Managing Demographic Data Inconsistencies in Healthcare Information Systems

Managing Demographic Data Inconsistencies in Healthcare Information Systems

Larbi Esmahi (Athabasca University, Canada) and Elarbi Badidi (U.A.E. University, UAE)
DOI: 10.4018/978-1-4666-0927-3.ch016


Healthcare IT and IS departments have the arduous task of managing the varied information sources into readily accessible, consistent and referential information views. Patient hospital workflows, from admission to discharge, provide a series of data streams for convergences into disparate systems. Protocols such as DICOM and HL7 exist for the purposes of exchanging information within the PACS and RIS information silos in the hospital enterprise. These protocols ensure data confidence for downstream systems, but are not designed to provide referential data cross system in the system-of-systems model. As data crosses the PACS and RIS information domains, data inconsistency is introduced. This paper explores the causes for data disparity and presents a referential data design for disparate systems through the implementation of an XML bus for data exchange and an RDF framework for data semantic.
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System-Of-Systems Architecture For E-Health

The electronic healthcare record (EHR) is a merged presentation of the information obtained through various systems in the healthcare enterprise (Hasselbring et al., 2000). Imaging and demographic data contribute to the contents. Additionally, the physician comments, markup and reports also contribute to the record. These individual pieces of the EHR are drawn from many disparate systems throughout the enterprise. The Record Information System (RIS) or alternatively a Health Information System (HIS) will be the primary demographic repository for patient information. As such, this text and contextual information will be used as the primary data source for downstream comparison. The Picture Archive and Communication System (PACS-ADMIN, 2007) will be used as a repository for imaging data (Miltchenko et al., 2003). Figure 1 presents the main components of the electronic health record that need to be integrated and synchronized.

Figure 1.

Main components for the system-of-systems


This architecture of system-of-systems describes a large-scale integration of many independent, self-contained systems in order to satisfy the global e-health needs. As the global economy and global business practices increase, individuals tend to be more transient. Their medical histories are an important precursor to successful health care provisioning. Contingent upon this medical history record is the successful integration of data from varied sources (hospitals, clinics, labs, etc.) including the mobile patient’s information. This information must be portable, presentable, and independent of the initial data program from which it was obtained. By far the greatest concern relates to data inconsistency and subsequent inaccuracy in an environment of disparate systems.

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