Background

In the general context of the Health System, Hospital Information Systems (HIS) communicate with each other or with other components of the Health Information System (SIS). The HIS can no longer be regarded as an autonomous, unique and well-defined element. Instead, it must be studied in a networked environment within which it is only one element among others with which it will exchange information regarded as reliable according to the defined levels of authorization.

The consequences of this implementation are multiple :

• At the level of the HIS itself, it becomes necessary to promote its capability to communicate. To do this, it must be "effectively" structured by applying usable standards, both for intra-hospital communication (exchanges between applications) and communication with the SIS ;
• At the level of SIS/HIS exchanges by securing the exchanged data and its standardization ;
• At a legal level by considering the patient’s rights to his/her medical file and the responsibilities of the producer of the information ;
• In order to fulfill these multiple demands, the architecture of the HIS and, more globally, of the SIS, must be based on the implementation of support services for interoperability.

It is therefore completely natural that these infrastructures constitute one of the strategic axes on which the GMSIH has based its studies since its creation. This strategic axis is very technical and includes all the projects defined as interoperability and support "services". These services, in particular those consisting of directory services and patient identification security services, are useful for HIS applications, but also take into consideration the "exchange" dimension between the HIS and the SIS.