The Endocrinology and Nutrition Unit of the Virgen del Rocío University Hospital (HUVR) wanted to evaluate the benefits of adding mobility to teleconsultation for patients with type 1 diabetes.
The teleconsultation system allowed patients to access their clinical reports, communicate with healthcare professionals and record information from their glucose meters and insulin pumps.
The Technological Innovation Group of the Virgen del Rocío Hospital together with the company Primum Health IT aimed to provide mobility to teleconsultation by configuring a mHealth project for the Virgen del Rocio University Hospital: a project called mTelesalud-Diabetes.
Primum Health IT is a company specializing in mHealth solutions. Its system allows remote monitoring of type I diabetes patients. The Primum solution has its own telemedicine platform.
This project presented the challenge of integrating the Telehealth platform of the Virgen del Rocío University Hospital with the external chronicle monitoring platform of Primum.
The messaging included general measurements such as blood pressure, weight and pulsations as well as glucose measurements and patient comments. In addition to the exchange of clinical information, the publication on a clinical wall that allowed communication between doctors and patients was to be implemented.
Caduceus brought its expertise in clinical systems integration and interoperability to ensure that information from the monitoring platform was available to hospital healthcare staff.
System integration had to meet certain technical requirements.
The information had to be encapsulated in the format ISO EN13606 based on archetypes. ISO EN13606 aims at semantic interoperability for the communication of Electronic Health Records (EHR). The standard establishes two models:
- Reference model: represents, independently of knowledge, the general components to represent any information of the EHR.
- Models based on archetypes: specify the structures defined by the reference model, modelling and restricting knowledge concepts.
The use of archetypes is utilized to encompass clinical concepts built on a reference model for electronic medical record information. This gives a semantic meaning to the data structure.
The two-way communication had to follow the IHE XDS (Cross-Enterprise Document Sharing) clinical documentation profile. This profile facilitates the registration, distribution and access of electronic health records among health organizations. To do this, a repository and a document register are defined. These documents are provided and consumed by participating organizations.
After analyzing the systems involved, it was decided to implement an interoperability solution based on Mirth Connect as the integration engine.
For the project, Mirth version 3.1.0 was used, on which the necessary channels were implemented to establish the exchange of ISO EN13606 according to IHE XDS profile. PostgreSQL was deployed as the integration database.
The solution developed by Caduceus was designed to integrate the HUVR telemedicine system with the mHealth platform of Primum.