Enabling Primary and Specialist Care Interoperability through HL7 CDA Release 2 and Chronic Care Model: an Italian case study

Interoperability is the key to enable clinical information systems for General Practitioners (GP) and Hospital Specialists (HS) in order to exchange and manage the Chronic Care Models (CCM) medical records, Patient Summary (PS), and Electronic Prescription (e-Prescription) documents while accessing the electronic health record. We present a localization experience for PS and e-prescription, based on the Health Level Seven Version 3 Clinical Document Architecture Release 2, developed for Italian healthcare. We describe also an experience on the implementation of CCM for sharing patient clinical data among healthcare providers in the management of diagnostic and therapeutic pathways for chronic diseases (diabetes). Finally, we propose, as a case study, a project for the integration of various services for GP/HS, in line with the context of Italian normative both at the national and regional levels (Tuscany region).