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Yearb Med Inform 1996; 05(01): 101-107
DOI: 10.1055/s-0038-1638051
Review Paper
Georg Thieme Verlag KG Stuttgart

Trends in Integrated Clinical Workstations

E. M. van Mulligen
1   Dept of Medical Informatics, Erasmus University Rotterdam
2   Netherlands Institute of Health Sciences
,
T. Timmers
3   Dept of Medical Informatics, Academic Medical Centre Amsterdam, The Netherlands
› Author Affiliations
Further Information

Publication History

Publication Date:
05 March 2018 (online)

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Abstract

During the last decade, several projects aiming at integrated clinical workstations have been described and several prototypes have been demonstrated. In most of these projects, the clinical workstation accesses information and functionality provided by the present proprietary legacy systems of health-care institutions. We discuss trends in integrated clinical workstations from the viewpoints of software engineering and integration, considering that the clinical workstation itself basically consists of three layers: a presentation layer, a data integration layer, and a communication layer. The software engineering view on clinical workstations focuses on the development of basic building blocks from which clinical workstations, specific to a particular medical domain, can be composed. The integration view on clinical workstations addresses methods and techniques to deal with the, in general, intrinsically closed information systems in health-care institutions.

Keywords

Health-care Professional Workstations - Software Engineering - Information Architecture - Integration - Brokering.
 

