributed architectures of Electronic Healthcare, which comprises the use of ICT tools to support and promote the prevention, diagnosis, treatment and  monitoring these diseases, and the management of health and lifestyle.

Since the early 90s, health care has undergone major changes in the public administration sector, both at an institutional and socio-health level and, in this process of modernization, there have been many initiatives to improve the efficiency of the service health and simplify, at every step of the way, the citizen’s ability to exercise his or her right to health and social care.

It is now recognized the important role that new technologies play in improving the quality and access to care: by making sensible use of technology without which it is impossible to improve, or even just maintain the quality of care being able, at the same time, to govern the costs of the Healthcare system.

From the point of view of information processing and automation of activities, the socio-clinical and healthcare sector has two features that, if not clearly distinct, give it a unique character because of its importance and prominence. The first is that clinical or health records, the simplest in organizational and operational terms, are often the result of complex processes involving multiple parties, various organizational entities and heterogeneous systems.  Second, the processing of healthcare information is often inseparable from that of the processing of administrative and accounting information.

In this context, the electronic health record (Electronic Health Record - EHR), which is a structure in which clinical care information is brought collected on an individual, that has been generated and managed over time by different parties, has become increasingly common requirement, and the effective interoperability of applications that feed or access the register and its elements  present an inescapable problem.

Thanks to standardization processes that have occurred to date, it has been possible to standardize the contents of the interactions between the application modules of health information systems - at least for certain operational scenarios, the standard HL7 CDA (Clinical Document Architecture), methods of semantic representation of clinical health documents, it is, in fact, now universally accepted - however the lack of functional interoperability, required in the health-clinical processes necessitates the redesign and the re-implementation, in virtually every process, the interactions required for the performance and use of these functions.

The problem of how to dynamically construct the electronic health records in order to make them shareable in their entirety is only in part a problem of standardization of formats of the elements of the register itself.

Today it is necessary to increase the level of standardization and to facilitate as much as possible the application cooperation through the deployment of a service oriented architecture (SOA - Service Oriented Architecture) standard and universal for health care. The paradigm of SOA metamodel of cooperation among autonomous and heterogeneous entities from the organizational point of view, will ensure, in fact, the complex collaboration of a large number of heterogeneous entities (organizations, applications, users, devices), the typical situation in healthcare, producing a standardization and interoperability of application services.

With the project HealthSOAF the partners intend to produce, through research and experimentation, innovative implementations of services for the global healthcare information technology market and to participate as protagonists in the HSSP project, changing a state of affairs that sees the Italian manufacturer’s search for significant results at the international level, but not very present in the international standardization bodies.

Thanks to HealthSOAF framework it will be possible to integrate the social and health process functions as provided by the “back-end” and “front-end” interaction that has evolved with and among citizens, patients, doctors, and organizations. A framework of services in an applicative environment is defined as a framework of collaboration between realized as exchange of services, a service is an activity, carried out by an operator subject (donor), productive of results that have value in use to another beneficiary (user), carried out in accordance with a service contract signed by both parties.

The services that make up the Framework will be designed and engineered by performing the reverse modeling form of the specification HSSP and taking the Contract-based model-driven approach (CMDB), which states that the description of the services are service contracts, the set the rights and obligations of providers and users, and these contracts are formal multilayer models, defined by the Model-Driven Architecture (MDA).

These services are for:

Ø  creation, search and retrieval of clinical data and health services, in accordance with the standard HSSP RLUS;

Ø  unique identification and management of a patient identification information and other subjects and objects, such as equipment that must be identified to ensure traceability and analysis of clinical trials, in accordance with the standard HSSP IX;

Ø  management of the terminologies of the documentation, drugs, laboratory tests, etc., as well as the relationships between these systems and the various systems with which they are coded in accordance with the standard HSSP CTS2;

Ø  multi search criterion of the health-clinical subjects (professionals, laboratories, hospitals ...) capable of providing specific services in a given geographical area and in a specific time frame, in accordance with the standard HSSP HSCPD;

Ø  control access to clinical information and health, ensure privacy and integrity of such information in accordance with the standard HSSP PASS;

Ø  access to knowledge, clinical and health embedded in a multitude of executable models of "intelligent" systems, expert systems, decision support systems, systems based on knowledge of guidelines implemented in accordance with the standard HSSP DSS.

Some services will be implemented by creating a specific add-on on different platforms already in the possession of partners, namely the new HSSP SOA interfaces.

The verification of adherence to the standards of the modules defined by the project HSSP will be made using an automated environment of black-box testing based on TTCN-3 that has been specially designed, implemented and put in place for this purpose.

The HealthSOAF Framework will be validated through the creation of a Demonstrator to experiment, in a real healthcare setting, how the interoperable service standards enable cooperation between the different users (doctors, hospital, laboratory, specialist centers, ASL) collaborating on the clinical process of integrated management of patients suffering from headache and migraine.

Last but not least, the partners intend to make a constructive contribution to the groups involved in standardization both nationally and internationally.

A first significant contribution emerging from the study and reverse modeling of the specification documents, both those that HL7 OMG as well as OMG, in terms of validation of the same; also the generic standard services will be "localized" in the specifically in the Italian health service evaluating, in terms of guidelines and standards, before the national situation and, later, the situation in Calabria, a region of convergence in which the Demonstrator will be implemented/used.