Design criteria for an e-health infrastructure network in emerging countries : a case study in the Middle East

Abstract

"E-health is an emerging field in the intersection of medical informatics, public health and business, referring to health services and information delivered or enhanced through the Internet and related technologies." (Eysenbach, 2001). Eliminating health disparities has emerged as a national priority in recent years. It is one of the main input requirements and objectives for e-Health network designs. Be it health information technology (HIT) or electronic health records (EHRs), all rely on an e-Health network in order to improve health care by enhancing the clinical quality and effective management of care.<br />The theses at hand deals with the thorough design of a country-wide e-Health infrastructure network for an emerging nation in the Middle East and presents an IT-strategy approach towards such a problem space which consists of 1) Full assessment of stakeholders, 2) Thorough assessment of key users, 3) Assessment and baselining of given infrastructure, 4) Assessment and baselining of surrounding projects, 5) Preliminary design, 6) Iterative loop for 1)-5) until the final architecture design is reached and all stakeholders requirements are covered.<br />Several iterations of the draft architecture have been designed to verify and exemplify the matching between each stakeholder's requirements and the proposed draft solution. The stepwise approach considered current best practices and international expert interviews and has lead to several network design drafts with varying design rules and details. Upon these iterations all stakeholders confirmed the draft architecture to be appropriate and matching their requirements. To achieve a maximum of performance and fault tolerance a reference pattern architecture has been developed to be applied to existing and future applications. Based on this pattern of the reference architecture, breakdown scenarios and their impact on the availability of the e-Health services have been analyzed. The assessment process has revealed four main practical design goals which are met in the pattern architecture design:<br />1) Minimization of the technical, architectural and operational complexity, 2) Maximization of the ease of expansion and capacity upgrades, 3) Minimization of the time to deployment, 4) The Network shall never be the bottleneck for applications, even in the absence of clear application definition or strategy.<br />Results and experiences of the nation-wide integrated network planning in e-Health at hand can be generated as storage models and findings for acquainted problem spaces. The thesis identifies ten main architectural imperatives as design criteria and verifies them on the developed e-Health network design.