Sanitario Regionale FVG



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IV Convegno di GARR-B Bologna, 24-26 giugno 2002 L Università di Trieste e il Sistema Sanitario Regionale FVG L'organizzazione del SISR - Sistema Informativo Sanitario della Regione Friuli Venezia Giulia e sua integrazione con la Ricerca del Sistema Trieste: le nuove frontiere raggiunte con il Progetto GARR-B PoReR WP-29 Paolo Inchingolo Delegato Rettorale Direttore GARR-B PoReR WP29 Università di Trieste

Health Telematics and Telemedicne in Trieste & region FVG: a long tradition in 1974 started the first regional health informatics & telematics (at 110 bit/s) service experiences E.g. tele-collection of epidemiological data for the government of the regional health from 1988 Trieste experimented advanced health informatics and telematics solutions thanks to its rich research environment, constituted by: the University of Trieste the CNR group GNBTS the Area Science Park many other scientific Institutions 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 2

The institution of the FVG Regional Electronic Information System (SIER) In 1972 the Regione Friuli Venezia Giulia (FVG) instituted, by a regional law, the SIER Regional Electronic Informative System a Company (currently named Insiel) to design, develop and manage the SIER With this legislative act, the Region FVG decided 30 years ago to use informatics and telematics to govern all its activities 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 3

The institution of the FVG Regional Electronic Information System (SIER) The SIER was organized in three separate domains: SIAR (Regional Administration Informative System) SIAL (Local Administration Informative System) SISR (Regional Health Informative System). SIER REGIONAL ELECTRONIC INFORMATIVE SYSTEM REGIONAL ELECTRONIC INFORMATIVE SYSTEM SIAR REGIONAL ADMINISTRATION REGIONAL ADMINISTRATION INFORMATIVE SYSTEM INFORMATIVE SYSTEM SIAL LOCAL ADMINISTRATION LOCAL ADMINISTRATION INFORMATIVE SYSTEM INFORMATIVE SYSTEM SISR REGIONAL HEALTH REGIONAL HEALTH INFORMATIVE SYSTEM INFORMATIVE SYSTEM 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 4

The FVG Regional Electronic Information System (SIER) The three domains have progressively grown over these 3 decades services communications Since 1996 they are fully operating in three corresponding Intranet Autonomous Systems (SISR, SIAL, SIAR) interconnecting the 700 sites of public institutions of the Region interconnecting safe-branches of service companies as Insiel and Italtbs as well as universities and other research centers offering advances services offering also cross services from one domain to the other (e.g. telemedicine services from a municipally - belonging to SIAL - to a group of hospitals - belonging to SISR) 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 5

Regional Policy: CRTA (Regional Committee for Advanced Communications) of the Regional Government 2 febbraio 1996: Delibera della Giunta Regionale FVG di istituzione della Commissione Regionale per le Telecomunicazioni Avanzate (CRTA) 19-20 giugno 1996: Conferenza sulle Telecomunicazioni Avanzate ottobre 1996: CRTA: proposte riguardanti le modalità e gli strumenti di cui la Regione dovrà dotarsi al fine dei suo intervento nella materia 4 ottobre1996: Delibera della Giunta su: INDIRIZZI DELLA REGIONE NEL CAMPO DELLE TELECOMUNICAZIONI AVANZATE: 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 6

ATM Private network of Regione FVG (1997) Tolmezzo UDINE TCP/IP Distribution to all Public Institutions (about 700 sites) via CDN or ISDN Safety and Privacy ATM BACKBONE Palmanova PORDENONE GORIZIA TRIESTE 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 7

The FVG Regional Electronic Information System (SIER) and the RUPAR-FVG The three Intranet domains (SIAR, SIAL and SISR) work since 1977 over a private ATM network are organized as 3 private ASs (Autonomous Systems) constituted in 1998 the first Italian Unitary Network of the Regional Public Administrations, called RUPAR-FVG 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 8

The Rules of the RUPAR the resolution of the FVG Regional Government - 5.6.98 DISPOSIZIONI TECNICHE PER LA CONFIGURAZIONE E LA GESTIONE DELLE INTERCONNESSIONI NELLA COSTITUENDA INTRANET RETE UNITARIA DELLA P.A. DELLA REGIONE FVG (RUPAR-FVG) TRA LE RETI DEGLI Enti LOCALI, LA RETE DELL'ENTE REGIONE, L'INTERNET E LE P.A. CENTRALI a cura di Paolo Inchingolo 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 9

