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Tummers J, Tobi H, Catal C, Tekinerdogan B. Designing a reference architecture for health information systems. BMC Med Inform Decis Mak 2021; 21:210. [PMID: 34238281 PMCID: PMC8263849 DOI: 10.1186/s12911-021-01570-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 06/22/2021] [Indexed: 11/29/2022] Open
Abstract
Background Healthcare relies on health information systems (HISs) to support the care and receive reimbursement for the care provided. Healthcare providers experience many problems with their HISs due to improper architecture design. To support the design of a proper HIS architecture, a reference architecture (RA) can be used that meets the various stakeholder concerns of HISs. Therefore, the objective of this study is to develop and analyze an RA following well-established architecture design methods. Methods Domain analysis was performed to scope and model the domain of HISs. For the architecture design, we applied the views and beyond approach and designed the RA’s views based on the stakeholders and features from the domain analysis. We evaluated the RA with a case study. Results We derived the following four architecture views for HISs: The context diagram, decomposition view, layered view, and deployment view. Each view shows the architecture of the HIS from a different angle, suitable for various stakeholders. Based on a Japanese hospital information system study, we applied the RA and derived the application architecture. Conclusion We demonstrated that the methods of the software architecture design community could be used in the healthcare domain effectively and showed the applicability of the RA. Supplementary Information The online version contains supplementary material available at 10.1186/s12911-021-01570-2.
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Affiliation(s)
- Joep Tummers
- Information technology, Wageningen University & Research, Hollandseweg 1, 6701KN, Wageningen, The Netherlands.
| | - Hilde Tobi
- Biometris, Wageningen University & Research, Droevendaalsesteeg 1, 6706OB, Wageningen, The Netherlands
| | - Cagatay Catal
- Department of Computer Science and Engineering, Qatar University, 2713, Doha, Qatar
| | - Bedir Tekinerdogan
- Information technology, Wageningen University & Research, Hollandseweg 1, 6701KN, Wageningen, The Netherlands
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Winter A, Takabayashi K, Jahn F, Kimura E, Engelbrecht R, Haux R, Honda M, Hübner UH, Inoue S, Kohl CD, Matsumoto T, Matsumura Y, Miyo K, Nakashima N, Prokosch HU, Staemmler M. Quality Requirements for Electronic Health Record Systems*. A Japanese-German Information Management Perspective. Methods Inf Med 2017; 56:e92-e104. [PMID: 28925415 PMCID: PMC6291988 DOI: 10.3414/me17-05-0002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 06/13/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND For more than 30 years, there has been close cooperation between Japanese and German scientists with regard to information systems in health care. Collaboration has been formalized by an agreement between the respective scientific associations. Following this agreement, two joint workshops took place to explore the similarities and differences of electronic health record systems (EHRS) against the background of the two national healthcare systems that share many commonalities. OBJECTIVES To establish a framework and requirements for the quality of EHRS that may also serve as a basis for comparing different EHRS. METHODS Donabedian's three dimensions of quality of medical care were adapted to the outcome, process, and structural quality of EHRS and their management. These quality dimensions were proposed before the first workshop of EHRS experts and enriched during the discussions. RESULTS The Quality Requirements Framework of EHRS (QRF-EHRS) was defined and complemented by requirements for high quality EHRS. The framework integrates three quality dimensions (outcome, process, and structural quality), three layers of information systems (processes and data, applications, and physical tools) and three dimensions of information management (strategic, tactical, and operational information management). CONCLUSIONS Describing and comparing the quality of EHRS is in fact a multidimensional problem as given by the QRF-EHRS framework. This framework will be utilized to compare Japanese and German EHRS, notably those that were presented at the second workshop.
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Affiliation(s)
- Alfred Winter
- Prof. Alfred Winter, University of Leipzig, Institute for Medical Informatics, Statistics and Epidemiology, Haertelstr. 16 -18, 04107 Leipzig, Germany, E-mail:
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Ammenwerth E, Knaup P, Winter A, Bauer AW, Bott OJ, Gietzelt M, Haarbrandt B, Hackl WO, Hellrung N, Hübner-Bloder G, Jahn F, Jaspers MW, Kutscha U, Machan C, Oppermann B, Pilz J, Schwartze J, Seidel C, Slot JE, Smers S, Spitalewsky K, Steckel N, Strübing A, van der Haak M, Haux R, ter Burg WJ. On Teaching International Courses on Health Information Systems. Lessons Learned during 16 Years of Frank - van Swieten Lectures on Strategic Information Management in Health Information Systems. Methods Inf Med 2017; 56:e39-e48. [PMID: 28272648 PMCID: PMC5388878 DOI: 10.3414/me16-01-0124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 02/18/2017] [Indexed: 11/09/2022]
Abstract
Background Health information systems (HIS) are one of the most important areas for biomedical and health informatics. In order to professionally deal with HIS well-educated informaticians are needed. Because of these reasons, in 2001 an international course has been established: The Frank – van Swieten Lectures on Strategic Information Management of Health Information Systems. Objectives Reporting about the Frank – van Swieten Lectures and about our students‘ feedback on this course during the last 16 years. Summarizing our lessons learned and making recommendations for such international courses on HIS. Methods The basic concept of the Frank – van Swieten lectures is to teach the theoretical background in local lectures, to organize practical exercises on modelling sub-information systems of the respective local HIS and finally to conduct Joint Three Days as an international meeting were the resulting models are introduced and compared. Results During the last 16 years, the Universities of Amsterdam, Braunschweig, Heidelberg/Heilbronn, Leipzig as well as UMIT were involved in running this course. Overall, 517 students from these universities participated. Our students‘ feedback was clearly positive. The Joint Three Days of the Frank – van Swieten Lectures, where at the end of the course all students can meet, turned out to be an important component of this course. Based on the last 16 years, we recommend common teaching materials, agreement on equivalent clinical areas for the exercises, support of group building of international student groups, motivation of using a collaboration platform, ensuring quality management of the course, addressing different levels of knowledge of the students, and ensuring sufficient funding for joint activities. Conclusions Although associated with considerable additional efforts, we can clearly recommend establishing such international courses on HIS, such as the Frank – van Swieten Lectures.
