Towards an information-centric architecture framework for health information logistics: a design science research...

Integrated care depends on timely awareness of parallel treatment activities and safe access to distributed patient records. However, multimorbid patients often navigate complex, non-linear pathways across care levels, resulting in information fragmentation that compromises decision-making, safety, and coordination. Existing electronic health record systems and interoperability initiatives offer limited support for pathway-oriented information logistics, particularly with respect to governance, provenance, and the integration of the patient's voice. This study aims to design a conceptual information-centric architecture framework to address these systemic gaps in awareness and access.

Applying Design Science Research (DSR), the study synthesized rigor from a scoping review with relevance derived from a longitudinal analysis of medical records from 14 multimorbid patients (1954-2024) in Northern Norway. A representative 19-year user scenario, validated by clinical expertise, together with stakeholder and root-cause analyses, informed the identification of recurrent failures in information logistics. High-level non-functional and functional requirements were iteratively derived, foregrounding Information Governance (IG), Data Management (DM), Security and Privacy, and Health Information Quality (HIQ) as essential socio-technical constraints. The resulting architecture was examined through a scenario-based demonstration and an early-stage ex-ante evaluation.

The study produced a prescriptive information-centric architecture framework (Meta-artifact) organized into layered, modular components that separate user interaction, pathway logic, and secure storage. Information tokens, consisting of metadata, clinical codes, and location pointers, enable governed, read-only virtual access to source records, reducing duplication and avoiding traditional replication burdens. HIQ operationalizes DM/IG by enforcing requirements for accuracy, currency, consistency, completeness, and contextual relevance across inter-organizational access. In a hospitalization-discharge scenario, the architecture provided timely notifications, governed access to distributed records, and transparent consent and audit controls, demonstrating conceptual feasibility and alignment with the identified problem and requirements.

This study contributes early-stage prescriptive design knowledge to improve inter-organizational information logistics. By embedding IG, DM, HIQ, and Security and Privacy as structural pillars and decoupling information from application constraints, the architecture provides a governance-aligned foundation for pathway-oriented coordination, proactive awareness, and safe, on-demand virtual access. This information-centric, token-based architecture, with a modular, standards-neutral design, supports adaptability and provides a foundation for future prototyping and empirical evaluation.