Skip to main content

Information Management in Distributed Healthcare Networks

  • Chapter
Data Management in a Connected World

Part of the book series: Lecture Notes in Computer Science ((LNISA,volume 3551))

Abstract

Providing healthcare increasingly changes from isolated treatment episodes towards a continuous treatment process involving multiple healthcare professionals and various institutions. Information management plays a crucial role in this interdisciplinary process. By using information technology (IT) different goals are in the focus: To decrease overall costs for healthcare, to improve healthcare quality, and to consolidate patient-related information from different sources.

Consolidation of patient data is ultimately aimed at a lifetime patient record which serves as the basis for healthcare processes involving multiple healthcare professionals and different institutions. To enable seamless integration of various kinds of IT applications into a healthcare network, a commonly accepted framework is needed. Powerful standards and middleware technology are already at hand to develop a technical and syntactical infrastructure for such a framework. Yet, semantic heterogeneity is a limiting factor for system interoperability. Existing standards do support semantic interoperability of healthcare IT systems to some degree, but standards alone are not sufficient to support an evidence-based cooperative patient treatment process across organizational borders.

Medicine is a rapidly evolving scientific domain, and medical experts are developing and consenting new guidelines as new evidence occurs. Unfortunately, there is a gap between guideline development and guideline usage at the point of care. Medical treatment today is still characterized by a large diversity of different opinions and treatment plans. Medical pathways and reminder systems are an attempt to reduce the diversity in medical treatment and to bring evidence to the point of care. Developing such pathways, however, is primarily a process of achieving consensus between the participating healthcare professionals. IT support for pathways thus requires a responsive IT infrastructure enabling a demand-driven system evolution.

This article describes modern approaches for “integrated care” as well as the major challenges that are yet to be solved to adequately support distributed healthcare networks with IT services.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Alonso, G., Casati, F., Kuno, H., Machiraju, V.: Web Services—Concepts, Architectures and Applications. Springer, Berlin (2003)

    Google Scholar 

  2. Bange, C.: Von ETL zur Datenintegration. IT Fokus 3(4), 12–16 (2004)

    Google Scholar 

  3. Bates, D.W., Kuperman, G.J., Wang, S., Gandhi, T., Kittler, A., Volk, L., et al.: Ten commandments for effective clinical decision support: making the practice of evidence-based medicine a reality. J. Am. Med. Inform. Assoc. 10(6), 523–530 (2003)

    Article  Google Scholar 

  4. Batini, C., Lenzerini, M., Navathe, S.B.: A Comparative Analysis of Methodologies for Database Schema Integration. ACM Computing Surveys 18(4), 323–364 (1986)

    Article  Google Scholar 

  5. Beale, T.: Archetypes: Constraint-based Domain Models for Future-proof Information Systems. In: OOPSLA 2002 workshop on behavioural semantics (2002)

    Google Scholar 

  6. Beale, T.: Archetypes and the EHR. Stud Health Technol. Inform 96, 238–244 (2003)

    Google Scholar 

  7. Berger, R.: Telematik im Gesundheitswesen – Perspektiven der Telemedizin in Deutschland. München: Bundesministerium für Bildung, Wissenschaft, Forschung und Technologie und Bundesministerium für Gesundheit (1997)

    Google Scholar 

  8. Beyer, M., Kuhn, K.A., Meiler, C., Jablonski, S., Lenz, R.: Towards a flexible, process-oriented IT architecture for an integrated healthcare network. In: Proceedings of the 2004 ACM Symposium on Applied Computing (SAC), pp. 264–271. ACM, New York (2004)

    Chapter  Google Scholar 

  9. Bhasale, A.L., Miller, G.C., Reid, S.E., Britt, H.C.: Analysing potential harm in Australian general practice: an incident-monitoring study. Med. J. Aust. 169(2), 73–76 (1998)

    Google Scholar 

  10. Bidgood, W.D., Horii, S.C., Prior, F.W., Van Syckle, D.E.: Understanding and Using DICOM, the Data Interchange Standard for Biomedical Imaging. Journal of the American Medical Informatics Association 4(3), 199–212 (1997)

    Article  Google Scholar 

  11. Bouguettaya, A., Benatallah, B., Elmagarmid, A.: Interconnecting Heterogeneous Information Systems. Kluwer Academic Publishers, Boston (1998)

    Google Scholar 

  12. Brennan, T.A., Leape, L.L.: Adverse events, negligence in hospitalized patients: results from the Harvard Medical Practice Study. Perspect Healthc Risk Manage 11(2), 2–8 (1991)

