Heterogeneous Integrations of the Healthcare Information System: An Empirical Study based on SOA and HL7
Date Issued
2010
Date
2010
Author(s)
Yang, Tzu-Hsiang
Abstract
Healthcare information systems (HISs) have become increasingly important over the last two decades. They help physicians, nurses, and administrative staff with their daily operations and workflows in hospitals. Many existing HISs are composed of departmental management systems and heterogeneous systems. In this dissertation, we survey the relevant literature and describe eight issues associated with the implementation of HISs in healthcare: (1) the heterogeneous integration of departmental management systems in the HIS, (2) the specific requirements of departmental management systems, (3) information system architectures, from the local scale to the global scale, (4) the continuously changing issues associated with HISs and environments, (5) the scalability of HIS architectures, (6) the adoption of electronic medical records (EMRs), (7) the performance scalability of HISs, and (8) the next generation of HIS architecture. Based on the issues identified, we propose four goals that a new HIS architecture must achieve: (1) adaptability and scalability, (2) heterogeneous system integration, (3) the adoption of EMRs, (4) high performance and performance scalability.
This dissertation proposes a new service-oriented architecture (SOA) for HISs, which resolves the issues described above and provides a single, uniform, and integrated view of patient information for physicians and nurses and achieves the four goals. The proposed system is based on a SOA and on web services that utilize Health Level Seven (HL7) standards as the abstraction level for complex and heterogeneous environments in the medical center. To resolve the issues faced by HISs, the following service characteristics are defined: (1) system interoperability for services, (2) adaptability and scalability for services, and (3) system’s fault tolerance for services. Based on these requirements for the HL7-based SOA HIS (SOA HIS) and for the service characteristics, we design service groups for a SOA HIS at medical centers.
To show that the proposed SOA HIS is reasonable and suitable for adoption in medical centers, we introduce the proposed architecture into the National Taiwan University Hospital (NTUH), which faces the same issues in terms of HISs. The results of this empirical study show that the SOA HIS possesses interoperability, adaptability, scalability, and fault tolerance. We also evaluate the performance of the SOA HIS. The weekly average response times for outpatient, inpatient, and emergency HL7Central systems are 0.035, 0.04, and 0.036 seconds, respectively. The weekly outpatient, inpatient, and emergency WebUI average response times are 0.79, 1.25, and 0.82 seconds, respectively. We also analyze the monthly performance and response time distributions, which show that the response times of both the WebUI and HL7Central demonstrate high performance characteristics.
The proposed HL7-based SOA HIS achieves our goals: (1) adaptability and scalability, (2) heterogeneous system integration, (3) the adoption of EMRs, and (4) high performance and performance scalability. We also discuss the empirical study and further requirements identified in the course of the study. The main contribution of this dissertation is the design and development of a HL7-based SOA HIS architecture that can achieve the set goals and resolve the research problems and the practical issues of HISs. Moreover, EMRs can be adopted into the HL7-based SOA HIS. The proposed HL7-based SOA HIS architecture can serve as a new HIS architecture for the coming decade.
Subjects
service-oriented architecture (SOA)
health level seven (HL7)
healthcare information system (HIS)
electronic medical record (EMR)
HL7-based SOA HIS (SOA HIS)
Type
thesis
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