A Personal Health Trajectory API: Addressing Problems in Health Institution-Oriented Systems

In the changing digital environment, universities face the necessity of integrating heterogeneous information systems. This study focuses on a set-theoretic approach to modeling the integration of these systems. It considers the construction of a model that will effectively facilitate interaction among various information resources within the university, belonging to different platforms and formats. Special attention is paid to optimizing data exchange processes and ensuring information integrity within the common digital space of the university. This work proposes a formal integration model that allows minimizing architectural coupling and ensuring the evolutionary development of the university's digital platform. The set-theoretic apparatus is used to formalize the IT landscape. A decomposition method based on the concept of "architectural quanta" (Architectural Quantum) is applied. Metrics of structural autonomy are proposed to assess effectiveness. A formal model describing the university's information system as a collection of loosely coupled quanta is introduced. An architectural integrity condition is established, prohibiting integration through shared databases. A structural autonomy coefficient (K_sa) is developed to quantitatively assess architectural quality. The model serves as a theoretical basis for implementing automated architecture control systems based on specialized metrics (Fitness Functions) in CI/CD pipelines, which helps reduce technical debt and accelerate the launch of new educational services (Time-to-Market). The main research method employed is a set-theoretic approach to modeling the integration of heterogeneous information systems in the context of digitalization. The scientific novelty lies in applying the set-theoretic apparatus to describe and model the processes of data integration from various sources with differing structures and formats. The developed model provides a formalized representation of the integration relationships between information systems, allowing for the optimization of data exchange processes and enhancing the efficiency of the university's information resources. The research results indicate the high effectiveness of the proposed approach for creating a unified information space within the university, contributing to improved quality of education, scientific research, and managerial processes. Practical implementation of the model will enhance the university’s competitiveness in the digital economy. The feasibility of building a flexible and scalable system capable of adapting to new requirements and changes in the university's information environment is proven.

The picture archiving and communication system (PACS) originated as an image management system for improving the efficiency of radiologic practices. It has evolved into a hospital-integrated system that stores information media in many forms, including voice, text, medical records, waveform images, and video recordings. The integration of these various types of information requires the technology of multimedia, including hardware platforms, information systems and databases, communication protocols, display technology, and system interfacing and integration. The purpose of this book is to discuss the conceptual and technologic advances in PACS development for all of these previously mentioned technologies. The book also emphasizes the growing field of PACS-based imaging informatics, where existing PACS resources are used for largescale horizontal and longitudinal clinical service, research, and education applications. The book is intended for those who are involved in a health care environment that manages the everyday practical realities of PACS planning, operation, and maintenance. The book will also serve as excellent curriculum material for the training of PACS information technology personnel because the author provides comprehensive concepts that tie medical imaging, medical physics, information technology, and clinical workflow with enterprise PACS (multiple, hospital-wide PACS). The author, H. K. Huang, has been involved in PACS development since the 1980s and is a leading scientist in the field. The book is divided into five parts and 23 chapters. Part 1, titled “Medical Imaging Principles,” summarizes the history of PACS, the fundamental concepts of digital medical imaging, and the different types of modalities integrated into PACS. Part 2, titled “PACS Fundamentals,” describes in detail the PACS subsystems and industry standards (Digital Imaging and Communications in Medicine and Health Level 7) that are used to integrate PACS with the hospital information system and radiology information system. Part 3, titled “PACS Operation,” describes the practical problems encountered by PACS administrators and users and discusses different techniques to solve these problems, with many examples from installed PACS sites around the world. Because the author developed PACS at the University of California, Los Angeles, in 1991 and the University of California, San Francisco, in 1995, he is able to draw from his expertise on the subject. The author also uses his experience from developing many state-of-theart prototypes (eg, fault tolerant storage system) funded by research grants. Part 4, titled “PACS-based Imaging Informatics,” presents image-processing techniques that can be used to mine the huge image and clinical data resources stored in the PACS archive. The analysis of lung nodules by using temporal computed tomographic and contentbased image indexing are some of the examples of advanced processing applications applied to PACS data mining. Part 5, titled “Enterprise PACS,” describes different models for implementing an enterprise PACS in terms of the architectural design of the system and financial and business models. This new book builds on two previous volumes on PACS that were written by the author. The text, image collections, and schematic diagrams in this current work achieve the author’s goal of providing up-to-date material concerning the technologic advances in PACS and imaging informatics. The text serves as a guide for those who are planning an enterprise PACS and provides teaching material for training PACS developers in industry and health care. The author has used portions of this book as lecture material for graduate courses at leading universities in the United States and abroad. The author also uses many examples to emphasize that the integration of heterogeneous health care information systems is becoming more complex and that, as more radiologists and clinicians expect higher standards in the reliability of the data, a systemic understanding of Digital Imaging and Communications in Medicine, Health Level 7, and Integrating the Healthcare Enterprise becomes ever more important to optimize enterprise workflow. The strength of the book lies in the vast experience that the author, who has implemented PACS at numerous institutions in the United States and abroad, has transmitted into this new book. Huang has conducted first-hand analysis of the various systems from PACS manufacturers that are used in clinical operation at large medical institutions and has performed up-to-date research in data mining of the huge image and data resources stored in the PACS repository.

