Regional Interoperability Project

Healthcare information systems interoperability for ASP Palermo – Sicily, Italy


The Project

The aim of the ASP Palermo (Provincial Health Authority of Palermo) project was to integrate the various clinical and administrative systems within the province and into a single, interoperable network of shared medical records and services. ASP Palermo’s main objectives were as stated:

  1. EMPI and Provider Directory – creating a centralized registry capable of cross-referencing patient identifiers as well as a centralized provider directory utilizing Single-Sign-On (SSO) capabilities.
  2. Patient Health Record (PHR).
  3. Computerized Physician Order Entry (CPOE) – Orders from any system can be effectively routed to the correct destination, regardless of vendor.
  4. Privacy Consent – Storage and Management of Patient Consent Documents.
  5. Centralized Data Dictionary Management – Creating a unified data dictionary to caters to both administrative purposes (Townships, General Practitioners, Departments/Wards, etc) and clinical use (ICD9-CM, Care and Clinical Services, etc)


Creating an integrated Health Information Networking covering the entire 1.25m population of the Province of Palermo required an extensive set of unique functionalities such as clinical pathways, integration of several hospitals and standardization of semantic information. X1.V1 was selected to operate using the following functionalities:

  • Enterprise Service Bus (ESB)
  • Enterprise Master Patient Index (EMPI)
  • Terminology and Coding Index
  • Clinical Repository
  • Authentication
  • Consent Management
  • Bi-Directional Flow of Documents (Messaging from Physicians to the Provincial Health Authority; Lab Information systems from the Provincial Health Authority to the Physicians)
  • Discharge Information
  • Patient Applications (notifications, document lists)
  • Screening and Prevention
  • Clinical Pathways and Chronic Care Models
  • Consent Management

X1.V1 was able to manage this multitude of tasks by leveraging advanced international standards, such as IHE (for transport and notifications) and HL7 (for messaging and content).

Project Outcomes

ASP Palermo was successfully able to leverage X1.V1 and achieve the following:

  • Rapid access to patient data aggregated across applications;
  • Centralized registries for patients and providers
  • A unified, complete view of a patient’s health record, including consent documents;
  • Improved organizational ability to comply with privacy regulations;
  • Improved clinical efficiency and patient safety;
  • Complete integration of disparate IT systems, regardless of vendor;
  • Automated notification system;
  • A single, unified patient identifier functioning across the entire province;
  • Fast integration pathways for future systems to be easily connected to Regional Oncology Screening and Pathology Networks.

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