Integrated computerized patient records: the DIOGENE 2 distributed architecture paradigm with special emphasis on its middleware design.

DIOGENE 2 is a full-scale distributed/open hospital information system that by June 1995 had already achieved its migration from a former mainframe system. Thanks to that architecture there is an obvious need for a common "glue" devoted to tightening up scattered applications into a middleware-based network of interoperability. After this the design of open/distributed Electronic Patient Records (EPRs) became feasible. A brief historical sketch of DIOGENE is presented from its initial to its present phase. A working prototype of these distributed EPRs is discussed showing current achievements during its first stage of production in the clinics of the University Hospitals of Geneva. On-going expansion to other public hospitals, as well as to general practioners (GPs) in the Geneva area, are partly described.