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Enterprise architecture provide a single plan that guide the interoperability of different systems or health IT project across organization (enterprise). If you would like to design an enterprise architecture of health information system among different hospitals within your province, who should involve in the designing process? What would be the role of each person?
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the stakeholder that should be included in the process
1. Doctor, nurses, medical technician, physiotherapist, dentist, pharmacist from every hospital in the province, and public health personnel to defined the scope of the system in order to serve their wants and needs from the health IT project to create the framework of health IT projects and also identified the data, function, network and people in the organization unit
2. Informatician to help in the system planning and connects wants and needs of public health official with information technology profession
3. Information technology profession will come after the initial plan is completed for working on data, application and technical architecture.All teams under the lead of system architecture write a plan for total landscape will look like when the project is complete, the plan includes the application process that needs to set up, and hardware will required.
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To include all person in developing EA is a good option. But in my experience, basic health staffs lack the IT knowledge especially in computer literacy and they don’t know what feature do they want and they can’t cope and use features that provided currently.
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Yes!!! This is the real situation! Many health professionals have no idea what the system that they would like to have. In addition, many IT professionals do not quite understand healthcare structure. This is why we need health informaticians!! And you could see how hard work that health informaticians have to face.
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Hi Pyae, that’s the point!!!!!! Most of the health care providers are not keen on IT. We are keen on working with people and also old-fashioned work. No one likes change!! Some of them not understanding the limitation of IT. They said why their ideas cannot come true, but they didn’t notice that the technology cannot respond to human demand without human planning, The IT just HELP to make things easier.
So I think if we really need to create a perfect EA from all stakeholders, we need to make them understand the concepts of informatics first.
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the stakeholder that should be included in the process
1. Doctor, nurses, medical technician, physiotherapist, dentist, pharmacist from every hospital in the province, and public health personnel to defined the scope of the system in order to serve their wants and needs from the health IT project to create the framework of health IT projects and also identified the data, function, network and people in the organization unit
2. Informatician to help in the system planning and connects wants and needs of public health official with information technology profession
3. Information technology profession will come after the initial plan is completed for working on data, application and technical architecture.All teams under the lead of system architecture write a plan for total landscape will look like when the project is complete, the plan includes the application process that needs to set up, and hardware will require.
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The following persons should include in process of EA design;
1. Health care provider from hospitals ( medical superintendent, doctors, nurses, lab technician, radiologist, pharmacist, focal of health financing, medical record units, supply chains). Their roles are to present what they want to include in architecture and giving input information required for architecture and requesting what kind of features will be easy and feasible to use(user interface).
2.IT professionals to design the EA. Their role is to develop IT architecture.
3.Informatiacian to bridge the between stakeholders and IT professional and develop standard data structures.All the above mention personal are needed in process of EA development. Current situation, stakeholders are directly contact and develop their own architecture which become lack of interoperability and standard data structure.
Important thing is initiative and innovative of government. Without government concern, such development can not be made.-
Pyae, I agree that having a strong commitment from the government or the leader is a key factor for development EA.
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Ajarn Saranath, I wonder if the Thai government supports the EA for health information systems? I’m not sure about the public hospital under the umbrella of the ministry of public health. But from my point, university hospital, each hospital develop their own HIS. Although in the same hospital such as Siriraj hospital. I don’t feel that it has a blueprint for HIS. We have separate EMR for primary care unit and Siriraj hospital, separate program for PACs and laboratory data. It depends on what time and which department created them. Some of them have data sharing at a different level but some of them cannot be connected. I showed this sample (of my hospital) to stated that all stakeholders that we discuss should be involved in the project. However, the most important person to create EA is the board of the hospital or the minister of public health to enforce the systems to have a good EA and interoperability.
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Creating a good EA must be able to respond the business strategy to determine the direction of the organization. All the projects to study and see which projects respond future business. The process must be cooperation of Stakeholders, it is necessary to jointly define the strategy and direction of business and IT in the same direction. This will help save the cost of project development by prioritizing the projects that will make a profit or responding to the business strategy from high to low. This method will help reduce the cost of choosing the right investment project. The last part is the survey. “Infrastructure + Software” in the whole system (Infrastructure + Software) to see if the systems in the organization are redundant or not by doing Gap Analysis and finally to the Architecture of the organization in the end. The stakeholder that should be include in the process consists of
1.Every part of organization and Health care provider from hospitals to design blue print of work.
