Enterprise Distribution Of Medical Information Anywhere, At Anytime

By Edward M. Smith, ScD

Treating patients at multiple healthcare facilities where each maintains their medical information in localized storage management systems and in many instances in proprietary application dependent formats is one of the greatest challenges to healthcare delivery and the emerging requirements for Health Information Exchange (HIE). To reduce the cost of healthcare, eliminate unnecessary clinical studies and streamline patient care, the patient's medical information must be available anywhere and at anytime to any authorized healthcare professional. This can be accomplished by registering medical information in standards-based enterprise storage management solutions that share data across any healthcare facility where a patient encounter occurs.

The implementation of a multi-enterprise standards-based medical informatics environment is beginning to evolve in Canada, Great Britain, Netherlands and elsewhere while in the United States a few localized HIE and Regional Health Information Organizations (RHIO) have been established. With the current investment from the US government through the American Recovery and Reinvestment Act (ARRA) initiative many healthcare providers will want to take advantage of this government incentive to participate in a unified network of Protected Health Information (PHI) to authorized users. Unfortunately the standards-based technical solutions are slow to being adopted in the United States making a regional or national network of medical information difficult to achieve.

Integrating the Healthcare Enterprise (IHE) started in 1997 to improve interoperability, utilizing existing standards, e.g. Health Level 7 (HL7), Digital Imaging and Communications in Medicine (DICOM), etc., between clinical applications. IHE's initial emphasis on Radiology has expanded to multiple clinical and IT domains and a global perspective (1). In 2003 (2) IHE initiated efforts on the healthcare infrastructure with Cross-Enterprise Document Sharing (XDS). In 2005 IHE began work on including images in XDS with XDS-I (3).

The information storage management system for clinical and related applications is central to providing swift and cost-effective healthcare at any healthcare facility. This system must deliver requested information seamlessly to any authorized user anywhere and at anytime. A standards-based enterprise storage management system that is independent of the application and transmits data (4) is critical to achieving the goals of:

• Interoperability between clinical applications
• Increased productivity
• Decreased operational cost and
• Facilitate implementation of an Electronic Health Record (EHR) system.