    Article  Google Scholar 

  13. Brennan, T.A., Leape, L.L., Laird, N.M., Hebert, L., Localio, A.R., Lawthers, A.G., et al.: Incidence of adverse events and negligence in hospitalized patients. Results of the Harvard Medical Practice Study I. N Engl. J. Med. 324(6), 370–376 (1991)

    Google Scholar 

  14. Cimino, J.J.: From data to knowledge through concept-oriented terminologies: experience with the Medical Entities Dictionary. J. Am. Med. Inform. Assoc. 7(3), 288–297 (2000)

    Article  Google Scholar 

  15. Committee on Quality of Health Care in America IoM. Crossing the Quality Chasm: A New Health System for the 21st Century. IOM (2001)

    Google Scholar 

  16. Conrad, S.: Schemaintegration – Integrationskonflikte, Lösungsansätze, aktuelle Herausforderungen. Informatik – Forschung und Entwicklung 17(3), 101–111 (2002)

    Article  Google Scholar 

  17. de Clercq, P.A., Blom, J.A., Korsten, H.H., Hasman, A.: Approaches for creating computer-interpretable guidelines that facilitate decision support. Artif. Intell. Med. 31(1), 1–27 (2004)

    Article  Google Scholar 

  18. Dick, R.S., Steen, E.B.: The Computer-Based Patient Record: An Essential Technology for Health Care, 2nd edn. National Academy Press, Washington (1997)

    Google Scholar 

  19. Elmagarmid, A., Rusinkiewicz, M., Sheth, A. (eds.): Management of Heterogeneous and Autonomous Database Systems. Morgan Kaufmann Publishers, San Francisco (1999)

    Google Scholar 

  20. Fayad, M., Johnson, R.: Domain-specific application frameworks frameworks experience by industry. John Wiley, New York (2000)

    Google Scholar 

  21. Forman, B.H., Cimino, J.J., Johnson, S.B., Sengupta, S., Sideli, R., Clayton, P.: Applying a controlled medical terminology to a distributed, production clinical information system. In: Proc. Annu.Symp. Comput. Appl. Med. Care, pp. 421–425 (1995)

    Google Scholar 

  22. Fox, J., Johns, N., Rahmanzadeh, A.: Disseminating medical knowledge: the PROforma approach. Artif. Intell. Med. 14(1-2), 157–181 (1998)

    Article  Google Scholar 

  23. Gross, P.A., Greenfield, S., Cretin, S., Ferguson, J., Grimshaw, J., Grol, R., et al.: Optimal methods for guideline implementation: conclusions from Leeds Castle meeting. Med. Care 39 (8 Suppl. 2), II85–II92 (2001)

    Google Scholar 

  24. Haux, R., Ammenwerth, E., Herzog, W., Knaup, P.: Gesundheitsversorgung in der Informationsgesellschaft – eine Prognose für das Jahr 2013. Informatik – Biometrie und Epidemiologie in Medizin und Biologie 35(3), 138–163 (2004)

    Google Scholar 

  25. Härder, T.: Realisierung von operationalen Schnittstellen. In: Lockemann, P.C., Schmidt, J.W. (eds.) Datenbank-Handbuch, Springer, Berlin (1987)

    Google Scholar 

  26. Härder, T., Hergula, K.: Ankopplung heterogener Anwendungssysteme an Föderierte Datenbanksysteme durch Funktionsintegration. Informatik – Forschung und Entwicklung 17(3), 135–148 (2002)

    Article  Google Scholar 

  27. Heiler, S.: Semantic Interoperability. ACM Computing Surveys 27(2), 271–273 (1995)

    Article  Google Scholar 

  28. Huff, S.M., Bidgood Jr., W.D., Cimino, J.J., Hammond, W.E.: A proposal for incorporating Health level seven (HL7) vocabulary in the UMLS Metathesaurus. In: Proc. Amia. Symp., pp. 800–804 (1998)

    Google Scholar 

  29. ID GmbH. ID MACS – Das semantische Netz. 2004. Berlin, ID – Gesellschaft für Information und Dokumentation im Gesundheitswesen mbH, http://www.id-berlin.de/deu/_2produkte/macs.php

  30. Jenders, R.A., Hripcsak, G., Sideli, R.V., DuMouchel, W., Zhang, H., Cimino, J.J., et al.: Medical decision support: experience with implementing the Arden Syntax at the Columbia-Presbyterian Medical Center. In: Proc. Annu. Symp. Comput. Appl. Med. Care, pp. 169–173 (1995)

