Designing a reference architecture for health information systems

Background
Healthcare relies on health information systems (HISs) to support the care and receive reimbursement for the care provided. Healthcare providers experience many problems with their HISs due to improper architecture design. To support the design of a proper HIS architecture, a reference architecture (RA) can be used that meets the various stakeholder concerns of HISs. Therefore, the objective of this study is to develop and analyze an RA following well-established architecture design methods.

Methods
Domain analysis was performed to scope and model the domain of HISs. For the architecture design, we applied the views and beyond approach and designed the RA’s views based on the stakeholders and features from the domain analysis. We evaluated the RA with a case study.

Results
We derived the following four architecture views for HISs: The context diagram, decomposition view, layered view, and deployment view. Each view shows the architecture of the HIS from a different angle, suitable for various stakeholders. Based on a Japanese hospital information system study, we applied the RA and derived the application architecture.

Conclusion
We demonstrated that the methods of the software architecture design community could be used in the healthcare domain effectively and showed the applicability of the RA.