Abstract
This paper concerns itself with the beneficial effects of the Unified Modeling Language (UML), a nonproprietary object modeling standard, in specifying, visualizing, constructing, documenting, and communicating the model of a healthcare information system from the user's perspective. The author outlines the process of object-oriented analysis (OOA) using the UML and illustrates this with healthcare examples to demonstrate the practicality of application of the UML by healthcare personnel to real-world information system problems. The UML will accelerate advanced uses of object-orientation such as reuse technology, resulting in significantly higher software productivity. The UML is also applicable in the context of a component paradigm that promises to enhance the capabilities of healthcare information systems and simplify their management and maintenance.
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REFERENCES
Coad, P., and North, D., Object Models: Strategies, Patterns, and Applications, Yourdon Press, New Jersey, 1995.
Pancake, C., The promise and cost of object technology: A five-year forecast. Commun. ACM 33(10):22-49, 1995.
OMG, Unified Modeling Language Specification,Version 1.4, September 2001, Retrieved October 27, 2001, from http://www.omg.org/technology/documents/formal/uml.htm
Booch, G., Rumbaugh, J., and Jacobson, I., The Unified Modeling Language User Guide, Addison-Wesley, Reading, MA, 1998.
Fowler, M., UML Distilled: Applying the Standard Object Modeling Language, Addison-Wesley, Reading, MA, 1997.
Rumbaugh, J., Jacobson, I., and Booch, G., The Unified Modeling Language Reference Manual, Addison-Wesley, Reading, MA, 1999.
Sittig, D. F., and Stead, W. W., Computer-based physician order entry: The state of the art. J. Am. Med. Inf. Assoc. 1(2):108-123, 1994.
Abdelhak, M., Grostick, S., Hanken, M. A., and Jacobs, E., Health Information: Management of a Strategic Resource, W.B. Saunders Company, Philadelphia, PA, 2001.
Whitten, J. L., Bentley, L. D., and Dittman, K. C., Systems Analysis and Design Methods, 5th edn., McGraw-Hill Irwin, New York, 2001.
Coad, P., and Yourdon, E., Object-Oriented Analysis, 2nd edn., Prentice-Hall, Englewood Cliffs, NJ, 1991.
Coleman, D., Arnold, P., Bodoff, S., Dollin, C., Gilchrist, H., Hayes, F., and Jeremaes, P., Object-Oriented Development: The Fusion Method, Prentice-Hall, Englewood Cliffs, NJ, 1994.
Coad, P., and Yourdon, E., Object-Oriented Design, Yourdon Press, New Jersey, 1991.
Friedman, C. P., and Wyatt, J. C., Evaluation Methods in Medical Informatics, Springer-Verlag, New York, 1996.
Lee, F., Teich, J. M., Spurr, C. D., and Bates, D. W., Implementation of physician order entry: User satisfaction and self-reported usage patterns. J. Am. Med. Inf. Assoc. 3:43-55, 1995.
Weir, C., Lincoln, M., Roscoe, D., and Moreshead, G., Successful implementation of an integrated physician order entry application: A systems perspective. Proc. Annu. Symp. Comput. Appl. Med. Care pp. 790-794, 1995.
Pressman, R. S., Software Engineering: A Practitioner's Approach, McGraw-Hill, New York, 1992.
Graham, I., Object-Oriented Methods, 2nd edn., Addison-Wesley, Reading, MA, 1994.
Booch, G., Object-Oriented Analysis and Design With Applications, 2nd edn., Benjamin/Cummings, Redwood City, CA, 1994.
Rumbaugh, J., Blaha, M., Premerlani, W., Eddy, F., and Lorenson, W., Object-Oriented Modeling and Design, Prentice-Hall, Englewood Cliffs, NJ, 1991.
Jacobson, I., Object-Oriented Software Engineering, Addison-Wesley, Reading, MA, 1993.
Rzepka, W., and Ohno, Y., Requirements engineering environments: Software tools for modeling user needs. IEEE Comput. 18(4):9-12, 1985.
LeBozec, C., Jaulent, M.-C., Zapletal, E., and Degoulet, P., Unified modeling language and design of a case-based retrieval system in medical imaging. Proc. AMIA Symp. pp. 887-891, 1998.
