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Letter to the Editor: Integration of Information

May 19, 2001

Frank Irving, Editor
ADVANCE for Health Information Executives

RE: "Five Steps to Secure Web-Integration of Legacy Systems," by Kipp Lassetter

Dear Editor;

This is in response to the above-titled article from the current issue of ADVANCE for Health Information Executives. Specifically, I would like to call attention to the following paragraph:

Standard data formats such as XML and HL7 allow the transfer of information between dissimilar health information systems, making it possible to extract data from legacy systems with minimal interface work. The ability to transfer and manage data as discrete elements makes it possible to present data from multiple sources to the user in one integrated, user-friendly interface.
In order to present data from multiple and different sources in one integrated interface, you need qualitative, analytical indexing. Lassetter has omitted to tell us how one is to integrate and then present such data. In fact, he even goes on to say, "An information system has no value if nobody uses it."

Hear, hear!

But how do we ensure our systems are useful?

"To design the best Web-integration solution, consider your end users," he adds. "It is now possible to integrate your legacy system into a single sign-on platform designed for health-care providers."

Okay, so it's possible, but how do we do this? We still aren't given any specifics as to how to integrate our data. And while Lassetter does note we will want to be able to add new data sources and applications, connections, eligibility data, practice management solutions, and more, he doesn't tell us how we should, in fact, add in this information. (That's probably because he wants us to use Medicity, his company, which provides just this sort of service to physicians who need to integrate patient records.)

He has neglected to mention the fundamental process of indexing. Information design, a buzzword these days, is good old-fashioned indexing. If you're talking about patient records, you might just mean sorting everything by patient names, as well as allowing for searching by pathology. But whether you are talking about a database, a portal, a Web site, a CD-ROM product, a multimedia production, an eBook or a paper book, you need to consider how your users will retrieve the information within. With books we have tables of contents and indexes to assist our users. With electronic files, the linearity of page order is gone, and we need to take a more global view as to how we present our information. And we still have to deal with fundamental issues of indexing: How do we pull together related information? How do we link different, but related information? In other words, how do we conceptually integrate all our information into one presentation?

There are plenty of other applications besides patient records management systems such as Medicity to consider. As Lassetter notes in his closing paragraph, "The Internet and related technologies are moving us steadily toward ubiquitous access to information and enhanced knowledge and decision-making abilities."

It is critical that we not leave out analysis in our presentation of information, no matter how ubiquitous the access, no matter how much information there is. Indexes and other organized information systems don't just have random series of headings; they provide logical sequences of information accessible to all users. No user -- physician, patient, or other consumer -- will return to our information system unless they are successful in finding the information they are looking for. This applies to database and other records management systems, to health information portals and Web sites, to multimedia health reference tools, to company intranets, and more.

Unfortunately, XML does not have a standard data format for index entries. Such an XML standard has yet to be written and agreed-upon.

© 2001 Pilar Wyman
Wyman Indexing
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