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Information Systems and Architectures

Author(s): Bui AA, Morioka C


Since the advent of computers in medicine, the objective of creating an electronic medical record (EMR) has been to transcend the traditional limitations of paper-based charts through a digital repository capable of quickly organizing patient data, and ultimately, aiding physicians with medical decision-making tasks. This chapter introduces concepts related to the EMR, and covers the development of information systems seen in today's clinical settings. The data and communication standards used by these systems are described (e.g., Digital Imaging and Communications in Medicine, DICOM; Health Level 7, HL7). But as healthcare progressively moves from a centralized practice to a more distributed environment involving multiple sites, providers, and an array of different tasks (both clinical and research), the underlying information architectures must also change. A new generation of informatics challenges has arisen, with different frameworks such as peer-to-peer (P2P) and grid computing being explored to create large scale infrastructures to link operations. We highlight several ongoing projects and solutions in creating medical information architectures, including teleradiology/telemedicine, the integrated healthcare enterprise, and collaborative clinical research involving imaging.

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