    Google Scholar 

  31. Kim, W., Seo, J.: Classifying Schematic and Data Heterogeneity in Multidatabase Systems. IEEE Computer 24(12), 12–18 (1991)

    Google Scholar 

  32. Kohn, L.T., Corrigan, J.M., Donaldson, M.: To Err Is Human. Building a Safer Health System. National Academy Press, Washington (2000)

    Google Scholar 

  33. Lenz, R., Huff, S., Geissbühler, A.: Report of conference track 2: pathways to open architectures. Int. J. Med. Inf. 69(2-3), 297–299 (2003)

    Article  Google Scholar 

  34. Lenz, R., Kuhn, K.A.: Towards a Continuous Evolution and Adaptation of Information Systems in Healthcare. Int. J. Med. Inf. 73(1), 75–89 (2004)

    Article  Google Scholar 

  35. Lenz, R., Kuhn, K.A.: Intranet meets hospital information systems: the solution to the integration problem? Methods Inf. Med. 40(2), 99–105 (2001)

    Google Scholar 

  36. Luftman, J.N., Papp, R., Brier, T.: Enablers and Inhibitors of Business-IT Alignment. Communications of the Association for Information Systems 1(11) (1999)

    Google Scholar 

  37. Lenz, R., Kuhn, K.A.: Zur Architektur und Evolution von Krankenhausinformationssystemen. In: Dittrich, K., König, W., Oberweis, A., Rannenberg, K., Wahlster, W. (eds.) Informatik 2003 – Innovative Informatikanwendungen, Beiträge der 33.Jahrestagung der Gesellschaft für Informatik e.V(GI), 2nd edn. pp. 435–444 (2003)

    Google Scholar 

  38. Maviglia, S.M., Zielstorff, R.D., Paterno, M., Teich, J.M., Bates, D.W., Kuperman, G.J.: Automating complex guidelines for chronic disease: lessons learned. J. Am. Med. Inform Assoc. 10(2), 154–165 (2003)

    Article  Google Scholar 

  39. McDonald, C.J., Hui, S.L., Smith, D.M., Tierney, W.M., Cohen, S.J., Weinberger, M., et al.: Reminders to physicians from an introspective computer medical record. A two-year randomized trial. Ann. Intern. Med. 100(1), 130–138 (1984)

    Google Scholar 

  40. Musen, M., Shahar, Y., Shortliffe, E.H.: Clinical decision support systems. In: Shortliffe, E.H., Perreault, L.E., Wiederhold, G., Fagan, L.M. (eds.), pp. 573–609. Springer, New York (2000)

    Google Scholar 

  41. Musen, M.A.: Domain ontologies in software engineering: use of Protege with the EON architecture. Methods Inf. Med. 37(4-5), 540–550 (1998)

    Google Scholar 

  42. Ohno-Machado, L., Gennari, J.H., Murphy, S.N., Jain, N.L., Tu, S.W., Oliver, D.E., et al.: The guideline interchange format: a model for representing guidelines. J. Am. Med. Inform. Assoc. 5(4), 357–372 (1998)

    Article  Google Scholar 

  43. Patel, N.: Adaptive Evolutionary Information Systems. Idea Group Publishing, London (2003)

    Google Scholar 

  44. Peleg, M., Boxwala, A.A., Ogunyemi, O., Zeng, Q., Tu, S., Lacson, R., et al.: GLIF3: the evolution of a guideline representation format. In: Proc. Amia. Symp. pp. 645–649 (2000)

    Google Scholar 

  45. Peleg, M., Tu, S., Bury, J., Ciccarese, P., Fox, J., Greenes, R.A., et al.: Comparing computer-interpretable guideline models: a case-study approach. J. Am. Med. Inform. Assoc. 10(1), 52–68 (2003)

    Article  Google Scholar 

  46. Pille, B.T., Antczak, R.K.: Application Integration. In: Ball, M.J., Douglas, J.V. (eds.) Performance Improvement Through Information Management, pp. 144–152. Springer, New York (1999)

    Google Scholar 

  47. Pryor, T.A., Hripcsak, G.: Sharing MLM’s: an experiment between Columbia-Presbyterian and LDS Hospital. In: Proc. Annu. Symp. Comput. Appl. Med. Care, pp. 399–403 (1993)

