The coexistence of different information systems that are unable to communicate with each other is a persistent problem in health care in general, and in shared care in particular. This is especially critical when it comes to information access needed at the point of care, e.g. in the patient's home. The purpose of this paper is to present the technical architecture of a virtual health record (VHR) that both integrates information from different electronic health records (EHRs) and allows for documenting at the point of care using mobile devices. The VHR supports a seamless information and communication flow between different care providers giving them mobile access to selected patient-oriented information. A service oriented system architecture where database functionality and services are separated has been implemented. This guarantees flexibility with regard to changed functional demands and allows third party systems to interact with the platform in a standardised way. Major requirements for the VHR have been documentation support at the point of care, integrated presentation of the information from different feeder systems, and the possibility of offline access to the data on handheld devices. Therefore, publishing was chosen for the integration design. A patient centred XML schema is published as an interface for integration with the information broker. The feeder systems deliver their information in XML.-files that are mapped against the ideal schema and inserted into the mediator database. The paper describes both an online web application and an offline solution that was implemented on personal digital assistants (PDAs). The system has been introduced in a Swedish home care district with an established fiber-optical network infrastructure connecting all the locations forming the study site.
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