Towards electronic healthcare centred on the patient

Computer scientist Juha Puustjärvi of Aalto University in Finland and pharmacist Leena Puustjärvi of The Pharmacy of Kaivopuisto in Helsinki explain how there is a growing desire to build on the patient's strengths, values and experiences in healthcare requires that the patient can obtain and understand available health information and make informed decisions about treatment in conjunction with healthcare workers. But, there is a problem. Although e-health applications provide patients and consumers with access to health information, each application is essentially a standalone system with its own internal systems for handling information.

In ongoing healthcare reforms that are taking place in many nations, there is an increasing need to control the cost of medical care as well as to promote patient-centred healthcare, the team says. "Patient-centred healthcare is an emerging e-health model that contributes to preventive medical care," they explain. "It optimises the healthcare system to focus on patient experience and outcomes for better health and well-being." Key to success of such as system is that healthcare workers, patients and their families have the ability to obtain and understand health information and services, and make appropriate decisions.

The Finnish team has now developed a Personal Health Server, that would allow disparate e-health tools to work together by sharing a computer glossary of terms, definitions and their relationships known technically as an ontology. They have derived the ontology for their Server by integrating ontologies from e-health tools, which support personal health records, e-health oriented blogs and information on different diseases and treatments as well as so-called "Ix," information therapy, the knowledge analogue of "Rx," prescribing information rather than pharmaceuticals. Their new system uses knowledge management technology and could easily be extended to capture information from additional e-health tools.

The Personal Health Server captures the functions of a personal health record, information therapy and health-oriented blog and has interoperability with e-health tools through its ontology specified using web ontology language, OWL. The Server stores the addresses, the URLs, of all the information entities and blog items and can be load on any server. The next step is to ensure that the healthcare industry migrates and converges on this standard so that patients may benefit from the emerging domain of patient-centred healthcare.