Journal of Medical Systems

, Volume 36, Issue 6, pp 3713–3724

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

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

DOI: 10.1007/s10916-012-9844-0

Cite this article as:
Tello-Leal, E., Chiotti, O. & Villarreal, P.D. J Med Syst (2012) 36: 3713. doi:10.1007/s10916-012-9844-0


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 

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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