Intense competition drives the need for dynamic and flexible integration of dispersed and heterogeneous information systems. This paper proposes a semantic gateway architecture for system integration in networked manufacturing to solve the semantic heterogeneity problems. The system integration mode based on semantic gateway is set up to enable unified expression and analysis of the information to be integrated, so that the flexibility and transparency of integration between heterogeneous systems are significantly improved.

The development of healthcare systems in accordance to the “Shared Care” paradigm results in co-operative health information systems across the boundaries of organisational, technological, and policy domains. Increasingly, these distributed and heterogeneous systems are based on middleware approaches, such as CORBA. Regarding the sensitivity of personal and medical data, such open, distributed, and heterogeneous health information systems demand a high level of data protection and data security, both with respect to patient information and with respect to users. The security concepts and measures available and additionally needed in health information systems based on CORBA architecture are described in this paper. The proposed security solution is also open to other middleware approaches, such as DHE or HL7.

The District Health Information System (DHIS) is an information system that is hosted in the Khomas regional office of the Ministry of Health and Social Services (MoHSS) in Namibia. Parallel to the DHIS, the MoHSS runs silo information systems in the 14 regions of Namibia which were donated by non-governmental organisations in addition to a regional DHIS. The DHIS and silo systems currently work in isolation from one another, hence this study is on finding a framework to enable semantic interoperability of data in these heterogeneous health information systems (HIS) so that the DHIS and these silo systems in the Namibian public hospitals can act as an integrated platform to share and exchange health- related information with each other. Thus, a protocol called Interlink protocol is developed in this research to enable integration. The DHIS and silo- interfaced system that will be developed in this research should be able to link or connect all the public hospitals in Namibia to the central database at the MoHSS for health information feed. The system would allow public hospitals to interlink with each other through a technology integrated platform. The study therefore seeks to interface DHIS and silo systems at a data level. The aim of this research therefore is to design and develop a framework for data semantic interoperability of DHIS and these other health information silo systems so that they can exchange health data and information.

