A standards-based ICT framework to enable a service-oriented approach to clinical decision support

This research provides evidence that standards based Clinical Decision Support (CDS) at the point of care is an essential ingredient of electronic healthcare service delivery. A Service Oriented Architecture (SOA) based solution is explored, that serves as a task management system to coordinate complex distributed and disparate IT systems, processes and resources (human and computer) to provide standards based CDS. This research offers a solution to the challenges in implementing computerised CDS such as integration with heterogeneous legacy systems. Reuse of components and services to reduce costs and save time. The benefits of a sharable CDS service that can be reused by different healthcare practitioners to provide collaborative patient care is demonstrated. This solution provides orchestration among different services by extracting data from sources like patient databases, clinical knowledge bases and evidence-based clinical guidelines (CGs) in order to facilitate multiple CDS requests coming from different healthcare settings. This architecture aims to aid users at different levels of Healthcare Delivery Organizations (HCOs) to maintain a CDS repository, along with monitoring and managing services, thus enabling transparency. The research employs the Design Science research methodology (DSRM) combined with The Open Group Architecture Framework (TOGAF), an open source group initiative for Enterprise Architecture Framework (EAF). DSRM’s iterative capability addresses the rapidly evolving nature of workflows in healthcare. This SOA based solution uses standards-based open source technologies and platforms, the latest healthcare standards by HL7 and OMG, Decision Support Service (DSS) and Retrieve, Update Locate Service (RLUS) standard. Combining business process management (BPM) technologies, business rules with SOA ensures the HCO’s capability to manage its processes. This architectural solution is evaluated by successfully implementing evidence based CGs at the point of care in areas such as; a) Diagnostics (Chronic Obstructive Disease), b) Urgent Referral (Lung Cancer), c) Genome testing and integration with CDS in screening (Lynch’s syndrome). In addition to medical care, the CDS solution can benefit organizational processes for collaborative care delivery by connecting patients, physicians and other associated members. This framework facilitates integration of different types of CDS ideal for the different healthcare processes, enabling sharable CDS capabilities within and across organizations

Towards a Service-Oriented Enterprise: The Design of a Cloud Business Integration Platform in a Medium-Sized Manufacturing Enterprise

This case study research followed the two-year transition of a medium-sized manufacturing firm towards a service-oriented enterprise. A service-oriented enterprise is an emerging architecture of the firm that leverages the paradigm of services computing to integrate the capabilities of the firm with the complementary competencies of business partners to offer customers with value-added products and services. Design science research in information systems was employed to pursue the primary design of a cloud business integration platform to enable the secondary design of multi-enterprise business processes to enable the dynamic and effective integration of business partner capabilities with those of the enterprise. The results from the study received industry acclaim for the designed solutions innovativeness and business results in the case study environment. The research makes contributions to the IT practitioner and scholarly knowledge base by providing insight into key constructs associated with service-oriented design and deployment of a cloud enterprise architecture and cloud intermediation model to achieve business results. The study demonstrated how an outside-in service-oriented architecture adoption pattern and cloud computing model enabled a medium-sized manufacturing enterprise to focus on a comprehensive approach to business partner integration and collaboration. The cloud integration platform has enabled a range of secondary designs that leveraged business services to orchestrate inter-enterprise business processes for choreography into service systems and networks for the purposes of value creation. The study results demonstrated enhanced levels of business process agility enabled by the cloud platform leading to secondary designs of transactional, differentiated, innovative, and improvisational business processes. The study provides a foundation for future scholarly research on the role of cloud integration platforms in enterprise computing and the increased importance of service-oriented secondary designs to exploit cloud platforms for sustained business performance