A Strategic Approach for Business-IT Alignment in Health Information Systems

  • Richard Lenz
  • Klaus A. Kuhn
Part of the Lecture Notes in Computer Science book series (LNCS, volume 2888)


Health Information Systems (HIS) are required to flexibly support complex clinical processes involving multiple user groups at different locations throughout a healthcare organization. Healthcare processes, however, are subject to change. A “responsive IT infrastructure” is required as a basis for rapid and effective business-IT alignment. In this article we describe the conditions (available products and standards) under which a strategy for system evolution is to be defined. A strategy based on an application framework and an integrated CASE tool has been elaborated and established at the university hospital in Marburg. Based on XP (extreme programming) and participatory design the software engineering process has been adapted and embedded into a continuous management process in which IT projects are prioritized according to current business needs. The goal is to minimize project risk and to achieve a continuously evolving information system which is driven by the actual needs for process improvement.


Generator Tool Health Information System Database Schema Business Process Model Electronic Document 
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  1. 1.
    Bates, D.W., Cohen, M., Leape, L.L., Overhage, J.M., Shabot, M.M., Sheridan, T.: Reducing the frequency of errors in medicine using information technology. J Am Med Inform Assoc 8, 299–308 (2001)CrossRefGoogle Scholar
  2. 2.
    Kohn, L.T.: To Err Is Human. In: Building a Safer Health System, National Academy Press, Washington (2000)Google Scholar
  3. 3.
    Sachverständigenrat für die Konzertierte Aktion im Gesundheitswesen: Finanzierung, Nutzerorientierung und Qualität. Report (2003)Google Scholar
  4. 4.
    Wilson, R.M., Harrison, B.T., Gibberd, R.W., Hamilton, J.D.: An analysis of the causes of adverse events from the quality in australian health care study. Med J Aust 170, 411–415 (1999)Google Scholar
  5. 5.
    Wilson, R.M., Runciman, W.B., Gibberd, R.W., Harrison, B.T., Newby, L., Hamilton, J.D.: The quality in australian health care study. Med J Aust 163, 458–471 (1995)Google Scholar
  6. 6.
    Dorenfest, S.I.: The decade of the ’90s. Healthc Inform 17 (2000) Google Scholar
  7. 7.
    Sauer, C.: Deciding the future for IS failures: Not the choice you might think. In: Curie, W., Galliers, R. (eds.) Rethinking management information systems, pp. 279–309. Oxford University Press, Oxford (1999)Google Scholar
  8. 8.
    Berg, M., Toussaint, P.: The mantra of modeling and the forgotten powers of paper: A sociotechnical view on the development of process-oriented ICT in health care. Int J Med Inf 69, 223–234 (2003)CrossRefGoogle Scholar
  9. 9.
    Smith, H., Fingar, P.: Business Process Management: The Third Wave, 1st edn. Meghan-Kiffer Press, tampa (2002)Google Scholar
  10. 10.
    Al-Mashari, M., Zairi, M.: BPR implementation process: An analysis of key success and failure factors. Business Process Management Journal 5, 87–112 (1999)CrossRefGoogle Scholar
  11. 11.
    Sheth, A., Larson, J.: Federated database systems for managing distributed, heterogeneous, and autonomous databases. ACM Computing Surveys 22, 183–235 (1990)CrossRefGoogle Scholar
  12. 12.
    Colomb, R.M.: Impact of semantic heterogeneity on federating databases. The Computer Journal 40, 235–244 (1997)CrossRefGoogle Scholar
  13. 13.
    Lenz, R., Kuhn, K.A.: Intranet meets hospital information systems: the solution to the integration problem? Methods Inf Med 40, 99–105 (2001)Google Scholar
  14. 14.
    Schadow, G., Fohring, U., Tolxdorff, T.: Implementing HL7: from the standard’s specification to production application. Methods Inf Med 37, 119–123 (1998)Google Scholar
  15. 15.
    Seliger, R.: Overview of HL7’s CCOW standard. Report (2001)Google Scholar
  16. 16.
    Dadam, P., Reichert, M., Kuhn, K.: Clinical workflows – the killer application for process-oriented information systems? In: Proc. 4th Int. Conf. on Business Information Systems, pp. 36–59 (2000)Google Scholar
  17. 17.
    Haux, R., Seggewies, C., Baldauf-Sobez, W., Kullmann, P., Reichert, H., Luedecke, L., Seibold, H.: Soarian – workflow management applied for health care. Methods Inf Med 42, 25–36 (2003)Google Scholar
  18. 18.
    Bidgood, W.D., Horii, S.C., Prior, F.W., van Syckle, D.E.: Understanding and using DICOM, the data interchange standard for biomedical imaging. J Am Med Inform Assoc 4, 199–212 (1997)CrossRefGoogle Scholar
