Information management in distributed healthcare networks

Abstract

Providing healthcare increasingly changes from isolated treatment episodes towards a continuous treatment process involving multiple healthcare professionals and various institutions. Information management plays a crucial role in this interdisciplinary process. By using information technology (IT) different goals are in the focus: To decrease overall costs for healthcare, to improve healthcare quality, and to consolidate patient-related information from different sources. Consolidation of patient data is ultimately aimed at a lifetime patient record which serves as the basis for healthcare processes involving multiple healthcare professionals and different institutions. To enable seamless integration of various kinds of IT applications into a healthcare network, a commonly accepted framework is needed. Powerful standards and middleware technology are already at hand to develop a technical and syntactical infrastructure for such a framework. Yet, semantic heterogeneity is a limiting factor for system interoperability. Existing standards do support semantic interoperability of healthcare IT systems to some degree, but standards alone are not sufficient to support an evidence-based cooperative patient treatment process across organizational borders. Medicine is a rapidly evolving scientific domain, and medical experts are developing and consenting new guidelines as new evidence occurs. Unfortunately, there is a gap between guideline development and guideline usage at the point of care. Medical treatment today is still characterized by a large diversity of different opinions and treatment plans. Medical pathways and reminder systems are an attempt to reduce the diversity in medical treatment and to bring evidence to the point of care. Developing such pathways, however, is primarily a process of achieving consensus between the participating healthcare professionals. IT support for pathways thus requires a responsive IT infrastructure enabling a demand-driven system evolution. This article describes modern approaches for "integrated care" as well as the major challenges that are yet to be solved to adequately support distributed healthcare networks with IT services. © Springer-Verlag Berlin Heidelberg 2005.