2.IT professionals design system, system database and application to support blue print.
3.Informatician to help in the system planning and cooperation every projects but Informatician are come form person in number 1 or 2 or Informatician Expert to help. -
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The policy maker should set priority to the issue on the interoperability. Then informatician should gather all stakeholder together. The EA would be introduced as a solution. Everyone should help to design what their needs and IT expert can develop the new system. Finally, Meeting should be arranged regularly to keep improving or updating the system.
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Informaticians, who function as an enterprise architecture for healthcare at provincial level, should considered including stakeholders such as
1) Healthcare providers eg. doctor, pharmacy, nurse, they have to describe their needs of data for health care activities specific for their profession, and consider the important part of EMR to be shared as public EHR.
2) Information technologists need to understand request form healthcare providers, public health officers,and patients. They have to use their IT skill for improvement of data interoperability.
3) Public health officers need to conterminously monitoring health data from each hospital without redundancy or missing, and real-time as possible. So they have to describe their needs for report and alarming certain parameter in EHR, both in individual level and population level.
4) Patients or health consumers. Because they are most effected by healthcare EA, Patient or health consumer must be involved for the personal health record, healthcare resources at each hospital, and public health problem and management within their local resident area.
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HI Anothai, I agree, patient or community is most important in HIS, health literacy in part of how to interpret their own health behaviors into data in a unit or in descriptions is critical for a data collector. Communication between the health worker and the patient is essential throughout process especially in data collecting levels and when the policy is implemented.
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I’d arrange a provincial meeting for key officials from the Provincial Health office. They will be acting as a planner of our provincial HIS. The plans, surely a top-down policy from the national level. There will have officials from District Health Office to get informed of the policy/strategy. The details will be on the model of the database and the purpose of each data set. as well as the role and responsibilities of the enterprise. The meeting is to make sure of interoperable data with the national and effectiveness of data logistics.
Next, will be at the district level, representatives from the hospital network will come to design on application architecture and human interfaces. The representatives may include hospital director or physician or other staff in charge of hospital information management and the hospital’s infrastructure/IT.
After that, at each hospital network which may include hospitals and public health division from Sub-district adm. org. / Sub-district municipality and schools. They will be acting as a builder of HIS’s infrastructure, and data collecting process through IT/software and distribution of data across the enterprise and within the organization.
Finally, at the professional level, leaders from each deliverable unit will come together to plan steps of entering data onto software with predefined unit/format and data collecting practice by tools/equipment at the point of services. This is to make sure the efficiency of data collecting by a forefront health worker.
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Ameen, when top-down policy at national level is distributed, the state level of public health department eg. สำนักงานป้องกันควบคุมโรคเขต ศูนย์อนามัยเขต response to policy in different ways. They develop data in their own format and this data can not integrated with other state. I think the top-down policy at national level should include EA development to make data interoperabliliy at national level, and yet be flexible to deal with difference of public health concerned in each state.
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Obviously, it will involve stakeholders, including randomized group of patients and medical personnel; investors and finally, the government. Centralizing the data systems should use a proven model.
I would give the most credit to right wing investors, followed by the more educated patients, as well as doctors/nurses. Actually, I might not trust the politicians (in the government) too much.
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There are several key persons in the province that should be included in the planning team. Firstly, at the provincial level, the provincial health office director who should be the head of the board. The IT staff who experienced in the electronic medical record in every platform in the province should be the chief technical officer. Also, the program-specific manager who would like to use the information from the hospital should give their disease-specific information. Secondly, at the district level, there are district health officers and health-promoting hospital who operate the health prevention program should give their operable information. Thirdly, hospital level, the hospital director IT staff and head of information management team should be recruited in the discussion. Since the hospital is the largest data input resource, hospital staff need to show how their input the data and how they can get used of that information best.
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Of course all of the stakeholder that should be included in the process.
When health Organization plan to interoperability work with diffenrence system of information tecnology. The important thing to planing framework to exchange data between organization consists of1. information blue print and technology model
2. data system and data architecture
3. application architecture
4. unit of health organization
5. stakeholder of health organization such as Doctor , nurse , data admin , programmer, radiologist, pharmacist ect must to understand process to work between the organization.
