A framework for the integration of distributed autonomous healthcare information systems.

This paper presents a domain-specific framework for the integration of geographically distributed heterogeneous autonomous healthcare information systems. Integration is seen and understood in terms of access to information resources, and in terms of content, structure, and visualization of patient record segments, with the goal of creating a virtual patient record at the medical workstations. The proposed approach covers integration aspects related to presentation, control, data, and function. The architecture and the components of the framework are based on the newly introduced Patient Meta-Record (PMR) concept, but also make use of existing or emerging standards for distributed object-oriented computing and information presentation. At the application and middle-ware layers of the presented healthcare information systems architecture, the PMR concept enhances or enables services for data mediation, distributed directory access, and workflow management. At the bitways layer, high performance networks provide a fast medium, which is indispensable for medical image distribution, collaborative work, hypermedia library applications, and teleconsultation.