Open source is a still unexploited chance for healthcare organizations and technology providers to answer to a growing demand for innovation and to join economical benefits with a new way of managing hospital information systems. This chapter will present the case of the web enterprise clinical portal developed in Italy by Niguarda Hospital in Milan with the support of Fondazione Politecnico di Milano, to enable a paperless environment for clinical and administrative activities in the ward. This represents also one rare case of open source technology and reuse in the healthcare sector, as the system's porting is now taking place at Besta Neurological Institute in Milan. This institute is customizing the portal to feed researchers with structured clinical data collected in its portal's patient records, so that they can be analyzed, e.g., through business intelligence tools. Both organizational and clinical advantages are investigated, from process monitoring, to semantic data structuring, to recognition of common patterns in care processes.
The aim of the paper is to discuss the application of a methodology for the structured evaluation of the porting of an eHealth solution. In particular a web Information System in the area of Medical and Nursing Informatics, the portal developed by an Healthcare Organization for supporting clinical management processes, is taken as practical example of such a process. A procedure used for the evaluation of reuse in public administration is brought forward and, through the example, it is shown how it could be applied to Healthcare Management Systems.
Interoperability between Healthcare Management Systems is a fundamental requirement to improve the quality of care, to assure patients continuous assistance and to improve clinical research. Pathology Networks create a common virtual environment which allows to overcome single HIS' borders, by connecting different healthcare organizations adopting common formats to share clinical data and, consequently, knowledge. Syntactic and semantic standards are paramount to enable interoperability in this context, since common document formats ensure efficient communication, while internationally known vocabularies allow the unambiguous interpretation of contents. This paper has the purpose to show a real experience of participation to a Pathology Network, providing a model based on open standards which could be taken as a reference model for similar initiatives in other healthcare environments. Benefits resulting from such an initiative will be presented, in terms of improvement for clinical research and quality of patients' care. The real case we describe is an example of how Pathology Networks can provide scientific features to Electronic Health Records, by adding information not usually reported on standard clinical sheets, but necessary to perform new analysis with the purpose of improving clinical research.
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