Important ingredients for health adaptive information systems.

Healthcare information systems frequently do not truly meet clinician needs, due to the complexity, variability, and rapid change in medical contexts. Recently the internet world has been transformed by approaches commonly termed 'Web 2.0'. This paper proposes a Web 2.0 model for a healthcare adaptive architecture. The vision includes creating modular, user-composable systems which aim to make all necessary information from multiple internal and external sources available via a platform, for the user to use, arrange, recombine, author, and share at will, using rich interfaces where advisable. Clinicians can create a set of 'widgets' and 'views' which can transform data, reflect their domain knowledge and cater to their needs, using simple drag and drop interfaces without the intervention of programmers. We have built an example system, MedWISE, embodying the user-facing parts of the model. This approach to HIS is expected to have several advantages, including greater suitability to user needs (reflecting clinician rather than programmer concepts and priorities), incorporation of multiple information sources, agile reconfiguration to meet emerging situations and new treatment deployment, capture of user domain expertise and tacit knowledge, efficiencies due to workflow and human-computer interaction improvements, and greater user acceptance.