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Translational medicine is becoming fundamental in promoting information flow between basic research and clinical practice, and in improving patients' health. The need for efficient systems to process and share information from multiple sources--including distinct areas of medicine--is a pressing need in biomedical research. Nevertheless, healthcare information systems are fragmented over different databases, medical institutions, and geographical locations. There are already several approaches to tackle this problem based on centralized or distributed solutions. Nonetheless, mainly due to privacy reasons, these models only work for specific silos. In this paper, we present a new ecosystem for connecting database owners and researchers. Our approach consists of gathering, via a common fingerprint, an extensive characterization of dispersed databases. This fingerprint typically contains high-level aggregated information addressing questions at a population level and allowing, for instance, quick identification of databases with data that may help to answer a specific research question. This work is being conducted in the context of EMIF (European Medical Information Framework), an IMI (The Innovative Medicines Initiative) joint undertaking funded project, wherein the Catalogue is being used to collect data from cohorts and Electronic Health Record systems of several European countries.

Over the last few years, the extended usage of medical imaging procedures has raised the medical community attention towards the optimization of their workflows. More recently, the federation of multiple institutions into a seamless distribution network has brought hope of increased quality healthcare services along with more efficient resource management. As a result, medical institutions are constantly looking for the best infrastructure to deploy their imaging archives. In this scenario, public cloud infrastructures arise as major candidates, as they offer elastic storage space, optimal data availability without great requirements of maintenance costs or IT personnel, in a pay-as-you-go model. However, standard methodologies still do not take full advantage of outsourced archives, namely because their integration with other in-house solutions is troublesome. This document proposes a multi-provider architecture for integration of outsourced archives with in-house PACS resources, taking advantage of foreign providers to store medical imaging studies, without disregarding security. It enables the retrieval of images from multiple archives simultaneously, improving performance, data availability and avoiding the vendor-locking problem. Moreover it enables load balancing and cache techniques.

Quality assurance for planned radiation exposure situations (e.g. Digital Radiography, Computed Tomography or Radio Fluoroscopic studies) requires the application of examination-specific scans protocols. These are tailored to patient age or size, body region and clinical indication for ensuring that the dose applied to each patient is as low as reasonably achievable for the clinical purpose of the image acquisition (ALARA principle). The European legal framework--2013/59/EURATOM--points that health authorities will be more pervasive on inspecting the dosimetry applied to patients. This paper discusses these legal alterations and presents an interoperable distributed system for dose monitoring, which is compliant with legal procedures and the IHE Radiation Exposure Monitoring profile (REM). The system combines the most representative stakeholders affected and directly interested in the patient radiological protection: patients, radiologists, practitioners, health authorities, and ethics committee. The system is capable of gathering, in real-time, dose information applied to the patient and storing it in a regional or national wide dose registry. The paper addresses which information should such systems hold and which should be accessed, from each stakeholder perspective. Furthermore, the system may detect irregular dose patterns, which could indicate dose abuses, and signal those findings to the appropriate stakeholders.