Integrated Digital Health Systems Design: A Service-Oriented Soft Systems Methodology

The application of information technology in healthcare has focused primarily on the implementation of specific systems such as electronic health records (EHRs) and clinical decision support systems (CDSSs), mainly for intraenterprise use. However, for the integrated health system (IHS) to function effectively in a complex inter-enterprise healthcare delivery environment, designers must focus on approaches such as soft systems methodology (SSM) to enable the design of robust integrated digital health systems (IDHSs). A service-oriented architecture (SOA) offers a flexible framework for IDHSs to become de-centralized, fully functional and modular systems with interoperability. This article identifies the design issues in IDHS and explores the potential of an SSM methodology-based SOA for the development of interoperable IDHSs. In the process we compare and contrast the functionalist socio-technical approach to the interpretive SSM. We also describe a prototype SOA application for an IDHS setting and discuss challenges in the application of SOA to healthcare.