SIAR, SISR and SIAL Autonomous Systems main connections of the SIER (1998) Backbone nodes of SIAR, SIAL, SISR IP Ass TOLMEZZO TARVISIO Phone circuits distribution MANIAGO MEDUNO GEMONA SIAR sites SPILIMBERGO COLLOREDO SAN DANIELE TARCENTO CIVIDALE Main Health sites - SISR AVIANO PORDENONE CORDENONS UDINE Main collection sites for local institutions - SIAL SACILE AZZANO X SAN VITO CORMONS CODROIPO PALMANOVA IALMICCO LATISANA S. G. DI NOGARO CERVIGNANO MONFALCONE GORIZIA GORIZIA Internet connections GRADO TRIESTE MUGGIA 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 10

The FVG Regional Electronic Information System (SIER) and the RUPAR-FVG Precise regional laws and rules from 1998 provide ordered uses and interconnections within the administrations of the SIER - RUPAR-FVG and with external public and private administrations. Examples: Harmonization of intranet network assignments Rules for routing, firewall and DMZ Unique organization of e-mail service Rules for responsability and safety management 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 11

SIER REGIONAL ELECTRONIC INFORMATIVE SYSTEM REGIONAL ELECTRONIC INFORMATIVE SYSTEM SIAR REGIONAL ADMINISTRATION REGIONAL ADMINISTRATION INFORMATIVE SYSTEM INFORMATIVE SYSTEM SIAL LOCAL ADMINISTRATION LOCAL ADMINISTRATION INFORMATIVE SYSTEM INFORMATIVE SYSTEM SISR REGIONAL HEALTH REGIONAL HEALTH INFORMATIVE SYSTEM INFORMATIVE SYSTEM 34 34 10 10 REGIONAL DIRECTORATES & AUTONOM. SERVICES REGIONAL FUNCTIONAL INSTITUTIONS 219 219 44 44 55 33 MUNIICIPALITIES ADMINISTRATIONS PROVINCIAL ADMINISTRATIONS COMMERCE, INDUSTRY AND ART CHAMBERS TOURISTIC PROMOTION COMPANIES 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 12 IACP Current organization of the FVG Regional Electronic Information System (SIER) 66 10 10 11 22 19 19 TERRITORIAL HEALTH BODIES PUBLIC HOSPITALS UNIVERSITY POLICLINICS SCIENTIFIC HOSPITALS (IRCCS) POLI-DISPENSARIES 66 PRIVATE HOSPITALS (CASE DI CURA) 356 356 1044 PHARMACIES FAMILY DOCTORS

The FVG Regional Electronic Information System (SIER) and the RUPAR-FVG The growth of the RUPAR-FVG has been highly favored by the tight collaboration with the University of Trieste The Area Science Park other local research institutions 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 13

LSR-NIH Bethesda - Usa GNB-TS CNR BME unit University of Trieste INFN Trieste BURLO Children Scientific Hospital 1988-1990 TBN Trieste s Biomedical Network CATTINARA Hospital MAGGIORE Hospital TBN E-LAN CRSTBS BME Center - Area Science park 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 14

Trieste: 1988 First Telemedicine-PACS installation in Europe Institute of Radiology, University of Trieste Cattinara Hospital USL 1 Triestina Frame Grabber AT&T CommView network interno Radiology Service USL 1 Triestina Maggiore Hospital Frame Grabber 2 Mb/s line 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 15

Trieste Science City: First adventures in Italy and in Europe end of 80 - beginning of 90 88 Trieste-Bethesda Biomedical network and INFN-TS network 89 Trieste-Cattinara: First fiber-optic networked Hospital 89 Trieste-Cattinara: First in Europe commercial PACS system 90 SIST - Sistema Informatico Scientifico Triestino 90 GARR-Pole of Trieste 90 First CDN-based Scientific & Academic network CDN 91 Trieste-Cineca (Bo) - First national 2 Mb/s link in Europe 92 First Europe-USA e-mail X400 service 1,5 Mb/s with Trieste-USA link - EC Cosine project 92: invention of the geographic domains: TRIESTE.IT and FVG.IT 92 RIPE-DANTE European Research Network Presidence 93 First Italian Metropolitan Area Network (34 Mb/s SIP/Alcatel) 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 16

