Health Care Information Systems: Architectural Models and Governance

The adoption of ICT within health care has been characterized by a series of phases evolving since the 1960s (Khoumbati et al., 2009). Health informatics adoption started mainly from financial systems, providing support to the organization’s billing, payroll, accounting and reporting systems. Clinical departments launched a major initiative during the 1970s that supported such internal activities as radiology, laboratory and pharmacy (Wickramasinghe & Geisler, 2008), where machinery could support high-volume operations with the implementation of standardized procedures. Financial systems once again became prominent in the 1980s, with major investments in cost accounting and materials management systems (Grimson, 2001). During the 1990s, attention turned towards enterprise-wide clinical systems, including clinical data repositories and visions of a fully computerized Electronic Medical Record (EMR) (Bates, 2005).