The NUCLEUS integrated electronic patient dossier breakthrough and concepts of an open solution.

This paper addresses the requirements of healthcare providers and hospital managers vis-à-vis electronic patient records that can be integrated. It starts from some critical failure factors, found with previous attempts to standardise the electronic health record. Standardisation appears to be the key issue: the subject of standardisation requires delicate positioning.

Structuring the patient record: NUCLEUS (customisation environment for multi-media integrated patient records).

The NUCLEUS project (AIM A2025) develops a prototype of a multi-media integrated patient record, based on the concepts of intelligent act management as conceived in RICHE (Esprit 2221). Moreover, NUCLEUS creates facilities for the customisation of such patient record according to the requirements of the health professionals (physicians, nurses, therapists, etc.) who operate and consult the patient record.

The RICHE Reference Architecture.

The RICHE Reference Architecture defines an open framework for health care information systems. Developed within the ESPRIT II programme, it is now the basis of several implementations in hospitals in Italy, Portugal, Ireland, France and the UK, and of follow-up initiatives such as EDITH (ESPRIT, no. 7508), NUCLEUS (AIM II, no.