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Methods Inf Med 2009; 48(06): 531-539
DOI: 10.3414/ME09-01-0023
Original Articles
Schattauer GmbH

Comparing a Japanese and a German Hospital Information System

Assessing Structural Quality by 3LGM2 Models
F. Jahn
1   Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
,
L. Ißler
2   Systemantics Gmb H, Aachen, Germany
,
A. Winter
1   Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
,
K. Takabayashi
3   Department of Medical Informatics and Management, Chiba University Hospital, Chiba, Japan
› Institutsangaben
Weitere Informationen

Publikationsverlauf

received: 25. März 2009

accepted: 07. Mai 2009

Publikationsdatum:
17. Januar 2018 (online)

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Summary

Objectives: To examine the architectural differences and similarities of a Japanese and German hospital information system (HIS) in a case study. This cross-cultural comparison, which focuses on structural quality characteristics, offers the chance to get new insights into different HIS architectures, which possibly cannot be obtained by inner-country comparisons.

Methods: A reference model for the domain layer of hospital information systems containing the typical enterprise functions of a hospital provides the basis of comparison for the two different hospital information systems. 3LGM2 models, which describe the two HISs and which are based on that reference model, are used to assess several structural quality criteria. Four of these criteria are introduced in detail.

Results: The two examined HISs are different in terms of the four structural quality criteria examined. Whereas the centralized architecture of the hospital information system at Chiba University Hospital causes only few functional redundancies and leads to a low implementation of communication standards, the hospital information system at the University Hospital of Leipzig, having a decentralized architecture, exhibits more functional redundancies and a higher use of communication standards.

Conclusions: Using a model-based comparison, it was possible to detect remarkable differences between the observed hospital information systems of completely different cultural areas. However, the usability of 3LGM2 models for comparisons has to be improved in order to apply key figures and to assess or benchmark the structural quality of health information systems architectures more thoroughly.

Keywords

Hospital information systems - health information systems - comparison - architectural models - structural quality
 

