Health Telematics (AIM) Final Report


	Updated: Feb 1, 97
AFASIA

A standard Framework for AIM Selected Interconnected Application

Project Code: A2120

Project value: 1000 KECU

EC contribution: 400 KECU

No of partners: 9

No of countries: 5

Duration: 24 months

Contact:
Prof. A. Fernández P. de Talens
Instituto di Fisiologia Clinica
Paolo Savi nr. 8
I-56100 Pisa, Italy
Tel.: +39-50-56.27.21
Fax: +39-50-55.34.61

Overview

AFASIA aimed at drafting an Integration Methodology to help developers of IT&T applications in Healthcare to design solutions in the context of a European Good Practice and to establish a forum on the appropriate design of common components, based on ongoing standardisation activities by CEN/TC 251 Standards on Medical Informatics.

Purpose and objectives

The overall target of the Accompanying Measure AFASIA (Standard Architectural Framework for A.I.M. Selected Interconnected Applications) was twofold.

To draft an Integration Methodology based on common components that helps developers of IT&T applications in Healthcare to design integrated solutions in the context of a European Good Practice.
To establish a Forum aiming to diffuse awareness on the relevance; to evoke consensus and to exchange knowledge on the appropriate design of common components within an open Healthcare distributed processing environment, based on the ongoing European CEN/TC 251 Standards on Medical Informatics.

The AFASIA Forum comprised an Industrial Panel and a Healthcare Authorities Panel established around the open group of Sponsoring Partners to assess the produced Methodology. To exploit its results AFASIA would organise -jointly with other AIM initiatives- several Workshops and other training or awareness ad-hoc initiatives relating to the issues of system integration specially directed towards SME.

There are two main reasons to set AFASIA:

European standardisation efforts under the CEN/TC 251 is running a dozen different Project Teams: Healthcare Information Framework, Healthcare Records Architecture, MI Vocabulary, Coding of Medical Procedures, Model of Semantic Representation, Laboratory Message Exchange, Exchange of Formats Syntax's, Coding Systems Registration, ECG Protocols, Image Interchange, HIS Security, Data Cards Contents, SO Healthcare Application Profiles, etc. This normative guideline are gaining consensus among the CEN members (the 18 National Standard Organisations) and into the EU itself, i.e. they are obtaining the consensus of specialists, Healthcare operators and researchers coming from Industries Healthcare Authorities and the Academy.
After its Pilot Phase and the main phase, the AIM Office launched the topping-up Call for Proposals with the explicit purpose of counterbalancing fragmentation, and encouraging interconnection between key projects and national initiatives. The interoperability to be proved by Integration Demonstrators should not be reduced to a mere technological integration (open platforms or common tools), not to integrate applications by common Service and APIs, but should lead up to business integration considering the organisation of the involved Healthcare Enterprises and their environmental contexts.

Indeed a general Methodology that states Rules & Procedures to specify integration was needed. Only then will it be possible to reverse the actual production of Healthcare systems. Instead of manufacturing -in a highly ineffective way from the scratch complete application package for end-users that show a too high degree of variability in requirements, it would worth to produce some basic pieces of software which could be connected together through a federate approach to form systems. In order to gain wide usability (and hence low cost) these pieces should be standardised both as functionalities and how they are identified.

One hypothesis underlying AFASIA was that a service could be offered to AIM projects to facilitate their migration/integration process. A Basic Integration Methodology based on CEN standards would be applied to the migration from current AIM projects to the area 3.1. Demonstrators (ISAR, TELEPRIM, BRITER & TRILOGY). Cooperation of these projects with AFASIA- under a Protocol of understanding- would avoid duplication of efforts under different umbrellas. The responsibility of the demonstrators will continue being wholly in the hands of those Projects, that could build upon common methodology. Common Integration Groups will deal with those aspects to develop together, because requiring knowledge or competencies from both parties.

AFASIA was also seen as covering the prototyping phase in the standardisation process that, heavily present in USA and Japan, is not considered under the actual CEN operation.

Results

The results presented by AFASIA are to be considered in a different way as those from other projects, because what has been produced is not an end result, but an intermediate one, the Basic Integration Methodology (BIM). AFASIA is an accompanying measure and the BIM constitutes the reference to which the IS of the different projects or enterprises, that co-operate with AFASIA, should be compared, in order to extract the common elements necessary to plan the integration process, that is to reach the corresponding expected inter working. On the light of the experience the final AFASIA Integration Methodology was produced.

The document centres the need of integration in the current evolution to the "Information Society" and defines the scope and limits of the AFASIA methodology. The different types, and several levels of integration are analysed. The technological support to integration allows to extend till the business re-engineering process. The main tools for integration were considered.

The different standards that would help the integration were considered, mainly the CEN TC251 Standards, and -among them the Healthcare Information Framework (HIF) represents an overall construct.

The Integration Process, its phases and the consequent guidelines were described. The EDITH and the ISAR approaches were deeper analysed and presented as "case" studies. An inventory of 31 Integration Methods and Tools has been reviewed and afforded.

The awareness work package, dealted with the building of the infrastructure, either managerial or telematic, that will allow the constitution and supporting of the AFASIA Forum. Mainly a Documentations Centre in Madrid, and a Computing and Demonstration Centre in Barcelona were the physical substrate to connect with a Telematic AFASIA Forum.

List of Deliverables

Year 1

Presentation of the AFASIA Basic Integration Methodology (R-P)
Basic Integration Methodology Manual (R/T-P)
1st. AFASIA Workshop Proceedings (R-P)
Report on the Analysis & Alignment of Application Projects (R-P/R)
Report on the Identified Common Components (R/T-P)
Presentation of the Identified Common Components (R-P)

Year 2

Extended Integration Methodology Elements (R-P)
2nd AFASIA Workshop Proceedings (R-P)
AFASIA Final Report (R-P)

List of Participants

Prof. Antonio Fernandez Perez de Talens Via Paolo Savi, 8 I-56100 Pisa, Italy Tel.: +39-50-55.36.00 Fax: +39-50-55.34.61	Dr. José M. de la Riva Grandal Edif. Espana-Gran Via 88 E-28008 Madrid, Spain Tel.: +34-1-559.06.76 Fax: +34-1-559.17.73
Dr. Pau Ferrer-Salvans Clinical Pharmacology Unit Feixa Llarga, s/n E-08907 L'Hospitalet de LL., Spain Tel.: +34-3-335.76.52 ext.3214 Fax: +34-3-263.36.16	Ing. Fabrizio Massimo Ferrara Via Rodi, 32 I-00195 Roma, Italy Tel.: +39-6-372.52.78 Fax: +39-6-325.23.36
Dr. Michel Demeester 8 rue E. Guirsch B-1390 Grez-Doiceau, Belgium Tel.: +32-10-84.55.19 Fax: +32-10-84.25.67	Prof. Niilo Saranumni Kanslerinkatu, 12B, Hervanta SF-33101Tampere, Finland Tel.: +358-31-316.31.11 Fax: +358-31-317.41.02
Ing. Enrico Annese Tecnopolis,7 I-70010 Valenzano (BA), Italy Tel.: +39-80-27.33.52 Fax: +39-80-27.33.54	Ing. Bonifacio Vega Berkshire RG 12 Brakcnell, U.K. Tel.: +44-344-36.00.00 Fax: +44-344-36.33.44
Mr. Jaume Roma Rodriguez Trav. de les Corts, 131-159 E-08907 Barcelona, Spain Tel.: +34-3-403.85.85 Fax: +34-3-403.89.25



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