1993: First Metropolitan Optical -Fibers Network of Trieste The SIST Network - Intense collaborative Scientific Research GARR COMPRENSORIO MIRAMARE (SISSA, ICTP, INFN Università) COMPRENSORIO S. GIOVANNI COMPRENSORIO PLE EUROPA UNIVERSITA COMPRENSORIO VIA DELL ISTRIA (IRCCS BURLO, Università) COMPRENSORIO OSPEDALE CATTINARA OGS OAT. COMPRENSORIO BASOVIZZA (AREA, SICROTRONE) COMPRENSORIO PADRICIANO AREA INTERNET 2 Mbps 6/34 Mbps VIA UNIVERSITA VIA TIGOR 1997 Connections GARR INTERNET 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 17

PACS telemedicine integration in SIST-TBN ISO/OSI compliant Remote access to PACS Development of Open and Versatile Tools for Remote Multi-Platform Workstations 1992: XRIS - X-Window Remote Image Station 1993: ARIS - Autonomous Remote Image Station 1994: SRIS - Integration with Stereotactic Neuro-surgery 1995: HRIS - HTML/HTTP browser 1995: SYMREP Integration with Elettra Synchrotron Mammography beam line hospital clinics surgery rooms Frame Grabber Frame Grabber CT AT&T CommView internal network MRI USs WSs MS-DOS/Windows Unix PC WorkStation WorkStation X-RIS Image Server Stereotactic Neurosurgery AT&T CommView PACS Gateway 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 18

Hospital Network PACS WS HTML Browser IRCCS Burlo Hospital SIST Metropolitan Area Network Cattinara Hospital Maggiore Hospital PACS WS Hospital Network HTML Browser Trieste & Regione FVG: MAN-WAN SISR-SIST Integration (1995) County Network Router County Personal Data Server router Other SIST sites SISR Regional Health Network router router Remote Hospital PACS WS HTML Browser Hospital Network 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 19

DPACS WS Non DICOM WS DPACS DATAGRAB PRIVATE DATA DPACS DATABASE INTERFACE DPACS QUERY RETRIEVE INTERFACE DPACS QUERY RETRIEVE GATEWAY 1996 - DPACS telemed project: the virtual integrated health card of the citizen DICOM QUERY RETRIEVE SCP DICOM QUERY RETRIEVE SCU EXTERNAL LINK MANAGEMENT DICOM DB DPACS SERVER DICOM QUERY RETRIEVE SCP DICOM STORAGE SCU/SCP DICOM MODALITY DICOM INTERNAL DICOM QUERY RETRIEVE SCU DICOM STORAGE SCU/SCP DICOM, SQL, HTTP CUSTOM SERVICE SQL DICOM WS 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 20

1996 - DPACS telemedicine project DPACS "Data and Picture Archiving and Communication System : development of an open, scalable, cheap and universal system with accompanying tools, to store, exchange and retrieve all health information of each citizen at hospital, metropolitan, regional, national and European levels, thus offering an "integrated virtual health card of the European Citizens" 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 21

DPACS: Anatomo-pathology Department DICOM integration 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 22

DPACS: Anesthesia Department integration DICOM 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 23

DPACS: Clinical Chemistry Lab integration DICOM 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 24

GARR-B PoReR WP29 MURST/MIUR Project GARR-B Empowering of Regional Networks The New Telematic Network of 2000's Trieste with extensions to Region FVG (Udine( Udine, Pordenone, Gorizia) and part of Region Veneto (Portoguraro( Portoguraro) formally

