Overview

e-Health — healthcare supported by software systems — is evolving quickly. Among the several e-Health research activities, research on Electronic Health Record (EHR) is particularly intensive. An EHR represents a set of medical information called fragments, which are stored in a digital format over different healthcare institutions. The introduction of EHR offers several benefits: better patient safety, lower cost of health services and improvements in healthcare audit and research. The main challenge in the EHR domain in order to keep such benefits is to ensure interoperability among EHR fragments belonging to an environment that is distributed, open and in which the security support represents a fundamental requirement to ensure the patient privacy. Several efforts have been made in the EHR domain in order to cope with such requirements, in particular:

• Definition of standards for EHR-fragment format and communication such as Health Level Seven (HL7) and Digital Imaging and Communications in Medicine (DICOM)
• Definition of standards like openEHR and CEN EN 13606 promoting semantic approaches to face heterogeneity and dynamism of fragment formats
• Definition of specifications like the Integrating the Healthcare Enterprise (IHE) specifications, to build EHR coordination middleware able to coordinate EHR-fragment providers and requesters
• Definition of EHR coordination middleware based on the semantic tuple-space computing, such as the one promoted by the Triple Space Computing (TSC) project

As shown by TSC, semantic tuple-space computing provides models to engineer EHR coordination middleware overcoming the limits of the solutions proposed in the IHE specifications. In fact, differently from the IHE specifications, TSC provides a solution based on semantic techniques as suggested by openEHR and CEN EN 13606, and models that are suitable to build applications supporting more complex dynamics than the mere exchange of EHR fragments. From the other hand, as well as the IHE solutions, TSC lacks of approaches able to cope with the dynamism of the applications making difficult to adapt a coordination middleware in case of application requirement changes. Accordingly, in this project we aim at providing models and approaches extending the solutions proposed in IHE and TSC, in order to augment their effectiveness in realising EHR services with particular reference to the requirement of interoperability and dynamicity.