A Three-Level Graph-Based Model for the Management of Hospital Information Systems

Abstract:

Information processing in hospitals, especially in university hospitals, is currently faced with two major issues: low-cost hardware and progress in networking technology leads to a further decentralization of computing capacity, due to the increasing need for information processing in hospitals and due to economic restrictions, it is necessary to use, commercial software products. This leads to heterogeneous hospital information systems using a variety of software and hardware products, and to a stronger demand for integrating these products and, in general, for a dedicated methodology for the management of hospital information systems to support patient care and medical research. We present a three-level graph-based model (3LGM) to support the systematic management of hospital information systems. 3LGM can serve as a basis for assessing the quality of information processing in hospitals. 3LGM distinguishes between a procedural level for describing the information procedures (and their information interchange) of a hospital information system and thus its functionality, a logical tool level, focusing on application systems and communication links, and a physical tool level with physical subsystems (e.g., computer systems) and data transmission. The examples that are presented have been taken from the Heidelberg University Hospital Information System.

Keywords:

Hospital Information Systems - Management of Hospital Information Systems - Quality Assessment - Heterogeneous Information Systems - Cooperative Information Systems

• References

• 1 Bakker AR, Ehlers CT, Bryant JR, Hammond WE. eds. Hospital information systems: scope – design – architecture. Amsterdam: North Holland; 1992
• 2 Ehlers CT. Aufgaben und Bedeutung eines Krankenhausinformationssystems. Informatik, Biometrie und Epidemiologie in Medizin und Biologie 1994; 25: 106-14.
• 3 Reichertz PL. Information systems – past, present, future. Keynote address, Medical Informatics Europe 84. Brussels: Medical School Hanover, Department of Medical Informatics; 1984
• 4 Van Mulligen EM, Timmers T, van den Heuvel F, van Bemmel JH. A Prototype integrated medical workstation environment. Comput Methods Programs Biomed 1993; 39: 333-41.
• 5 Lagemann A, Grothe W, Haux R, Pilz J, Sawinski R, Werner R, Winter A. Konzeption und Realisierung eines medizinischen Arbeitsplatzsystems. In: Pöppi SJ, Lipinski H-G, Mansky T. eds. Medizinische Informatik, ein integrierender Teil arzunterstützender Technologien. Munic: MMV Medizin; 1994: 120-3.
• 6 Ball MJ, Silva JS, Douglas JV, Degoulet P, Kaihara S. eds. The Health care professional workstation. Special issue of Int J Biomed Comp 1994; 34: 1-416.
• 7 Jydstrup RA, Gross MJ. Cost of information handling in hospitals. Health Services Res 1966; 1: 235-71.
• 8 van Bemmel JH. An International perspective on information management and technology in health care. Keynote lecture at the Conference on Clinical Information 1993. London: Erasmus University of Rotterdam, Department of Medical Informatics; 1993
• 9 Bakker AR. An integrated hospital information system in The Netherlands. MD Computing 1990; 7: 91-7.
• 10 Lun KC, Degoulet P, Piemrne T, Rienhoff O. eds. MEDINFO 92 – Proceedings of the Seventh World Congress on Medical Informatics. Amsterdam: North Holland; 1992
• 11 Brodie ML, Ceri S. On intelligent and cooperative information systems: A workshop summary. Int J Intell Coop Inform Systems 1992; 1: 249-89.
• 12 Standards in Medical Informatics. Proceedings of the Conference held on January 29, 1993 at the Institution of Civil Engineers, London, SW1. London: Europ. Conf. Ltd.; 1993
• 13 Schultz S, Abraham I. HL7: An emerging standard for health information systems. In: Barber B, Cao D, Qin D, Wagner G. eds. MEDINFO 89 – Proceedings of the Sixth World Congress on Medical Informatics. Amsterdam: North-Holland; 1989: 1032-5.
