Inadequate availability of patient information is a major cause for medical errors and affects costs in healthcare. Traditional approaches to information integration in healthcare do not solve the problem. Applying a document-oriented paradigm to systems integration enables inter-institutional information exchange in healthcare. The goal of the proposed architecture is to provide information exchange between strict autonomous healthcare institutions, bridging the gap between primary and secondary care. In a long-term healthcare data distribution scenario, the patient has to maintain sovereignty over any personal health information. Thus, the traditional publish-subscribe architecture is extended by a phase of human mediation within the data flow. DEUS essentially decouples the roles of information author and information publisher into distinct actors, resulting in a triangular data flow. The interaction scenario will be motivated. The significance of human mediation will be discussed. DEUS provides a carefully distinguished actor and role model for mediated pub-sub. The data flow between the participants is factored into distinct phases of information interchange. The artefact model is decomposed into role-dependent constituent parts. Both a domain specific (healthcare) terminology and a generic terminology is provided. From a technical perspective, the system design is presented. The sublayer for network transfer will be highlighted as well as the subsystem for human-machine interaction.

翻译：患者信息获取不足是导致医疗错误的主要原因之一，并影响医疗成本。传统医疗信息集成方法未能解决该问题。采用面向文档的范式进行系统集成，能够实现医疗机构间的信息交换。所提出的架构旨在实现严格自治的医疗机构之间的信息交换，弥合初级诊疗与次级诊疗之间的鸿沟。在长期医疗数据分布场景中，患者需保持对个人健康信息的主权控制。因此，传统发布-订阅架构通过引入数据流中的人工调解阶段进行扩展。DEUS本质上将信息作者与信息发布者的角色解耦为不同参与者，形成三角数据流。本文阐述了该交互场景的动机，并讨论了人工调解的重要性。DEUS为调解型发布-订阅提供了精心区分的参与者与角色模型。参与者之间的数据流被划分为不同的信息交换阶段，工件模型被分解为依赖角色的组成部分。同时提供了领域特定（医疗）术语与通用术语。从技术角度展示了系统设计，重点介绍了网络传输子层与人机交互子系统。