Document-based service platform for telemedicine applications

Telemedicine is gaining popularity due to its high potential for cost savings and increased efficiency in healthcare delivery. However, most telemedicine systems available in the markets are limited to particular applications and lack interoperability with other information systems and measurement devices. In this paper, we present a generic service platform, which is applicable in a wide range of telemedicine applications and in other areas involving the need for confidential information exchange. The platform particularly addresses the security challenges in the case when the information technology (IT) is outsourced to an external company. It also provides semantic interoperability by providing support to HL7 CDA R2 documents. The platform implementation, the PIR document service, is composed of software components for the health service provider, the IT service provider and the telemedicine customers. These include desktop, mobile and browser-based applications. The platform was tested in a tele-consultation trial where the Heart Centre of Pirkanmaa Hospital District offered cardiology consultation service for two remote health care units. The outcome of the test was positive. Both the Heart Centre cardiologists and the physicians of the remote units considered the benefits of the consultation service to be high. The consultation cases included refining cardiology diagnostics and medication as well as guidance for patient logistics. The physicians considered it feasible to use a commercial consultation service when available.