6. Leader to drive process -
First of all, each hospital should have an agreement of interoperability between them implemented by the hospital director, like MOU. Then, the patients in the area should know for personal benefit. The representation of healthcare providers and public health officers of every hospital makes an agreement of what data should be linked. Then, informaticians who act like an EA will work with a programmer, database administration, or security specialist, for instance, to planning a blueprint of the system and think about how to link the data among the different systems.
After the first draft is released, they all should work together again to evaluate and revise the plan.
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If we would like to design an enterprise architecture of health information system among different hospitals within my province, the persons who should involve in the designing process are as following:
1. The provincial health officers as the authority leaders who will gather all stake holders for the meeting and designing EA. This level require responsiveness to legislative, regulatory, and policy tertiary.
2. The specific public health programmer who will take part in designing for particular stable information such as some emerging warning systems.
3. The health care providers at the different levels (community, primary, secondary and tertiary hospitals including clinician consultant) who will design at different context of operational information related to clinical information.
4. Technical or software support staff who will maintain and support the EHR systems
5. Health information management and exchange specialist who can support to ensure the quality and integrity of medical data and interoperability of data.
6. Health information privacy and security specialist who can play role to maintain the privacy and confidentiality of information interface.
7. Programmers and software engineer who will manage, evaluate, educate, perform further research and development of the HIS. -
Firstly, I agree with Khun Supawat, he said that the policy maker should set the priority of all issues on the interoperability. In my opinion, all of the stakeholders should join to brainstorm and share ideas together to develop policy, framework, standardization and so on and do agree with Dr. Saranath about the quite difficulty of system design which will serve the needs of all stakeholder’s requirements. Then it should have a group of persons, for example, the integration team who takes the action to analyze the impact, summarize, develop standard policy and template, comunicate to all stajeholders.
To design an enterprise architecture of health information system among different hospitals, and who should involve in the designing process? I think this can not specific, it depends on what the health information system develop for ?
The Open Group Architecture Framework (TOGAF) divides enterprise architecture into four layered categories
(1) Business architecture:
– explains the processes used for a business to achieve its goals, for instance, the business architecture of health information system consists of health services like patient records, individual health records, classification of diseases, symptoms and procedures, diagnostic reports, suggestions, prescriptions and treatment plans, etc.(2) Application architecture:
– deals with the development of different applications and the interaction between them. This architecture is highly applicable in the designing and development of relevant software requirements for interfacing with healthcare systems like standardized instruments for data collection, data-communication services, data analysis and modeling, report generating and speech recognition application in local language.(3) Data architecture:
– explains methods of data storage and retrieval, Data models, Metadata dictionary, Classification standards and systems(4) Technical architecture:
– explains how software infrastructure and hardware infrastructure support applications and their interactions, Local/wide area networks, Operating system Interoperability, mobile phone technology, speech recognition technology and web technology.To design an enterprise architecture of health information system among different hospitals, it should develop the EA first, then apply it to control the project implementation.
Remake: for my case, I will adope Data analytics and Blockchain tecknology into this system.
– Data Analytics: as health data is a large volume, to analyze data and find impact to slove the problem. Then I decide to use data analytic.
– Blockchain technology: as data/ transaction is from diffence hospitals, privacy and security issues are very important. Blocchain will eliminate these problems.For who should involve in the designing process to brainstrom knowledge, share idea, analyze impact and find out the solution are as below:
– Business architecture: explains the processes used for a business to achieve its goals -> System analysis (SA)/ Business Analysis (BA), BI consultant,
– Application architecture: to deal with the development -> integration team, informatician
– Data architecture: to explains methods of data storage -> Data engineer,data sciencetist, hospital IT team (to support as-is data structure)
– Technical architecture: to explains how software infrastructure and hardware infrastructure support applications and their interactions -> Software architecture, Analytics/ Blockchain Specialist,
– Healthcare provider: to give system requirement (as-is/ to-be) -> doctor, nurse, patient, pharmacist, medical technician etc.
Remark: for developer: to develop program -> BI developers, Big Data Programmer, Blockchain developer. They are in the next phase which is after design phase.
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