Actions in Health Care Organizations: An Ontological Analysis

In order to ensure that the information and knowledge needed for the management of healthcare is appropriately shared, human behavior within health care organizations (HCOs) needs to be carefully analyzed. Hence, guidelines, protocols, and messaging standards must be combined with models of resources and processes of patient care that are based on a sound ontology of organizations. This requires a general theory of the ontology of social institutions. Among the many groups attempting to develop efficient ways of sharing information across healthcare systems and organizations is Health Level 7 (HL7). Here I address the question whether HL7 reflects a sound analysis of behavior within HCOs on the basis of a sound ontology of organizations. I then apply ontological principles designed to show how the Reference Information Model (RIM) might be modified in such a way as to support efficient communication of medical information within and between healthcare organizations.