The logistics industry currently faces a prevalent "data silo" issue. This leads to information isolation and system fragmentation and severely restricts the ability of cross-platform business collaboration and intelligent decision-making. To address this problem, this paper proposes a non-intrusive logistics system architecture design for data silo integration. The architecture is based on key mechanisms such as edge access, protocol abstraction, and a unified data bus. It realizes lightweight integration of heterogeneous logistics information systems, and features low coupling, high compatibility, and strong adaptability. The designed system includes acquisition layer protocol adaptation components, transport layer edge routing mechanisms, and platform layer intelligent processing engines. It supports multi-protocol concurrent access and fault self-recovery capabilities. Deployment and testing in enterprise scenarios show that the system outperforms traditional solutions in data acquisition delay control, stability maintenance, and multi-protocol adaptation. The non-intrusive system not only leads significantly in throughput, reaching 12,000 entries per second. This is much higher than the 7,500 entries per second of traditional Application Programming Interface (API) integration and the 9,200 entries per second of the Enterprise Service Bus (ESB) architecture. It also performs excellently in average response time, which is only 45 milliseconds, significantly lower than the other two solutions. In particular, this system achieves efficient integration without modifying the original systems and effectively solves the problem of coexisting multi-systems and non-interoperable data in enterprises. This paper provides a promotable reference architecture for the informatization transformation of logistics.

In this paper we sketch an approach to the integration of heterogeneous tourist information systems into database federations. Since many tourist information systems offer WWW-interfaces based on HTML-files and furthermore, many local information systems are based on specific file formats, we have to consider such file associations. For the integration of these file associations, the main problem is the lack of meta-information. Therefore, we have to derive an appropriate local conceptual schema. The derived conceptual schemata and the schemata of other tourist database systems will be integrated into a federated schema. Moreover, we briefly discuss the benefits of a federated tourist information system.

This study aims to explain the relationship between information system (IS) integration and hospital efficiency, measured in two years, 1997 and 1998. The study used 349 urban hospitals in the analysis. The hospitals' IS integration strategy was measured by multiple indicators of the software system applications and IS resources used in 1997. Hospital performance was measured by the levels of efficiency, using technical efficiency scores computed by Data Envelopment Analysis (DEA) for 1997 and 1998. The DEA analysis shows that, among the urban hospitals studied, the number of efficient hospitals increased during the period 1997-1998. It was found that information system integration is statistically significantly associated with the DEA technical efficiency scores in 1997 and 1998. However, system integration is negatively associated with the 1997 efficiency score and changed to a positive direction in 1998. Hospitals that deployed a highly integrated IS strategy did not show an immediate benefit. However, the IS integration strategy enhanced hospitals' technical efficiency in the next year.

In this paper, a methodology for integrating heterogeneous industrial information systems is presented. The methodology is strongly based on the extensive reuse of already-made components and is conceptually divided in three levels, one for each kind of designer that is typically involved in this type of projects. To accomplish a better integration of the activities and tools necessary to develop industrial information systems with the proposed methodology, three appropriate organizational configurations are adopted.

This paper develops a knowledge-based model of information systems (IS) integration in acquisition-based growth programs. Previous research has found important differences in the acquirers’ abilities for acquisition IS integration, and that these differences play key roles in explaining the economic benefits of acquisition-based growth. A knowledge-based view of acquisition IS integration contributes explanation to how differences in abilities arise. Our knowledge-based model is developed by an analytic induction approach, comprising both deductive and inductive analysis of the industry group Trelleborg. The analyses yield five propositions that explain the building of knowledge for acquisition IS integration by the mechanisms of routine refinement, superstitious learning, expertise building, sub-activity refinement and related expertise building. Together, the five propositions form a knowledge-based model of acquisition IS integration. The model suggests that ‘serial acquirers’ form the knowledge necessary for attending to an IS integration challenge over a series of heterogeneous acquisitions. Differences in acquirers’ abilities for acquisition IS integration that depend on knowledge variations are therefore persistent and hard to overcome for the inexperienced acquirer.