    Google Scholar 

  48. Rahm, E., Bernstein, P.A.: A survey of approaches to automatic schema matching. The VLDB Journal 10(4), 334–350 (2001)

    Article  MATH  Google Scholar 

  49. Rector, A.L., Nowlan, W.A.: The GALEN project. Comput Methods Programs Biomed. 45(1-2), 75–78 (1994)

    Article  Google Scholar 

  50. Rector, A.L., Nowlan, W.A., Glowinski, A.: Goals for concept representation in the GALEN project. In: Proc. Annu. Symp. Comput. Appl. Med. Care, pp. 414–418 (1993)

    Google Scholar 

  51. Rocha, R.A., Huff, S.M.: Coupling vocabularies and data structures: lessons from LOINC. In: Proc. AMIA. Annu. Fall. Symp.pp. 90–94 (1996)

    Google Scholar 

  52. Schriefer, J.: The synergy of pathways and algorithms: two tools work better than one. Jt. Comm. J. Qual. Improv. 20(9), 485–499 (1994)

    Google Scholar 

  53. Seliger, R.: Overview of HL7’s CCOW Standard, Health Level Seven, Inc. (2001), http://www.hl7.org/library/committees/sigvi/ccow_overview_2001.doc

  54. Sheth, A., Larsen, J.: Federated Database Systems for Managing Distributed, Heterogeneous, and Autonomous Databases. ACM Computing Surveys 22(3), 183–235 (1990)

    Article  Google Scholar 

  55. Shiffman, R.N., Liaw, Y., Brandt, C.A., Corb, G.J.: Computer-based guideline implementation systems: a systematic review of functionality and effectiveness. J. Am. Med. Inform. Assoc. 6(2), 104–114 (1999)

    Article  Google Scholar 

  56. Shiffman, R.N., Michel, G., Essaihi, A., Thornquist, E.: Bridging the guideline implementation gap: a systematic, document-centered approach to guideline implementation. J. Am. Med. Inform. Assoc. 11(5), 418–426 (2004)

    Article  Google Scholar 

  57. Stonebraker, M.: Integrating islands of information. EAI Journal, 1–5 (September/October1999)

    Google Scholar 

  58. Tan, F.B., Gallupe, R.B.: A framework for research into business-IT alignment: a cognitive emphasis. In: Kangas, K. (ed.) Business strategies for information technology management, pp. 50–73. Idea Group Publishing, Hershey (2003)

    Google Scholar 

  59. Tanenbaum, A.S.: Computer networks, 2nd edn. Prentice-Hall, Englewood Cliffs (1988)

    Google Scholar 

  60. van Bemmel, J.H., Musen, M.A. (eds.): Handbook of Medical Informatics. Springer, Heidelberg (1997)

    Google Scholar 

  61. Vegoda, P.: Introducing the IHE (Integrating the Healthcare Enterprise) concept. J. Healthc. Inf. Manag. 16(1), 22–24 (2002)

    Google Scholar 

  62. Vincent, C., Neale, G., Woloshynowych, M.: Adverse events in British hospitals: preliminary retrospective record review. BMJ 322(7285), 517–519 (2001)

    Article  Google Scholar 

  63. Weed, L.L.: Medical records that guide and teach. The New England Journal of Medicine 278(12), 652–657 (1968)

    Article  Google Scholar 

  64. Wilson, R.M., Harrison, B.T., Gibberd, R.W., Hamilton, J.D.: An analysis of the causes of adverse events from the Quality in Australian Health Care Study. Med. J. Aust. 170(9), 411–415 (1999)

    Google Scholar 

  65. Wilson, R.M., Runciman, W.B., Gibberd, R.W., Harrison, B.T., Newby, L., Hamilton, J.D.: The Quality in Australian Health Care Study. Med. J. Aust. 163(9), 458–471 (1995)

    Google Scholar 

  66. Wingert, F.: SNOMED-Manual. Springer, Heidelberg (1984)

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2005 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Lenz, R. (2005). Information Management in Distributed Healthcare Networks. In: Härder, T., Lehner, W. (eds) Data Management in a Connected World. Lecture Notes in Computer Science, vol 3551. Springer, Berlin, Heidelberg. https://doi.org/10.1007/11499923_17

Download citation

  • DOI: https://doi.org/10.1007/11499923_17

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-26295-4

  • Online ISBN: 978-3-540-31654-1

  • eBook Packages: Computer ScienceComputer Science (R0)

Publish with us

Policies and ethics