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