In the last half-century the world has witnessed dramatic gains in health status. These are occurring in developing countries now but started in Europe and other wealthier countries around the global in the late 19th century and early 20thcentury. These improvements were partly attributed to increasing in education and income of the population which resulted in more hygienic living conditions and nutrition later in the 20th, expansion of health and public health services by governments and biomedical innovations. Sub-Saharan Africa still carries most of the global burden of disease with low life expectancy at birth with majority of deaths occurring to children under the age of 5 years. Infectious diseases are the major contributors to the disease burden in sub-Saharan Africa that affect the poorest in addition to noncommunicable diseases. The health system is a major determinant in reversing
\nthis burden in sub-Saharan Africa. Health systems in sub-Saharan Africa are weak and need to cope with simultaneous communicable and noncommunicable epidemics. Health information systems play a significant role in steering health system strengthening and documenting progress as it provides reliable information on health determinants, health system performance and population health status. Despite its importance, health information systems in many developing countries are weak, fragmented and often focused exclusively on disease-specific programme
\nareas. Integration of health information systems will provide the basis for public health professionals to look at the health system from different viewpoints.
\nEnterprise architecture (EA) is a management tool that provides means for aligning information systems with organisation’s mission, goals and objectives. EA is used to develop a comprehensive description of all of the key elements and relationships of an organization and its alignment with an organization’s mission, goals, and strategic objectives with information systems. EA can be used as a method for designing health information systems in terms of a well defined set of building blocks, and showing how the building blocks fit together and how they communicate with each other. This research aims to study the potential of EA as a strategic methodology that can be used to systematically gather and document health information system
\nrequirements to design a unified comprehensive health information system that integrates data from diverse sources at all levels of the health system for localised evidence-based decision making and health systems strengthening.
\nThis research used qualitative method to collect primary and secondary data. Primary research data was collected through in-depth interviews with key stakeholders and observation and discussions in workshops and meetings. Secondary research include desk research by searching for published and unpublished research outputs, white papers, reports, user manuals and training materials.
\nGathering and documenting requirements and processes that facilitate systematic design and development of health information systems that are usable, integrated, interoperable and sustainable are practices neglected by Ministries of Health and donor partners in health systems strengthening. In response, this thesis presents original studies on the potential use of an EA approach to strengthen health information systems in low income countries.
\nEA is a systems science approach that is widely used in software design in developed countries.
\nIt is common to see, in developing countries, the application of EA to be focusing on developing eHealth or HIS architecture in silos with little attention paid its application in the context of the health system. This thesis shows developing countries would benefit more from EA by applying it to simplify the complexity of the health system through guiding a systems thinking approach to describe processes, personnel, information systems, data and sub-systems their alignment and
\nhow they are all intended to complement health systems goals and strategic direction. In the process of developing EA developing countries should use the opportunity to reassess the current processes, indicators and data usage and take a decision to either eliminate processes that are no longer required or rationalise them.
\nDeveloping countries has realised the potential of ICT in improving healthcare delivery and availability of information for evidence decision making. Despite this realisation many HISs in developing countries are chaotic characterised by silo systems unable to communicate with each other. EA approach facilitates the design of integrated HISs by describing HIS in a more systemic holistic way.
\n
\nZusammenfassung
\nIn den letzten fünfzig Jahren hat sich der Gesundheitszustand der Weltbevölkerung dramatisch verbessert. Während sich dieser Fortschritt heute vor allem auf Entwicklungsländer beschränkt, begann er in Europa und anderen wohlhabenden Ländern auf der ganzen Welt schon im späten 19. und frühen 20. Jahrhundert. Solche Verbesserungen sind teilweise der höheren Bildung und dem höheren Einkommen der Bevölkerung zuzuschreiben, welche hygienischere
\nLebensverhältnisse und Ernährungsgewohnheiten im 20. Jahrhundert zur Folge hatten, aber auch erweiterten Gesundheitsdiensten durch Regierungen und biomedizinischen Erfindungen. 
\nAfrika südlich der Sahara trägt nach wie vor den grössten Teil der globalen Krankheitslast mit einer tiefen Lebenserwartung bei der Geburt und der höchsten Todesfallrate bei Kindern unter 5 Jahren. Infektionskrankheiten sind neben nichtansteckenden Krankheiten Hauptbestandteil der Krankheitslast, die die ärmsten in Afrika südlich der Sahara trifft. Das Gesundheitssystem ist ein bedeutender Einflussfaktor, wenn es um die Reduktion dieser Krankheiten in Afrika südlich der
\nSahara geht. Gesundheitssysteme in Afrika südlich der Sahara sind schwach und kämpfen gleichzeitig mit Epidemien ansteckender und nichtansteckender Krankheiten. 
\nGesundheitsinformationssysteme spielen eine wichtige Rolle bei der Verbesserung der Gesundheitssysteme und helfen, den Fortschritt zu dokumentieren, da sie verlässliche Informationen zu Gesundheitsfaktoren, Effizienz des Gesundheitssystems und den Gesundheitszustand der Bevölkerung liefern. Obwohl sie so bedeutend sind, sind Gesundheitsinformationssysteme in vielen Entwicklungsländern schwach, bruchstückhaft und oft nur auf bestimmte betroffene Gebiete beschränkt. Die Vernetzung der Gesundheitsinformationssysteme würde es für Angestellte des Gesundheitswesens ermöglichen, das Gesundheitssystem von verschiedenen Blickwinkeln her zu betrachten.
\n „Enterprise architecture“ (EA) ist ein Führungsinstrument, das es ermöglicht,
\nInformationssysteme mit dem Auftrag und den Zielvereinbarungen einer Organisation zu vergleichen. EA entwickelt eine umfassende Beschreibung aller Schlüsselelemente und Beziehungen einer Organisation, um das Informationssystem auf den Auftrag und die strategischen Ziele der Organisation auszurichten. EA kann zur Entwicklung von Gesundheitsinformationssystemen mittels genau definierter Bausteine verwendet werden und zeigen wie die Bausteine zusammenpassen und miteinander in Verbindung stehen. Die vorliegende Forschungsarbeit untersucht die Möglichkeiten von EA als strategische Methode zum systematischen Sammeln und Dokumentieren von Anforderungen eines Gesundheitsinformationssystems. Dadurch soll ein umfassendes, einheitliches Gesundheitsinformationssystem entwickelt werden, das Daten von verschiedenen Quellen auf allen Stufen des Gesundheitssystems zusammenführt, um eingegrenzte, evidenzbasierte
\nEntscheidungen und die Stärkung des Gesundheitssystems zu fördern.
\nIn dieser Forschungsarbeit wurden qualitative Methoden verwendet, um primäre und sekundäre Daten zu sammeln. Primäre Daten wurden durch Tiefeninterviews mit den wichtigsten Interessenvertretern erhoben, sowie anhand von Beobachtungen und Diskussionen in Workshops und Sitzungen. Die sekundäre Datenerhebung beinhaltet Schreibtischarbeit wie die Suche nach publizierten und nicht-publizierten Forschungsergebnissen, Weissbüchern, Berichten, Bedienungsanleitungen und Schulungsunterlagen.Das Sammeln und Dokumentieren von Vorgaben und Prozessen, die das systematische Designen und Entwickeln von Gesundheits-informationssystemen, die anwendbar, umfassend, kompatibel und nachhaltig sind, vereinfachen, wird von den Gesundheitsministerien und Geberpartnern bei
\nder Stärkung der Gesundheitssysteme vernachlässigt. Die vorliegende Arbeit präsentiert Originalstudien zur möglichen Anwendung von EA, um Gesundheits-informationssysteme in einkommensschwachen Ländern zu stärken.
\nEA ist eine systematische, wissenschaftliche Herangehensweise, deren Anwendung im Softwaredesign in entwickelten Ländern weit verbreitet ist. Üblicherweise wird in
\nEntwicklungsländern EA bei der Entwicklung von eHealth oder der Architektur von
\nGesundheitsinformationssystemen in Silos angewendet, wobei der Verwendung im
\nZusammenhang mit dem Gesundheitssystem wenig Beachtung geschenkt wird. Die vorliegende Arbeit zeigt, dass Entwicklungsländer mehr von EA profitieren würden, wenn sie es zur Vereinfachung von Komplexitäten im Gesundheitssystem anwenden würden. Durch einen „Systems Thinking“-Ansatz könnten Prozesse, Personal, Informationssysteme, Daten und Subsysteme beschrieben und angepasst werden, um Ziele und strategische Richtung des Gesundheitssystems zu ergänzen. Während der Erarbeitung des EA sollten Entwicklungsländer die Gelegenheit nutzen, ihre Prozessabläufe, Indikatoren und Datenanwendungen zu überdenken,
\nund überholte Prozesse zu eliminieren oder zu rationalisieren.
\nEntwickelte Länder haben das Potential der Informations- und Kommunikations-technologie erkannt, um die Gesundheitsvorsorge und die Verfügbarkeit von Informationen fü

