E-health and healthcare enterprise information system leveraging service-oriented architecture.
ABSTRACT To present the successful experiences of an integrated, collaborative, distributed, large-scale enterprise healthcare information system over a wired and wireless infrastructure in National Taiwan University Hospital (NTUH). In order to smoothly and sequentially transfer from the complex relations among the old (legacy) systems to the new-generation enterprise healthcare information system, we adopted the multitier framework based on service-oriented architecture to integrate the heterogeneous systems as well as to interoperate among many other components and multiple databases. We also present mechanisms of a logical layer reusability approach and data (message) exchange flow via Health Level 7 (HL7) middleware, DICOM standard, and the Integrating the Healthcare Enterprise workflow. The architecture and protocols of the NTUH enterprise healthcare information system, especially in the Inpatient Information System (IIS), are discussed in detail.
The NTUH Inpatient Healthcare Information System is designed and deployed on service-oriented architecture middleware frameworks. The mechanisms of integration as well as interoperability among the components and the multiple databases apply the HL7 standards for data exchanges, which are embedded in XML formats, and Microsoft .NET Web services to integrate heterogeneous platforms.
The preliminary performance of the current operation IIS is evaluated and analyzed to verify the efficiency and effectiveness of the designed architecture; it shows reliability and robustness in the highly demanding traffic environment of NTUH.
The newly developed NTUH IIS provides an open and flexible environment not only to share medical information easily among other branch hospitals, but also to reduce the cost of maintenance. The HL7 message standard is widely adopted to cover all data exchanges in the system. All services are independent modules that enable the system to be deployed and configured to the highest degree of flexibility. Furthermore, we can conclude that the multitier Inpatient Healthcare Information System has been designed successfully and in a collaborative manner, based on the index of performance evaluations, central processing unit, and memory utilizations.
- SourceAvailable from: Frank W RockholdNew England Journal of Medicine 05/2008; 358(16):1738-40. · 51.66 Impact Factor
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ABSTRACT: An electronic medication administration record is at the intersection of several disciplines: medicine, nursing, pharmacy, and allied health; however, it is the centerpiece of nurses' work for medication administration in acute care settings. Despite the crucial nature of the electronic medication administration record, human-computer interaction and health literature are silent about design recommendations and evaluations for such records. This study determined critical on-line medication management tasks for acute care nurses through videotaped, semistructured interviews with nurses and then observations of nurses during medication administration tasks. Subsequently, a novel electronic medication administration record prototype was developed and evaluated. The usability evaluation of this new record was positive based upon scores from the Questionnaire for User Interaction Satisfaction and comments about the display. Mean scores for this questionnaire averaged 7.2 to 7.9 (on a scale of 1-9) or from 80.2% to 87.8%. Accuracy scores were low for tasks requiring nurses to examine data outside the immediate field of view. Specific design recommendations are made to alleviate accuracy errors for specific tasks in acute care settings.CIN Computers Informatics Nursing 01/2007; 25(2):67-75. · 0.82 Impact Factor
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ABSTRACT: Ever since health-care information systems have been implemented, their security is being considered an important issue, especially in the light of the fact that their data are deemed to comprise extremely sensitive information. The prospect of storing health information in electronic form raises concerns about patient privacy and data security. Any attempt to introduce computerised health-care information systems should, therefore, guarantee adequate protection of the confidentiality and integrity of patient information. At the same time, the patient information also needs to be readily available to all authorised health-care providers, in order to ensure the proper treatment of the patient. The principal aim of the present paper is, however, not to make a new contribution to the subject of security per se, but rather to give an overview of current trends in the security aspects of health-care information systems. The final section of the paper will be devoted to a number of proposals for further research possibilities in the domain of health-care information systems security.International Journal of Medical Informatics 05/1999; 54(1):39-54. · 2.06 Impact Factor