The Failed Implementation of the Electronic Prescription in Germany - A Case Study

Many countries worldwide are striving for improving the quality of care and for reducing costs in the health care sector by establishing large IT infrastructures. In Germany, the introduction of the electronic health card and the national telematics infrastructure is lagging years behind the original schedule. In this paper, we describe and analyze a case study of one selected part of this ultra-large intervention. The selected part is the failed implementation of the electronic prescription. The related activities started in 2003 and ended in 2010 when a decision was made to abandon this part of the intervention. We present a detailed analysis of the project and identify 14 reasons in five categories for the project’s failure. Furthermore, we provide a multi-layered overview of the episodes and sub-projects

Tools for health professionals within the German health telematics platform, Journal of Telecommunications and Information Technology, 2005, nr 4

Shared care concepts such as managed care and continuity of care are based on extended communication and co-operation between different health professionals or between them and the patient respectively. Health information systems and their components, which are very different in their structure, behaviour, data and their semantics as well as regarding implementation details used in different environments for different purposes, have to provide intelligent interoperability. Therefore, flexibility, portability, knowledge-based interoperability and future-orientation must be guaranteed using the newest development of model driven architecture. The ongoing work for the German health telematics platform based on an architectural framework and a security infrastructure is described in some detail. This concept of future-proof health information networks with virtual electronic health records as core application starts with multifunctional electronic health cards. It fits into developments currently performed by many other developed countries. The paper introduces into the German health telematics platform and its tools based on smart card

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A Test Vehicle For Compliance With Resilience Requirements In Index-Based E-Health Systems

Increasingly, national and international governments have a strong mandate to develop national e-health systems to enable delivery of much-needed healthcare services. Research is, therefore, needed into appropriate security and reliance structures for the development of health information systems which must be compliant with governmental and alike obligations. The protection of e-health information security is critical to the successful implementation of any e-health initiative. To address this, this paper proposes a security architecture for index-based e-health environments, according to the broad outline of Australia’s National E-health Strategy and National E-health Transition Authority (NEHTA)’s Connectivity Architecture. This proposal, however, could be equally applied to any distributed, index-based health information system involving referencing to disparate health information systems. The practicality of the proposed security architecture is supported through an experimental demonstration. This successful prototype completion demonstrates the comprehensibility of the proposed architecture, and the clarity and feasibility of system specifications, in enabling ready development of such a system. This test vehicle has also indicated a number of parameters that need to be considered in any national indexed-based e-health system design with reasonable levels of system security. This paper has identified the need for evaluation of the levels of education, training, and expertise required to create such a system

FUTURE-ORIENTED AND PATIENT-CENTRIC? A QUALITATIVE ANALYSIS OF DIGITAL THERAPEUTICS AND THEIR INTEROPERABILITY

This paper focuses on the integration of digital therapeutics (DTx) into future-oriented and patient-centric care pathways. Based on a workshop series and problem-centered interviews in Germany, the current state-of-the-art of regulatory and technical integration of DTx was mapped as a landscape of DTx interoperability. The results focus on key interfaces of DTx, namely with Electronic Health Records (EHRs), devices, and other digital health innovations such as telemedicine, and highlight current challenges and potentials for future development. On a broader level, the results point to unresolved issues of care coordination, the optional role of the EHRs as regulated platforms for care, and the importance of integrating DTx data into public data spaces for research

Information Systems and Healthcare XX: Toward Seamless Healthcare with Software Agents

Healthcare processes are frequently fragmented and often badly supported with IT. Inter- and intra-organizational communication and media frictions complicate the continuous provision of information according to the principle of information logistics. Based on extensive literature review, we present the vision of seamless healthcare with horizontally and vertically integrated healthcare processes enabled by seamless IT support. Its implementation requires the establishment of a communication infrastructure and the deployment of adequate standards in healthcare. There are already comprehensive approaches for dealing with integrating heterogeneous information systems. However, they lack a common communication infrastructure and do not support proactivity and flexibility which are dominant characteristics in healthcare. We propose a software agent-based approach for realizing the vision of seamless healthcare. We present a corresponding implementation for integrating heterogeneous information systems in the context of the German Health Telematics Infrastructure. Based on the concept and the implementation, we show that the modular approach is capable of supporting a wide range of different applications. We furthermore outline which facets of an agent-based solution could be implemented in an operative real-world environment. In closing we derive implications for IT decision makers in healthcare and show directions for future approaches for reducing information logistics related deficits in healthcare

Monitoring in fog computing: state-of-the-art and research challenges

Fog computing has rapidly become a widely accepted computing paradigm to mitigate cloud computing-based infrastructure limitations such as scarcity of bandwidth, large latency, security, and privacy issues. Fog computing resources and applications dynamically vary at run-time, and they are highly distributed, mobile, and appear-disappear rapidly at any time over the internet. Therefore, to ensure the quality of service and experience for end-users, it is necessary to comply with a comprehensive monitoring approach. However, the volatility and dynamism characteristics of fog resources make the monitoring design complex and cumbersome. The aim of this article is therefore three-fold: 1) to analyse fog computing-based infrastructures and existing monitoring solutions; 2) to highlight the main requirements and challenges based on a taxonomy; 3) to identify open issues and potential future research directions.This work has been (partially) funded by H2020 EU/TW 5G-DIVE (Grant 859881) and H2020 5Growth (Grant 856709). It has been also funded by the Spanish State Research Agency (TRUE5G project, PID2019-108713RB-C52 PID2019-108713RB-C52 / AEI / 10.13039/501100011033)

eGovernment Interoperability Issues in Lithuania

The paper analyzes the interoperability importance and role in development of eGovernment. The interoperability challenges was faced in different EU countries since 2000. System complexity, multiplicity and diversity in the public sector is posing extreme challenges to common interoperability standards the eGovernment Interoperability Frameworks (eGIFs) pose as a cornerstone for the provision of one-stop, fully electronic services to businesses and citizens. The paper analyzes eGovernment development preconditions in Lithuania, overview and good practice experience in developing eGovernment interoperability framework at EU level (European Interoperability Framework) and national levels – UK, Germany and Greece. Comparing these frameworks by different criteria the guidelines for developing eGovernment interoperability framework in Lithuania are designed. The project for Lithuania eGovernment Interoperability framework development is supported by Ministry of Interior of the Republic of Lithuania and State Science Fundation