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Figure 5.14 Self-monitoring system for an asthma patient
FONG et al 2011 In order to carry out the network maintenance successfully
without effecting the entire system in an organization it is im- portant to have a copy of the building layout map which illus-
trates the physical network of the building whereby wiring locations, access entries and related infrastructures. It allows the
merging of all the latest gadgets in appropriate locations. Data networking and energy supply should be attached to newly-
integrated gadgets since most monitoring devices could attain energy from cables. Effective integration includes configuring
new portions into the system. All the existing networks might have different network architectures that need varied integrating
demands. Existing communicative channels include IEEE 802.11 WLANs are IP channels that simplifies interaction
through standardizations. However, several previous channels may require extra procedures due to network protocol.
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5.3.1 Middleware
Middleware is a vital tool in network integration. It provides services that are able to communicate and link to any systems.
The word middle in the name itself resembles its purpose as a medium of communication or link between application and op-
erating system in a computer. According to Krakowiak 2009, tazari et al 2010a, tazari et al 2012b, a detailed tutorial for
middleware is provided. Rimasss 2002 has come up with mid- dleware abilities which can serve as a communication tool,
providing data accessibility and utility control for the connected devices. Another use was discovered by Sphani 1999 who
stated that middleware is used for different healthcare purposes.
Middleware aims to aid the combination of different computa- tional systems, medical devices, surveillance functions and da-
tabase among others. As it supports the interactions of different functions related to Enterprise Application Integration EAI
and describes the combinations of different functions in the healthcare network, the software is actively adjusted to facilitate
its access into the database. Enterprise Application Integration addresses issues related to consolidation and connection, where
the consolidation of data is conducted through the incorporation of application programming interfaces APIs for data adaption.
To access to the OS or libraries of computational devises, an interface is provided according to functions.
5.3.2 Database
A huge volume of data is stored in different formats such as themes or subjects, files and records for a systematic organiza-
tion and facilitates the retrieval of data according to user’s ob- jectives. Files refer to individual data while records are a
collective data based on themes. In the application of healthcare, files contain single medical activities of patients
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such as the prescription of medicines, while records hold more comprehensive information of patients from health complica-
tions identified to the prescription of medicines as well as other personal information. The size of data varies according to
healthcare institutions i.e. smaller database in clinics and phar- macies and enormous database in national health institutions.
From this, the integration of database is essentially a very diffi- cult task. For example, in Canada alone, one of the aspects that
has to be taken into consideration in data integration include the differences in encoding schemes as a result of entries from dif-
ferent languages French and English being the most spoken languages and this is further complicated by the conformation
of legacy databases of each system vendor. Each function is de- signed for different objectives in the healthcare institution and
equipped with a unique database according to matching infor- mation. Through the integration of these functions, medical his-
tory and data sharing can take place which results in a good medical practice. Figure 5.15 shows an example of an integra-
tion of functions and database. The most important feature in data integration is consistency, where medical information from
different healthcare institutes can be shared and renewed through a system.
Figure 5.15 Data sharing in hospitals FONG et al 2011
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5.3.3 Involvement of different parties
Like other systems, the healthcare information system must be complemented with various human-users such the technical
support, system design and engineering teams. Different users result in different perceptions of the system. Hence, it is im-
portant to maintain the originality of the user interface, and changes in how the system is used are kept at a minimum level.
This aspect is especially important with healthcare systems as any error cannot be tolerated and puts lives at risks. It is im-
portant to ensure that system operators can still use the system prior to changes. To ensure this, system maintainer must retain
the original functions and system interface even after new ones are installed or upon integration of systems. The success of sys-
tem management includes a good communication between users and system suppliers. During system maintenance, users must
be informed in advance for the rescheduling or arranging for alternatives to avoid any complications in case of the occur-
rence of medical emergencies. To keep operational disruption at the minimum level, every procedure that can be conducted prior
to system shut down is carried out earlier. System testing is conducted as a crucial part to identify and rectify complications
following system integration. In section 9.1, system reliability will be examined. As the conclusion for this chapter, the func-
tion of system testing will be briefly reviewed. The extended function of unit testing is integration testing. In this function,
individual functions will be examined before integration. Also during this process, unit testing is performed during system in-
tegration to ensure the detection of system error within func- tions and rectified before system integration is finalized to avoid
further completion made to the whole system. This is important as sometimes errors only occur when individual functions have
been integrated into the system. To ensure system reliability, these arduous procedures must be performed prior to and after
system integration is finalized. The most common issue encoun-
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tered in integration is function compatibility especially from various service providers. To solve this problem, standards are
developed to optimize system compatibility. There are three similar interpretations of system integration abbreviated by CII:
Common Integrated Infrastructure: A model for the in-
tegration of new and legacy applications in organiza- tions for identical functions Helm, 1999, which
include the healthcare institutions.
Compatibility, Interoperability, and Integration: Regu-
lations developed to make sure the conformation of measurements as mentioned.
Configuration Identification Index: A process to mani-
fest and link files accordingly for different systems. User acceptance test is the last procedure conducted to verify
system’s efficiency and applicability to make sure that system integration conforms to operator’s demands. It is also important
to inform users about the functions that have been added.
5.4 Evaluation of IT infrastructures and solution providers
There is a wide business opportunity offered in the healthcare for IT organizations due to the expansive applications of infor-
mational technology. There are various categories of business collaboration that can take place between IT firms and
healthcare institutes in acknowledging numerous important is- sues. Given this, readers must have a good comprehension on
the related issues as a preparation of the information provided.
