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Open hospital information system for europe built on the riche framework

Industrialisation of riche results for provision of an open,
adaptable hospital information system at affordable price,
enabling gradual inclusion of existing components and/or
migration of solutions to eurhis-conforming applications.

Background, Rationale and Opportunity Computerized Hospital Information Systems (HIS) have a major impact on the quality of care to patients and on the increase in the effectiveness of health services. Fragmented development and high unit prices have so far been prohibitive in providing widespread access to these systems for the 16,000 hospitals in Europe. Present systems are largely restricted to managerial functions. Patient care is often not supported. Hence, health professionals find little incentive in present systems, which is the reason why the demand for HIS far exceeds expectation and actual possibilities. The next generation of HIS takes a radically innovative approach. The was first developed in the ESPRIT project RICHE (1989-92). RICHE has produced a European framework for open modular HIS, providing direct support to the primary process of giving care to patients. Its approach to this primary process is the Act Management System. This is a highly innovative set of facilities for health professionals to control their own primary process, manage associated professional data and communicate with their colleagues in a consistent and unequivocal way. Specialised (medical, nursing, etc.) front-end systems provide access to these advanced facilities, each in the way most suitable for the related user category. In the meantime, the RICHE concepts have been further expanded. The results of these activities include the integrated customisable patient dossier (developed in the AIM project NUCLEUS). These results are not ready to be integrated in the overall HIS. The adopted open, modular approach allows hospitals to build their own systems in accordance with their local requirements on a common communication platform, applying the same proven method and European standards. The emergence of such open systems will cause a revolution in the IT marketplace. The advantages are vendor independence, flexibility, availability, and cost effectiveness. Now that the feasibility of this new technology has been demonstrated, it must be industrialised and made available to the majority of European hospitals in order to support the basic functions of patient care at affordable unit costs. The French hospital groups association STAF (approximately 70 public hospitals) and SIRIF (over 30 public hospitals) have undertaken, through GIE REFERENCE, the industrialisation of this common HIS platform. As the REFERENCE kernel, it is now available for integration with many compatible end-user applications and compound modules on the basis of which practical implementation of the new generation of HIS can be achieved. Mission, Scope and Objectives Mission: The mission of the EURHIS project is to industrialise available RICHE results and to develop and integrate departmental applications with the REFERENCE kernel for the provision of Open, Patient-based Hospital Information Systems for Europe, suitable for the varying requirements of various hospitals and countries. These systems will be open, modular and distributed within the common RICHE framework. In this way, interoperability and flexibility will be offered, allowing stepwise development in accordance with budgetary possibilities, substitution or incorporation of existing application components and/or gradual migration of existing solutions towards EURHIS- conforming applications. This approach will lead to an expanding catalogue of conforming applications, products and services, under open market conditions from which hospitals can integrate their own tailor-made systems. Scope: The project will build upon the results of the completed research and proven technologies and thus concentrate on the integration of these results, validating them and, in the real environment of hospitals, make them available to the hospital market. Special attention will be paid the dissemination of concepts and practical knowledge to candidate end-users, health professionals and hospital managers. The scope of the project will be focused on the common basic functions of general hospitals, i.e. - HIS kernel providing common services and databases: Patient (identification, location, etc.), Act Management, Hospital Structures, resources, etc. - standard APIs between the HIS kernel and the functional applications - possibility to interface the kernel with existing applications - Medical and Nursing Information System for both outpatients and inpatients, as part of the ward system - Medical Support Applications, i.e. Laboratory, X-ray, Operating Theatre and Pharmacy - Ancillary Services Applications, i.e. archives - analysing tools for managerial purposes (including DRGs, cost categories, etc.) - integration tools - security tools. This part of the EURHIS solution is largely dependent on the politico-administrative context, legal systems and financing mechanisms of particular countries. Where dependencies exist, they can be configured and customised in the system. In the pilot sites envisaged in FRANCE, SPAIN and the NETHERLANDS therefore, the country-specific Patient Administration System, as well as the hospital management system will be incorporated so as to increase the general exploitation opportunity for EURHIS-based solutions. Objectives: On this basis, the following specific objectives have been accepted: - to start from and base upon the REFERENCE kernel, available in June 1994 - to agree on a well defined set of API specifications and an overall federation and integration strategy for applications in the frame of the REFERENCE kernel - to integrate within this frame several available conforming applications, such as a professional Patient Dossier system for physicans and nurses, for inpatient and outpatient care and key elements of an integrated ward application - to adapt and connect through the agreed API diagnostic information systems for pathology, imaging, etc. as well as operating theatre and pharmacy (drug dispensing) information systems - to integrate and exploit intelligent management analysis tools, including DRGs and advanced result analysis - to link with applicable PAS and hospital management systems in the pilot sites of FRANCE, SPAIN and the NETHERLANDS - to position and integrate compound services in the areas of security and confidentiality (in line with healthcare- specific requirements), advanced integrated dossiers of professional patient information, archives management and documentation management and retrieval, each based upon and exploiting the facilities of the REFERENCE kernel - to install and validate EURHIS solutions in actual hospitals in FRANCE, SPAIN and the NETHERLANDS - to contribute to the creation of a European market for EURHIS, by publication of its results and conventions by dissemination of its concepts, and by explaining the practical impact of this approach for the candidate end-users and decision makers; the healthcare professionals and hospital managers - to feedback the EURHIS results into the RICHE framework and contribute towards the practical development of this framework on the basis of the experience gained in the EURHIS approach to industrialisation and integration. These objectives will be achieved in the first two years of the project. This first phase of EURHIS therefore aims at the practical integration, industrialisation, packaging, installation and operational validation of a reasonably comprehensive HIS, comprising the main corporate and departmental applications, based upon the REFERENCE kernel. The second phase of EURHIS also consists of two years. In this phase more advanced technologies will be added to the system, including: - integration and industrialisation of a multimedia clinical workstation - development and industrialisation of a portable nursing workstation - functional integration and industrialisation of picture archiving and communication services (PACS) - development and integration of advanced management analysis tools, also based on available professional workfloor level data - to expand and industrialise additional medical support and ancillary services information systems, offering an expanding catalogue of conforming application modules - to improve phase 1 results in line with the results of further developments in act management and related concepts. 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Acronym: 
EURHIS (IMP)
Project ID: 
1 221
Start date: 
01-09-1994
Project Duration: 
38months
Project costs: 
21 910 000.00€
Technological Area: 
Market Area: 

Raising the productivity and competitiveness of European businesses through technology. Boosting national economies on the international market, and strengthening the basis for sustainable prosperity and employment.