Difference between revisions of "Hospital information system"

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A '''hospital information system''' ('''HIS''') (sometimes referred to as a '''healthcare information system''' or '''clinical information system''') is a comprehensive, integrated information system designed to manage the medical, administrative, financial, and legal aspects of a hospital and its service processing. As information management demands become more rigorous, "hospitals are becoming more reliant on the ability of [a] hospital information system (HIS) to assist in the diagnosis, management and education for better and improved services and practices."<ref name="HISMalaysia">{{cite journal |url=http://www.ipedr.com/vol5/no1/45-H00097.pdf |format=PDF |title=Assessing User Satisfaction of using Hospital Information System (HIS) in Malaysia |author=Amin, Indah Mohd; Hussein, Surya Sumarni; Mohd Isa, Wan Abdul Rahim Wan |journal=International Proceedings of Economics Development and Research |series=2011 International Conference on Social Science and Humanity |volume=5 |issue=1 |year=2011 |pages=210–213 |doi=10.7763/IPEDR}}</ref>
[[File:Tanzania hospital information mgt system.jpg|thumb|300px|right|An employees demonstrates a hospital information system in an Tanzanian hospital.]]A '''hospital information system''' ('''HIS''') (sometimes referred to as a '''healthcare information system''' or '''clinical information system'''<ref name="CISComp">{{cite book |url=http://books.google.com/books?id=A0A8vI6PhhoC |chapter=Chapter 1: Introduction: The Evolution of Health Information Systems |title=Clinical Information Systems: A Component-Based Approach |author=Van de Velde, Rudi; Degoulet, Patrice |publisher=Springer |year=2003 |pages=1–14 |isbn=0387955380}}</ref>) is a comprehensive, integrated information system designed to manage the medical, administrative, financial, and legal aspects of a [[hospital]] and its service processing.<ref name="HMIS">{{cite book |url=http://books.google.com/books?id=8YjlAAAAQBAJ |chapter=Chapter 5: Acute Care Health Information Management Systems |title=Health Management Information Systems: A Handbook for Decision Makers |edition=2nd |author=Smith, Jack |publisher=McGraw-Hill International |year=1999 |pages=167–210 |isbn=0335205658}}</ref> As information management demands become more rigorous, "hospitals are becoming more reliant on the ability of [a] hospital information system (HIS) to assist in the diagnosis, management and education for better and improved services and practices."<ref name="HISMalaysia">{{cite journal |url=http://www.ipedr.com/vol5/no1/45-H00097.pdf |format=PDF |title=Assessing User Satisfaction of using Hospital Information System (HIS) in Malaysia |author=Amin, Indah Mohd; Hussein, Surya Sumarni; Mohd Isa, Wan Abdul Rahim Wan |journal=International Proceedings of Economics Development and Research |series=2011 International Conference on Social Science and Humanity |volume=5 |issue=1 |year=2011 |pages=210–213 |doi=10.7763/IPEDR}}</ref>