GARR-B PoReR WP29 The New Telematic Network of 2000's Trieste An Agreement of University of Trieste with Telecom Italia & CSELT RD A Cooperation of University of Trieste with Municipality of Trieste, Province of Trieste, Insiel spa - Region FVG, Area Research Park, 3 Hospitals, all other scientific Institutions, some other companies

integration of university with area research park, health & assistance systems, municipality, civic network, and region RUPAR-FVG SIAR (ENTE REGIONE) SIAL (ENTI LOCALI) SISR (SANITA - SSR) COMPRENSORIO VIA S. FRANCESCO INSIEL-REGIONE COMPRENSORIO PLE EUROPA UNIVERSITA L-NAP UNIV- SIST Trieste - FVG RETE EXTRA URBANA UNIVERSITA Nettuno Nextra POP GARR-B TRIESTE COMPRENSORIO PASSO COSTANZI COMUNE INTRANET IP RETE CIVICA (Comune di Trieste) SPIN ALTRI ISP INTERBUSINESS Studenti 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 27

with differentiated virtual private networks interoperating each other RUPAR-FVG PVN TS UNIV- AREA NETTUNO/NEXTRA COMPRENSORIO PLE EUROPA UNIVERSITA RETE EXTRA URBANA UNIVERSITA SIAR (ENTE REGIONE) SIAL (ENTI LOCALI) SISR (SANITA - SSR) PVN INSIEL COMPRENSORIO VIA S. FRANCESCO INSIEL-REGIONE COMPRENSORIO PASSO COSTANZI COMUNE INTRANET IP RETE CIVICA (Comune di Trieste) PVN TS ENTI SIST e altri enti scientifici PVN TS - UNIVERSITA esclusa rete biomedica PVN COMUNE TS PVN TRIESTE CITTA DIGITALE L-NAP UNIV- SIST Trieste - FVG PVN TS - RETE BIOMEDICA SISR PVN TS - RETE BIOMEDICA RICERCA e DIDATTICA POP GARR-B TRIESTE Nettuno Nextra SPIN ALTRI ISP INTERBUSINESS Studenti 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 28

The characteristics of the New Telematic Network of 2000 Trieste (GARR-B PoReR WP29) are: WP29) are: 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 29

The TCP/IP INTERNET.. One global resource Is not the solution for the New Telematic Network of 2000 s Trieste 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 30

TS2000 NETWORK: SDH rings & GbEth networks INSIEL - RUPAR-FVG via S. Francesco 155 Mb/s Telecom main service site S. Maurizio 34 Mb/s GARR-B National Research Network 28x155 Mb/s 155 Mb/s UNIVERSITY of Trieste campus Valerio 34 Mb/s GigaBit-Eth O.F. networks IRCCS BURLO HOSPITAL 34 Mb/s AREA SCIENCE PARK Padriciano 34 Mb/s AREA SCIENCE PARK Basovizza 34 Mb/s TRIESTE MUNICIPALITY passo Costanzi 7 Optical-Fibers Rings SDH 7x 622 Mb/s 34 Mb/s Regione -FVG Via Giulia 34 Mb/s 34 Mb/s 34 Mb/s MAGGIORE HOSPITAL MIRAMARE Internat. Campus ISAS, ICTP, Univ.Ts, INFN CATTINARA HOSPITAL GigaBit-Eth O.F. networks 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 31

TS2000 NETWORK: SDH rings and XDSL peripheral interconnections Telecom main service site S. Maurizio GARR-B National Research Network Telecom Serv.. site UNIVERSITY of Trieste campus Valerio INSIEL - RUPAR-FVG via S. Francesco AREA SCIENCE PARK Padriciano Telecom Serv.. site Telecom Serv.. site AREA SCIENCE PARK Basovizza TRIESTE MUNICIPALITY passo Costanzi PERIPHERAL CONNECTIONS HDSL - ADSL 2-8 Mb/s Telecom Serv.. site Regione -FVG Via Giulia Univ. Trieste x 28 Municipality of Trieste x 7 Province of Trieste x 2 CNR, OAT, OGS, MIB, Bish. Sem., etc. CATTINARA HOSPITAL Telecom Serv.. site Telecom Serv.. site IRCCS BURLO HOSPITAL MAGGIORE HOSPITAL MIRAMARE Internat. Campus ISAS, ICTP, Univ.Ts, INFN 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 32

Portogr. PN UD ATMosfera TS2000 NETWORK: REGIONAL AND NATIONAL INTERCONNECTIONS PHASE 1. GO UNIVERSITA di Trieste via Valerio AA-NAP CENTRAL EUROPEAN COUNTRIES RUPAR-FVG INSIEL - RUPAR-FVG via S. Francesco Centrale 2 Centrale S. Maurizio 155 Mb/s TRIESTE Centrale 8 OSPEDALE CATTINARA Regional & interregional VCs and VPNs QoS for e-learning & e-health ITALIAN RESEARCH NETWORK GARR-B 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 33

