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In today's modern healthcare environments, patients often receive medical treatment from a number of physicians, at different sites, based on any number of factors. In order to provide the optimum treatment for the patient, physicians require access to their patients' records as part of the overall care process. The records are typically fragmented within different healthcare organizations or, in many cases, restricted for use within a single healthcare system.

Optimum patient care requires that the records needed are shared between different healthcare providers. At present, the typical way to transfer the patient record is to either send a fax or make hard copies or, in the case of images, use electronic media such as a CD or DVD. This process needs to be repeated by each physician who provided the patient with care in order to provide a complete picture of the patient's medical history. Alternatively the data exchange becomes the responsibility of the patient to obtain copies and transport them between organizations.

This manual process is obviously expensive and inefficient for both the patient and physicians. In many cases, if a person needs to visit an emergency room in a location away from their primary healthcare provider, the records are simply not available. If the records are stored electronically, they probably conform to one or more electronic standards. Since there are different versions of those standards, consistency across vendors varies greatly. Even if the systems are interconnected, there is a good chance that the medical records on one system cannot be read on another.

An example of the lack of interoperability that MDES can address is a leading healthcare provider in Europe that struggled with providing a patient centric view of data across its environment. This 1,300 bed healthcare organization services an area comprised of 600,000 residents offering 24-hour specialized medical treatment. Prior to MDES, medical records consisted of disjointed paper copies of medical records, segmented by facility. Where there were digital systems employed, incompatibility between the systems limited sharing among providers. The scope of the problem was widespread and involved 64 different systems utilizing 1,500 proprietary data interfaces, each with a different patient index. As a result, clinical documentation was rarely reused and it was difficult to integrate local physicians into the hospital environment. This organization suffered from degradation in care as well as high operational costs. This problem is not isolated to this specific healthcare system and exists globally in many healthcare organizations.

The MDES solution addresses these challenges and provides the means to create an intelligent infrastructure providing a patient-centric view of clinical information. It enables the network infrastructure to eliminate the operational costs of manual transport or proprietary health information exchanges (HIE) and reduce the delays associated with alternative solutions. The MDES solution from Cisco integrates IHE standards-based applications from Tiani-Spirit onto a Cisco Application Extension Platform (AXP) to form the basis for efficient exchange of clinical information between disparate systems.