==History==
==History==


The idea of implementing a computerized information-handling system in the hospital sphere came as early as 1965, when Lockheed Martin conducted an information gathering project on the feasibility of such a system.<ref name="LHHIS">{{cite book |url=http://books.google.com/books?id=8vsFGwAACAAJ |title=Lockheed Hospital Information System |publisher=Lockheed Aircraft Corporation |year=1965 |pages=82}}</ref><ref name="DemEvalHos">{{cite book |url=http://books.google.com/books?id=6RA7YzUXYg8C |title=Demonstration and evaluation of a total hospital information system |author=Gall, John E.; Norwood, Donald D.; El Camino Hospital |publisher=U.S. Dept. of Health, Education, and Welfare, Public Health Service, Health Resources Administration, National Center for Health Services Research |series=NCHSR research summary series |year=1977 |pages=38}}</ref> Lockheed built a prototype hospital information system called "MIS" or "Medical Information System," and El Camino Hospital agreed to pilot it incrementally. In 1971 Lockheed was forced to sell its HIS research division to Technicon Data Systems; however, El Camino ultimately decided to fully implement it in 1972.<ref name="DemEvalHos" /><ref name="EvoHosSys">{{cite journal |url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2203735/pdf/procascamc00012-0066.pdf |format=PDF |title=Evolution of a Hospital Information System |author=Buchanan, Neilson S. |journal=Proceedings of the Annual Symposium on Computer Application in Medical Care |issue=1 |pages=34–36 |date=05 November 1980 |pmcid=PMC2203735}}</ref> The system had features such as laboratory test scheduling, IV ordering, and pharmacy management.<ref name="EvoHosSys" />  
The idea of implementing a computerized information-handling system in the [[hospital]] sphere came as early as 1965, when Lockheed Martin conducted an information gathering project on the feasibility of such a system.<ref name="LHHIS">{{cite book |url=http://books.google.com/books?id=8vsFGwAACAAJ |title=Lockheed Hospital Information System |publisher=Lockheed Aircraft Corporation |year=1965 |pages=82}}</ref><ref name="DemEvalHos">{{cite book |url=http://books.google.com/books?id=6RA7YzUXYg8C |title=Demonstration and evaluation of a total hospital information system |author=Gall, John E.; Norwood, Donald D.; El Camino Hospital |publisher=U.S. Dept. of Health, Education, and Welfare, Public Health Service, Health Resources Administration, National Center for Health Services Research |series=NCHSR research summary series |year=1977 |pages=38}}</ref> Lockheed built a prototype hospital information system called "MIS" or "Medical Information System," and El Camino Hospital agreed to pilot it incrementally. In 1971 Lockheed was forced to sell its HIS research division to Technicon Data Systems; however, El Camino ultimately decided to fully implement it in 1972.<ref name="DemEvalHos" /><ref name="EvoHosSys">{{cite journal |url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2203735/pdf/procascamc00012-0066.pdf |format=PDF |title=Evolution of a Hospital Information System |author=Buchanan, Neilson S. |journal=Proceedings of the Annual Symposium on Computer Application in Medical Care |issue=1 |pages=34–36 |date=05 November 1980 |pmcid=PMC2203735}}</ref> The system had features such as laboratory test scheduling, IV ordering, and pharmacy management.<ref name="EvoHosSys" />  


By the late 1970s to the early 1980s, other hospitals around the world had implemented hospital information systems<ref name="TaxHIS">{{cite journal |url=http://link.springer.com/article/10.1007%2FBF02285254 |title=A taxonomy: Hospital information systems evaluation methodologies |author=Krobock, John R. |journal=Journal of Medical Systems |volume=8 |issue=5 |pages=419–429 |date=October 1984 |doi=10.1007/BF02285254}}</ref> with functionality like accounting, budgeting, patient census, inventory, scheduling, registration, and even instrument automation.<ref name="AdvInComp16">{{cite book |url=http://books.google.com/books?id=0dj2HGAZs4wC |chapter=Perspectives in Clinical Computing |title=Advances in Computers |volume=16 |author=Rubinoff, Morris; Yovits, M. Marshall Clinton |publisher=Academic Press |year=1977 |pages=128–177 |isbn=0080566480}}</ref> Researchers and companies were also debating and writing about the efficacy of these systems.<ref name="HCS">{{cite book |url=http://books.google.com/books?id=80pRAAAAMAAJ |title=Hospital Computer Systems |author=Collen, Morris Frank |publisher=Wiley |year=1974 |pages=768 |isbn=0471165107}}</ref><ref name="HISEncyc">{{cite book |url=http://books.google.com/books?id=rpnDzWi-bDoC |chapter=Hospital Information Systems |author=Anderson, Elizabeth B.; Kent, Allen (ed.); Lancour, Harold (ed.) |title=Encyclopedia of Library and Information Science, Volume 11 |publisher=CRC Press |year=1974 |pages=1–18 |isbn=0824720113}}</ref><ref name="HISHomer">{{cite book |url=http://books.google.com/books?id=hlJrAAAAMAAJ |title=Hospital Information Systems |author=Schmitz, Homer H. |publisher=Aspen Systems Corporation |year=1979 |pages=188 |isbn=0894431560}}</ref> Yet by this same time period, HIS's positive impact on hospitals — based on operating costs — was not apparent.<ref name="TaxHIS" />
By the late 1970s to the early 1980s, other hospitals around the world had implemented hospital information systems<ref name="TaxHIS">{{cite journal |url=http://link.springer.com/article/10.1007%2FBF02285254 |title=A taxonomy: Hospital information systems evaluation methodologies |author=Krobock, John R. |journal=Journal of Medical Systems |volume=8 |issue=5 |pages=419–429 |date=October 1984 |doi=10.1007/BF02285254}}</ref> with functionality like accounting, budgeting, patient census, inventory, scheduling, registration, and even instrument automation.<ref name="AdvInComp16">{{cite book |url=http://books.google.com/books?id=0dj2HGAZs4wC |chapter=Perspectives in Clinical Computing |title=Advances in Computers |volume=16 |author=Rubinoff, Morris; Yovits, M. Marshall Clinton |publisher=Academic Press |year=1977 |pages=128–177 |isbn=0080566480}}</ref> Researchers and companies were also debating and writing about the efficacy of these systems.<ref name="HCS">{{cite book |url=http://books.google.com/books?id=80pRAAAAMAAJ |title=Hospital Computer Systems |author=Collen, Morris Frank |publisher=Wiley |year=1974 |pages=768 |isbn=0471165107}}</ref><ref name="HISEncyc">{{cite book |url=http://books.google.com/books?id=rpnDzWi-bDoC |chapter=Hospital Information Systems |author=Anderson, Elizabeth B.; Kent, Allen (ed.); Lancour, Harold (ed.) |title=Encyclopedia of Library and Information Science, Volume 11 |publisher=CRC Press |year=1974 |pages=1–18 |isbn=0824720113}}</ref><ref name="HISHomer">{{cite book |url=http://books.google.com/books?id=hlJrAAAAMAAJ |title=Hospital Information Systems |author=Schmitz, Homer H. |publisher=Aspen Systems Corporation |year=1979 |pages=188 |isbn=0894431560}}</ref> Yet by this same time period, HIS's positive impact on hospitals — based on operating costs — was not apparent.<ref name="TaxHIS" />


