Implementação ESB numa unidade hospitalar. Uso normalizado de mensagens HL7

Atualmente, os sistemas de informação hospitalares têm de possibilitar uma utilização diferenciada pelos diferentes intervenientes, num cenário de constante adaptação e evolução. Para tal, é essencial a interoperabilidade entre os sistemas de informação do hospital e os diversos fornecedores de serviços, assim como dispositivos hospitalares. Apesar da necessidade de suportar uma heterogeneidade entre sistemas ser fundamental, o acesso/troca de informação deve ser feito de uma forma protocolada, segura e transparente. A infraestrutura de informação médica moderna consiste em muitos sistemas heterogéneos, com diversos mecanismos para controlar os dados subjacentes. Informações relativas a um único paciente podem estar dispersas por vários sistemas (ex: transferência de pacientes, readmissão, múltiplos tratamentos, etc.). Torna-se evidente a necessidade aceder a dados do paciente de forma consolidada a partir de diferentes locais. Desta forma, é fundamental utilizar uma arquitetura que promova a interoperabilidade entre sistemas. Para conseguir esta interoperabilidade, podem-se implementar camadas de “middleware” que façam a adaptação das trocas de informação entre os sistemas. Todavia, não resolvemos o problema subjacente, ou seja, a necessidade de utilização de um standard para garantir uma interacção fiável entre cliente/fornecedor. Para tal, é proposto uma solução que passa por um ESB dedicado para a área da saúde, denominada por HSB (Healthcare Service Bus). Entre as normas mais usuais nesta área devem-se salientar o HL7 e DICOM, esta última mais especificamente para dispositivos de imagem hospitalar, sendo a primeira utilizada para gestão e trocas de informação médica entre sistemas. O caso de estudo que serviu de base a esta dissertação é o de um hospital de média dimensão cujo sistema de informação começou por ser uma solução monolítica, de um só fornecedor. Com o passar dos anos, o fornecedor único desagregou-se em vários, independentes e concorrentes, dando lugar a um cenário extremamente preocupante em termos de manutenção e evolução futura do sistema de informação existente. Como resultado do trabalho efetuado, foi proposta uma arquitetura que permite a evolução do sistema atual de forma progressiva para um HSB puro.Currently, healthcare information systems must customizable to meet each actor’s needs, in a scenario of continuous adaptation and evolution. To achieve this it is essential interoperability between the multiple hospital information systems and between these and the external service providers’. Despite the need to support heterogeneous systems, access/exchange of information should be in a standard, secure and transparent way. The infrastructure of modern health information consists of many heterogeneous systems, with different mechanisms to control the underlying data. Information on a single patient may be scattered across multiple systems (e.g. patient transfer, readmission, multiple treatments, etc.). It becomes evident the need to access patient data in a consolidated manner from different locations. Thus, it is essential to use an architecture that promotes interoperability between systems. To achieve this interoperability, layers of "middleware" can be implemented that adapt information exchange between systems. However, this does not solve the underlying problem, namely the need to standardize information to ensure reliable interaction between customer / supplier. To this end, we propose a solution based on an ESB specially tailored for the healthcare business, the so-called HSB (Healthcare Service Bus). Among the information exchange standards in this area, HL7 and DICOM are the most common, the latter specifically for hospital imaging devices, the first being used for information exchange between medical information systems. The case study in this dissertation addresses the problems of a medium-sized hospital information system, which began as a monolithic solution from one supplier. Over the years, the sole supplier split into multiple competing suppliers, giving rise to a very worrying scenario in terms of maintenance and further development of the existing information system. As a result of this work, we propose an architecture that enables the gradual evolution of the current system to a pure HSB

The influence of stakeholder relations on the implementation of information systems strategy in public hospitals in South Africa: an activity theory perspective

Includes bibliographical references.Literature reveals that there exists a research gap between the development of information systems (IS) strategy and the implementation thereof. There is also a need for further research regarding the implementation of IS strategy in public hospitals in South Africa. The exploration of implementation in the context of public hospitals in South Africa, a country with many good policies and strategies that have been developed but that are not always implemented, is highly relevant. In this study we undertook to explore the intricacies of stakeholder relations and the implications of these relations on the implementation of IS strategy in public hospitals in South Africa. This research was interpretive following a case study approach. Two provinces of South Africa were selected as cases: the Western Cape province and the Kwazulu Natal province. The Activity Analysis and Development (ActAD) framework, an enhanced form of activity theory, was used as the theoretical framework. Data was collected using semi-structured interviews, meetings, documents analysis and physical artefacts observation. The collected data was analysed using thematic analysis. The findings of this study reveal that factors related to stakeholder relations include the situational stakeholder relations dynamics and the level and motive of involvement in IS strategic activities and IS strategy operationalization processes at the different hierarchical levels. These factors affect the implementation of the IS strategy in public hospitals in South Africa by influencing different elements of the IS strategy implementation activity system. In the end we developed a framework, the stakeholder relations’ influence (SRI) framework which depicts the influence of stakeholder relations on the implementation of IS strategy in public hospitals in South Africa