A design strategy for health information systems to address care process management

Health information systems (HISs) offer great potential for supporting healthcare delivey, particularly collaborative care delivery that is provided across multiple settings and providers. To date many HISs have focused on digitzing data or processes on a departmental or healthcare provider basis. This approach has resulted in unintended consequences due to different types of interoperability issues. New approaches are needed to design integrated HISs to support collaborative care delivery. There is also a need for studies that articulate interoperability needs for HISs and how to evaluate different aspects (i.e., data, process and technical) of interoperability. This paper uses a three year case study of the design of the Palliative Care Information System (PAL-IS) to study system design and interoperability considerations for a collaborative HIS. We describe the two phases in which PAL-IS was designed and also identify criteria for evaluating interoperability of collaborative HISs.