Databases Reference
In-Depth Information
A visionary architecture
The healthcare information factory is a visionary architecture. It does not describe what is, today.
Instead it describes what ought to be, tomorrow. In addition, the healthcare information factory
is a holistic vision—it looks at the totality of the needs for information across the entire world of
healthcare.
The healthcare information factory has been shaped by the combining of the understanding of the
needs for information management coupled with the structure of medicine and healthcare. Both stan-
dard information practices and the reality of information for healthcare have been factored into the
defining of the healthcare information factory.
In many regards the world of healthcare and information systems that service healthcare is similar
to the world of information processing found in other environments. And at the same time the world
of information systems for healthcare is quite different from information processing found in other
environments. This technical paper is about the larger architecture that surrounds the world of infor-
mation processing for healthcare.
Architectural differences
Information systems for healthcare are quite different from information systems for other endeav-
ors. In the classic commercial rendition of information systems, the information systems are self-
contained. All of the information is generated, used, analyzed, and otherwise managed inside the
corporation. The corporation is an autonomous capsule of its own information. But in healthcare, the
information generated inside the doctor's office, hospital, and clinic has great implication outside of
the confines of the provider. From a research standpoint, the clinical information that is generated
inside the provider's facility is useful in many other places other than the hospital.
In a word, where corporate information circulates in a closed-loop system, information in the
healthcare environment operates in anything but a closed system. The open-system approach to the
collection, usage, and management of healthcare information has many far-reaching implications.
Another major difference between information and information processing in the world of health-
care and the other world of commercial systems is that information inside the world of healthcare
contains a lot of textual information, while information inside commercial systems is dominated by
repetitious, numeric-based transactions. The orientation toward text-based information presents a
challenge because the ubiquitous commercial database management systems that are widely used—
DB2, Oracle, Teradata, and NT SQL Server—are designed to handle repetitious occurrences of data,
primarily numeric data. And the textual data that makes up much of the world of the healthcare infor-
mation factory is anything but transaction oriented or repetitious.
There are then a whole host of important differences between the worlds of healthcare information
processing and commercial information processing.
Architectural similarities
From an architectural standpoint there are many similarities between the two worlds. There are large
volumes of data. There is a need for looking at data holistically. There is a need for data transfor-
mation. There is a need to support both day-to-day clinical activities and research. In a word, there
