Integration and Beyond
Linking Information from Disparate Sources and into Workflow
- Affiliations of the authors: Vanderbilt University, Nashville, Tennessee (WWS, RAM); Stanford University Medical School, Stanford, California (MAM); Oregon Health Sciences University, Portland, Oregon (WRH)
- Correspondence and reprints: William W. Stead, MD, Associate Vice Chancellor for Health Affairs, Vanderbilt University, 416 Eskind Biomedical Library, 2209 Garland Avenue, Nashville, TN 37232-8340; e-mail: 〈bill.stead{at}mcmail.vanderbilt.edu〉
- Received 1 November 1999
- Accepted 18 November 1999
Abstract
The vision of integrating information—from a variety of sources, into the way people work, to improve decisions and process—is one of the cornerstones of biomedical informatics. Thoughts on how this vision might be realized have evolved as improvements in information and communication technologies, together with discoveries in biomedical informatics, and have changed the art of the possible. This review identified three distinct generations of “integration” projects. First-generation projects create a database and use it for multiple purposes. Second-generation projects integrate by bringing information from various sources together through enterprise information architecture. Third-generation projects inter-relate disparate but accessible information sources to provide the appearance of integration. The review suggests that the ideas developed in the earlier generations have not been supplanted by ideas from subsequent generations. Instead, the ideas represent a continuum of progress along the three dimensions of workflow, structure, and extraction.
Footnotes
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This paper was presented in part as the keynote to the Cornerstone on Integrating Information, one of four Cornerstone sessions included in the program of the AMIA Annual Fall Symposium, Washington, DC, November 6-10, 1999.
The work leading to the conceptualization of the three generations and three dimensions was supported in part by grants G08-LM04613 and G08-LM05443 from the National Library of Medicine (NLM); the work on provider order entry, by grants R01-LM06226 and G08-LM05443 from the NLM; the work on component-based architectures for decision support, by grant LM05708 from the NLM; the work on Cliniweb, by grant 1U01-LM05879 from the NLM and grant DE-FG03-94ER61918 from the Department of Energy; and the metadata work, by training grant LM07088 from the NLM.
