Success Story: Perugia Hospital

Integration and information visibility

  • Headquarters

    Perugia, Italy
  • Industry

  • Challenge

    Create a Clinical Data Repository that integrates all the clinical and healthcare information processed by different systems within the hospital and organizes the data in a standard structured format, enabling improved patient care and optimization of operating costs

  • Solution

  • Results

    • Improved healthcare quality achieved through online availability of the patient’s clinical history, enabling rapid, structured consultation of the patient’s clinical information
    • Optimization of operating costs through better support for automation
    • Standards-based (including HL7 and DICOM) integration and communication between the Data Repository and applications used for hospital services, diagnostics and administration

“The benefits expected to result from implementation of the system include improved healthcare quality achieved through online availability of the patient’s clinical history, optimisation of operating costs through better support for automation in the wards and preparation of links at the local level, all with a view to offering patients better service.”

The Perusia Project

One of the biggest problems with the way Information Technology is used for healthcare applications in Europe is failure to aggregate management of clinical documentation with a “patient-oriented” vision. Information must be readily available to permit improvement of clinical processes. Knowledge of a patient’s clinical history is of essential importance in identifying the actions to be taken. It is clear what needs to be done: it must be possible to access all the patient’s clinical information when and where it is needed. This can be achieved by putting a Clinical Data Repository together with a patient-oriented vision (EHR or Electronic Health Record).

Authorised operators can view the clinical records of a patient undergoing treatment from any workstation, and thus have essential information on the patient’s present and past at their disposal when making important decisions. In the same way, the healthcare facility’s administrative office will automatically have complete documentation available on all the services provided.

The Clinical Data Repository brings together all the clinical and healthcare information processed by different systems within the hospital, organizing the information in a standard structured format. This database constitutes an important source of information for both ward clinics and hospital management, offering a panoramic view of users’ clinical and medical records. This history includes all contacts that each user has had with hospital facilities, from hospitalization to individual outpatient services.

This form of organization ensures that the range of healthcare services is extended from the hospital to other facilities in the area, making information available outside the hospital to guarantee continuity in patient care.

In a complex system such as the Perugia hospital information system, with a large number of heterogeneous applications and a strong need to work together (exchanging data and requesting and providing services), a tool capable of overseeing integration at all stages (design, development and management) has a crucial role to play.

“The benefits expected to result from implementation of the system include improved healthcare quality achieved through online availability of the patient’s clinical history, optimization of operating costs through better support for automation in the wards and preparation of links at the local level, all with a view to offering patients better service.”

Benefits Expected

“The benefits expected to result from implementation of the system include improved healthcare quality achieved through online availability of the patient’s clinical history, optimization of operating costs through better support for automation in the wards and preparation of links at the local level, all with a view to offering patients better service.”

Integration and communication between the Data Repository and applications used for hospital services, diagnostics and administration are based on international standards, including HL7 for structural data and DICOM for images.

The PERUSIA project in course at the Perugia Hospital Trust was inspired by the need to have patients’ clinical files available with integration of vertical software solutions in the hospital’s IT system so as to make patients’ clinical information available to the healthcare workers who require it.

The goal of the PERUSIA project is the management of all tasks and information on the IT-based services the hospital provides to both inpatients and outpatients.

The project involves implementation at the Hospital Trust of the ITACA solution, built by Axway and Noematica in the context of an important project with European Community funding, aimed at meeting one of the most important needs of European healthcare systems: aggregate management of clinical documentation with a “patientcentred” vision.

The PERUSIA system will therefore benefit from treatment and assistance processes, and specifically:

  • the quality of clinical services (permitting rapid, structured consultation of the patient’s clinical information)

  • management of communication flows between departments and services/clinics (requests for services, planning and results available online)

Availability of information in various aggregation and correlation modes (DRG, pathology, specialisation, etc.) provides the Hospital Trust with clinical and scientific information (protocols) and economic information (cost per service).

As the Project involves most internal processes and all healthcare personnel, it will be implemented with a gradual approach, in stages based on priority of action and training required for users as well as consolidation of the changes as they are made.

Solution Adopted

The solution adopted is based on two international leading software products: Axway’s Integrator / Sentinel as integration and control middleware, and GMD gmbH’s e-health. solutions, supplied by Noematica, as the application front-end and EPR (Electronic Patient Record) repository, complemented by the professional services required for solution implementation, customization and start-up.

Specifically, Axway’s Integrator and Sentinel permit non-intrusive, simple, parameterised and modular integration of processes among various vertical healthcare applications and the e-health.solutions application, operating in near-real-time mode and performing data extraction from RDBMS and files followed by validation, enrichment, transformation (HL7, Oracle), addressing and populating data in the target application, while at the same time checking on progress.

e-health.solutions from Noematica is an innovative web-based platform producing a Clinical Information System on the basis of the Electronic Medical Record. Its advanced functions permit construction of a Clinical Data Repository (CDR) which is the basis for management of treatment processes.

A powerful development tool called “Application Designer” permits ongoing adaptation of the system to evolution of clinical and healthcare scenarios. e-health. solutions is designed on the basis of the most advanced paradigms, starting with application of international communications standards (HL7 and DICOM) and produced entirely with Java technology. Thus technological innovation is applied to the healthcare facility’s core activity to allow it to evolve toward new targets for efficiency.

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