The advantages of the introduction of information and communication technologies (ICT) in the complex healthcare sector are already well known and well stated in the past. It is common knowledge that in order to install any type of information system in healthcare, six main groups of issues have to be dealt with: organizational and cultural matters related to healthcare, technological gap between healthcare professionals and information science experts, legal requirements on the confidentiality of personal data, of patient related data and on data privacy, industrial and market position of healthcare informatics and interoperability complexity, lack of vision and leadership of the health care managers and health authorities and user acceptability and usability of the proposed information systems. In order to meet these issues stated above, a special focus group (Z3) performed an assessment of the situation of healthcare informatics in Greece and of the main key points that would lead to success. In that sense it is now common knowledge that Greece is lagging information and communication technology progress in healthcare because almost none of the above mentioned issues were dealt with. This assessment is the result of the interaction of more than 150 decision makers, medical informaticians, healthcare practitioners and other individual involved in healthcare. As a conclusion, this focus group resulted in 4 major propositions that will lead to healthcare informatics introduction with better success chances: focus on terminologies and standards, focus on interoperability and information systems sustainability, focus on clear goals and system metrics that can create a healthcare performance management cockpit, and focus on people and what they have to say, by creating a e-health forum. These conclusions were taken into consideration by the Greek government and are incorporated the IASYS project, the national healthcare informatics framework for the next ten years.
The integration of information systems represents one of the most urgent priorities of a regional healthcare authority in order to meet its clinical, organizational and managerial needs. Current practice shows that the most promising approach to achieve a regional healthcare information system is to use a health level 7 (HL7) message based communication system implemented by an asynchronous common communication infrastructure between healthcare sites. The system is a complete and integrated information system at a regional level that comprises all types of healthcare levels, that includes interoperability issues, that covers most of the needed components, and that is able to work efficiently in a secure wide area network to ensure data privacy and confidentiality. Another important feature of the proposed solution is that it creates an interoperability framework that can be replicated from one healthcare institution to another. In that sense, common interoperability messages can be used to interconnect heterogeneous information systems. In response to this strategy, more than 10 different consortiums have submitted proposals to the Greek government and the proposed interoperability framework seems to be widely accepted as a solution to enhance information and communication technologies developments in the healthcare sector in Greece.
A fundamental pre-requisite for the establishment of a scaleable regional health information network (RHIN) is the development of an architectural framework and tools for the integration of specialized autonomous systems and e-health service platforms supported by an underlying health information infrastructure (HII). In this context, HYGEIAnet, which is the RHIN of Crete in Greece, has identified and utilized a number of critical software components enabling integrated access to clinically significant information, based on an open architecture addressing successfully the various interoperability challenges at hand. HYGEIAnet provides the framework for the reuse of standardized common components and public interfaces, thus enabling integrated and personalized delivery of healthcare.
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