A.S. Mezhov, E.Y. Solodkov

To improve the quality of medical care and reduce the associated costs effective instruments for collection and provision of the information about the patient are needed. Complete and qualitative information about the patient is necessary for the medical organization as well as for the other organizations connected with medical care services. The solution of this problem requires not only the provision of the complete information, but the solution of the whole range of related tasks. Here we can include the implementation of the aspects like the provision of the relevance information about the patient, the provision of the opportunity of the quick information exchanges between different organizations, guaranteed safety and accessibility of the information at any time, realization of the flexible and quick search of the necessary information, the opportunity of the implementation of the analyses, etc. Additionally to this list, equally important technical aspects should be added: the provision of the system performance on the proper level and the capability of the quick processing of the huge amount of information. The implementation is based on the concept of the Cross-Enterprise Document Sharing (XDS) ? the IHE profile that describes the rules of the intercorporate exchanges of the documents between the medical organizations. According to this concept, patient-s electronic health record (EHR) represents a range of structured electronic health records (SEHR). Also, the model of the distributed storage of the documents is used, that is to say the original documents are stored on the side of the creator and owner, and the participants of the information exchange can see them only in the view mode. The emphasis of the solution is made on the provision of the accessibility of the information and the opportunity of the quick analyses since these circumstances determine the capability of the quick decision making, on which might depend on the life of a human. For this reason, SEHR accompanied by the minimum of necessary information that will be sufficient for make a decision in most cases. The structure of the SEHR is represented in the form of the header information, determined in the accordance of the HL7 CDA standard, and the enclosure. The enclosure should contain the necessary and sufficient information, which helps the expert to make the necessary decision in the most cases. This approach lets to exclude the necessity of the request of the original document from the owner-organization. The enclosure might be structured (in the form of OpenEHR standard), as well as non-structured. Taking into consideration the amount of the data, which comes from all the organizations of the region, the intensity of their publication, the quantity of the possible users, and also the requirement to the speed of the information search, the emphasis was made on the systems that are able to work in the cluster infrastructure. In the given context, first of all, it is all about centralized storage of the information which meets the requirements above, plus, provides the opportunity of the indexed data for the provision of the opportunity of the quick search.