Integration story-Introduction

Someone once said that the medical information system is one of the most complex information systems in the world, and even compares its complexity with the moon landing program. The authenticity of this statement is difficult to study, and few people have made quantitative estimates or cross-industry comparisons. Therefore, when I thought it was just a time when medical information system manufacturers sold their own products to hospitals, A Rhetoric made up to raise the price.

However, it is indeed complicated. Like Enterprise Informatization, medical informatization also needs to understand and coordinate the relationship between different departments/departments. It may be that enterprise informatization has been developing for many years. Many companies have been able to take over the entire ERP system, such as finance, production, invoicing, and customer relations, but in the medical industry, so far, almost no company has completed PACS, RIS, Lis, ehr, his and so on. In addition, even if a vendor can attract business experts from every department familiar with the hospital, it also needs to make great efforts in business to break the barriers that have long been formed in the huge White Tower, because the information system itself needs to penetrate these barriers to achieve more efficient sharing and collaboration. It can be imagined that it is difficult.

As a result, vendors can only adopt the policy of division and governance. Some people do PACS/RIS, some do Lis, some do his/EMR, and each vendor becomes an expert in a department system, it is as difficult as moving into a new industry as it is to establish another department system. However, at the end of the hospital, if each system only runs independently, the productivity it can provide will be greatly reduced. The only way is to establish a cross-vendor integration mechanism that may even cooperate with each other.

For some simple his statements that allow clinicians to write doctor's advice and look at medical records, it seems that the text work does not require too much data from other systems to work properly. Some systems, such as PACS/RIS, become the first field to introduce industry standards if they cannot obtain images from devices. From the late 1990s s to the early year 00 s, the rapid development of PACS/RIS also prompted Rapid Upgrade of DICOM. This standard was first used to solve the problem of data transmission between Image devices. After version 3.0, the workflow-related components were enhanced, the emergence of the task list enables integration between PACS/RIS and devices from data sharing to collaboration.

Compared with information technology in other industries, we can also find examples like DICOM to solve communication problems between different vendors. In the past, I learned about the communication protocol of smart buildings through a classmate. There are also Terminologies such as information objects and service classes. However, such a protocol does not seem to cover all the problems in Medical Integration, so people have established an integrated framework like IHE, which is equivalent to the design pattern at the business layer. I have never understood whether such a precedent exists in other industries. At least for medical engineers, except for the terrible DICOM binary stream or the blunt HL7 text, you can also use this mode to communicate with each other. This probably reflects the complexity of the medical information system from one aspect.

Engineers in the medical industry are indeed lucky to have IHE. IHE may not abstract all the complexities in the real world, but at least provides an effective tool that we currently can use. In recent years, the development of IHE has entered a broader medical field besides medical imaging, and has provided us with more integration stories on UML drawings.

Even so, in the dark aisles and small studios after the hospital leaves work, we still often see engineers fighting with lights, these poor people seem to be abandoned forever beyond the magical aura that Ihe experts boast about.

Indeed, there are still too many problems to solve in the field of integration. Some problems may never be imagined at the last moment. People who work at the site, under pressure from their bosses and customers, sometimes can only abandon the rules of all previous standards and models, rely on their own experience, analysis, speculation, and even have a little luck, for more information, see recruitment and splitting. Then their experience will gradually accumulate and become part of the standards and models for everyone to share, so that humanity has made some progress.

(In the future, change "integration Story" in the title to "Medical Integration Story ")

 

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