In the early to mid 1990s Japan was leading the way in adoption of hospital information systems and their integration into the majority of the activities in the hospital, including the preparation of health insurance claims. In 1991, 81.6 percent of all Japanese hospitals were using [[health informatics]] technology to prepare claims.<ref name="HISInfostruct">{{cite book |url=http://books.google.com/books?id=joIMwwnevcEC |chapter=Chapter 8: Information Systems in Japanese Healthcare |title=Healthcare Infostructures: The Development of Information-based Infrastructures for the Healthcare Industry |author=Yoshikawa, Aki; Ishikawa, Koichi B. |publisher=Greenwood Publishing Group |year=1995 |pages=82–95 |isbn=027595157X}}</ref><ref name="HISJap">{{cite journal |url=http://www.ncbi.nlm.nih.gov/pubmed/10283175 |title=Hospital Information systems in Japan: Their Trends of Past, Present and Future |author=Miyake, H. |journal=Japan-hospitals : the journal of the Japan Hospital Association |volume=6 |pages=35–44 |date=July 1987 |pmid=10283175}}</ref> [[Picture archiving and communication system]]s (PACSs) were becoming fully integrated into the HIS along with the connections needed for medical imaging equipment. Integration of the HIS with the systems of insurance associations was also being prototyped, creating the potential for more integrated patient medical record databases.<ref name="HISInfostruct" />
In the early to mid-1990s Japan was leading the way in adoption of hospital information systems and their integration into the majority of the activities in the hospital, including the preparation of health insurance claims. In 1991, 81.6 percent of all Japanese hospitals were using [[health informatics]] technology to prepare claims.<ref name="HISInfostruct">{{cite book |url=http://books.google.com/books?id=joIMwwnevcEC |chapter=Chapter 8: Information Systems in Japanese Healthcare |title=Healthcare Infostructures: The Development of Information-based Infrastructures for the Healthcare Industry |author=Yoshikawa, Aki; Ishikawa, Koichi B. |publisher=Greenwood Publishing Group |year=1995 |pages=82–95 |isbn=027595157X}}</ref><ref name="HISJap">{{cite journal |url=http://www.ncbi.nlm.nih.gov/pubmed/10283175 |title=Hospital Information systems in Japan: Their Trends of Past, Present and Future |author=Miyake, H. |journal=Japan-hospitals : the journal of the Japan Hospital Association |volume=6 |pages=35–44 |date=July 1987 |pmid=10283175}}</ref> [[Picture archiving and communication system]]s (PACSs) were becoming fully integrated into the HIS along with the connections needed for medical imaging equipment. Integration of the HIS with the systems of insurance associations was also being prototyped, creating the potential for more integrated patient medical record databases.<ref name="HISInfostruct" />


