C-CARE intends to improve access to essential personal clinical data at any time by authorised healthcare professional having the need to know. To do this, it uses standard tools, namely XML. C-CARE, capitalising upon previous works, will specify a meta-thesaurus to describe and identify the information to insert in the different XML documents, stored on a server. Different Document Type Definitions (DTD) will meet the specific requirements of the different application domains. Each DTD will comprise a summary highlighting relevant aspects of a patient's condition. This information will be accessible to patients and healthcare professionals through secure access via the public data network. Thanks to Text-To-Speech (TTS) technology, medical data will be also accessible through PSTN and mobile phone networks. The C-CARE system will be validated in different clinical domains and countries in order to assess its potential impact on continuity of care and its multi-linguistic aspects.
C-CARE aims to develop tools in support of continuity of care by collecting and storing essential, relevant and up-to-date patient health-related information accessible to authorised users, patients included, any time anywhere, e.g., from the patient's home, from a vehicle on the road or from a hospital emergency department. C-CARE will give access to information through both standard Internet technology and traditional voice telephony, bridging the technological gap between different categories of potential users. Continuity of care is recognised as a key issue for improving quality and cost-effectiveness of healthcare. However the two extreme approaches i.e., a single, comprehensive and centralised EHR per patient or a virtual EHR physically scattered over a number of systems (GP, hospital, specialist clinics, etc.) always available through the network are both unrealistic. C-CARE will result in a set of services, based on emerging industry standards (XML, XSL, Text-to-Speech), providing data in text or speech to users ranging from specialists ("Permanent Virtual Referral Letter"), and GPs on duty to Pharmacists, Home-care and Preventive Care, specialists and patients.
The main challenge of the project is to meet an urgent request of healthcare professionals, using information technology in their daily practice, to share selected parts of a patient's record with authorised persons, whenever and wherever they may need it, in a secure and controlled but also automated way. By doing so, these healthcare professionals will support more effectively the other persons involved in the process of continuous care, including the patients themselves. As the project handles very sensitive information, particular care will be put in ensuring the full compliance with the EU Directive 95/46 and its national transpositions, and a close communication with national and ethical authorities, professional associations and patient representatives (WP2). Security and data storage specifications will be produced, according to several scenarios, in order to enable parsing, storage and management of patient data and secure access to them by authorised third parties, with due regard to legal and ethical constraints. Special attention will be given to vocal access to the C-CARE server through PSTN and to related security aspects (WP6). Security aspects will surely influence the implementation and marketing strategies that could therefore differ from country to country. It is plausible to imagine that, depending on local conditions, C-Care services can be provided as a centralised service on a regional basis or as an add-on service on top of existing healthcare information system. In the latter case, the security issues are dealt with by the host information system. Concrete implementation and commercialisation recommendations will be produced, addressing each of the possible scenarios (WP9). The services will be designed and implemented based on a common semantic (WP4) and content definition (WP5) effort, which build upon the work done by standardisation bodies (CEN, ASTM, HL7, ISO) as well as by previous R&D projects (IHC, REMEDES, CoCo).
C-CARE will produce generic definitions (D4.2, 6, 7.1), tools (D7.2) and an exploitation plan (D9), for the production and secure management of clinical data subsets. The project will deliver a library of Document Type Definitions (D5.1) and of variable extensible style sheets (D5.2) covering the most relevant areas of patients' conditions. The project will result in tools for the secure delivery of selected patient health data through standard browsers and TTS technology over PSTN and mobile networks.
Funding SchemeCSC - Cost-sharing contracts