Bailin, S. C., Object-oriented requirements analysis. In Dorfman, M., and Thayer, R. H. (eds.), Software Engineering, IEEE Computer Society Press, Los Alamitos, CA, pp. 286-307, 1997.
Sim, E., Object-oriented requirements analysis: Its challenges and use. In Gibson, R.G. (ed.), Object-Oriented Technologies: Opportunities and Challenges, Idea Group Publishing, Hershey, PA, pp. 1-24, 1999.
Martin, J., and Odell, J., Object-Oriented Analysis and Design, Prentice-Hall, Englewood Cliffs, NJ, 1992.
Egyhazy, C. J., Eyestone, S. M., Martino, J., and Hodgson, C. L., Object-oriented analysis and design:A methodology for modeling the computer-based patient record. Top. Health Inf. Manage. 19(1):48-65, 1998.
The Good Electronic Health Record, Retrieved November 1, 2001, from http://www.gehr.org/
Synapses, Retrieved November 4, 2001, from http://www.cs.tcd.ie/synapses/public/
CORBAMed, Retrieved November 4, 2001, from http://cgi.omg.org/cgi-bin/doclist.pl
HL7 Version 3.0 RIM, Retrieved November 11, 2001, from http://www.hl7.org/about/
Blobel, B., Advanced tool kits for EPR security. Int. J. Med. Inf. 60:169-175, 2000.
The European ISHTAR Project, Retrieved November 4, 2001, from http://www.ehto.org/ht_projects/initial_project_description/ishtar.html
The European TrustHealth Project, Retrieved November 4, 2001, from http://www.ehto.org/ht_projects/html/dynamic/130.html
Blobel, B., Application of the component paradigm for analysis and design of advanced health system architectures. Int. J. Med. Inf. 60:281-301, 2000.
Blobel, B., and Roger-France, F., A systematic approach for analysis and design of secure health information systems. Int. J. Med. Inf. 62:51-78, 2001.
Blobel, B., The European TrustHealth Project experiences with implementing a security infrastructure. Int. J. Med. Inf. 60:193-201, 2000.
Banhart, F., and Lohmann, R., An object-oriented approach for structuring the electronic medical record. Stud. Health Technol. Inf. 77:622-626, 2000.
Kuikka, E., Eerola, A., Porrasmaa, J., Miettinen, A., and Komulainen, J., Design of the SGML-based electronic patient record system with the use of object-oriented analysis methods. Stud. Health Technol. Inf. 68:838-841, 1999.
PARSEC, Patient Records for Shared Care, Royal Brompton Hospital NHS Trust, 1994, Retrieved April 28, 2001, from http://www.rbh.nthames.nhs.uk/PROJECTS/Parsec/parsec.htm
Graeber, S., Object-oriented modeling of hospital information systems. Medinfo 8(1):492-497, 1995.
Kuma, H., and Tsuchiya, Y., Database access method for autonomous distributed total hospital information systems and its object-oriented design. Medinfo 8(1):387-390, 1995.
Seto, K., Kamiyama, T., and Matsuo, H., An object-modeling method for hospital information systems. Medinfo 98:981-985, 1998.
Hubner, U., Klein, F., Hofstetter, J., Kammeyer, G., and Seete, H., Building a web-based drug ordering system for hospitals: From requirements engineering to prototyping. Stud. Health Technol. Inf. 77:62-67, 2000.
Ohe, K., A hospital information system based on Common Object Request Broker Architecture (CORBA) for exchanging distributed medical objects-an approach to future environment of sharing healthcare information. Medinfo 9(2):962-964, 1998.
Ryder, R. M., and Inamdar, B., An object-oriented, knowledge-based system for cardiovascular rehabilitation. Proc. Annu. Symp. Comput. Appl. Med. Care pp. 280-283, 1995.
Wang, C., Ohe, K., Sakurai, T., and Kaihara, S., An ECG storage and retrieval system embedded in client server HIS utilizing object-oriented DB. J. Med. Syst. 20(1):35-43, 1996.
Pappas, C., Mavromatis, A., Maglaveras, N., Tsikotis, A., Pangalos, G., and Ambrosiadou, V., Cardiological database management system as a mediator to clinical decision support. Methods Inf. Med. 35(1):52-58, 1996.
