Information systems are a complex thing, and they are mostly not used stand-alone anymore. In that context, many different issues must be considered. It starts with defining the system's purpose, includes the use cases and scenarios in combination with the necessary data ideally separated into distinct domains. Furthermore, it requires the selection of an appropriate set of supporting components/tools and a development environment including some technology to enable continuous integration. And the endeavor does not come to an end with the development of the system itself. To manage those challenges, thinking about design and architectural principles becomes a mandatory element. The situation gets more complicated with growing expectations regarding communication and cooperation between the more and more complex and dynamic ecosystem's actors. The resulting information system has to adhere to different, sometimes contradictory principles and requirements, frequently controlled by different authorities. This paper focuses less on developing information systems in general but concentrates on the aspects that must be considered when multiple requirements from different stakeholders for data exchange and knowledge sharing for advanced interoperability must be met. The latter is commonly underspecified due to missing proper verification of the correct interpretation of data. One intent of the paper is to promote the deployment of information models as a common basis to derive data exchange specifications establishing advanced interoperability. However, it also addresses the necessity to guarantee that the information models and implementable artifacts correctly represent the intended functions and objectives as well as the underlying concepts of the business system in its prevailing context. Therefore, we cannot limit our considerations on the data and information viewpoints.

• Klíčová slova
• communication standard, data exchange, data set, information model, interoperability,
• Publikační typ
• časopisecké články MeSH
• systematický přehled MeSH

The value of data models in general and information models in specific has been evaluated by many scientific papers. UML as one modelling notation has documented its value as a foundation for precise specifications. Analyzing implementation guides for data exchange, they rarely include or are based on information models but simple data sets, if at all, as simple technical representation thereof. This paper wants to argue in favor of information models as a basis for creating interoperability specifications using a quite simple example and to include - or at least reference - them when providing implementation guides. The reader is invited to transfer this example to even more complex scenarios.

• Klíčová slova
• FHIR, Information models, data exchange, data sets, interoperability,
• Publikační typ
• časopisecké články MeSH

Multidisciplinary and highly dynamic pHealth ecosystems according to the 5P Medicine paradigm require careful consideration of systems integration and interoperability within the domains knowledge space. The paper addresses the different aspects or levels of knowledge representation (KR) and management (KM) from cognitive theories (theories of knowledge) and modeling processes through notation up to processing, tooling and implementation. Thereby, it discusses language and grammar challenges and constraints, but also development process aspects and solutions, so demonstrating the limitation of data level considerations. Finally, it presents the ISO 23903 Interoperability and Integration Reference Architecture to solve the addressed problems and to correctly deploy existing standards and work products at any representational level including data models as well as data model integration and interoperability.

• Klíčová slova
• 5P Medicine, architecture, integration, interoperability, knowledge management, knowledge representation, modeling, pHealth ecosystem,
• MeSH
• ekosystém * MeSH
• jazyk (prostředek komunikace) MeSH
• systémová integrace * MeSH
• Publikační typ
• časopisecké články MeSH

INTRODUCTION: The electronic prescribing system (EPS) is now widely used in the USA and largely also in EU member countries. Nevertheless, comparisons of different EPS are very scarce. Whilst the EU strives for cross-border interoperability in healthcare, the aim of this study is to provide a contemporary account of the state of national EPS in such countries. METHODS: For the sake of consistency the state of each of the EPS as of the end of 2018 was researched using an e-mail questionnaire. Respondents were chosen from among authors who have previously published studies on electronic prescriptions. RESULTS: Data on EPS was gathered from 23 out of the 28 EU member states. In 2018 EPS was in daily use in 19 EU states, and one further country had a pilot project, whereas the remaining 3 were only at the planning stage. Most of the EPS do not differ significantly in basic design, however authentication procedures vary substantially. DISCUSSION: There is a significant increase in EPS usage in EU countries as compared with previous studies. Cross-border interoperability in the EU is still limited, and further advancement might be hampered by differences in authentication procedures. CONCLUSION: Although it was not possible to acquire data from all the EU countries, this study shows the present state of electronic prescription in most of them and demonstrates continuous development in this area.