  • References

  • 1 Health Level Seven: An Application Protocol for Electronic Data Interchange in Healthcare Environments. Version 2.1.
    PubMedGoogle Scholar
  • 2 Draft DICOM Standard, PS-3 through PS- 11, ACRINEMA 1992
    PubMed
  • 3 ISO 9735 (1 988): Electronic Data Interchange for Administration, Commerce and Transport (EDIFACT)- Application Level Syntax.
    PubMed
  • 4 ISO/IEC 8824: Information Technology - Open Systems Interconnection - Specification of Abstract Syntax Notation One CASN. l).
    PubMed
  • 5 Draft Pl157.1 Standard for Healthcare Data Interchange - Information Model Methods, IEEE
    PubMed
  • 6 Seliger R. Mapping HL7 Version 2.x to OLE and CORBA. Work-In-Progress. July 1995. Hewlett-Packard Medical Products Group, Andover, United States of America.
    Google Scholar
  • 7 Fournier F. The MINI software factory: development of kernel mechanisms around process modeling and software bus techniques. J Systems Integration 1992; 2: 145-80.
    PubMedGoogle Scholar
  • 8 Van Mulligen EM, Timmers T, Van Bemmel JH. A new architecture for integration of heterogeneous software components. Methods of Information in Medicine 1993; 32: 292-301.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Lemaitre D, Sauquet D, Fofol L, Tanguy L, Jean F-C, Degoulet P. Legacy systems: managing evolution through integration in a distributed and object-oriented computing environment. In Gardner RM. ed. Towards Cost-Effective Clinical Computing. Proceedings of the 19th Symposium on Computer Applications in Medical Care.. Philadelphia: Hanley & Belfus Inc; 1995: 132-6.
    Google Scholar
  • 10 Moorman PW, van Ginneken AM, vander Lei J, van Bemmel JH. A model for structured data entry based on explicit descriptional knowledge. Meth Inform Med 1994; 33: 454-63.
    PubMedGoogle Scholar
  • 11 Van Ginneken AM, Starn H, Moorman PW. A multi-strategy approach for medical records of specialists. In:. Greenes RA, Peterson HE, Protti DJ. eds. Proceedings of the 8th World Congress on Medical Informatics. MEDINFO 95.. Amsterdam: North-Holland; 1995: 290-4.
    Google Scholar
  • 12 Dick RS, Steen EB. eds. The Computer Based Patient Record. An Essential Technology for Health Care.. Washington DC: Institute of Medicine; 1991: 15-9.
    Google Scholar
  • 13 Rind DM, Safran C. Real and imagined barriers to an electronic medical record. In:. Safran C. ed. Proceedings of the Seventeenth SCAMC.. New York: McGraw-Hill; 1993: 74-8.
    Google Scholar
  • 14 Griffith SM, Kalra D, Lloyd DSL, Ingram D. A Portable Communicative Architecture for Electronic Health care records: The Good European Health care Record Project. In:. Greenes RA, Peterson HE, Protti DJ. eds. Proceedings of the 8th World Congress on Medical Informatics. MED INFO 95.. Amsterdam: North-Holland; 1995: 223-6.
    Google Scholar
  • 15 Rector AL, Nowlan W A, Kay S. Foundations for an electronic record. Meth Inform Med 1991; 30: 179-86.
    PubMedGoogle Scholar
  • 16 Raijnikanth M, Jakobson G, Lafond C, Papp W, Piatetsky-Shapiro G. Multiple Database Integration in Calida: design and implementation. In:. Ng P, Ramamoorthy CV, Seifert LC, Yeh RT. eds. Proceedings of the First International Conference on Systems Integration.. Los Alamitos: IEEE Computer Society Press; 1990: 378-84.
    Google Scholar
  • 17 Landers T, Rosenberg R. An Overview of Multibase. Distributed databases.. Amsterdam: North-Holland Publishing; 1982: 153-83.
    Google Scholar
  • 18 Codd EF. Extending the database relational model to capture more meaning. ACM T Database Syst 1979; 4: 397-434.
    PubMedGoogle Scholar
  • 19 Nguyen GT, Rieu D. Schema evolution in object -oriented database systems. Data and Knowledge Engineering 1989; 4: 43-67.
    CrossrefPubMedGoogle Scholar
  • 20 Kilov H. From Semantic to Object-Oriented Data Modeling. In:. Ng P, Ramamoorthy CV, Seifert LC, Yeh RT. eds. Proceedings of the First International Conference on Systems Integration.. Los Alamitos: IEEE Computer Society Press.; 1990: 384-93.
    Google Scholar
  • 21 Esterhay RJ. User metaphors for health care professional workstations. Int J Biomed Comput 1994; 34: 95-113.
    CrossrefPubMedGoogle Scholar
  • 22 McCray AT, Razi A. The UMLS Knowledge Source Server. In:. Greenes RA, Peterson HE, Protti DJ. eds. In: Greenes RA, Peterson HE, Protti DJ. eds. Proceedings of the 8th World Congress on Medical Informatics. MEDINFO 95.. Amsterdam: North-Holland; 1995: 141-5.
    Google Scholar
  • 23 Cimino JJ, Socratous SA, Grewal R. The informatics Superhighway: prototyping on the World-Wide Web. In:. Gardner RM. ed. Towards Cost-Effective Clinical Computing. Proceedings of the 19th Symposium on Computer Applications in Medical Care. Philadelphia: Hanley & Belfus Inc; 1995: 111-5.
    Google Scholar
  • 24 Hinds A, Greenspan P, Kahane IS. WHAM! A forms constructor for medical record access via the World Wide Web. In:. Gardner RM. ed. Towards Cost-Effective Clinical Computing. Proceedings of the 19th Symposium on Computer Applications in Medical Care.. Philadelphia: Hanley & Belfus Inc; 1995: 116-20.
    Google Scholar
  • 25 Barnes M, Barnett GO. An architecture for a distributed guideline server. In:. Gardner RM. ed. Towards Cost-Effective Clinical Computing. Proceedings of the 19th Symposium on Computer Applications in Medical Care.. Philadelphia: Hanley & Belfus Inc; 1995: 233-7.
    Google Scholar
  • 26 Robertson GG, Card SK, Mackinlay JD. Information visualization using 3D interactive animation. Commun ACM 1993; 36: 57-71.
    PubMedGoogle Scholar
  • 27 Weed LL. Knowledge Coupling: New Premises and New Tools for Medical Care and Education. New York: SpringerVerlag,; 1991
    Google Scholar
  • 28 Young CY, Tang PC, Annevelink J. An Open Systems Architecture for Development of a Physician’s Workstation. In:. Clayton PD. ed. Proceedings of the 15th Annual Symposium on Computer Applications in Medical Care.. New York: McGraw-Hill Inc.; 1991: 491-5.
    Google Scholar
  • 29 Matheson NW, Cooper JAD. Academic information in the academic health sciences center: roles for the library in information management. J Med Educ 1982; 57: 1-93.
    PubMedGoogle Scholar
  • 30 Jean F-C, Jaulent MC, Coignard J, Degoulet P. Distribution and communication in Software Engineering Environments. Application to the HELlOS Software Bus. In:. Clayton PD. ed. Proceedings of the 15th Annual Symposium on Computer Applications in Medical Care.. New York: McGraw-Hill Inc.; 1991: 506-10.
    Google Scholar
  • 31 Van Mulligen EM, Timmers T, Van den Heuvel F, Van Bemmel JH. A prototype integrated medical workstation environment. Com put Methods Programs Biomed 1993; 39: 331-41.
    PubMedGoogle Scholar
  • 32 Greenes RA. A "building block" approach to application development for education and decision support in radiology: Implications for integrated Clinica Unformation System Environments. J Dig Imag 1991; 4: 213-25.
    CrossrefPubMedGoogle Scholar
  • 33 Sinha A. Client-server computing. Commun ACM 1992; 35: 77-97.
    PubMedGoogle Scholar
  • 34 OMG. The Common Object Request Broker: Architecture and Specification. OMG Document 91.12.1, X/Open publisher.
    PubMedGoogle Scholar
  • 35 Toohey J. Using OLE 2.x in Application Development. 1994 Que Corporation.
    PubMedGoogle Scholar
  • 36 Degoulet P, Safran C, Bowers GH. Design and processing issues for the health care professional workstation: summary and recommendations. Int J Biomed Comp 1994; 34: 241-7.
    CrossrefPubMedGoogle Scholar
  • 37 Power LR. Post-facto integration technology: new discipline for an old practice. In:. Hg PA, Ramamoorthy CV, Seifert LC, Yeh RT. eds. Proceedings of the First Conference on Systems Integration. Los Alamitos: IEEE Computer Society Press 1990; 4-13.
    PubMedGoogle Scholar
  • 38 OSF. Introduction to OSF DCE. Englewood Cliffs, New Jersey: Prentice Hall. 1992
    PubMedGoogle Scholar