Abstract
Grassroots healthcare institutions (GHIs) are the smallest administrative levels of medical institutions, where most patients access health services. The latest report from the National Bureau of Statistics of China showed that 96.04 % of 950,297 medical institutions in China were at the grassroots level in 2012, including county-level hospitals, township central hospitals, community health service centers, and rural clinics. In developing countries, these institutions are facing challenges involving a shortage of funds and talent, inconsistent medical standards, inefficient information sharing, and difficulties in management during the adoption of health information technologies (HIT). Because of the necessity and gravity for GHIs, our aim is to provide hospital information services for GHIs using Cloud computing technologies and service modes. In this medical scenario, the computing resources are pooled by means of a Cloud-based Virtual Desktop Infrastructure (VDI) to serve multiple GHIs, with different hospital information systems dynamically assigned and reassigned according to demand. This paper is concerned with establishing a Cloud-based Hospital Information Service Center to provide hospital information software as a service (HI-SaaS) with the aim of providing GHIs with an attractive and high-performance medical information service. Compared with individually establishing all hospital information systems, this approach is more cost-effective and affordable for GHIs and does not compromise HIT performance.






Similar content being viewed by others
References
National Bureau of Statistics of China (2013) China Statistical Yearbook-2013. http://www.stats.gov.cn/tjsj/ndsj/2013/indexeh.htm
Classen, D. C., and Bates, D. W., Finding the meaning in meaningful use. New England Journal of Medicine 365(9):855–858, 2011.
Bowes III WA Assessing readiness for meeting meaningful use: identifying electronic health record functionality and measuring levels of adoption. In: AMIA Annual Symposium Proceedings, 2010. American Medical Informatics Association, p 66
Williams F, Boren SA (2008) The role of electronic medical record in care delivery in developing countries. International Journal of Information Management 28 (6):503–507. doi:http://dx.doi.org/10.1016/j.ijinfomgt.2008.01.016
Blumenthal, D., Stimulating the adoption of health information technology. New England Journal of Medicine 360(15):1477–1479, 2009.
Goldzweig, C. L., Towfigh, A., Maglione, M., and Shekelle, P. G., Costs and benefits of health information technology: new trends from the literature. Health Affairs 28(2):w282–w293, 2009.
Buntin, M. B., Burke, M. F., Hoaglin, M. C., and Blumenthal, D., The benefits of health information technology: a review of the recent literature shows predominantly positive results. Health Affairs 30(3):464–471, 2011.
Li, J.-S., Zhang, X.-G., Wang, H.-Q., Wang, Y., Wang, J.-M., and Shao, Q.-D., The Meaningful Use of EMR in Chinese Hospitals: A Case Study on Curbing Antibiotic Abuse. Journal of medical systems 37(2):1–10, 2013.
Zhang, N. J., Seblega, B., Wan, T., Unruh, L., Agiro, A., and Miao, L., Health Information Technology Adoption in US Acute Care Hospitals. Journal of medical systems 37(2):1–9, 2013.
Payne, T. H., Bates, D. W., Berner, E. S., Bernstam, E. V., Covvey, H. D., Frisse, M. E., Graf, T., Greenes, R. A., Hoffer, E. P., and Kuperman, G., Healthcare information technology and economics. Journal of the American Medical Informatics Association 20(2):212–217, 2013.
Poon, E. G., Jha, A. K., Christino, M., Honour, M. M., Fernandopulle, R., Middleton, B., Newhouse, J., Leape, L., Bates, D. W., and Blumenthal, D., Assessing the level of healthcare information technology adoption in the United States: a snapshot. BMC Medical Informatics and Decision Making 6(1):1, 2006.
Miller, R. H., and Sim, I., Physicians’ use of electronic medical records: barriers and solutions. Health affairs 23(2):116–126, 2004.
Lin, C., Lin, I.-C., and Roan, J., Barriers to physicians’ adoption of healthcare information technology: an empirical Study on multiple hospitals. Journal of medical systems 36(3):1965–1977, 2012.
