Objec ves: The correct seman cs management represents a fundamental requirement to create health informa on exchange (HIE) systems able to support clinical data sharing. A research is now underway to set up an infrastructure to aggregate data coming from health informa on systems, and it will be experimented to support regional HIE in Veneto region, Italy. Methods: In the fi rst period, the focus was on the seman cs management of Clinical Document Architecture Release 2 (CDA R2) laboratory reports, in which observa ons must be encoded using LOINC ® vocabulary. The exis ng components considered were the Laboratory Informa on Systems (LISs) of the local departments of the region (23 units) and the regional HIE. To manage the seman cs of the data, the design and the implementa on of a terminology service, the Health Terminology Service (HTS), compliant to the Common Terminology Service Release 2 (CTS2) standard was considered. Results: The HTS, formed by a set of web services, as CTS2 indicates, is the core of the proposed infrastructure. It is connected with an applica on that allows crea ng, dele ng, upda ng and managing the versioning of the maps between the laboratory observa ons and the LOINC ® en es. Conclusions: The adop on of CTS2 specifi ca on allows the HTS to support diff erent use cases, which are essen al to supports the clinical data sharing of the HIE content. During the development, the authors faced some problems that cause a delay in the implementa on of the solu on. The authors are s ll working to connect the HTS with the exis ng systems and to improve the solu on.
Prevention and surveillance of healthcare associated infections caused by multidrug resistant organisms (MDROs) has been given increasing attention in recent years and is nowadays a major priority for health care systems. The creation of automated regional, national and international surveillance networks plays a key role in this respect. A surveillance system has been designed for the Abruzzo region in Italy, focusing on the monitoring of the MDROs prevalence in patients, on the appropriateness of antibiotic prescription in hospitalized patients and on foreseeable interactions with other networks at national and international level. The system has been designed according to the Service Oriented Architecture (SOA) principles, and Healthcare Service Specification (HSSP) standards and Clinical Document Architecture Release 2 (CDAR2) have been adopted. A description is given with special reference to implementation state, specific design and implementation choices and next foreseeable steps. The first release will be delivered at the Complex Operating Unit of Infectious Diseases of the Local Health Authority of Pescara (Italy).
An infrastructure for the management of semantics is being developed to support the regional health information exchange in Veneto – an Italian region which has about 5 million inhabitants. Terminology plays a key role in the management of the information fluxes of the Veneto region, in which the management of electronic health record is given great attention. An architecture for the management of the semantics of laboratory reports has been set up, adopting standards by HL7. The system has been initially developed according to the common terminology service release 2 (CTS2) standard and, in order to overcome complexities of CTS2 is being revised according to the Fast Healthcare Interoperability Resources (FHIR) standard, which has been subsequently introduced. Aspects of CST2 and of FHIR have been considered in order to retain most suitable aspects of both. This integration can be regarded as most worthwhile.
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