ARCHIMED: a Network of Integrated Information Systems.

ARCHIMED is a Network of Integrated Information Systems (NIIS). This novel concept of hospital information system has a major advantage over the currently used distributed systems. The normalized representation structure of its databases enable its Navigators to reach simultaneously not only the data coming from different hospital departments, laboratories, and other hospital facilities, but also the data from different hospitals associated in the network.

Happy birthday DIOGENE: a hospital information system born 20 years ago.

Since its birth in 1978, DIOGENE, the Hospital Information System of Geneva University Hospital has been constantly evolving, with a major change in 1995, when migrating from a centralized to an open distributed architecture. Since a few years, the hospital had to face health policy revolution with both economical constraints and opening of the healthcare network. The Hospital Information System DIOGENE plays a significant role by integrating four axes of knowledge medico-economical context for better understanding and influencing resources consumption the whole set of patient reports and documents (reports, encoded summaries, clinical findings, images, lab data, etc.) patient-dependent knowledge, in a vision integrating time and space external knowledge bases such as Medline (patient-independent knowledge) integration of these patient-dependent and -independent knowledges in a Case-Based Reasoning format, providing on the physician desktop all relevant information for helping him to take the most appropriate adequate decision.

Medico-economical use of the medical record or the bridge between minimal and detailed data.

Medico-economical use of the medical record: the title encloses two different notions which represent two different trends within medical informatics. The first trend is worried about weighting aspects of health resources consumption, mainly about hospital acute care; their key-words are "DRG (Diagnostic Related Groups), Case-Mix, reimbursement by pathology, measurement of indicators (severity or outcome), costs". The other trend is looking for deeper understanding of the medical process and for better diffusion of relevant information helping the day-to-day care process; they speak of "CPR (Computerized patient record), full text reports and corresponding retrieval, detailed data, medical records on Internet, large access to literature and databases". It is mandatory to realize a bridge between these two trends for facing the information technology revolution entering into a self-revolutioning medicine. The purpose of this paper is to begin this bridge by showing what the DRG people expect from the CPR people and what the latter should receive from the former.