Lang, E., Bott, O. J., and Pretschner, D. P., Specification of a computer-based information system for ophthalmology using modeling and simulation techniques. Medinfo 8(2):1092, 1995.
Moller, D. P., and Horner, C., Object-oriented data management: An approach to computerized anesthesia documentation. Int. J. Clin. Monit. Comput. 10(4):247-250, 1993.
Glacomoni, M., Ruggiero, C., and Sacile, R., An object programming based environment for protein secondary structure prediction. Front. Med. Biol. Eng. 7(2):111-128, 1996.
Vahrson, W., Herman, K., Kleffe, J., and Witting, B., Object-oriented sequence analysis: SCL-A C++ class library. Comput. Appl. Biosci. 12(2):119-127, 1996.
Ptitsyn, A. A., and Grigorovich, D. A., Object-oriented data handler for sequence analysis software development. Comput. Appl. Biosc. 11(6):583-589, 1995.
Ensing, M., Paton, R., Speel, P. H., and Rada, R., An object-oriented approach to knowledge representation in a biomedical domain. Artif. Intell. Med. 6(6):459-482, 1994.
Bader, G.D., and Hogue, C.W.V., BIND-a data specification for storing and describing biomolecular interactions, molecular complexes and pathways. Bioinformatics 16(5):465-477, 2000.
Wells, I. G., Farnan, L. P., and Rayment, M. W., Client/server computing: Is the future direction for the clinical laboratory? Clin. Chim. Acta 248(1):31-8l, 1996.
Qiu, D., Junghans, G., Marquardt, K., Kroll, H., Mueller-Eckhardt, C., and Dudeck, J., Discovering objects in a blood recipient information system. Med. Inf. (Lond.) 20(3):209-228, 1995.
Staccini, P., Joubert, M., Quaranta, J. F., Fieschi, D., and Fieschi, M., Modelling health care processes for eliciting user requirements: A way to ling a quality paradigm and clinical information system design. Stud. Health Technol. Inf. 77:51-56, 2000.
Orphanoudakis, S. C., Chronaki, C., and Kostomanolakis, S., I2C: A system for the indexing, storage, and retrieval of medical images by content. Med. Inf. (Lond.) 19(2):109-122, 1994.
Martinez, R., Rozenblit, J. W., Cook, J. F., Chacko, A. K., and Timboe, H. L., Virtual management of radiology examinations in the virtual radiology environment using common object request broker architecture services. J. Digit. Imaging 12(2, Suppl.1):181-185, 1999.
Cook, J. F., Rozenblit, J. W., Chacko, A. K., Martinez, R., and Timboe, H. L., Meta-manager: A requirements analysis. J. Digit. Imaging 12(2, Suppl.1):186-188, 1999.
Ganguly, P., and Ray, P., A methodology for the development of software agent based interoperable telemedicine systems: A tele-electrocardiography perspective. Telemed. J. 6(2):283-294, 2000.
de Champeaux, D., Lea, D., and Faure, P., Object-Oriented System Development, Addison-Wesley, Reading, MA, 1993.
Henderson-Sellers, B., and Edwards, J., Object-oriented systems life cycle. Commun. ACM 33(Sept.):143-159, 1990.
The New Zealand Electronic Medical Record Standard, Electronic Medical Records Standards Subcommittee, February 25, 1998, Retrieved October 1, 2001, from http://www.nzhis.govt.nz/infostandards/emr/SC606.html
Kruchten, P., The Rational Unified Process: An Introduction, Addison-Wesley, Reading, MA, 2000.
Jacobson, I., Christerson, M., Jonsson, P., and Övergaard, G., Object-Oriented Software Engineering-A Use Case Driven Approach, Addison-Wesley, Reading, MA, 1992.
van der Maas, A. A. F., ter Hofstede, A. H. M., and ten Hoopen, A. J., Requirements for medical modeling languages. J. Am. Med. Inf. Assoc. 8(2):146-162, 2001.