During this time hospitals and developers were also focused on two particular goals for the HIS: to further adapt the system to the clinical environment, and to establish communication links between the HIS and other outside entities like [[Laboratory|laboratories]] and pharmacies.<ref name="HISInfostruct" />
During this time hospitals and developers were also focused on two particular goals for the HIS: to further adapt the system to the clinical environment, and to establish communication links between the HIS and other outside entities like [[Laboratory|laboratories]] and pharmacies.<ref name="HISInfostruct" /> The achievement of these and other integration goals became apparent by the middle to late 1990s, with many health systems becoming consolidated and/or linked through interfaces. The road towards integration of the HIS with other health care systems was still difficult due to the diversity of tasks, the technical limitations, the preference towards departmental systems, and developer philosophy at the time. Performing synchronous updates between heterogeneous systems, managing communication servers, and handling overlapping functionality were other key problems in this integration process.<ref name="HIS2nd">{{cite book |url=http://books.google.com/books?id=bb0KrZ0VkxEC |chapter=Chapter 3: Interface Tools for Healthcare Information Technology |title=Healthcare Information Systems |edition=2nd |author=Stuewe, Scott; Beaver, Kevin (ed.) |publisher=CRC Press |year=2002 |pages=31–46 |isbn=1420031406}}</ref><ref name="HMIS" /><ref name="MIE99">{{cite book |url=http://books.google.com/books?id=SFczJPTHQ54C |chapter=Hospital Information Systems: Chances and Obstacles on the Way to Integration |title=Medical Informatics Europe '99 |author=Lenz, Richard; Blaser, Rainer; Kuhn, Klaus A.; Kokol, Peter (ed.); Zupan, Blaž (ed.); Stare, Janez (ed.) |publisher=IOS Press |year=1999 |pages=25–30 |isbn=0967335515}}</ref>


By the 2000s, advances in component-based technologies, communication systems, distributed systems, and network-centric architectures brought the opportunity for homogeneity and data sharing to a new level. Improved communication standards like [[Health Level 7]] and [[XML]] packaging structures like Simple Object Access Protocol (SOAP) also contributed, bringing a new "era of real medically oriented information systems that encourage integration of all existing satellite systems (external and internal) into one coherent, interoperable environment around [[electronic health record]]s (EHR)."<ref name="CISComp" />


==Functionality==
==Functionality==


A HIS may be composed of one or more software components, including specialty-specific extensions as well as a large variety of sub-systems in medical specialties, including [[laboratory information system]]s, (LISs), [[radiology information system]]s (RISs) or [[picture archiving and communication system]]s (PACSs).
A modern HIS may be composed of one or more software components, including specialty-specific extensions as well as a large variety of sub-systems in medical specialties, including [[laboratory information system]]s, (LISs), [[radiology information system]]s (RISs) or [[picture archiving and communication system]]s (PACSs).


The functionality of a HIS may include help with paper-based [[information]] processing, resident work positioning, and mobile data acquisition and presentation.  
Primary functionality of a hospital information system includes<ref name="HMIS" />:
 
* patient care management
* procedure management
* reporting
* medical-administrative care management
* communications
* research and training
* general and cost accounting
* human resource management
* inventory control
* ancillary systems management
* medical record management
 
The functionality of a HIS may also include assistance with paper-based [[information]] processing, resident work positioning, pharmaceutical management, and mobile data acquisition and presentation.  
 
==Further reading==
 
* {{cite web |url=http://www.library.nhs.uk/booksandjournals/results.aspx?t=*Hospital+Information+Systems&stfo=True&sc=bnj.pub.MED&p=1&sf=srt.publicationdate&sfld=fld.title |title=Healthcare Databases Simple Search: Hospital Information Systems |publisher=National Institute for Health and Care Excellence |accessdate=02 October 2013}}
* {{cite book |url=http://books.google.com/books?id=8YjlAAAAQBAJ |title=Health Management Information Systems: A Handbook for Decision Makers |edition=2nd |author=Smith, Jack |publisher=McGraw-Hill International |year=1999 |pages=348 |isbn=0335205658}}


==References==
==References==
<references />
<references />
<!---Place all category tags here-->
[[Category:Health informatics]]
[[Category:Laboratory informatics]]
[[Category:Software systems]]

Latest revision as of 16:52, 22 August 2014

An employees demonstrates a hospital information system in an Tanzanian hospital.

