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Methods Inf Med 2003; 42(01): 01-07
DOI: 10.1055/s-0038-1634203
Original article
Schattauer GmbH

Building a Comprehensive Clinical Information System from Components

The Approach at Intermountain Health Care
P.D. Clayton
1   Intermountain Health Care, Salt Lake City UT, USA, USA
2   University of Utah, USA
,
S.P. Narus
1   Intermountain Health Care, Salt Lake City UT, USA, USA
2   University of Utah, USA
,
S.M. Huff
1   Intermountain Health Care, Salt Lake City UT, USA, USA
2   University of Utah, USA
,
T.A. Pryor
1   Intermountain Health Care, Salt Lake City UT, USA, USA
2   University of Utah, USA
,
P.J. Haug
1   Intermountain Health Care, Salt Lake City UT, USA, USA
2   University of Utah, USA
,
T. Larkin
1   Intermountain Health Care, Salt Lake City UT, USA, USA
,
S. Matney
1   Intermountain Health Care, Salt Lake City UT, USA, USA
,
R.S. Evans
1   Intermountain Health Care, Salt Lake City UT, USA, USA
2   University of Utah, USA
,
B.H. Rocha
1   Intermountain Health Care, Salt Lake City UT, USA, USA
2   University of Utah, USA
,
W.A. Bowes III
1   Intermountain Health Care, Salt Lake City UT, USA, USA
,
F.T. Holston
1   Intermountain Health Care, Salt Lake City UT, USA, USA
,
M.L. Gundersen
1   Intermountain Health Care, Salt Lake City UT, USA, USA
› Author Affiliations
Further Information

Publication History

Publication Date:
07 February 2018 (online)

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Summary

Objectives: To discuss the advantages and disadvantages of an interfaced approach to clinical information systems architecture.

Methods: After many years of internally building almost all components of a hospital clinical information system (HELP) at Intermountain Health Care, we changed our architectural approach as we chose to encompass ambulatory as well as acute care. We now seek to interface applications from a variety of sources (including some that we build ourselves) to a clinical data repository that contains a longitudinal electronic patient record.

Results: We have a total of 820 instances of interfaces to 51 different applications. We process nearly 2 million transactions per day via our interface engine and feel that the reliability of the approach is acceptable. Interface costs constitute about four percent of our total information systems budget. The clinical database currently contains records for 1.45 m patients and the response time for a query is 0.19sec.

Discussion: Based upon our experience with both integrated (monolithic) and interfaced approaches, we conclude that for those with the expertise and resources to do so, the interfaced approach offers an attractive alternative to systems provided by a single vendor. We expect the advantages of this approach to increase as the costs of interfaces are reduced in the future as standards for vocabulary and messaging become increasingly mature and functional.

Keywords

HELP - IHC - CDR
 

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