It is generally acknowledged that integration of large-scale information systems is a challenging problem. A domain that particularly encounters this problem currently is healthcare, where information systems tend to be heterogeneous and in constant evolution. A particular need for health professionals is the ability to ask medical questions across a heterogeneous information system, then visualise and analyse the results in a synthetic and coherent manner. In this paper, we present a case study of a heterogeneous data source search meta-engine framework, based on category theory. This framework addresses the problem of cross-interrogation of heterogeneous data sources, such as relational database management systems, documentary database systems, or collections of documents. It additionally attempts to address the problem of constant evolution of such information systems. The framework has been successfully applied to the biomedical data of the medical information system at the Institut Curie, a major French cancer care centre. Different aspects of this work are illustrated, such as the mathematical foundations of the Prométhée framework, the methodology used for its implementation, and the impact that Prométhée has encountered since its deployment in a hospital environment.KeywordsCategory TheoryMedical Information SystemConstant EvolutionRelational Database Management SystemHeterogeneous Data SourceThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Sequential configuration is a fundamental pattern that occurs when integrating systems that span domains and levels of abstraction. This task requires the integration of heterogeneous autonomous information systems, processes, and applications. We propose an extensible system for correlating sequential configurations across loosely-coupled systems. Our framework defines fundamental abstractions and interfaces that enable the implementation of domain-specific models. We build upon our framework to provide a suite of tools to support applications that manage the configuration lifecycle. Our implemented prototype application integrates the processes, tools, and data involved in the first two stages of the IT outsourced services contract lifecycle.