Beeler, G., Developing HL7 Models using UML and Rational Rose, November 7, 1997, Retrieved November 4, 2001, from http://www.hl7.org/library/data-model/Rose tooling/Tutorials/Rose tooling.doc
Pisanelli, D. M., Ferri, F., and Ricci, F. L., An object-oriented tool for the generation and management of multimedia patient folders. Proc. Annu. Symp. Comput. Appl. Med. Care pp. 524-548, 1994.
Krol, M., and Reich, D. L., Object-oriented analysis and design of a health care management information system. J. Med. Syst. 23(2):145-158, 1999.
Bodemann, J., and Hasselbring, W., Interdisciplinary Object-Oriented Domain Analysis for Electronic Medical Records, Retrieved November 3, 2001, from http://citeseer.nj.nec.com/316578.html
Riesco, A. M., Tomas, R. M., and Mira, J. M., A customizable framework for the assessment of therapies in the solution of therapy decision tasks. Artif. Intell. Med. 18:57-82, 2000.
Aluen, M., Arrechedera, H., Matteo, A., and Metzner, C., Developing a web-based object-oriented multimedia medical system. Proc. 32nd Hawaii Int. Conf. Syst. Sci. pp. 1-8, 1999.
Tse, T. H., and Pong, L., An examination of requirements specification languages. Comput. J. 34(2):143-152, 1991.
Miller, G. A., The magic number seven, plus or minus two: Some limits on our capability for processing information. Psychol. Rev. 63:81-97, 1956.
Lobach, D. F., Gadd, C. S., and Hales, J. W., Structuring clinical practice guidelines in a relational database model for decision support on the Internet. Proc. AMIA Annu. Fall Symp. pp. 158-162, 1997.
Hoffman, K. J., Demystifying mental health information needs through integrated definition (IDEF) activity and data modeling. Proc. AMIA Annu. Fall Symp. pp. 111-115, 1997.
Zucker, J., Chase, H., Molholt, P., Soliz, E., and Kahn, R. M., Conceptual modeling techniques for online curriculum design. Proc. AMIA Annu. Fall Symp. p. 1022, 1997.
Farmer, J., Claims and Eligibility Service for HIPAA (CAESH), December 20, 2000, Retrieved November 12, 2001, from http://www.omg.org/docs/corbamed/01-01-01.txt
Nadkarni, P. M., Marenco, L., Chen, R., Skoufos, E., Shepherd, G., and Miller, P., Organization of heterogeneous scientific data using theEAV/CR representation. J. Am. Med. Inf. Assoc. 6(6):478-493, 1999.
Lemaitre, D., Sauquet, D., Fofol, I., Tanguy, L., Jean, F.-C., and Degoulet, P., Legacy systems: Managing evolution through integration in a distributed and object-oriented computing environment. Proc. Annu. Symp. Comput. Appl. Med. Care pp. 132-136, 1995.
Alexander, C., Ishikawa, S., Silverstein, M., Jacobson, M., Fiksdahl-King, I., and Angel, S., A Pattern Language, Oxford University Press, New York, 1977.
Alexander, C., The Timeless Way of Building, Oxford University Press, New York, 1979.
Fowler, M., Analysis Patterns: Reusable Object Models, Addison-Wesley, Reading, MA, 1997.
Rising, L., Design patterns: Elements of reusable architectures. In Rising, L. (ed.), The Patterns Handbook: Techniques, Strategies and Applications, Cambridge University Press, Cambridge, U.K., pp. 9-13, 1998.
Corfman, R., An overview of patterns. In Rising, L. (ed.), The Patterns Handbook: Techniques, Strategies and Applications, Cambridge University Press, Cambridge, U.K., pp. 19-30, 1998.
Schmidt, D. C., Experience using design patterns to develop reusable object-oriented communication software. Commun. ACM 38(10), 65-74, 1995.
Boye, N., and Veirum, N. E., Ontology-based, medical domain-specific, use-case driven, EMRs for use in clinical quality assurance and passive decision support. Stud. Health Technol. Inf. 70:36-38, 2000.
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Aggarwal, V. The Application of the Unified Modeling Language in Object-Oriented Analysis of Healthcare Information Systems. Journal of Medical Systems 26, 383–397 (2002). https://doi.org/10.1023/A:1016449031753
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DOI: https://doi.org/10.1023/A:1016449031753