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the security to be focal point to the design of such so-
lutions because it will determine if these frameworks
will, in the future, have a practical value.
6 CONCLUSIONS
We presented a study of the current situation and of
the future directions in dynamic interoperable solu-
tions for healthcare systems. We focused on the re-
sults of an online questionnaire collected from the
participants of the Swiss eHealth summit. The re-
sults showed a general trend towards the use of IHE
and HL7 which is a good indicator of solutions that
can support integration with other systems. The re-
sults also suggested that the future interoperability
will require more dynamic and open solutions to-
wards record exchange. Finally we discussed some
technical solutions that can make the difference to-
wards supporting these future scenarios. As part of
our future work, we plan to further investigate the im-
plications of the four proposed scenarios. The techni-
cal solution is only one aspect of realising these sce-
narios. We plan to study what are the practical, legal
and ethical aspects that may prevent institutions to go
towards more dynamic settings and how to overcome
them. Including issues of depersonalization and min-
imization of data and the way these can be integrated
in cross-institutional IHE settings.
ACKNOWLEDGEMENTS
This work was funded by the Switzerland FNS grant
nr. 200021 135386 / 1.
REFERENCES
Androutsellis-Theotokis, S. and Spinellis, D. (2004). A sur-
vey of Peer-to-Peer content distribution technologies.
ACM Comput. Surv., 36(4):335–371.
Dolin, R. H., Alschuler, L., Beebe, C., Biron, P. V., Boyer,
S. L., Essin, D., Kimber, E., Lincoln, T., and Matti-
son, J. E. (2001). The HL7 Clinical Document Archi-
tecture. Journal of the American Medical Informatics
Association, 8(6):552–569.
Garde, S., Knaup, P., Hovenga, E., and Heard, S.
(2007). Towards semantic interoperability for elec-
tronic health records–domain knowledge governance
for open ehr archetypes. Methods of information in
medicine, 46(3):332–343.
Geissbuhler, A., Spahni, S., Assimacopoulos, A., Raetzo,
M., and Gobet, G. (2004). Design of a patient-
centered, multi-institutional healthcare information
network using Peer-to-Peer communication in a
highly distributed architecture. Medinfo, 11(Pt
2):1048–52.
Goltra, P. S. (1997). MEDCIN: a new nomenclature for
clinical medicine. Springer.
Grimson, J., Grimson, W., and Hasselbring, W. (2000). The
SI challenge in health care. Commun. ACM, 43:48–55.
Gunter, D. T. and Terry, P. N. (2005). The emergence of
national electronic health record architectures in the
united states and australia: Models, costs, and ques-
tions. J Med Internet Res, 7(1):e3.
Guo, Y., Hu, Y., Afzal, J., and Bai, G. (2011). Using
P2P technology to achieve eHealth interoperability. In
Service Systems and Service Management (ICSSSM),
pages 1 –5.
Hendler, J. (2001). Agents and the Semantic Web. IEEE
Intelligent Systems, 16:30–37.
IHE (2008). White paper: Cross community infor-
mation exchange. http://www.ihe.net/ Techni-
cal Framework/upload/IHE ITI TF White Paper
Cross Community 2008-11-07.pdf.
IHE (2011). Technical framework integration profiles vol 1.
http://www.ihe.net.
Isern, D., Snchez, D., and Moreno, A. (2010). Agents ap-
plied in health care: A review. International Journal
of Medical Informatics, 79(3):145 – 166.
Kalra, D. (2006). Electronic health record standards. vol-
ume 45, pages 136–144. Methods Inf Med.
Kilic, O., Dogac, A., and Eichelberg, M. (2010). Provid-
ing interoperability of ehealth communities through
peer-to-peer networks. Information Technology in
Biomedicine, IEEE Transactions on, 14(3):846–853.
McDonald, C. J., Huff, S. M., Suico, J. G., Hill, G.,
Leavelle, D., Aller, R., Forrey, A., Mercer, K., De-
Moor, G., Hook, J., et al. (2003). LOINC, a universal
standard for identifying laboratory observations: a 5-
year update. Clinical chemistry, 49(4):624–633.
Michelet, C., Fragnire, F., and Gnaegi, A. (2011). Infomed,
dossier patient partag en Valais. Journal of Swiss
Medical Informatics, 72.
Reinhold, S., Henning, M., Dominik, A. and Patrick, R.
2011. e-Heallth Semantic and Content for Switzerland
Schloeffel, P., Beale, T., Hayworth, G., Heard, S., and
Leslie, H. (2006). The relationship between cen 1360
6, hl7 and openehr. HIC and HINZ Proceedings, 24.
Stearns, M. Q., Price, C., Spackman, K. A., and Wang, A. Y.
(2001). SNOMED clinical terms: overview of the de-
velopment process and project status. In Proceedings
of the AMIA Symposium, page 662. American Medical
Informatics Association.
Urovi, V., Olivieri, A., Bromuri, S., Fornara, N., and
Schumacher, M. (2013). A P2P Agent Coordination
Framework for IHE based Cross-Community Health
Record Exchange. In ACM 28th Symposioum on Ap-
plied Computing, page to appear.
Wozak, F., Ammenwerth, E., Hoerbst, A., Soegner, P., Mair,
R., and Schabetsberger, T. (2008). IHE based Interop-
erability - Benefits and Challenges. volume 136 of
Studies in Health Technology and Informatics, pages
771–776. IOS Press.
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