Conceptual nodes, projects and starting point

This research direction crystallized around several complementary landmarks: a project proposal from which the ideas originated, a central information concept, a broader conceptual framework, a regional project in Italy in which these ideas acquired an architectural and operational form, and a distinct direction devoted to modelling clinical trials.

The starting point was R2V2R, a 2011 project proposal that was not accepted for funding, but which was important to me because it brought together for the first time, in a coherent form, ideas later developed around the Virtual Healthcare Record, the Digital Healthcare Ecosystem, digital avatars and the integration of the real and virtual worlds.

• R2V2R – Real to Virtual to Real
  The proposal that gave rise to an entire research direction concerning the seamless integration of the real world of care with its virtual counterpart.
• Virtual Healthcare Record
  The concept of a longitudinal virtual medical record, centred on the integration, organization and delivery of coherent views of the patient’s clinical state and history.
• Digital Healthcare Ecosystem
  The broader conceptual framework in which systems, actors, resources and digital services cooperate in a distributed, adaptive and patient-oriented environment.
• LuMiR
  A regional project in Basilicata in which these ideas were put into practice at institutional scale, within an architecture oriented towards continuity of care and interoperability.
• Clinical Trials
  A related direction in medical informatics, centred on modelling the clinical-trial process, the relationship between protocol and CRF, data interoperability and semantic extensions connected with selection criteria.

Cross-cutting syntheses

Some papers do not belong to a single concept or project, but attempt to view medical informatics as a whole and to connect several research directions. In this section, they serve as points of conceptual orientation.

• Paradigm Shifts in Health Informatics (2013)
  A synthesis paper linking paradigm-based modelling, business models, HL7/RIM, LuMiR, the Virtual Health Record, multi-agent systems and the Digital Health Ecosystem. The article interprets the evolution of the field as a transfer of knowledge between engineering, computer science and healthcare, and as part of the broader process of digitalization.

Structure of the section

To avoid mixing concepts, projects and publications, the section is organized on several levels:

• Genesis: R2V2R.
• Concepts: Virtual Healthcare Record; Digital Healthcare Ecosystem; Health Digital State.
• Projects: LuMiR and other related implementations.
• Architectures: SOA, multi-agent systems, agentification, organizational interoperability.
• Cross-cutting syntheses: papers that bring together and interpret the evolution of several directions.
• Related directions: Clinical Trials, ontologies and semantic modelling.