Biomedical subjects

Stéphane Spahni

Publications and source records attributed to Stéphane Spahni.

7 recordsLinked to original sources

PubMed2006

Comprehensive management of the access to the electronic patient record: towards trans-institutional networks.

BACKGROUND: A system ensuring tight control access is used since 5 years at the University Geneva Hospitals (HUG) over a four campuses health care system with ambulatory care settings behaving like a small community care network. Access to identified clinical information is limited to care providers that have a therapeutic relationship with the patient and to those data needed for that relation. The same policy applies to administrative or scientific research accesses. This paper presents how the HUG met the challenging goal of protecting patient privacy within regulatory limits while keeping the system operational in terms of use and management. SOLUTION: The main characteristics of the system are: (a) an institution-wide policy for access rights to the computerized patient record; (b) an institutional management of the contracts of the collaborators; (c) access profiles based on application-independent, fine-grained access rights; (d) a decentralized attribution of profession-specific access profiles; (e) a complete, centralized log of all accesses to the clinical information system; and (f) a decentralized verification of the accesses. Many of these characteristics can be maintained when evolving towards a trans-institutional computerized patient record, but new constraints need to be taken into account.

Access to Information↗

PubMed2006

Implementing a new ADT based on the HL7 version 3 RIM.

The University Hospitals of Geneva (HUG) are the result of the merge of six hospitals into one single organization. While a true fusion of the management has been effectively done, it was not the case 5 years after for several databases, and in particular the ADT (admission, discharge, transfer). In order to truly realize the fusion, a new ADT service has been built using state of the art technology and standards in order to replace the existing seven services. This paper presents the results of the redesign and development of the new ADT service. The data model, based on HL7 RIM, is described and the technologies selected are presented. Finally, a status after 1 year of production is presented.

Hospital Information Systems↗

PubMed2006

Comprehensive management of the access to a component-based healthcare information system.

OBJECTIVE: to describe the key concepts and elements used to implement a comprehensive access management system to a distributed, component-based healthcare information system. METHODS: the a priori access is based on an institution-wide policy for access rights coupled to proximity process for the granting of such rights. Access rights are explicit and externalized from the information systems components. A posteriori control is based on a centralized, exhaustive journal of accesses to all components coupled to a decentralized verification process for suspicious accesses. RESULTS: the system has been operational for three years, initially used for the access to the computerized patient record components, and now extending to all the components of the hospital information system. The same architecture will be used for the development of the trans-institutional community health information network.

Access to Information↗

PubMed2005

Health search engine with e-document analysis for reliable search results.

OBJECTIVE: After a review of the existing practical solution available to the citizen to retrieve eHealth document, the paper describes an original specialized search engine WRAPIN. METHOD: WRAPIN uses advanced cross lingual information retrieval technologies to check information quality by synthesizing medical concepts, conclusions and references contained in the health literature, to identify accurate, relevant sources. Thanks to MeSH terminology [1] (Medical Subject Headings from the U.S. National Library of Medicine) and advanced approaches such as conclusion extraction from structured document, reformulation of the query, WRAPIN offers to the user a privileged access to navigate through multilingual documents without language or medical prerequisites. RESULTS: The results of an evaluation conducted on the WRAPIN prototype show that results of the WRAPIN search engine are perceived as informative 65% (59% for a general-purpose search engine), reliable and trustworthy 72% (41% for the other engine) by users. But it leaves room for improvement such as the increase of database coverage, the explanation of the original functionalities and an audience adaptability. CONCLUSION: Thanks to evaluation outcomes, WRAPIN is now in exploitation on the HON web site (http://www.healthonnet.org), free of charge. Intended to the citizen it is a good alternative to general-purpose search engines when the user looks up trustworthy health and medical information or wants to check automatically a doubtful content of a Web page.

Europe↗

PubMed2005

Implementing a New ADT Based on the HL-7 Version 3 RIM.

The University Hospitals of Geneva (HUG) are the result of the merge of six hospitals into one single organization. While a true fusion of the management has been effectively done, it was not the case five years after for several databases, and in particular the ADT (Admission, Discharge, Transfer). In order to truly realize the fusion, a new ADT service has been built using state of the art technology and standards in order to replace the existing seven services. This paper presents the results of the redesign and development of the new ADT service. The data model, based on HL-7 RIM, is described and the technologies selected are presented. Finally, a status after a few months of production is presented.

Hospitals↗

PubMed2004

Design of a patient-centered, multi-institutional healthcare information network using peer-to-peer communication in a highly distributed architecture.

OBJECTIVE: to design a community healthcare information network for all 450,000 citizen in the State of Geneva, Switzerland, connecting public and private healthcare professionals. Requirements include the decentralized storage of information at the source of its production, the creation of a virtual patient record at the time of the consultation, the control by the patient of the access rights to the information, and the interoperability with other similar networks at the national and european level. METHODS: a participative approach and real-world pilot projects are used to design, test and validate key components of the network, including its technical architecture and the strategy for the management of access rights by the patients. RESULTS: a distributed architecture using peer-to-peer communication of information mediators can implement the various requirements while limiting to an absolute minimum the amount of centralized information. Access control can be managed by the patient with the help of a medical information mediator, the physician of trust.

Community Networks↗

PubMed2002

Secure exchange of medical data: requirements and solutions.

It is now common to access and to exchange data through computer networks. The major applications used are Web access and, e-mail. But while there is no security concern when accessing classical or anonymous data, the exchange of sensitive data (e.g. patient-related information) is subject to legal constraints. This paper summarizes the current legal obligations in Switzerland and presents state of the art techniques for applying the legal rules. A commercial implementation in Switzerland is taken as illustration.

Computer Security↗