eHealth taxonomies

For some time I have been interested in IT as used by the Healthcare Industry. This has been in a vague sort of way - mostly just keeping abreast of current developments and reading articles every so often. Last year I attended an event in my home town organised by AIIA which prompted me to look a little deeper. As usual with these things I decided to create a summary of what I knew and hence try to sketch out a mental model of the area. Perhaps even put together a reference architecture or similar.
One thing that quickly became clear was that there are several disparate aspects to the industry, each of which appears to be working in isolation. There are, of course, overlaps and dependencies but - as far as I can tell - everyone working in the area seems to be working only on their own aspect. In addition, and as usual, everyone was treating their industry as if it was completely different from every other enterprise ever undertaken before.
The following table is an example of the sort of sub-domains commonly considered:

Aspect	Description
Electronic Health Records	Enabling the communication of patient data between different healthcare professionals (GPs, specialists etc.)
Digital Service Orders	A means of requesting diagnostic tests and treatments electronically and receiving the results
eMedication & Prescriptions	Suggesting options, printing and/or electronic transmission of prescriptions. Supporting and tracking medication dispensing
Clinical Decision Support	Providing information electronically about protocols and standards for Healthcare professionals to use in diagnosing and treating patients Searchable source of current thinking about health care. E.g. overviews of journals, best practice guidelines or epidemiological tracking
Tele-medicine	Physical and psychological diagnosis and treatments at a distance, including tele-monitoring of patients functions. Innovative use of sensors and data interpretation to deduce patient condition and status without physical presence
Health Information Systems	Business support functions such as appointment scheduling, patient data management, work schedule management etc.
Health Visualisation	Mechanisms for presenting patient details in an easily understandable way, including use of mobile devices, by high-lighting or graphically presenting key information.
Case Management	Ability for healthcare professionals to collaborate and share information on patients through digital equipment. The collection of all information relevant to the current patient situation in a single, usable form.

This certainly provided a business oriented view and is a valid decomposition. To my mind there are a number of overlaps and similarities, at least from an IT point of view, which suggest a different formulation. Hence:

• Health records. Each institution and each practitioner may hold their own or share a patient folder. These may be paper or digitised and will contain both structured and unstructured data. Centrally controlled and shared EHR is a sub-domain which has its own special considerations
• Advanced Diagnostics. In this I include both the Decision Support points listed in the table as well as the use of bulk data for population statistics and reporting - which may be for the clinic, hospital, district or state, depending on who holds the data and the detail available
• Tele-health is an emerging area and jointly includes new sensors and detection methods with back-to-base communications. Of course some sort of mechanism to extract meaningful information important, but even simple alerts based on min-max can be useful in a heart-rate monitor on a bed-ridden patient (wherever that bed may be - at home or in a hospital).
• Medical devices using firmware or similar embedded logic. This includes implants such as pace-makers but also prosthetics and even fitness devices. There is some overlap here with the tele-health category which I may need to be clarified as I follow this track later. The difference at this stage is whether the device is self-contained or reports to some central control (most will do both).
•  Facility management is the bored category. For instance ERP, HR and Asset Management for clinics, hospitals and nursing/aged homes. There are distinct requirements for each type of organisation but there is also a commonality. Items such as admissions and domestic services are shared with the hospitality industry but with key differences which need to be considered.
• Additional and specialist systems are involved when talking about X-ray system controls or Medication tracking etc. These tend to be stand-along applications feeding into the major components or integration/communication patterns between them (e.g. eReferrals). I think this category needs more thought since it is mostly a catch-all at this stage.

I am hoping to create a landscape (perhaps even a map) which describes how all these fit together. And drill down into the concerns of each as I get the time.