14. VMware (2006) VMware Infrastructure 3 VDI Server Sizing and Scaling. http://www.vmware.com/pdf/vdi_sizing_vi3.pdf
Kuo AM-H (2011) Opportunities and challenges of cloud computing to improve health care services. Journal of medical Internet research 13 (3)
Rosenthal, A., Mork, P., Li, M. H., Stanford, J., Koester, D., and Reynolds, P., Cloud computing: A new business paradigm for biomedical information sharing. Journal of Biomedical Informatics 43(2):342–353, 2010.
VMware Success Story (2007) Huntsville Hospital. http://www.vmware.com/files/pdf/customers/07Q3_HuntsvilleHospital_Health_SS_1pgr_R3.pdf
Yoo, S., Kim, S., Kim, T., Kim, J. S., Baek, R.-M., Suh, C. S., Chung, C. Y., and Hwang, H., Implementation Issues of Virtual Desktop Infrastructure and Its Case Study for a Physician’s Round at Seoul National University Bundang Hospital. Healthcare informatics research 18(4):259–565, 2012.
Yoo, S., Kim, S., Kim, T., Baek, R.-M., Suh, C. S., Chung, C. Y., and Hwang, H., Economic analysis of cloud-based desktop virtualization implementation at a hospital. BMC medical informatics and decision making 12(1):119, 2012.
Mell, P., and Grance, T., The NIST definition of cloud computing (draft). NIST special publication 800(145):7, 2011.
IHE (2012) Integrating the Healthcare Enterprise Profiles. http://www.ihe.net/Profiles/
Ge, Y., Ahn, D. K., Unde, B., Gage, H. D., and Carr, J. J., Patient-controlled sharing of medical imaging data across unaffiliated healthcare organizations. Journal of the American Medical Informatics Association 20(1):157–163, 2013.
Karthikeyan, N., and Sukanesh, R., Cloud Based Emergency Health Care Information Service in India. Journal of medical systems 36(6):4031–4036, 2012.
Silva, L. A. B., Costa, C., and Oliveira, J. L., A PACS archive architecture supported on cloud services. International journal of computer assisted radiology and surgery 7(3):349–358, 2012.
Regola N, Chawla NV (2013) Storing and Using Health Data in a Virtual Private Cloud. Journal of medical Internet research 15 (3)
Poulymenopoulou, M., Malamateniou, F., and Vassilacopoulos, G., Emergency healthcare process automation using mobile computing and cloud services. Journal of medical systems 36(5):3233–3241, 2012.
Fernández-Cardeñosa, G., de la Torre-Díez, I., López-Coronado, M., and Rodrigues, J. J., Analysis of cloud-based solutions on EHRs systems in different scenarios. Journal of medical systems 36(6):3777–3782, 2012.
Lipsitz, J, Hughes L (2008) Total Economic ImpactTM Of VMware Virtual Desktop Infrastructure – Healthcare Industry. Forrester Consulting
Tan, C.-H., and Teh, Y.-W., Synthetic Hardware Performance Analysis in Virtualized Cloud Environment for Healthcare Organization. Journal of Medical Systems 37(4):1–13, 2013. doi:10.1007/s10916-013-9950-7.
Siddiqui Z, Abdullah AH, Khan MK, Alghamdi AS (2014) Smart Environment as a Service: Three Factor Cloud Based User Authentication for Telecare Medical Information System. Journal Of Medical Systems 38 (1). doi:10.1007/s10916-013-9997-5
Acknowledgments
This work was supported by the National Natural Science Foundation (Grant No. 61173127), National High-tech R&D Program (No. 2013AA041201), and the Zhejiang University Top Disciplinary Partnership Program.
Author information
Authors and Affiliations
Corresponding author
Additional information
This article is part of the Topical Collection on Systems-Level Quality Improvement
Rights and permissions
About this article
Cite this article
Yao, Q., Han, X., Ma, XK. et al. Cloud-Based Hospital Information System as a Service for Grassroots Healthcare Institutions. J Med Syst 38, 104 (2014). https://doi.org/10.1007/s10916-014-0104-3
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s10916-014-0104-3