Abstract. Information technology has been widely recognized as a key building block to the Government modernization agenda for the NHS, and a vital component to assisting continuous improvement in clinical practice, patient safety and standard of care. Medicine is far from a static field, and this is especially true for research into the prevention and treatment of breast cancer is thankfully ever changing and advancing towards more comprehensive care and therapy for the condition. With such a fluid and fluctuating set of requirements, software that aids in the delivery and prognosis of therapy faces real challenges in its design so that it can adapt successfully as and when required to new requirements in the field. This paper will discuss the challenges that designers of such software must solve, and highlights the issues facing current state-of-the-art solutions in the domain of breast cancer prognosis. The paper then introduces the notion of system self-governance to produce a rigid yet highly dynamic system that is evaluated through a case study involving several leading UK cancer hospitals. The paper concludes with analysis of how the principals introduced in the paper can be applied to the wider domain of eHealthcare
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