Ολοκλήρωση εφαρμογών και διαλειτουργικότητα πληροφοριακών συστημάτων φροντίδας υγείας

Abstract

The current thesis focuses on interoperability issues within healthcare organizations. It attempts to formulate a set of best practices and guidelines for the successful design and implementation of interoperability frameworks in healthcare. Thus, it provides a discussion on several healthcare-oriented objectives and pre-requisites along with a set of approaches for achieving interoperability. The emphasis of the current work is on the key role of healthcare processes within healthcare organizations and their tight connection with any interoperability solution introduced, in terms of modeling, utilizing and coordinating all the available resources (data, human and material assets). The approach which is proposed in the current thesis is related with the adoption of a Service-Oriented Architectural framework (SOA). In order to demonstrate the capabilities of such a framework in the healthcare context, a prototype implementation was developed. An important feature of the proposed framework is the implementation of a virtual electronic health record paradigm which is exclusively operating over the SOA framework and it can dynamically synthesize distributed patient data into a unified environment for cross-platform data delivery to a variety of clients. In addition, the thesis attempts to investigate the current status, in terms of interoperability, within the Greek Public healthcare prefectures all over Greece. In order to fulfill this objective, publicly available data were collected from the Greek Information Society organization regarding specific IT attributes of the Greek healthcare organizations for the period 2000 until 2006. The study included fifteen out of the total seventeen regional healthcare prefectures in Greece. The data gathered was utilized in order to perform an initial statistical analysis but was also used in order to perform a Data Envelopment Analysis (DEA) research study for the level of Information Technology (IT) efficiency in terms of infrastructure and software applications within the Greek National Health System. The results produced clearly highlighted that despite the limited sampling, there is also limited utilization of the physical and software infrastructure for achieving interoperability. Furthermore, the current work is investigating the evaluation strategies and criteria regarding service oriented interoperability frameworks in the healthcare domain. A thorough literature review is performed based on the dilemma of technical versus non-technical evaluation methodologies. Based on such a discussion, the thesis is proposing an organizational impact evaluation. The proposed methodology is based on the initial IS Success model, as proposed by DeLone and McLean (1992). The IS Success model was adapted in the context of specific service-oriented characteristics which are used in order to assess specific dimensions like System Quality and Information Quality of the DeLone and McLean model. The proposed theoretical framework was utilized in order to perform an empirical study, amongst sixty two (62) participants, for the organizational impact of the service-oriented prototype implementation. The data gathered was analyzed using a structural equation modeling technique, specifically partial least squares (PLS).