Hospital Information Systems

  • P. Degoulet
Part of the Health Informatics book series (HI)


Hospital information systems (HIS) are computer systems designed to ease the management of all the hospital’s medical and administrative information and to improve the quality of health care. After a brief historical review, this chapter describes the overall strategy to select, deploy and then evaluate the deployed solution. Clear IT governance and IT alignment strategies are prerequisite to HIS deployment success. Emphasis is put on business process analysis/reengineering to select the business components which integration will constitute the overall HIS. In the clinical domain, main business components include the Patient Identification (PID), Admission/Discharge/Transfer (ADT), the electronic health record (EHR), the computerized provider order entry (CPOE) and the resource and appointment scheduling (AS) systems. Deployment phases are considered from basic ancillary services to integration into broader system and HIS data reuse for research. HIS return on investment (ROI) is described from a clinical, organizational and financial point of view.


Hospital Information Systems (HIS) Clinical Information Systems (CIS) Strategic alignment IT governance Health business components Electronic Patient Record (EPR) Electronic Health Record (EHR) Computerized Provider Order Entry (CPOE) CCOW HL7 IHE Risk analysis HIS evaluation HIS return on investment (ROI) 


  1. HIMSS Analytics (2013) (Description of different levels of adoption of EMR solutions by healthcare providers. It includes annual survey of their deployment in various countries). Accessed 21 Apr 2013
  2. Ash JS, Berg M, Coiera E (2004) Some unintended consequences of information technology in health care: the nature of patient care information system related errors. J Am Med Inform Assoc 11(2):104–112PubMedCrossRefGoogle Scholar
  3. Ash JS, Sittig DF, Dyskstra R et al (2009) The unintended consequences of computerized provider order entry: Findings from a mixed methods exploration. Int J Med Inform 78(suppl 1):S69–S76Google Scholar
  4. Boussadi A, Bousquet C, Sabatier B et al (2011) A business rules design framework for a pharmaceutical validation and alert system. Methods Inf Med 50:36–50PubMedCrossRefGoogle Scholar
  5. CCOW (2013) (HL7 CCOW webpage). Accessed 31 Mar 2013
  6. COSO (2013) (COSO official website). Accessed 31 Mar 2013
  7. Council of the Institute of Medicine (1994) America’s health in transition: protecting and improving quality. National Academy Press, Washington, DCGoogle Scholar
  8. Degoulet P, Fieschi M (1999) Introduction to clinical informatics. Springer, New York. Corrected 2d printing. 1999 (With which this chapter shares a part of the introduction, figures 12.6 and 12.7 various ideas shared with Marius Fieschi during 30 years of fruitful collaboration)Google Scholar
  9. Degoulet P, Safran C, Bowers GH (1994) Design and processing issues for the health care professional workstation. Int J Biomed Comp 34(1–4):241–247CrossRefGoogle Scholar
  10. Degoulet P, Sauquet D, Jaulent MC et al (1998) Rationale and design considerations for a semantic mediator in health information systems. Methods Inf Med 37:518–526PubMedGoogle Scholar
  11. DICOM (2013). (DICOM NEMA main website). Accessed 31 Mar 2013
  12. Georgel F (2009) IT gouvernance, 3ème édition. Dunod, ParisGoogle Scholar
  13. US Government (2002) (Pub.L. 107–204, 116 Stat. 745, enacted July 30, 2002). Accessed 31 Mar 2013
  14. HIMSS (2013) (Site of the HIMMS association (Healthcare Information and Management Systems Society), a major organisation devoted to the understanding and promotion of professional health informatics. HIMMS organises annual international meetings on the different continents.). Accessed 31 Mar 2013
  15. HL7 (2013) (Main HL7 web page). Accessed 31 Mar 2013
  16. IHE (2013) (Main IHE web page). Accessed 31 Mar 2013
  17. IHTSDO (2013) (SNOMED-CT documentation site). Accessed 31 Mar 2013
  18. Isaca (2012) (Cobit 5 framework). Accessed 31 Mar 2013
  19. ITIL (2013) (ITIL official website). Accessed 31 Mar 2013
  20. Kohane IS, Churchill SE et al (2012) A translational engine at the national scale: informatics for integrating biology and the bedside. J Am Med Inform Assoc 19(2):181–185PubMedCrossRefGoogle Scholar
  21. Koppel R, Metlay JP, Cohen A et al (2005) Role of computerized physician order entries in facilitating medication errors. JAMA 293(10):1197–1203PubMedCrossRefGoogle Scholar
  22. Le Roux B (2009) La transformation stratégique du système d’information. Lavoisier, ParisGoogle Scholar
  23. Lorenzi NM, Riley RT (2010) Organizational aspects of health informatics. Managing technological change. Springer, New York. (A useful textbook on the organizational aspects of HIS)Google Scholar
  24. Meyer R, Degoulet P (2008). Assessing the capital efficiency of healthcare information technologies investments: an econometric perspective. Yearb Med Inform 2008:114–127Google Scholar
  25. Meyer R, Degoulet P (2010) Choosing the right amount of healthcare information technologies investments. Int J Med Inform 79:235–31CrossRefGoogle Scholar
  26. OMG (2008) (Documents sssociated with Semantics of Business Vocabulary and Business Rules (SBVR), version 1.0). Accessed 31 Mar 2013
  27. ONC (2013) (Web site national coordinator for health IT in the US. Provides a structure approach for the evaluation of the meaningful use of EHRs). Accessed 31 Mar 2013
  28. Sauquet D, Jean FC, Lemaitre D et al (1994) The HELIOS unification bus: a toolbox to develop client/server applications. Comput Methods Programs Biomed 45(Suppl):S13–S22PubMedGoogle Scholar
  29. Sittig DF, Krall M, Kaalaas-Sittig J, Ash JS (2005) Emotional aspects of computer-based provider order entry: a qualitative study. J Am Med Inform Assoc 12(5):561–567PubMedCrossRefGoogle Scholar
  30. Tomas JL (2007) ERP et PGI: Sélection, déploiement et utilisation opérationnelle. 5ème édition. Dunod, Paris. (A methodological guide for the selection, deployment and use of enterprise resource planning (ERP) solutions)Google Scholar
  31. tranSMART (2013) (tranSMART project website). Accessed 31 Mar 2013
  32. Van de Velde R, Degoulet P (2003) Clinical information systems. A component-based approach. Springer, New York. (Provides a detailed analysis of main HIS functionalities, of a building approach based on a set of components)Google Scholar

Copyright information

© Springer-Verlag France 2014

Authors and Affiliations

  1. 1.CRC INSERM U872 eq 22René Descartes UniversityParisFrance

Personalised recommendations