Cross-organizational healthcare process automation using a service-oriented approach

Mikaela Poulymenopoulou
University of Piraeus

Topic: Clinical Informatics
Track: Practice
Type: Oral presentation

     Full text: Not available
     Last modified: September 25, 2006
     Presentation date: 10/16/2006 12:00 PM in RYH Tudor 8
     (View Schedule)

Abstract
With the advent of shared and integrated care, in which care processes are designed around patient needs, cooperation, collaboration and data exchange among disparate healthcare organizations have become particularly important and the need to develop process-oriented healthcare information systems that support cross-organizational healthcare processes has received considerable attention. However, when it is required to preserve existing investments on information systems and resources, the real challenge is to create a process-oriented healthcare system architecture that encompasses existing systems while it promotes inter-organizational cooperation through the logistics principle of information that requires the availability of the right information, at the right time, at the right location, in the needed quality and in an appropriately detailed form [2,6].

Process automation with the use of web services has recently started to receive considerable attention in the healthcare field, with regard to both intra- and inter-organizational healthcare processes, especially when heterogeneous systems that have to be retained are involved. Web services can be viewed as a programming paradigm for integrating heterogeneous applications and for extracting and integrating data from heterogeneous information systems. They are self contained and self described modular applications which can be published, found and used on the web. In automating inter-organizational healthcare processes, where at least two organizations are involved, web services and web services compositions can provide an ideal platform that enables easy integration of possibly heterogeneous applications of the participating organizations, that enhances and empowers collaboration and coordination between them and that enables patient information retrieval from possibly heterogeneous information resources of the participating organizations [1,2,4]. As regards patient information integration and exchange among process participants, some important considerations involve the use of appropriate clinical information standards (e.g. CDA) for structuring patient information, the use of standard terminology systems (ICD, LOINC, SNOMED) for coding patient information and the use of appropriate informatics standards (e.g. SOAP messages) for exchanging this integrated patient information [5]. In addition, as concerns security, authorization and authentication services should be considered in order to control process activities executions, web services invocations and accesses to patient information [3].

In this article, two approaches are presented for cross-organizational healthcare processes integration and automation and for facilitating integrated patient information to process participants. The first approach is most applicable in cases where the development of a new integrated healthcare information system is preferable. This approach proposes the development of a service-oriented information system with the use of workflow technology along with web services. The second approach is most applicable in cases where the organizations existing healthcare information systems should be retained, evolved and interconnected. This approach proposes the use of a loosely coupled architecture with the use of web services and their compositions as a means for interconnecting existing information systems. According to these approaches, two healthcare information systems have been implemented in the field of emergency healthcare in order to support and automate inter-organizational emergency healthcare processes executed in two Athens health districts, accordingly.

References

[1] Anzbock R. and Dustdar S., Modeling and implementing medical web services. Data and Knowledge Engineering, In Press, 2005.
[2] Beyer M., Uhn K. A., Meiler C., Jablonski S. and Lenz R., Towards a flexible, process-oriented IT architecture for an integrated healthcare network. ACM Symposium on Applied Computing, Nicosia, Cyprus, 264-271, 2004.
[3] Beznosov K., Flinn D., Kawamoto S. and Hartman B., Introduction to web services and their security. Information Security Technical Report, 10, 2-14, 2005.
[4] Dogac A., Laleci G., Kirbas S., Kabak Y., Sinir S., Yildiz A. and Gurcan Y., Artemis: Deploying semantically enriched web services in the healthcare domain. Information Systems Journal, In Press, 2005.
[5] Muller M., Uckert F., Burkle T. and Prokosch H., Cross-institutional data exchange using the clinical document architecture (CDA). International Journal of Medical Informatics, 74(2-4), 245-256, 2005.
[6] Poulymenopoulou M., Malamateniou F. and Vassilacopoulos G., Emergency healthcare process automation using workflow technology and web services. Medical Informatics and the Internet in Medicine, 28(3), 195-207, 2003.