An event-based notification approach for the delivery of patient medical information

Data sharing is pivotal in current medical practice so as to better treat patients by taking the best medical decisions, and to optimize healthcare costs by reducing the need to repeat unnecessary medical tests and by better managing healthcare structures. To improve the delivery of treatment outcomes and test results, the request-triggered retrieval of clinical documents provided by current Health Information Systems is not sufficient. The addition of a notification solution is necessary to inform users as soon as their clinical documents of interest have been produced so that they can retrieve them by means of the traditional Health Information Systems. In addition, this notification solution also has to implement the event-based information exchange patterns, which characterize the current attempts at integrating heterogeneous Health Information Systems in a seamless manner. This paper proposes an architecture for an effective asynchronous notification of clinical documents. Our intention is to bridge the gap between primary and secondary care, and between the clinical personnel and the administrators. The proposed solution is based on a publish/subscribe service, properly extended to allow us to jointly notify collections of correlated documents. Moreover, it has been implemented by means of a web service-based platform in accordance with the Web Service Notification specification so as to obtain a solution easy to integrate and manage. A systematic analysis has been carried out to assess the suitability of the implemented solution to satisfy the requirements for notifying medical documents, and to evaluate the notification latency in different use conditions. (C) 2013 Elsevier Ltd. All rights reserved.