A hospital information system (HIS) (sometimes referred to as a healthcare information system or clinical information system[1]) is a comprehensive, integrated information system designed to manage the medical, administrative, financial, and legal aspects of a hospital and its service processing.[2] As information management demands become more rigorous, "hospitals are becoming more reliant on the ability of [a] hospital information system (HIS) to assist in the diagnosis, management and education for better and improved services and practices."[3]

History

The idea of implementing a computerized information-handling system in the hospital sphere came as early as 1965, when Lockheed Martin conducted an information gathering project on the feasibility of such a system.[4][5] Lockheed built a prototype hospital information system called "MIS" or "Medical Information System," and El Camino Hospital agreed to pilot it incrementally. In 1971 Lockheed was forced to sell its HIS research division to Technicon Data Systems; however, El Camino ultimately decided to fully implement it in 1972.[5][6] The system had features such as laboratory test scheduling, IV ordering, and pharmacy management.[6]

By the late 1970s to the early 1980s, other hospitals around the world had implemented hospital information systems[7] with functionality like accounting, budgeting, patient census, inventory, scheduling, registration, and even instrument automation.[8] Researchers and companies were also debating and writing about the efficacy of these systems.[9][10][11] Yet by this same time period, HIS's positive impact on hospitals — based on operating costs — was not apparent.[7]

In the early to mid-1990s Japan was leading the way in adoption of hospital information systems and their integration into the majority of the activities in the hospital, including the preparation of health insurance claims. In 1991, 81.6 percent of all Japanese hospitals were using health informatics technology to prepare claims.[12][13] Picture archiving and communication systems (PACSs) were becoming fully integrated into the HIS along with the connections needed for medical imaging equipment. Integration of the HIS with the systems of insurance associations was also being prototyped, creating the potential for more integrated patient medical record databases.[12]

During this time hospitals and developers were also focused on two particular goals for the HIS: to further adapt the system to the clinical environment, and to establish communication links between the HIS and other outside entities like laboratories and pharmacies.[12] The achievement of these and other integration goals became apparent by the middle to late 1990s, with many health systems becoming consolidated and/or linked through interfaces. The road towards integration of the HIS with other health care systems was still difficult due to the diversity of tasks, the technical limitations, the preference towards departmental systems, and developer philosophy at the time. Performing synchronous updates between heterogeneous systems, managing communication servers, and handling overlapping functionality were other key problems in this integration process.[14][2][15]

By the 2000s, advances in component-based technologies, communication systems, distributed systems, and network-centric architectures brought the opportunity for homogeneity and data sharing to a new level. Improved communication standards like Health Level 7 and XML packaging structures like Simple Object Access Protocol (SOAP) also contributed, bringing a new "era of real medically oriented information systems that encourage integration of all existing satellite systems (external and internal) into one coherent, interoperable environment around electronic health records (EHR)."[1]

Functionality

A modern HIS may be composed of one or more software components, including specialty-specific extensions as well as a large variety of sub-systems in medical specialties, including laboratory information systems, (LISs), radiology information systems (RISs) or picture archiving and communication systems (PACSs).

Primary functionality of a hospital information system includes[2]:

  • patient care management
  • procedure management
  • reporting
  • medical-administrative care management
  • communications
  • research and training
  • general and cost accounting
  • human resource management
  • inventory control
  • ancillary systems management
  • medical record management

The functionality of a HIS may also include assistance with paper-based information processing, resident work positioning, pharmaceutical management, and mobile data acquisition and presentation.

