| eHealthNT |
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| eHealthNT implementation is a joint initiative of the Australian Government's Department of Health and Ageing and the Northern Territory Government's Department of Health and Community Services |
SEHR Technical System Architecture
Overview
The eHealthNT Shared Electronic Health Record (SEHR) system is designed around a central server sending and receiving medical information from numerous clinical information systems. The SEHR system receives secured medical summary messages (called event summaries) from medical service providers around the Territory and stores them in the SEHR Repository Database. Authorised health professionals registered to participate in the SEHR can view these event summaries.
The SEHR system uses an Argus email tool to generate HL7 messages, containing the event summary, and attaches them to HeSA PKI encrypted emails sent to the Repository Database via a Big Pond email account. Authorised health professionals using their clinical information system can securely view, using SSL, via the Internet the medical information stored in the SEHR Repository for a specified patient. The diagram below illustrates these concepts.
The event summaries generated by the clinical information system are usually single consultation events from health centres, or hospital emergency/inpatient discharge summaries, but may also be an initial health profile (soon to be replaced by current health profile) summary or a pathology test result. All these summaries are stored as discrete pieces and these events can be viewed specifically via the Internet directly or via a web window within a clinical information system. Only authorised health professionals registered to participate in the Shared Electronic Health Record are able to access the medical data over the Internet - and then only after entering a user ID and password. An index listing all the event summaries for a patient is shown. Once selecting the appropriate event summary a web view of that event summary is sent to the viewer. The following diagram shows the basic overview of these concepts.
Sending and Viewing Technical Design in Detail
Sending Event Summary to SEHR Repository
The diagram below shows in detail the sending processes.
The key to sending is the use of the Argus email tool, which has two key components:
- the Argus API that allows the Clinical Information System to directly call functions that interact with Argus Messenger.
- the Argus Messenger, which can generate an email, attach files to them and encrypt the emails. These emails are sent to a single Bigpond email account where it awaits retrieval.
At the SEHR Repository Argus Messenger is also running, automatically downloading emails from the Bigpond email account about every 10 minutes. Argus Messenger has a set of predefined rules that require HL7 attachments on emails to be interpreted by Argus' Template tool, which converts the HL7 into a more readable comma delimited file. In turn a PERL program called the Repository Engine reads the comma delimited file and stores the event summary against the appropriate patient in the Repository Database.
Viewing Events from SEHR Repository
The diagram below describes the viewing processes required to allow an authorised health professional using their Clinical Information System to read the Shared Electronic Health Record Repository event summaries.
- The first step is a request to view made by the medical provider via their clinical information system, in which the authorised health professional must enter their user ID and password. The Shared Electronic Health Record Repository server through a response program returns a url address with a parameter of the selected patient's unique identifier, only if the health professional's user id and password are accepted.
- In the second step the clinical information system on receiving the returned url puts this url into its built-in web browser which makes a web request for that url address. This url address uses HTTPS which uses SSL encryption. The url address location is the Shared Electronic Health Record Repository's web server which returns the requested first web page containing the patient's biographic and an index of event summaries. The event summaries can be reached via links on the presented web pages.