TS2000 NEW NETWORK: the first connected sites COMPRENSORIO OSPEDALE CATTINARA (Università, COMPRENSORIOAOTS) OSPEDALE MAGGIORE + via Pietà/Vasari (Università, AOTS) COMPRENSORIO VIA DELL ISTRIA (IRCCS BURLO, Università) OSPEDALE SANTORIO (AOTS, Università) VIA FILZI VIA S. ANASTASIO VIA MONTFORT COMPRENSORIO VIA S. FRANCESCO INSIEL-REGIONE FVG PVN REGIONE: SISR, SIAR, SIAL VIA UNIVERSITA MIB VIA TIGOR VIA MANZONI VIA ECONOMO VIA VALMAURA COMPRENSORIO MIRAMARE (SISSA, ICTP, INFN Università) OGS OAT Univers. COMPRENSORIO S. GIOVANNI (Università, ASS1, altri enti) POP GARR-B TRIESTE SINCRO INFN COMPRENSORIO BASOVIZZA AREA - SINCROTRONE COMPRENSORIO PLE EUROPA UNIVERSITA L-NAP UNIV- SIST Trieste FVG COMPRENSORIO PADRICIANO AREA VIA D ALVIANO VIA COMBI VIA LAZZAR. V. UTS - Sede PORDENONE ASS1-1 ASS1-n UTS - Sede GORIZIA EXTRA URBANO UNIVERSITA ICCU SBN ROMA COMPRENSORIO PASSO COSTANZI (COMUNE) TRIESTE CITTA DIGITALE UTS - Sede PORTOGRUARO UTS - OGS UDINE UNIV UDINE UDINE INTERBUSINESS Studenti Nettuno Nextra SPIN ALTRI ISP RETE CIVICA BIBL CIVICA MUSEO RIVOLT MUSEO STORIA C.entro CIVICO Centro CIVICO VIA DOCCE BIBL QUARANT BELENO 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 34

Some of the services on the TS2000 TN (GARR-B (GARR-B PoReR WP 29) (many extended to Pordenone, Gorizia, Udine,, Portogruaro) collaborative research didatics (also high-school - university) administration of university, municipalities, hospitals, Area Science Park, research centers, etc. Health assistence global integration access ports to medical doctors and pharmacies health research intranet universal accesses full libraries integration (SBN) support to S.M.E.s phone over ATM-VCs and over IP multi-teleconferencing over IP with streaming over intranet/internet tele-didatics tele-formation emergency monitoring and actions 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 35

GARR-B PoReR WP29 Regional Network Phase 2. Proprietary 34-155 Mbps Radio Bridges + O.F. channels IP - MPLS network PORDENONE UNIV UD CEE/SEE UNIV TS+UD GORIZIA UNIV TS+UD UNIV TS PORTOGRUARO COMPRENS..MIRAMARE UNIV TS COMPRENS. VALERIO COMPRENS CATTINARA COMPRENS.. BURLO TRIESTE COMPR. AREA PADRICIANO COMPRENS. T8 IT & EC COMPRENS MAGGIORE INSIEL REGIONE SISR COMUNE TRIESTE 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 36

GARR-B PoReR Regional Network: new technology and extension to Regione FVG 2600 Videoconferencing Station Vtel LAN PSTN Voice gateway ISDN BRI Multi Conference Unit Radius Server 7500 GSR3 7500 IP-TV Server Regional High-speed 4 th Generation global network Videoconferencing Station Vtel 2600 LAN LAN PIX Firewall 2600 MPLS core 6260 GSR1 SRP / DPT STM-4 6400 GSR2 Area Provider 6500 3500 3500 Giga Ethernet Ring 3500 827-4V LAN Virtual Private LAN Analog phone 827-4V LAN Analog phone NetMeeting Terminal IP Phones Call Manager 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 37 LAN

Rete SIAL Rete SIAR Ex MAN SIST Via Farneto Osp. Cattinara SISR Trieste (1) April 2000 Rete sanità Gorizia Router CCC Osp. Maggiore Rete sanità Udine Backbone SISR Backbone ASS1 Osp. Maddalena Osp. Santorio Rete sanità Pordenone Burlo 2 Burlo Ex MAN SIST April 2000 ItalTBS ARS SISR-Trieste 1 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 38