Further reading


References

  1. ↑ 1.0 1.1 Van de Velde, Rudi; Degoulet, Patrice (2003). "Chapter 1: Introduction: The Evolution of Health Information Systems". Clinical Information Systems: A Component-Based Approach. Springer. pp. 1–14. ISBN 0387955380. http://books.google.com/books?id=A0A8vI6PhhoC. 
  2. ↑ 2.0 2.1 2.2 Smith, Jack (1999). "Chapter 5: Acute Care Health Information Management Systems". Health Management Information Systems: A Handbook for Decision Makers (2nd ed.). McGraw-Hill International. pp. 167–210. ISBN 0335205658. http://books.google.com/books?id=8YjlAAAAQBAJ. 
  3. ↑ Amin, Indah Mohd; Hussein, Surya Sumarni; Mohd Isa, Wan Abdul Rahim Wan (2011). "Assessing User Satisfaction of using Hospital Information System (HIS) in Malaysia" (PDF). International Proceedings of Economics Development and Research. 2011 International Conference on Social Science and Humanity 5 (1): 210–213. doi:10.7763/IPEDR. http://www.ipedr.com/vol5/no1/45-H00097.pdf. 
  4. ↑ Lockheed Hospital Information System. Lockheed Aircraft Corporation. 1965. pp. 82. http://books.google.com/books?id=8vsFGwAACAAJ. 
  5. ↑ 5.0 5.1 Gall, John E.; Norwood, Donald D.; El Camino Hospital (1977). Demonstration and evaluation of a total hospital information system. NCHSR research summary series. U.S. Dept. of Health, Education, and Welfare, Public Health Service, Health Resources Administration, National Center for Health Services Research. pp. 38. http://books.google.com/books?id=6RA7YzUXYg8C. 
  6. ↑ 6.0 6.1 Buchanan, Neilson S. (5 November 1980). "Evolution of a Hospital Information System" (PDF). Proceedings of the Annual Symposium on Computer Application in Medical Care (1): 34–36. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2203735/pdf/procascamc00012-0066.pdf. 
  7. ↑ 7.0 7.1 Krobock, John R. (October 1984). "A taxonomy: Hospital information systems evaluation methodologies". Journal of Medical Systems 8 (5): 419–429. doi:10.1007/BF02285254. http://link.springer.com/article/10.1007%2FBF02285254. 
  8. ↑ Rubinoff, Morris; Yovits, M. Marshall Clinton (1977). "Perspectives in Clinical Computing". Advances in Computers. 16. Academic Press. pp. 128–177. ISBN 0080566480. http://books.google.com/books?id=0dj2HGAZs4wC. 
  9. ↑ Collen, Morris Frank (1974). Hospital Computer Systems. Wiley. pp. 768. ISBN 0471165107. http://books.google.com/books?id=80pRAAAAMAAJ. 
  10. ↑ Anderson, Elizabeth B.; Kent, Allen (ed.); Lancour, Harold (ed.) (1974). "Hospital Information Systems". Encyclopedia of Library and Information Science, Volume 11. CRC Press. pp. 1–18. ISBN 0824720113. http://books.google.com/books?id=rpnDzWi-bDoC. 
  11. ↑ Schmitz, Homer H. (1979). Hospital Information Systems. Aspen Systems Corporation. pp. 188. ISBN 0894431560. http://books.google.com/books?id=hlJrAAAAMAAJ. 
  12. ↑ 12.0 12.1 12.2 Yoshikawa, Aki; Ishikawa, Koichi B. (1995). "Chapter 8: Information Systems in Japanese Healthcare". Healthcare Infostructures: The Development of Information-based Infrastructures for the Healthcare Industry. Greenwood Publishing Group. pp. 82–95. ISBN 027595157X. http://books.google.com/books?id=joIMwwnevcEC. 
  13. ↑ Miyake, H. (July 1987). "Hospital Information systems in Japan: Their Trends of Past, Present and Future". Japan-hospitals : the journal of the Japan Hospital Association 6: 35–44. PMID 10283175. http://www.ncbi.nlm.nih.gov/pubmed/10283175. 
  14. ↑ Stuewe, Scott; Beaver, Kevin (ed.) (2002). "Chapter 3: Interface Tools for Healthcare Information Technology". Healthcare Information Systems (2nd ed.). CRC Press. pp. 31–46. ISBN 1420031406. http://books.google.com/books?id=bb0KrZ0VkxEC. 
  15. ↑ Lenz, Richard; Blaser, Rainer; Kuhn, Klaus A.; Kokol, Peter (ed.); Zupan, Blaž (ed.); Stare, Janez (ed.) (1999). "Hospital Information Systems: Chances and Obstacles on the Way to Integration". Medical Informatics Europe '99. IOS Press. pp. 25–30. ISBN 0967335515. http://books.google.com/books?id=SFczJPTHQ54C. 
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