Journal of Medical Systems

, Volume 36, Issue 6, pp 3713–3724 | Cite as

Process-Oriented Integration and Coordination of Healthcare Services across Organizational Boundaries

  • Edgar Tello-Leal
  • Omar Chiotti
  • Pablo David Villarreal
Original Paper


The paper presents a methodology that follows a top-down approach based on a Model-Driven Architecture for integrating and coordinating healthcare services through cross-organizational processes to enable organizations providing high quality healthcare services and continuous process improvements. The methodology provides a modeling language that enables organizations conceptualizing an integration agreement, and identifying and designing cross-organizational process models. These models are used for the automatic generation of: the private view of processes each organization should perform to fulfill its role in cross-organizational processes, and Colored Petri Net specifications to implement these processes. A multi-agent system platform provides agents able to interpret Colored Petri-Nets to enable the communication between the Healthcare Information Systems for executing the cross-organizational processes. Clinical documents are defined using the HL7 Clinical Document Architecture. This methodology guarantees that important requirements for healthcare services integration and coordination are fulfilled: interoperability between heterogeneous Healthcare Information Systems; ability to cope with changes in cross-organizational processes; guarantee of alignment between the integrated healthcare service solution defined at the organizational level and the solution defined at technological level; and the distributed execution of cross-organizational processes keeping the organizations autonomy.


Process-oriented integration Cross-organizational process Healthcare processes Clinical document architecture Model-driven architecture Healthcare information systems 


Conflict of interest

The authors (Edgar Tello-Leal, Omar Chiotti, and Pablo D. Villarreal) of the manuscript “Process-oriented Integration and Coordination of Healthcare Services across Organizational Boundaries”, we declare no conflicts of interest, and we did not hope to receive at any time a payment or services from a third party for any aspect of the submitted work, including but no limited to grants, data monitoring board, study design, manuscript preparation, statistical analysis, employment, consultancies, stock ownership, honoraria, paid expert testimony, patent applications and travel grants.


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Edgar Tello-Leal
    • 1
  • Omar Chiotti
    • 2
  • Pablo David Villarreal
    • 3
  1. 1.Autonomous University of TamaulipasVictoriaMexico
  2. 2.INGAR, National Council of Scientific and Technological ResearchSanta FeArgentina
  3. 3.CIDISI, National Technological University Santa Fe FacultySanta FeArgentina

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