The Patient Portal of the Personal Cross-Enterprise Electronic Health Record (PEHR) in the Rhine-Neckar-Region.

Over the last years we stepwise implemented our vision of a personal cross-enterprise electronic health record (PEHR) in the Rhine-Neckar-Region in Germany. The patient portal is one part of the PEHR architecture with IHE connectivity. The patient is enabled to access and manage his medical record by use of the patient portal. Moreover, he can give his consent regarding which healthcare providers are allowed to send data into or read data from his medical record. Forthcoming studies will give evidence for improvements and further requirements to develop.

Patient Portal Integration - A Native IHE Connector Implementation for PEHR.

Providing patients with access to their medical data has recently evolved as a topic in several countries. Different approaches are possible. For example patient portals are used for patient access towards medical data. The University Hospital Heidelberg is engaged in a research project to develop a personal cross-enterprise electronic health record (PEHR). The objective of this work is to describe the architecture and implementation of a component called IHE Connector which represents the native IHE-based integration between the patient portal and the PEHR core components. The architecture of the PEHR is accepted based on international standards. The core components consist out of ready to use software products like a master patient index. The patient portal has been developed using Liferay framework. The IHE Connector is mainly based on the Open eHealth Integration Platform (IPF) Framework, which has been deeply integrated into the patient portal to support the needed IHE transactions. Several IHE profiles for sharing documents and patient information are supported by the IHE Connector. As IPF already provides interfaces for some IHE profiles others had to be developed from scratch. The IHE Connector can not only be used for connectivity between patient portal and PEHR core, but also provide connectivity for third party apps and healthcare providers' information systems.

Implementing PEHR: Design and Integration of a Consent Creator Service.

Giving the patient full control over his medical data electronically remains one of the most discussed topics in healthcare today. The INFOPAT project in the Rhine-Neckar region focuses on a personal cross-enterprise electronic health record (PEHR) in which the patient plays a major role. Thus, he should be provided with the possibility of granting access to his medical data which could be realized using a consent creator service. This paper presents a user interface concept for such a service as well as aspects for the technical implementation. In addition, a pattern for integrating the service into an existing IHE based infrastructure is shown. These concepts could be further adapted for improving patient empowerment in health care projects.

An Architecture for the Integration of Clinical Data from a PEHR in a Regional Research Platform.

Making clinical information available for research is not only relevant for healthcare institutions, but also for regional EHRs, as cross-sectorial information can be made accessible. In the INFOPAT (INFOrmation technology for PATient-oriented health care in the Rhine-Neckar metropolitan region) project we are thus implementing both, a regional personal cross-enterprise electronic health record (PEHR) and a regional research platform (RRP) based on information from the PEHR. IHE profiles are implemented to achieve interoperability between healthcare institutions electronic medical records (EMR) and PEHR on the one hand, as well as PEHR and RRP on the other hand. The use case for the RRP is cross-sectorial quality assessment and improvement for colorectal cancer based on a quality indicator (QI) approach including patients' perspectives. For semantic interoperability the responses are transferred in the form of HL7 CDA L2 documents. The resulting architecture for a RRP shows that implementing a PEHR in combination with a RRP based on international communication standards is possible. Also IHE XDS can be used for integration of patient care and biomedical research infrastructures.

Implementing the Patient Portal of the PEHR in the Metropolitan Region Rhine-Neckar - Experiences with Liferay.

A patient portal with access to a personal cross-enterprise electronic health record (PEHR) had to be developed for the project "INFormation technology for PATient-oriented healthcare in the Rhine-Neckar metropolitan region" (INFOPAT). Liferay was chosen as the platform technology in previous researches. Multiple portlets for patients, study members, security officers and administrators had been developed in Java. In this paper all portlets are presented. For three portlets the communication between them, Liferay and the PEHR are described in detail. To communicate with the PEHR a façade called IHE Connector had been implemented too. Despite the broad functionality of the Liferay Core some workarounds had to be implemented. The lack of information in the provided documentation of Liferay lead to delays in development. The Liferay IDE and Liferay itself showed an unstable state.