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Affiliation(s)
- Elske Ammenwerth
- Institute of Medical Informatics, UMIT – University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
- Prof. Dr. Elske Ammenwerth, Institute of Medical Informatics, UMIT – University for Health Sciences, Medical Informatics and Technology, Eduard-Wallnöfer-Zentrum 1, 6060 Hall in Tirol, Austria,
| | - Petra Knaup
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
- Prof. Dr. Petra Knaup, Institute of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany,
| | - Alfred Winter
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
- Prof. Dr. Alfred Winter, Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Härtelstr. 16–18, 04107 Leipzig, Germany,
| | - Axel W. Bauer
- History, Philosophy, and Ethics in Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Oliver J. Bott
- University of Braunschweig – Institute of Technology and Hannover Medical School, Peter L. Reichertz Institute for Medical Informatics, Braunschweig, Germany
- Department of Information and Communication, Hannover University of Applied Sciences and Arts, Hannover, Germany
| | - Matthias Gietzelt
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Birger Haarbrandt
- University of Braunschweig – Institute of Technology and Hannover Medical School, Peter L. Reichertz Institute for Medical Informatics, Braunschweig, Germany
| | - Werner O. Hackl
- Institute of Medical Informatics, UMIT – University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - Nils Hellrung
- University of Braunschweig – Institute of Technology and Hannover Medical School, Peter L. Reichertz Institute for Medical Informatics, Braunschweig, Germany
- Symeda GmbH, Braunschweig, Germany
| | - Gudrun Hübner-Bloder
- Institute of Medical Informatics, UMIT – University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - Franziska Jahn
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Monique W. Jaspers
- Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Ulrike Kutscha
- Center of Information Technology and Medical Engineering, University Hospital of Heidelberg, Heidelberg, Germany
| | - Christoph Machan
- Institute of Medical Informatics, UMIT – University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - Bianca Oppermann
- University of Braunschweig – Institute of Technology and Hannover Medical School, Peter L. Reichertz Institute for Medical Informatics, Braunschweig, Germany
| | - Jochen Pilz
- Center of Information Technology and Medical Engineering, University Hospital of Heidelberg, Heidelberg, Germany
| | - Jonas Schwartze
- University of Braunschweig – Institute of Technology and Hannover Medical School, Peter L. Reichertz Institute for Medical Informatics, Braunschweig, Germany
| | - Christoph Seidel
- Department for Information Technology and Business Development, Braunschweig Medical Center, Braunschweig, Germany
| | - Jan-Eric Slot
- IT Academic Center, University of Amsterdam, Amsterdam, The Netherlands
- ICT Department, Bernhoven Hospital, Uden, The Netherlands
| | - Stefan Smers
- Department for Information Technology, University Hospital of Leipzig, Leipzig, Germany
| | - Katharina Spitalewsky
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
- Clinical Trial Center (CTCW), University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Nathalie Steckel
- University of Braunschweig – Institute of Technology and Hannover Medical School, Peter L. Reichertz Institute for Medical Informatics, Braunschweig, Germany
- Department UK-IT, University Hospital of Bonn, Bonn, Germany
| | - Alexander Strübing
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Minne van der Haak
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
- Siemens AG, Erlangen, Germany
| | - Reinhold Haux
- University of Braunschweig – Institute of Technology and Hannover Medical School, Peter L. Reichertz Institute for Medical Informatics, Braunschweig, Germany
- Prof. Dr. Reinhold Haux, Peter L. Reichertz Institute for Medical Informatics, University of Braunschweig – Institute of Technology and Hannover Medical School, Muehlenpfordtstr. 23, 38106 Braunschweig, Germany,
| | - Willem J. ter Burg
- Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Willem Jan ter Burg, MSc, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, P.O.Box 2 22700, 1100 DE Amsterdam, The Netherlands,
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