Abstract
E-Health systems, through their use of Internet and wireless technologies, offer the possibility of near real-time data integration to support the delivery and management of health care. In practice, the wide range of choice in technologies, vendors, protocols, formats, and information representations can make even simple exchanges of information between systems problematic. Much of the focus on healthcare interoperability has been on resolving interoperability issues of system to system information exchanges. But issues around people to people interactions and people to system interactions are just as important to address from an interoperability point of view. In this paper, we identify interoperability deficiencies in collaborative care delivery and develop a methodology in two parts. In the first part, an ontology is developed to represent collaborative care delivery. In the second part, the ontology is used to design an architecture for interoperable clinical information system design. We then use a case study in palliative care to provide a proof of concept of the methodology. The case study provides an inventory of the interoperability requirements for palliative care and a perspective on the design and implementation of a people oriented clinical information system that supports collaborative health care delivery in palliative care.
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Accreditation Canada, Hospice, Palliative, and End-of-Life Services Standard, http://www.accreditation.ca/accreditation-programs/qmentum/standards/hospice-palliative-and-end-of-life-services/ last accessed November, 2010.
Ash, J. S., Sittig, D. F., Poon, E. G., Guappone, K., Campbell, E., & Dykstra, R. H. (2007). The extent and importance of unintended consequences related to computerized provider order entry. Journal of the American Medical Informatics Association, 14, 415–423.
Avison, D., & Young, T. (2007). Time to rethink health care and ICT? Communications of the ACM, 50(6), 69–74.
Benson T. (2010). Principles of health interoperability HL7 and SNOMED. Chapter 2: Why interoperability is hard. Springer-Verlag London Limited.
Berg, M., & Toussaint, P. (2003). The mantra of modeling and the forgotten powers of paper: A sociotechnical view on the development of process-oriented ICT in health care. International Journal of Medical Informatics, 69, 223–234.
Blobel, B., & Pharow, P. (2009). Analysis and evaluation of EHR approaches. Methods of Information in Medicine, 48(2), 162–169.
Cancer Care Ontario (2009). Palliative care collaborative care plans, Available from http://www.cancercare.on.ca, last accessed November, 2010
Carstairs, S. (2005). Still not there—Quality end-of-life care: A progress report, quality end of life care coalition of Canada, Available from http://sen.parl.gc.ca/scarstairs/PalliativeCare/Still%20Not%20There%20June%202005.pdf last accessed November, 2010.
Choi, B. C. K. (2005). Understanding the basic principles of knowledge translation. Journal of Epidemiology and Community Health, 59(2), 93.
Coiera, E. (2004). Four rules for the reinvention of health care. BMJ (Clinical Research Ed.), 328(7449), 1197–1199.
Coiera, E., & Hovenga, E. J. S. (2007). Building a sustainable health system. IMIA: yearbook medical informatics, 2(1), 11–18.
Demiris, G., Washington, K., Oliver, D. P., & Wittenberg-Lyles, E. (2008). A study of information flow in hospice interdisciplinary team meetings. Journal of Interprofessional Care, 22(6), 621–629.
Eppler, M. J., & Mengis, J. (2004). The concept of information overload: A review of literature from organization science, accounting, marketing, MIS, and related disciplines. Information Society, 20(5), 325–344.
Ferris, F., Balfour, H., Bowen, K., Farley, J., Hardwick, M., Lamontagne, C., Lundy, M., Syme, A., & West, P. (2002). A model to guide hospice palliative care: Based on national principles and norms of practice. Canadian Hospice Palliative Care Association Ottawa.
Fonseca, F. (2007). The double role of ontologies in information science research. Journal of the American Society for Information Science and Technology, 58(6), 786–793.
Garde, S., Knaup, P., Hovenga, E. J. S., & Heard, S. (2007). Towards semantic interoperability for electronic health records. Methods of Information in Medicine, 46, 332–343.
Hevner, A. R., March, S. T., Park, J., & Ram, S. (2004). Design science in information systems research. MIS Quarterly, 28(1), 75–105.
Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the twenty-first century. Washington, DC: National Academies Press.
Kalagiakos, P., & Ikonomou, G. (2009). Ubiquitous patient monitoring. Journal on Information Technology in Healthcare, 7(4), 202–213.
Kuziemsky, C. E., Weber-Jahnke, J. H., Lau, F., & Downing, G. M. (2008). An interdisciplinary computer based information tool for palliative severe pain management. Journal of the American Medical Informatics Association, 15(3), 374–382.
Musen, M. A. (2002). Medical informatics: Searching for underlying components. Methods of Information in Medicine, 41(1), 12–19.
Oh, H., Rizo, C., Enkin, M., & Jadad, A. (2005). What is eHealth: A systematic review of published definitions. Journal of Medical Internet Research, 7(1), e1.
Park, H. A., & Hardiker, N. (2009). Clinical terminologies: A solution for semantic interoperability. Journal of Korean Society of Medical Informatics, 15(1), 1–11.
Pereira J. (2009). Informatics in palliative medicine. In N. I. Cherry, N. N. A. Christakis, M. Fallon, S. Kaasa, R. K. Portenoy, G. Hanks (Eds.), Oxford Textbook of Palliative Medicine. Oxford University Press (OUP), 4th edition.
Pirnejad, H., Niazkhani, Z., Berg, M., & Bal, R. (2008). Intra-organizational communication in healthcare. Methods of Information in Medicine, 47(4), 336–345.
Schadow, G., Mead, C. N., & Walker, D. M. (2006). The HL7 reference information model under scrutiny. Studies in Health Technology and Informatics, 124, 151–156.
Shiffman, R. N., Liaw, Y., Brandt, C. A., & Corb, G. J. (1996). Computer-based guideline implementation systems: A systematic review of functionality and effectiveness. Journal American Medical Informatics Association, 6, 104–114.
World Health Organization. Statistical Information System. Geneva (CH): WHO; 2010 [Available from: http://www.who.int/whosis/en/index.html last accessed November, 2010.
Zhang, S., & Bodenreider, O. (2006). Law and order: Assessing and enforcing compliance with ontological modeling principles in the foundational model of anatomy. Computers in Biology and Medicine, 36, 674–693.
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This work was supported by an NSERC Discovery Grant and by a Collaborative Health Research Project grant from CIHR and NSERC (Canada) on Performance Management at the Point of Care.
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Mouttham, A., Kuziemsky, C., Langayan, D. et al. Interoperable support for collaborative, mobile, and accessible health care. Inf Syst Front 14, 73–85 (2012). https://doi.org/10.1007/s10796-011-9296-y
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DOI: https://doi.org/10.1007/s10796-011-9296-y