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. 2011 Sep-Oct;18(5):683-9.
doi: 10.1136/amiajnl-2011-000111. Epub 2011 May 12.

Design and development of an international clinical data exchange system: the international layer function of the Dolphin Project

Jing-song Li  1 , Tian-shu Zhou, Jian Chu, Kenji Araki, Hiroyuki Yoshihara
Affiliations

Design and development of an international clinical data exchange system: the international layer function of the Dolphin Project

Jing-song Li et al. J Am Med Inform Assoc. 2011 Sep-Oct.

Abstract

Objective: At present, most clinical data are exchanged between organizations within a regional system. However, people traveling abroad may need to visit a hospital, which would make international exchange of clinical data very useful.

Background: Since 2007, a collaborative effort to achieve clinical data sharing has been carried out at Zhejiang University in China and Kyoto University and Miyazaki University in Japan; each is running a regional clinical information center. Methods An international layer system named Global Dolphin was constructed with several key services, sharing patients' health information between countries using a medical markup language (MML). The system was piloted with 39 test patients.

Results: The three regions above have records for 966,000 unique patients, which are available through Global Dolphin. Data exchanged successfully from Japan to China for the 39 study patients include 1001 MML files and 152 images. The MML files contained 197 free text-type paragraphs that needed human translation. Discussion The pilot test in Global Dolphin demonstrates that patient information can be shared across countries through international health data exchange. To achieve cross-border sharing of clinical data, some key issues had to be addressed: establishment of a super directory service across countries; data transformation; and unique one-language translation. Privacy protection was also taken into account. The system is now ready for live use.

Conclusion: The project demonstrates a means of achieving worldwide accessibility of medical data, by which the integrity and continuity of patients' health information can be maintained.

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Conflict of interest statement

Competing interests: None.

Figures

Figure 1
Figure 1
A general map of the entire Dolphin Project, including Global Dolphin. MML, Medical markup language.
Figure 2
Figure 2
The workflow of an exchange case example. MML, Medical markup language.
Figure 3
Figure 3
An example of data transformation using the Ensemble tool.
Figure 4
Figure 4
A segment of the terminology mapping table.
See this image and copyright information in PMC

References

    1. Kass-Hout TA, Gray SK, Massoudi BL, et al. NHIN, RHIOs, and Public Health. J Public Health Manage Pract 2007;13:31–4 - PubMed
    1. Overhage JM, Evans L, Marchibroda J. Communities' readiness for health information exchange: the National Landscape in 2004. J Am Med Inform Assoc 2005;12:107–12 - PMC - PubMed
    1. Finnell JT, Overhage JM, Dexter PR, et al. Community clinical data exchange for emergency medicine patients. AMIA Annu Symp Proc 2003:235–8 - PMC - PubMed
    1. Shapiro JS. Evaluating public health uses of health information exchange. J Biomed Inform 2007;40(6 Suppl):S46–9 - PMC - PubMed
    1. Maenpaa T, Suominen T, Asikainen P, et al. The outcomes of regional healthcare information systems in health care: a review of the research literature. Int J Med Inform 2009;78:757–71 - PubMed

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