PurposeThe purpose of this paper is to understand the relationship between information systems (IS) integration and business performance in the context of the ad traffic system of a media company.Design/methodology/approachA system dynamics (SD) model that shows ad traffic system structure was developed and simulation scenarios were examined.FindingsSimulation scenarios identify the dysfunctional effects of the lack of IS integration. The model shows how IS integration problems increase the dynamic complexity of business processes, resulting in poor business performance. It also shows how and why IS integration improvements can lead to superior performance.Research limitations/implicationsResearchers of business process management will benefit from a wider adoption of simulation and SD modeling approaches. The modeling process and model validation are discussed.Practical implicationsSD modeling can help organizations analyze and streamline their business processes through IT, significantly and sustainably improving their business performance.Originality/valueModeling the relationship between IS integration and business performance through time.

Health information systems are of extreme importance and they became an intrinsic part of the healthcare sector. However, in today’s molds and with the advent of the Internet and mobile devices, a paradigm shift, from the current isolated systems to interoperable distributed systems, that take advantage of ubiquitous computing, is needed. In critical situations, such as decision making in healthcare, it is necessary to have access to all of the patient’s information; for the information must be reliable and must be accessed in an easy and fast way. The present work proposes an architecture that aims to answer the needs of interoperability between heterogeneous health information systems and the need for ubiquity of medical information. A prototype was developed that tries to provide interoperability through a service-oriented architecture using web services. A mobile component was also developed to enable ubiquitous access to medical information. This work is based on the authors’ knowledge about the Portuguese National Health Service.