• Klíčová slova
• Drug prescription, Electronic prescription, Information system, Interoperability,
• MeSH
• elektronické předepisování * MeSH
• Evropská unie MeSH
• pilotní projekty MeSH
• Publikační typ
• časopisecké články MeSH

People living with diabetes have many medical devices available to assist with disease management. A critical aspect that must be considered is how systems for continuous glucose monitoring and insulin pumps communicate with each other and how the data generated by these devices can be downloaded, integrated, presented and used. Not only is interoperability associated with practical challenges, but also devices must adhere to all aspects of regulatory and legal frameworks. Key issues around interoperability in terms of data ownership, privacy and the limitations of interoperability include where the responsibility/liability for device and data interoperability lies and the need for standard data-sharing protocols to allow the seamless integration of data from different sources. There is a need for standardised protocols for the open and transparent handling of data and secure integration of data into electronic health records. Here, we discuss the current status of interoperability in medical devices and data used in diabetes therapy, as well as regulatory and legal issues surrounding both device and data interoperability, focusing on Europe (including the UK) and the USA. We also discuss a potential future landscape in which a clear and transparent framework for interoperability and data handling also fulfils the needs of people living with diabetes and healthcare professionals.

• Klíčová slova
• Big data, Diabetes therapy, Glucose monitoring, Insulin delivery systems, Interoperability, Medical devices, Review,
• MeSH
• diabetes mellitus * farmakoterapie   MeSH
• elektronické zdravotní záznamy MeSH
• krevní glukóza MeSH
• lidé MeSH
• selfmonitoring glykemie * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Spojené království MeSH
• Názvy látek
• krevní glukóza MeSH

Health and social care ecosystems are currently a matter of foundational organizational, methodological and technological paradigm changes towards personalized, preventive, predictive, participative precision (5P) medicine. For designing and implementing such advanced ecosystems, an understanding and correct representation of structure, function and relations of their components is inevitable. To guarantee consistent and conformant processes and outcomes, the specifications and principles must be internationally standardized. Summarizing the first author's Keynotes over the last 15 years of pHealth conferences, the paper discusses concepts, standards and principles of 5P medicine ecosystems including their design and implementation. Furthermore, a guidance to find and to deploy corresponding international standards in practical projects is provided.

• Klíčová slova
• 5P medicine, System architecture, ecosystem, integration, interoperability, knowledge management, knowledge representation, modeling,
• MeSH
• ekosystém * MeSH
• individualizovaná medicína * MeSH
• Publikační typ
• časopisecké články MeSH

The paper describes several classification systems that could improve patient safety through semantic interoperability among contemporary electronic health record systems (EHR-Ss) with support of the HL7 v3 standard. We describe a proposal and a pilot implementation of a semantic interoperability platform (SIP) interconnecting current EHR-Ss by using HL7 v3 messages and concepts mappings on most widely used classification systems. The increasing number of classification systems and nomenclatures requires designing of various conversion tools for transfer between main classification systems. We present the so-called LIM filler module and the HL7 broker, which are parts of the SIP, playing the role of such conversion tools. The analysis of suitability and usability of individual terminological thesauri has been started by mapping of clinical contents of the Minimal Data Model for Cardiology (MDMC) to various terminological classification systems. A national-wide implementation of the SIP would include adopting and translating international coding systems and nomenclatures, and developing implementation guidelines facilitating the migration from national standards to international ones. Our research showed that creation of such a platform is feasible; however, it will require a huge effort to adapt fully the Czech healthcare system to the European environment.

• MeSH
• chorobopisy - spojování metody   MeSH
• elektronické zdravotní záznamy organizace a řízení   MeSH
• kardiologie metody   organizace a řízení   MeSH
• kardiovaskulární nemoci klasifikace   MeSH
• lidé MeSH
• programovací jazyk MeSH
• řízený slovník * MeSH
• sémantika MeSH
• šíření informací metody   MeSH
• systémová integrace * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

