The objective of GEHR was to develop a common architecture for computerised health records across Europe which is applicable and acceptable across clinical domains, countries and computer systems. The architecture aims to provide the framework for the storage and access to all the clinical information required for the provision of patient care. The project started in January 1992 and had a budget providing 40 person-years of effort divided amongst 20 partners and subcontractors.

The project has now drawn to a close but the work is continuing in a number of other projects and many groups worldwide are taking up the basic tenets of GEHR. A prototype GEHR based system was developed by MIG as part of the GEHR project. This is known as PRISM (PRototype Information System for Medicine). PRISM is being used as the basis for the SHINDIG system.

For more information see the GEHR homepages maintained by Centre for Health Informatics and Muliprofessional Education (CHIME) where access can be found many of the GEHR deliverables describing, amongst other things, detailed requirements for comprehensiveness, communicability, portability and adherence to ethico-legal requirements.

MIG's EHCR expertise is being utilised in the Black Sea Tele Diab (BSTD) project - supporting the application of IT to the delivery of diabetes care in the countries bordering the Black Sea. MIG has hosted a training week for developers from this area and MIG personnel have visited key groups in these countries.

This project is being carried out under the EU INCO / COPERNICUS programme. This programme is intended to support research and technical development in the countries of Central Europe and the Newly Independent States.

For more information see the BSTD homepage..

MIG's Quality Assurance expertise has seen it playing a substantial part in the IGOS and IGOS II projects:-

IGOS (Image Guided Orthopaedic Surgery)
A major objective of IGOS was to establish guidelines to assist surgeons and health care professionals in the choice of suitable IGOS techniques, thereby reducing the trauma of orthopaedic interventions and improving efficiency
and effectiveness.
MIG was involved in drawing up a rigorous assessment strategy for the various IGOS techniques. This included selection of appropriate assessment criteria and was carried out in conjunction with the principal clinical teams.
The IGOS techniques under development include methods for:

• Hip surgery
• Pelvic surgery
• Knee surgery
• Total knee arthroplasty
• Anterior Cruciate Ligament reconstruction
• Maxillo-facial surgery
• Spine surgery

IGOS II is continuing the good work begun in IGOS. The main concentration is upon quantitative evaluation of the clinical and socio-economic import of IGOS methods and the establishment of standards in the domain of IGOS. The
demands of the EU Medical Devices Directives (and the US FDA regulations) are of particular importance.

An EHCR standard is required that can be relied upon to be communicable, portable, comprehensive, an ethico-legal record of care and an effective facilitator of medical education. This can only be achieved by an EU-supported standard which has a reliable means to evolve, proper feedback mechanisms, and which is properly supported.

The special needs of healthcare data (e.g. the necessity to retain integrity over long periods of time, the need for reliable storage of diverse data including data types not yet foreseen) mean that it is not sufficient to allow commercial interests gradually to develop a de facto standard. A standard must be developed, albeit with commercial needs in mind, with
healthcare needs paramount.

The EHCR-SupA project is reviewing existing architectures and architecture related projects (CEN, GEHR, Synapses, I4C etc.), with the intention of developing a consensus and so deriving a 'CEN next version'. An additional objective is to establish a means for feedback and future development, maintenance and so on of the standard.

EHCR-SupA (funded by EU Telematics) has two principal objectives:

1. the creation and use of a people network for dissemination, feedback, consensus forming and general promotion.
2. the drafting of improved architectures together with illustrative demonstrations and guidelines.

1. The needs of all users who interact with the Electronic Healthcare Record (EHCR) for training and advice to establish good practice in the use of electronic healthcare records.
2. The needs both of Application System vendors and of users of EHCR systems for support while the EHCR Architecture undergoes a process of refinement.

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PROREC

The main goal of PROREC is to promote and co-ordinate the European wide convergence towards comprehensive, communicable and secure Electronic Healthcare Records EHCR). This will be achieved by co-ordinating and supporting the European Commissions Telematics Applications for Health projects and other initiatives in the area of EHCRs, both nationally and internationally.

The most important activity to be carried out is promoting the widespread use of Electronic Healthcare Records by installing in Europe a permanent network of centres focusing on the dissemination of information related to electronic healthcare records. This network will be backed up by a European Steering Committee (PROREC International), simulating and preparing the activities of what should become in a later stage a true European Institution on the Electronic Healthcare Record.

Click here for more information.

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Some of our European collaborators include:

Belgium

• Health Data Management Partners
• ERIM
• Federation des Associaton Medecins
• Generalistes de Bruxelles
• Institut D'Hygiene et d'Epidemiologie

Germany

• Zentralinstitut fur die
• Kassenarztliche Versorgung
• RWTH Aachen / Lehrstuhl fur Biomedizinische Technik
• Abteilung fur Orthopadishe Chirurgie und Rheumaorthopadische
• GEMETEC Aachen
• BerufsGenossennschatliche Unfallklinik Franfurt am Main
• Stierlen MAQUET
• AESCULAP

Luxembourg

• Associaton des Medicins et Medecins Dentistes
• Microdata SARL
• Centre de Recherche Public
• Henri Tudor

Greece

• University of Athens

United Kingdom

• St Bartholomew's Hospital
• Medical College
• The Royal Hospitals NHS Trust
• City & East London FHSA
• The Royal Marsden Hospital
• East Riding Health Authority
• SmithKline Beecham

France

• Croix Rouge Francaise
• C2V
• Kalamazoo S.A.
• France Telecom
• Centre Hospitalier Universitaire de Grenolbe
• Clinique Mutualiste de Grenoble
• Universite Joseph Fourier
• Perception Reasoning ACTION in Medicine

Portugal

• Instituto Clinica General Zona Norte

Spain

• Clinica Puerta de Hierro