Medical information systems integration (Panel Discussion)

For hospitals as well as for other complex organizations, the growth of integrated computer systems beyond traditional applications areas, such as financial processing, has led to a dilemma. Either the new applications are developed (or purchased) with the restrictive requirement of integrability with existing applications, or additional resources need to be devoted to the problem of allowing interchange of data among systems. In most cases, these system-to-system interfaces are developed on an ad hoc basis, tailored closely to the two systems being interfaced, and must therefore be modified whenever either system is changed. Although this situation is often tolerable when only two or three systems are involved, it usually consumes resources anc limits flexibility to an appreciable extent. The real problems with this approach, however, become apparent when the number of interacting information systems exceeds two or three, or when resources are simply not available to create and maintain ad hoc interfaces. Unfortunately, many institutions today are in the process of acquiring cr developing their third or fourth distinct application system, and this information systems integration problem is being encountered with increasing frequency. In particular, many users who elect to acquire applications systems from several different systems vendors have found that the functionality and efficiency of each of the systems is seriously impaired by continuing struggles with interfaces, even when the same hardware is in use on all the systems. From the vendor's viewpoint, this situation is equally bad. Some vendors respond by proposing a single, comprehensive information system to meet all of the organization's needs. Although this approach may seem the desirable one from the developer's standpoint, it has several serious drawbacks in practice.