Healthcare and Distributed Systems Technology

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  • Topic: Medical informatics, Hospital information system, Information systems
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ANSAworks 95

Healthcare and Distributed Systems Technology

Francesco FEDELE
Marketing Manager

GESI Srl
Via Rodi, 32 00124 Rome - ITALY Tel. + 39 6 3725278 - 3729675 Fax + 39 6 3252336 eMail: mc0077@mclink.it

Cambridge - UK 3 April 1995

The Hospital Information System
The healthcare organisational structure in all European countries is naturally distributed, being a geographical spread of centres at different levels of complexity: from the general hospitals down to individual GPs. The ultimate objective of such a structure is to build a network of complementary centres (hospitals, laboratories, ambulatories, co-ordination centres, etc.) spread over the territory, to meet effectively the social needs in the area. Despite the fact that each individual centre is autonomous and devoted to the delivery of a particular set of services, they are mutually inter-dependent and interworking to ensure the effectiveness of the activities, in terms of prevention, caring and costs. Furthermore, the on-going modifications in the social context, due to the ageing of the European population, anticipate an increase in such decentralisation approach for the health care services in the coming years. The importance of home-care, ambulatory care and long term nursing care will also increase with respect to the role of the hospitals, which tend to be high-qualified centres, for short specialised treatment. Also the structure of the hospital itself is evolving from a vertical, aggregated organisation, towards the integration of a set of specialised departments, each of them with its own logistic, organisational and administrative requirements. Central government level

Elementary and aggregated data, structured according to standard criteria

Territorial level

Epidemiological and planning activities Epidemiological centres

coordination centres

Elementary and aggregated data, structured according to standard criteria

Patient caring level

Elder

Ambulatory

Integration through a geographical network, according to formal interfaces and protocols

Laboratory

Hospital

GP

management

materials

Federation of cooperating units, supported by systems individually optimised and mutually interworking

wards diagnostics

administration

ambulatories

According to such ultimate organisational goal of the whole structure, also the information systems supporting the individual centres must be structured as a federation of autonomous systems,

individually optimised according to the specific characteristics of the involved units. In parallel, the individual systems must be consistent with information and procedural standards, in order to permit the mutual interoperability to provide an effective and efficient support to the co-operation individually provided by each single unit. On a smaller scale, the same organisational model must be applied in the computerisation of the individual healthcare centres (e.g. the hospital). Each hospital is composed of a set of units, individually specialised for the execution of special activities and the delivery of particular services; all units of the hospital, however, must mutually interact consistently for the effective working of the global structure. To support effectively such organisational aspects, the healthcare information systems must be structured as a federation of different applications, each of them being autonomous and individually optimised to support the specific characteristics of the involved units and users. In fact, the diversity of the individual hospital organisations, the complexity of the clinical protocols and the variety of the preferences of the various users make it extremely difficult to envisage a unique, "monolithic" system, effectively usable in the whole structure. On the opposite, a number of applications are already available on the market, individually specialised to specific aspects and needs of the hospital structure. Users...
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