• 14 Health Industry Level 7 Interface Standards Version 2.1. Ann Arbor, MI: Health Level Seven, Inc.; 1991
• 15 Santucci G, Asbjorn Jensen O, Bach EF. et al. Rationale for a community strategy in the field of information and communications technologies applied to health care. Meth Inform Med 1990; 29: 84-91.
• 16 Leguit FA. Interfacing integration. In: Bakker AR, Ehlers CT, Bryant JR, Hammond WE. eds. Hospital Information Systems: Scope – Design – Architecture. Amsterdam: North Holland; 1992: 141-8.
• 17 Münz J, Dvorák M, Gotfryd O, Volejnícek O. Decomposition and modularity of hospital information systems. In: Barber B, Cao D, Qin D, Wagner G. eds. MEDINFO 89-Proceedings of the Sixth World Congress on Medical Informatics. Amsterdam: North-Holland; 1989: 364-7.
• 18 Yamamoto K, Sudo M, Masukawa J, Fujie A, Hisae T. Network and integration in Fukui medical school information system. In: Barber B, Cao D, Qin D, Wagner G. eds. MEDINFO 89 – Proceedings of the Sixth World Congress on Medical Informatics. Amsterdam: North-Holland; 1989: 330-3.
• 19 Ferstl OK, Sinz EJ. Grundlagen der Wirtsclzaftsinformatik. Vol. I. Munic: Oldenbourg; 1993
• 20 Haux R. ed. Rahmenkonzept für den rechnerunterstützten Teil des Heidelberger Klinikuminformationssystems. University of Heidelberg, Department of Medical Informatics; 1992
• 21 Winter A, Haux R, Schleisiek KP. Systematic development of a hospital information system with distributed data- and methodbase systems: the AACHMED project. In: Roger FH, Grünroos T, Tervo-Pellika R, O’ Moore R. eds. Medical Informatics Europe 85. Berlin: Springer; 1985: 487-91.
• 22 Winter A, Emser K, Haux R, Raab F, Repges R, Schleisiek KP, Stoll U, Valder Ch. Entwurf und Implementierung einer zentralen Auskunfiskomponente eines Krankenhausinformationssystems. In: Ehlers CT, Beland H. eds. Perspektiven der Informationsverarbeitung in der Medizin – Kritische Synopse der Nwzung der Informatik in der Medizin. Berlin: Springer; 1986: 299-302.
• 23 Winter A, Janßen H, Haux R, Glück E, Wiederspohn J. Zur verteilten Datenverarbeitung bei heterogenen Subsystemen am Beispiel des Heidelberger Klinikuminformationssystems. In: Reuter A. ed. GI – 20. Jahrestagung, Vol 2. Berlin: Springer; 1990: 232-41.
• 24 Winter A. Die Verwaltung verteilter Datenbestände in einem Klinikuminformationssystem auf der Basis eines unirelationalen Informationssystemmodels. Doctoral thesis University of Heidelberg, Faculty of Theoretical Medicine; 1990
• 25 Gerneth F, Haux R, Selbmann HK. On research subsystems and their integration in the computer-supported part of hospital information systems. Med Inform 1991; 16: 77-95.
• 26 Janßen H. Die rechnerunterstützte Befundübermittlung in der Medizin. Doctoral thesis University of Heidelberg, Faculty of Theoretical Medicine; 1992
• 27 Haux R, Winter A. Medizinische Informatik im Krankenhaus. Quintessenzen in der Medizin 1993; 1: 507-23.
• 28 Winter A. Beschreibung, Bewertung und Planung heterogener Krankenhausinformationssysteme. Habilitation thesis University of Heidelberg, Faculty of Theoretical Medicine; 1994
• 29 ISO/IEC 2382-1. 1993. Information technology – Vocabulary. Part 1: Fundamental Terms. Geneva: ISO/IEC;
• 30 De Marco T. Structured Analysis and System Specification. Englewood Cliffs: Yourdon; 1979
• 31 Gane C, Sarson T. Structured Systems Analysis: Tools and Techniques. Prentice Hall; 1979
• 32 Sølvberg A, Kung DC. Information Systems Engineering. Berlin: Springer; 1993
• 33 Berge C. Graphs and Hypergraphs. Amsterdam: North Holland; 1985
• 34 Scheer AW. Architektur integrierter Informationssysteme. Berlin: Springer; 1991
• 35 Geihs K. Infrastrukturen für heterogene verteilte Systeme. Informatik Spektrum 1993; 16: 11-23.
• 36 Bryant JR. Towards a HIS Reference Structure. In: Bakker AR, Ehlers CT, Bryant JR, Hammond WE. eds. Hospital Information Systems: Scope – Design – Architecture. Amsterdam: North Holland; 1992: 125-32.
• 37 Peterson HE, Isaksson AI. eds. Communication Networks in Health Care. Amsterdam: North Holland; 1982