The management of the information technology in a virtual medical service centre is subject to different requirements than the IT-management of a hospital resembling more a closed shop. Building a virtual centre calls for performance of an open shop principle, because the entire treatment chain cannot be mapped within one single institution, but requires integrated cooperation in order to manage a patient’s clinical pathway. Not only the spatial displacement, but also the unavoidable higher process orientation within a virtual cooperation deserves particular consideration. Additionally, the information management is challenged by the fact that the provision of relevant information in standardised form is an indispensable element of a virtual centre. In this context, the question about potential structural assembling, and organisational principles and elements of virtual medical service centres has to be answered in order to conclude on the basic requirements of data management and the appropriate solution approaches. This shall be presented partly using the example of the virtual oncological medical centre in Tyrol.
TopBackground
The question about the role of medical informatics in modified organisational structures has been frequently posed in the context of medical service supply (Power, 1999). In particular, an integrative IT-policy has considerably increased in importance through the standardisation of patient pathways, introduction of evidence-based medicine, standards, guidelines, and directives, and therefore, the inevitable necessary cooperation of healthcare providers. Especially in the earlier stages, exemplary models were introduced which were supposed to make the changed requirements more manageable (Ölvingson, Hallberg, Timpka, & Lindqvist, 2002). This, however, does not only affect the cooperation between healthcare providers, but also the technical-based integration of patient data, as well as the extensive bonding of other persons and units involved with the treatment chain. Particularly opened by the evolution of telemedicine, concepts are currently being developed in this area (Bradley, Williams, Brownsell, & Levi, 2002), which integrate technical possibilities such as virtual reality into medical treatment processes (Burdea, 2003).
The first and pivotal approaches of information technology in medical networks primarily concentrate on the field of electronic patient record. Correlating to this, scientifically evaluated projects and models introduced criteria which have to be considered by the IT-management in medical networks (Van den Haak, Mludek, Wolff, Bützlebruck, Oetzel, & Zierhut, 2002). It can therefore be adhered to, that through this structural development of the various sectors of the health system which are geared towards integrated care, medical informatics becomes more complex, too. Increased dialogue structures, principles of the standardisation of terminology, data exchange, and the comparability of data, and the resulting necessary transparency of medical healthcare providers have become subject matters of discussion and research (Coddington, 1997; Francis & Hart, 1998).