  • References

  • 1 Wyatt JC, Spiegelhalter D. Evaluating medical expert systems: what to test and how?. Medical Informatics 1990; 15 (03) 205-217.
    CrossrefPubMedSuche in Google Scholar
  • 2 Friedman CP, Owens DK, Wyatt JC. Evaluation and Technology Assessment. In: Shortliffe EH. et al. (eds). Biomedical Informatics Computer Applications in Health Care and Biomedicine. New York: Springer; 2006
    Suche in Google Scholar
  • 3 Winter AF, Ammenwerth E, Bott OJ, Brigl B, Buchauer A, Graeber S. et al. Strategic Information Management Plans: The basis for systematic information management in hospitals. Int J Med Inform 2001; 64 2–3 99-109.
    CrossrefPubMedSuche in Google Scholar
  • 4 Winter A, Brigl B, Wendt T. Modeling Hospital Information Systems (Part 1): The Revised Three-layer Graph-based Meta Model 3LGM2;. Methods Inf Med 2003; 5: 544-551.
    Thieme ConnectPubMedSuche in Google Scholar
  • 5 Blobel B. Educational Challenge of Health Information Systems’ Interoperability. Methods Inf Med 2007; 46: 52-56.
    Thieme ConnectPubMedSuche in Google Scholar
  • 6 Wendt T, Haeber A, Brigl B, Winter A. Modeling Hospital Information Systems (Part 2): Using the 3LGM2; Tool for Modeling Patient Record Management. Methods Inf Med 2004; 3: 256-267.
    Thieme ConnectPubMedSuche in Google Scholar
  • 7 Staemmler M. Modeling a health telematics network: does the 3LGM2 approach assist in its management and operation?. Stud Health Technol Inform 2006; 124: 691-696.
    PubMedSuche in Google Scholar
  • 8 Burke DE, Wang BBL, Wan TTH, Diana ML. Exploring Hospitals’ Adoption of Information Technology. Journal of Medical Systems 2002; 26 (04) 349-355.
    CrossrefPubMedSuche in Google Scholar
  • 9 Haux R, Winter A, Ammenwerth E, Brigl B. Strategic Information Management in Hospitals. An Introduction to Hospital Information Systems. New York: Springer-Verlag; 2004
    Suche in Google Scholar
  • 10 Van Den Bosch B, Bellon E, De Deurwaerder A, Vanautgaerden M, Bangels M. Recommendations and quality criteria for hospital information systems. Federal Public Service of Belgium, Health, Food Chain Safety and Environment, 2002 https://portal.health.fgov.be/pls/portal/docs/PAGE/INTERNET_PG/HOMEPAGE_MENU/GEZONDHEIDZORG1_MENU/AUTOMATSER ING1_MENU/HOPITAUX1_MENU/HOPTAUX1_DOCS/HIS_V1S_EN.PDF last access on 2009-03-17.
    PubMedSuche in Google Scholar
  • 11 Hasselbring W. Information System Integration. Communications of the ACM 2000; 43 (06) 33-38.
    PubMedSuche in Google Scholar
  • 12 Winter A, Brigl B, Haux R, Ißler L, Strübing A. Ontology-Based Assessment of Functional Redundancy in Health Information Systems. In: MoDELS 2008 satellite proceedings. Berlin/Heidelberg: Springer; 2009. In print.
    Suche in Google Scholar
  • 13 Brigl B, Huebner-Bloder G, Wendt T, Haux R, Winter A. Architectural Quality Criteria for Hospital Information Systems. AMIA 2005 Symposium Proceedings; 2005 pp 81-85.
    PubMedSuche in Google Scholar
  • 14 Karp RM. Reducibility Among Combinatorial Problems. In: Miller RE, Thatcher JW. editors. Complexity of Computer Computations. New York: Plenum; 1972. pp 85-103.
    CrossrefSuche in Google Scholar
  • 15 Huebner-Bloder G, Ammenwerth E, Winter A, Brigl B. Specification of a Reference Model for the Domain Layer of Hospital Information Systems. Connecting Medical Informatics and Bio-Informatics; 2005 pp 497-502.
    PubMedSuche in Google Scholar
  • 16 Ammenwerth E, Buchauer A, Haux R. A Requirements Index for Information Processing in Hospitals. Methods Inf Med 2002; 41 (04) 282-288.
    Thieme ConnectPubMedSuche in Google Scholar
  • 17 Harmon SY. Evaluating and comparing information systems. IEEE International Conference on Systems, Man, and Cybernetics 1998; 1: 1009-1014.
    PubMedSuche in Google Scholar
  • 18 Spewak SH, Hill SC. Enterprise Architecture Planning. New York: John Wiley & Sons; 1992
    Suche in Google Scholar
  • 19 Takabayashi K. From Marco Polo Islands. Methods Inf Med 2007; 46 (06) 669-670.
    Thieme ConnectPubMedSuche in Google Scholar
  • 20 Tellis WM, Andriole KP. Finding the optimal picture archiving and communication system (PACS) architecture: a comparison of three PACS designs. J Digit Imaging. 2001; 14 2 Suppl 1 72-76.
    PubMedSuche in Google Scholar
  • 21 Jaana M, Ward MM, Paré G, Wakefield DS. Clinical information technology in hospitals: A comparison between the state of Iowa and two provinces in Canada. Int J Med Inform 2005; 74: 719-731.
    CrossrefPubMedSuche in Google Scholar
  • 22 Jha AK, Doolan D, Grandt D, Scott T, Bates DW. The use of health information technology in seven nations. Int J Med Inform 2008; 77 (12) 848-854.
    CrossrefPubMedSuche in Google Scholar
  • 23 Clayton PD, Narus SP, Huff S, Pryor TA, Haug PJ, Larkin T, Matney S, Evans RS, Rocha BH, Bowes WA, Halston ET, Gundersen ML. Building a comprehensive clinical information system from components The approach at Intermountain Health Care. Methods Inf Med 2003; 1 (42) 1-7.
    PubMedSuche in Google Scholar
  • 24 Ißler L. Informationsverarbeitung im Informationsmanagement. Dissertation, University of Leipzig; 2008. – Available only in German.
    Suche in Google Scholar
  • 25 Ammenwerth E, Ehlers F, Hirsch B, Gratl G. HIS-Monitor: An approach to assess the quality of information processing in hospitals. Int J Med Inform 2007; 76: 216-225.
    CrossrefPubMedSuche in Google Scholar