KernPaeP - a web-based pediatric palliative documentation system for home care.

KernPaeP is a new web-based on- and offline documentation system, which has been developed for pediatric palliative care-teams supporting patient documentation and communication among health care professionals. It provides a reliable system making fast and secure home care documentation possible. KernPaeP is accessible online by registered users using any web-browser. Home care teams use an offline version of KernPaeP running on a netbook for patient documentation on site. Identifying and medical patient data are strictly separated and stored on two database servers. The system offers a stable, enhanced two-way algorithm for synchronization between the offline component and the central database servers. KernPaeP is implemented meeting highest security standards while still maintaining high usability. The web-based documentation system allows ubiquitous and immediate access to patient data. Sumptuous paper work is replaced by secure and comprehensive electronic documentation. KernPaeP helps saving time and improving the quality of documentation. Due to development in close cooperation with pediatric palliative professionals, KernPaeP fulfils the broad needs of home-care documentation. The technique of web-based online and offline documentation is in general applicable for arbitrary home care scenarios.

Securing a web-based teleradiology platform according to German law and "best practices".

The Medical Data and Picture Exchange platform (MDPE), as a teleradiology system, facilitates the exchange of digital medical imaging data among authorized users. It features extensive support of the DICOM standard including networking functions. Since MDPE is designed as a web service, security and confidentiality of data and communication pose an outstanding challenge. To comply with demands of German laws and authorities, a generic data security concept considered as "best practice" in German health telematics was adapted to the specific demands of MDPE. The concept features strict logical and physical separation of diagnostic and identity data and thus an all-encompassing pseudonymization throughout the system. Hence, data may only be merged at authorized clients. MDPE's solution of merging data from separate sources within a web browser avoids technically questionable techniques such as deliberate cross-site scripting. Instead, data is merged dynamically by JavaScriptlets running in the user's browser. These scriptlets are provided by one server, while content and method calls are generated by another server. Additionally, MDPE uses encrypted temporary IDs for communication and merging of data.

Trauma Network North-West - improving holistic care for trauma patients by means of internet and mobile technologies.

The Trauma Network North-West as an initiative seeks to improve the initial and follow-up care for severely injured patients in need of immediate intensive care. The main goals are intensification and optimization of exchange of information, expertise and knowledge among participating clinics. By (a) foundation of the network itself and (b) establishment of a sophisticated IT infrastructure for web-based and mobile communication, instantaneous and concomitant care for trauma patients shall be significantly improved. The network's workflow incorporates participating clinics within a central platform, including parameters such as level of health care, geographic coordinates, overstrained care units and defective medical devices. Mobile components allow locating nearby clinics based on an emergency physician's coordinates and automatic triggering of disposition via coordination offices. A tight interplay between server components and location-based services shall reduce unnecessary transportation as well as financial expenditure. The central web-based system is currently established and evaluated in an initial test phase.

Clearinghouse: a teleradiology platform emphasizing security of data and communication.

The Clearinghouse application platform is a web based solution for secure digital exchange of radiological images and other clinical documents among authorized researchers and physicians. It implements a sophisticated security and role model to protect privacy and to minimize the risk of eavesdropping of patient data. The Clearinghouse serves as a centralized platform for distributed, distantly located medical research and health care. It is based on Open-Source software, thus ensuring continued support, maintenance, security and last but not least continuity of the platform. The use of the Clearinghouse minimizes turnaround times by superseding comparably slow and insecure conventional communication methods otherwise used for the exchange of radiological images and clinical documents, such as standard mail and courier services. Furthermore, it alleviates the integration of distantly located expert knowledge into diagnostic routines, culminating in an increased health care quality regardless of location of patients or physicians.

K-Box: automatic structuring and exchange of medical documents based on the clinical documentation architecture (CDA).

Sustainable health systems should understand information as a resource which also has to be managed efficiently. Today's electronic documentation is only the mandatory first step to automatic information exchange between hospitals, physician offices, pharmacies and other participants. The K-Box is a modular system which allows different monolithic information systems to be connected and integrated by using the clinical document architecture (CDA) as the standard document exchange format. A prototype K-Box has been implemented and a trial run is scheduled. The workflow selected for the trial produces discharge summaries in CDA format.

Empowerment of patients and communication with health care professionals through an electronic health record.

OBJECTIVE: The aim of this project was to design and develop a personal electronic health record (EHR) in order to support patient empowerment and additionally to enhance their communication and information exchange with health professionals through this EHR. METHOD: The functionality of a personal Electronic Healthcare Record (EHR) may vary from a simple web-based interface for interactive data entry and data review up to a much more powerful system additionally supporting electronic data/document communication between clinical information systems of primary care practitioners or hospitals and even reminder based support for the empowered citizen, to actively take care of his health, based on relevant disease management programs. It is one means to support patient empowerment, additionally supported by tools for building a patient community. Since storage and communication of data in an EHR comprises sensible personal health data, each of those functions needs specific security and access management requirements to be considered and implemented. RESULT: Clinical pilot projects are already done or under development.

Implementing security and access control mechanisms for an electronic healthcare record.

Personal Electronic Health Records (EHR) have recently been published as one means to support patient empowerment and patient control over their personal health record. The functionality of such an EHR may vary from a simple web-based interface for interactive data entry and data review up to a much more powerful system additionally supporting electronic data/document communication between clinical information systems of primary care practitioners or hospitals and even reminder based support for the empowered citizen, to actively take care of his health, based on relevant disease management programs. Since storage and communication of data in an EHR comprises sensible personal health data, each of those functions need specific security and access management requirements to be considered and implemented. In this article the most critical requirements for these aspects will be classified and respective mechanisms to provide secure data storage and communication as well as flexible access management functions will be presented.