Cyber-healthcare cloud computing interoperability using the HL7-CDA standard

The HL7 standard was initially designed to enable interoperability of healthcare information within large hospitals. HL7's focus has recently been extended to regional healthcare cloud infrastructures but not yet reached the lightweight fog infrastructures emerging from niche healthcare areas such as body area networks (BANs) and the massive flow of personal medical records resulting from off-the-shelf e-health devices and networks. This paper addresses the issue of interoperability between fog and cloud computing platforms by i) proposing a framework for a standardized exchange of information between healthcare entities ii) designing and implementing a software tool to be integrated into medical data dissemination protocols to ensure interoperability and iii) evaluating the impact of the software tool on the transport of data when exchanging healthcare information using “in-band” and “out-band” transport over the IEEE802.15.4/ZigBee and WiFi protocols. Our results reveal that, for the lightweight devices used by fog infrastructures, “out-band” transport over WiFi with edge data translation into HL7 records is a better option than “in-band” transport.