Background/Objectives: Health and social care systems around the globe are currently undergoing a transformation towards personalized, preventive, predictive, participative precision medicine (5PM), considering the individual health status, conditions, genetic and genomic dispositions, etc., in personal, social, occupational, environmental, and behavioral contexts. This transformation is strongly supported by technologies such as micro- and nanotechnologies, advanced computing, artificial intelligence, edge computing, etc. Methods: To enable communication and cooperation between actors from different domains using different methodologies, languages, and ontologies based on different education, experiences, etc., we have to understand the transformed health ecosystem and all its components in terms of structure, function and relationships in the necessary detail, ranging from elementary particles up to the universe. In this way, we advance design and management of the complex and highly dynamic ecosystem from data to knowledge level. The challenge is the consistent, correct, and formalized representation of the transformed health ecosystem from the perspectives of all domains involved, representing and managing them based on related ontologies. The resulting business viewpoint of the real-world ecosystem must be interrelated using the ISO/IEC 21838 Top Level Ontologies standard. Thereafter, the outcome can be transformed into implementable solutions using the ISO/IEC 10746 Open Distributed Processing Reference Model. Results: The model and framework for this system-oriented, architecture-centric, ontology-based, policy-driven approach have been developed by the first author and meanwhile standardized as ISO 23903 Interoperability and Integration Reference Architecture. The formal representation of any ecosystem and its development process including examples of practical deployment of the approach, are presented in detail. This includes correct systems and standards integration and interoperability solutions. A special issue newly addressed in the paper is the correct and consistent formal representation Conclusions: of all components in the development process, enabling interoperability between and integration of any existing representational artifacts such as models, work products, as well as used terminologies and ontologies. The provided solution is meanwhile mandatory at ISOTC215, CEN/TC251 and many other standards developing organization in health informatics for all projects covering more than just one domain.

• Klíčová slova
• ecosystems, health and social care transformation, information modelling, knowledge representation and management, language types, ontologies, systems architecture,
• Publikační typ
• časopisecké články MeSH

OBJECTIVES: The data interchange in the Czech healthcare environment is mostly based on national standards. This paper describes a utilization of international standards and nomenclatures for building a pilot semantic interoperability platform (SIP) that would serve to exchange information among electronic health record systems (EHR-Ss) in Czech healthcare. The work was performed by the national research project of the "Information Society" program. METHODS: At the beginning of the project a set of requirements the SIP should meet was formulated. Several communication standards (openEHR, HL7 v3, DICOM) were analyzed and HL7 v3 was selected to exchange health records in our solution. Two systems were included in our pilot environment: WinMedicalc 2000 and ADAMEKj EHR. RESULTS: HL7-based local information models were created to describe the information content of both systems. The concepts from our original information models were mapped to coding systems supported by HL7 (LOINC, SNOMED CT and ICD-10) and the data exchange via HL7 v3 messages was implemented and tested by querying patient administration data. As a gateway between local EHR systems and the HL7 message-based infrastructure, a configurable HL7 Broker was developed. CONCLUSIONS: A nationwide implementation of a full-scale SIP based on HL7 v3 would include adopting and translating appropriate international coding systems and nomenclatures, and developing implementation guidelines facilitating the migration from national standards to international ones. Our pilot study showed that our approach is feasible but it would demand a huge effort to fully integrate the Czech healthcare system into the European e-health context.

• MeSH
• elektronické zdravotní záznamy organizace a řízení   MeSH
• programovací jazyk * MeSH
• sémantika * MeSH
• systémová integrace * MeSH
• ukládání a vyhledávání informací MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Česká republika MeSH

It is important for older and disabled people who live alone to be able to cope with the daily challenges of living at home. In order to support independent living, the Smart Home Care (SHC) concept offers the possibility of providing comfortable control of operational and technical functions using a mobile robot for operating and assisting activities to support independent living for elderly and disabled people. This article presents a unique proposal for the implementation of interoperability between a mobile robot and KNX technology in a home environment within SHC automation to determine the presence of people and occupancy of occupied spaces in SHC using measured operational and technical variables (to determine the quality of the indoor environment), such as temperature, relative humidity, light intensity, and CO2 concentration, and to locate occupancy in SHC spaces using magnetic contacts monitoring the opening/closing of windows and doors by indirectly monitoring occupancy without the use of cameras. In this article, a novel method using nonlinear autoregressive Neural Networks (NN) with exogenous inputs and nonlinear autoregressive is used to predict the CO2 concentration waveform to transmit the information from KNX technology to mobile robots for monitoring and determining the occupancy of people in SHC with better than 98% accuracy.

• Klíčová slova
• KNX technology, Smart Home Care, localization, mobile robot, occupancy, presence,
• MeSH
• lidé MeSH
• oxid uhličitý MeSH
• robotika * metody   MeSH
• samostatný způsob života MeSH
• senioři MeSH
• služby domácí péče * MeSH
• technologie MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• oxid uhličitý MeSH