P. Giotti V. Locchi V. Nordio V. Pietraferrata SISR Trieste (2) April 2000 V. Puccini Backbone ASS1 V. Ghiberti V. Vespucci V. Stock Muggia Aurisina 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 39

V. Geppa CSM Gambini V. Lamarmora S. Giacomo V. Valmaura V. Udine V. Orsera V. Pasteur Via Mauroner SISR Trieste (3) April 2000 CSM Aurisina V. Locchi Centrodonna CSM Miramare SG. Mensa I. S. D. N. Centro tumori V. Morpurgo SG. SERT Prosecc o SG. Alcologia Pineta Carso V.Travni SG. Med. SG. Salute Mentale k Lavoro Backbone ASS1 Igea Salus Casa verde Burlo2 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 40

SIST TBN Trieste Biomedical Network April 2000 Fondazione Callerio San Giovanni Via Manzoni Burlo Cattinara GNBTS Vasari San Maurizio Valmaura Via Sommacco University of Trieste - Via Valerio 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 41

From SISR + TBN-SIST to TPBN GARR-B PoReR WP29 the Trieste Protected Biomedical Network Institution - Subject University Hospitals Scientific Hospitals (IRCCS) Research Institutions Companies with agreements Region + Health Regional Agency Citizens Function Teaching + Research (+ Service) Service (+ Research + Teaching) Research + Service (+ Teaching) Research (+ Service + Teaching) Service (+ Teaching + Research) Service [coord] (+ Research) Users of Service +Teaching 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 42

TPBN GARR-B PoReR WP29: The protected biomedical networks on the NRT 2000 s Trieste september 2000 Insiel & Region FVG Maggiore SIAR- SIAL- SISR Hospital Cattinara Hospital PABX 155 Mb/s 34 Mb/s Health Service (SISR) 34 Mb/s IRCCS Burlo Hospital SDH RING 7x622 Mb/s 34 Mb/s 34 Mb/s Trieste Municipality HDSL ADSL Territory Health sites, pharmacies, medical doctors, etc 155 Mb/s University Campus - Medicine, Biology & Bioengineering Health and Biomedical Didactics, Research & Development (University, Area Science Park, etc. SIST-TBN) 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 43

TPBN: accesses from the territory Ambulanza Clients portatili (domicilio) Casa di Cura Re te Bio me d ica Sanitaria di Servizi Cardiologo Via Farneto Backbone ASS n 1 Accesso GSM Accesso GSM Rete Radiomobile SISR regione Backbone SISR Trieste Via San Francesco - Insiel Accesso GSM Homecare GNBTS/HTL Re te Bio me d ica di Ricerca e Sviluppo Medico di Base Specialista reperibile Ospedale 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 44

DPACS-MedArcNet VI-EHR: the Virtual Integrator of the Electronic Health Records MISS MIS MISS IHIS AHIS MISS IHIS : Integrated Hospital Information System AHIS : Administrative Hospital Information System MIS : Medical Information System MISS : Medical Information Subsystem DPACS University Trieste SPERIGEST IFC-CNR Pisa MIS 1 CLIENT 1 MIS 2 COMUN. LATO MIS INTEGRATORE VIRTUALE COMUN. LATO CLIENT CLIENT 2 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 45

REAL WILLING of all the involved Institutions of Trieste and Reg. FVG to constitute a SYSTEM by setting this one as the first goal for the future of the city and of the region as a bridge for the enlarged Europe Azienda Ospedaliera "Ospedali Riuniti" Trieste I.R.C.C.S. Istituto per l'infanzia «Burlo Garofolo» 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 46

Trans-national national activites and policies IT FVG AU Masters MCE: Management in Clinical Engineering (specialist) HTT: Health Telematics & Telemedicine NISDM: Networking and Internet Services Design and Management SL CRO HU BO Centers: ICETS Networks: UNIADRION ABIC-BME CEEUN Bilateral agreements Projects: Cross Border Telemed TAHTA Transnational EHR AA-NAP Cross Border E-health Safety YU 25.6.02 GARR-B - P. Inchingolo - L Università di Trieste e il Sistema Sanitario Regionale FVG 47