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Building a comprehensive clinical information system from components. The approach at Intermountain Health Care.
P D Clayton1, S P Narus, S M Huff
1Intermountain Health Care, University of Utah, USA. copclayt@ihc.com
Methods of Information in Medicine
|April 16, 2003
Summary
The interfaced approach to clinical information systems architecture is a viable alternative to single-vendor systems, offering acceptable reliability and efficiency for managing large patient data. Future advancements in standards may further enhance its advantages.
Area of Science:
- Health Informatics
- Computer Science
- Information Systems Architecture
Background:
- Intermountain Health Care previously developed most clinical information system (HELP) components internally.
- A shift occurred towards an interfaced architecture to integrate ambulatory and acute care systems.
- The new approach utilizes a clinical data repository for a longitudinal electronic patient record.
Purpose of the Study:
- To evaluate the merits and drawbacks of an interfaced clinical information systems architecture.
- To present findings from Intermountain Health Care's transition to an interfaced system.
Main Methods:
- Implemented an interfaced architecture connecting diverse applications to a central clinical data repository.
- Managed 820 interfaces across 51 applications, processing nearly 2 million transactions daily.
- Maintained a clinical database with 1.45 million patient records.
Main Results:
- The interfaced system demonstrated acceptable reliability, processing approximately 2 million transactions per day.
- Interface costs represented about 4% of the total information systems budget.
- The clinical database query response time averaged 0.19 seconds.
Conclusions:
- The interfaced approach is a compelling alternative to monolithic or single-vendor systems for organizations with adequate expertise and resources.
- Anticipated improvements in interface costs and maturity of standards (vocabulary, messaging) will increase the benefits of this architecture.
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