  19. 19.
    Wein, B.B.: [IHE (Integrating the Healthcare Enterprise): A new approach for the improvement of digital communication in healthcare]. Rofo Fortschr Geb Rontgenstr 175, 183–186 (2003)CrossRefGoogle Scholar
  20. 20.
    Ferrara, F.M.: The CEN healthcare information systems architecture standard and the DHE middleware. A practical support to the integration and evolution of healthcare systems. Int J Med Inf 48, 173–182 (1998)Google Scholar
  21. 21.
    Hurlen, P., Skifjeld, K., Andersen, E.P.: The basic principles of the Synapses federated healthcare record server. Int J Med Inf 52, 123–132 (1998)CrossRefGoogle Scholar
  22. 22.
    Grimson, W., Jung, B., van Mulligen, E.M., van Ginneken, A., Pardon, S., Sottile, P.A.: Extensions to the HISA standard – the SynEx computing environment. Methods Inf Med 41, 401–410 (2002)Google Scholar
  23. 23.
    Light, B., Holland, C., Kelly, S., Wills, K.: Best of breed IT strategy: An alternative to enterprise resource planning systems. In: Proceedings of the 8th European Conference on Information Systems, vol. 1, pp. 652–659 (2000)Google Scholar
  24. 24.
    Clayton, P.D., Narus, S.P., Huff, S.M., Pryor, T.A., Haug, P.J., Larkin, T., Matney, S., Evans, R.S., Rocha, B.H., A., W., Bowes, I., Holston, F.T., Gundersen, M.L.: Building a comprehensive clinical information system from components. The approach at Intermountain Health Care. Methods Inf Med 42, 1–7 (2003)Google Scholar
  25. 25.
    Kuhn, K.A., Lenz, R., Elstner, T., Siegele, H., Moll, R.: Experiences with a generator tool for building clinical application modules. Methods Inf Med 42, 37–44 (2003)Google Scholar
  26. 26.
    Degoulet, P., Marin, L., Lavril, M., Bozec, C.L., Delbecke, E., Meaux, J.J., Rose, L.: The HEGP component-based clinical information system. Int J Med Inf 69, 115–126 (2003)CrossRefGoogle Scholar
  27. 27.
    Lenz, R., Elstner, T., Siegele, H., Kuhn, K.A.: A practical approach to process support in health information systems. J Am Med Inform Assoc 9, 571–585 (2002)CrossRefGoogle Scholar
  28. 28.
    Lilienthal, C., Züllighoven, H.: Techniques and tools for continuous user participation. In: PDC 1996, Proc. of the Participatory Design Conference 1996, pp. 153–159 (2003)Google Scholar
  29. 29.
    Nadkarni, P.M., Marenco, L., Chen, R., Skoufos, E., Shepherd, G., Miller, P.: Organization of heterogeneous scientific data using the EAV/CR representation. J Am Med Inform Assoc 6, 478–493 (1999)CrossRefGoogle Scholar
  30. 30.
    Kruchten, P.: The Rational Unified Process – An Introduction. In: Object Technology, Addison-Wesley, Canada (2000)Google Scholar
  31. 31.
    Beck, K.: Extreme Programming. Addison-Wesley, München (2000)Google Scholar
  32. 32.
    Hinrichs, F., Lenz, R., Griss, P.: Modellierung und Prozessoptimierung in einer orthop ädischen Klinik. Zeitschrift für Orthopädie und ihre Grenzgebiete 139, 172 (2001)CrossRefGoogle Scholar
  33. 33.
    Lenz, R., Herlofsen, H., Hinrichs, F., Zeiler, T., Kuhn, K.: Abteilungsübergreifende Prozessoptimierung – Ein Anwendungsbeispiel. Informatik Biometrie und Epidemiologie in Medizin und Biologie 33, 88–90 (2002)Google Scholar
  34. 34.
    Lenz, R., Elstner, T., Kuhn, K.: Experiences with a holistic information system. J Am Med Inform Assoc (suppl) 952 (2001)Google Scholar
  35. 35.
    Gruhn, V., Thiel, A.: Komponentenmodelle – DCOM, JavaBeans, Enterprise Java- Beans, CORBA, 1st edn. Professionelle Softwareentwicklung. Addison-Wesley, München (2000)Google Scholar
  36. 36.
    Szyperski, C.: Component software – beyond object-oriented programming, 1st edn. Addison-Wesley, Harlow (1999)Google Scholar
  37. 37.
    Lenz, R., Huff, S., Geissbühler, A.: Report of conference track 2: Pathways to open architectures. Int J Med Inf 69, 297–299 (2003)CrossRefGoogle Scholar
  38. 38.
    McGoveran, D.: Business semantics. EAI Journal 10 (2000)Google Scholar
  39. 39.
    Stonebraker, M.: Integrating islands of information. EAI Journal, 1–5 (1999)Google Scholar
  40. 40.
    Gell, G., Schmucker, P., Pedevilla, M., Leitner, H., Naumann, J., Fuchs, H., Pitz, H., Kole, W.: SAP and partners: IS-H and IS-H*MED. Methods Inf Med 42, 16–24 (2003)Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2003

Authors and Affiliations

  • Richard Lenz
    • 1
  • Klaus A. Kuhn
    • 1
  1. 1.Institute of Medical InformaticsPhilipps-University MarburgMarburgGermany

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