title: Reviewing the integration of patient data: how systems are evolving in practice to meet patient needs.
abstract: BACKGROUND
  The integration of Information Systems (IS) is essential to support shared care and to provide consistent care to individuals--patient-centred care. This paper identifies, appraises and summarises studies examining different approaches to integrate patient data from heterogeneous IS.
  
  
  METHODS
  The literature was systematically reviewed between 1995-2005 to identify articles mentioning patient records, computers and data integration or sharing.
  
  
  RESULTS
  Of 3124 articles, 84 were included describing 56 distinct projects. Most of the projects were on a regional scale. Integration was most commonly accomplished by messaging with pre-defined templates and middleware solutions. HL7 was the most widely used messaging standard. Direct database access and web services were the most common communication methods. The user interface for most systems was a Web browser. Regarding the type of medical data shared, 77% of projects integrated diagnosis and problems, 67% medical images and 65% lab results. More recently significantly more IS are extending to primary care and integrating referral letters.
  
  
  CONCLUSIONS
  It is clear that Information Systems are evolving to meet people's needs by implementing regional networks, allowing patient access and integration of ever more items of patient data. Many distinct technological solutions coexist to integrate patient data, using differing standards and data architectures which may difficult further interoperability.
authors.affiliation: Department of Biostatistics and Medical Informatics, Faculty of Medicine of University of Porto, Porto, Portugal. rcorreia@med.up.pt
authors.forename: Ricardo J
authors.initials: RJ
authors.lastname: Cruz-Correia
authors.forename: Pedro M
authors.initials: PM
authors.lastname: Vieira-Marques
authors.forename: Ana M
authors.initials: AM
authors.lastname: Ferreira
authors.forename: Filipa C
authors.initials: FC
authors.lastname: Almeida
authors.forename: Jeremy C
authors.initials: JC
authors.lastname: Wyatt
authors.forename: Altamiro M
authors.initials: AM
authors.lastname: Costa-Pereira
mesh_terms: D006801:Humans; D007256:Information Systems / Q000458:organization & administration*; D020407:Internet; D016347:Medical Records Systems, Computerized; D018802:Patient-Centered Care; D018511:Systems Integration; D014584:User-Computer Interface