An HL7/CDA framework for the design and deployment of telemedicine services

The advance of regional healthcare networks has created increasing demand for telemedicine services tailored to particular medical specialties and healthcare settings. At the same time, emerging telemedicine protocols and guidelines combined with various medical standards provide specifications not only for the exchanged clinical content but also for the physical setting and technology in use. This paper presents a framework for the design and deployment of telemedicine services based on open standards: HL7/CDA for clinical documents, DICOM 3 for imaging, and SCP-ECG for ECGs. The originality of the approach lays on: (a) the creation, maintenance, and reuse of clinical document templates adhering to the HL7 Clinical Document Architecture (CDA)-a recent ISO standard and (b) interoperability with middleware services of the health information infrastructure (HII). This work adds value to the WebOnCOLL collaboration infrastructure, which has been deployed successfully for provision of remote consultation services in cardiology.