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Integration and Beyond

Linking Information from Disparate Sources and into Workflow

Vanderbilt University, Nashville, Tennessee (WWS, RAM); Stanford University Medical School, Stanford, California (MAM); Oregon Health Sciences University, Portland, Oregon (WRH)

Corresdpondence and reprints: William W. Stead, MD, Associate Vice Chancellor for Health Affairs, Vanderbilt University, 416 Eskind Biomedical Library, 2209 Garland Avenue, Nashville, TN 37232-8340; e-mail: <bill.stead{at}mcmail.vanderbilt.edu>.

Received for publication: 11/01/99; accepted for publication: 11/18/99.

The vision of integrating information—from a variety of sources, into the way people work, to improve decisions and process—is one of the cornerstones of biomedical informatics. Thoughts on how this vision might be realized have evolved as improvements in information and communication technologies, together with discoveries in biomedical informatics, and have changed the art of the possible. This review identified three distinct generations of "integration" projects. First-generation projects create a database and use it for multiple purposes. Second-generation projects integrate by bringing information from various sources together through enterprise information architecture. Third-generation projects inter-relate disparate but accessible information sources to provide the appearance of integration. The review suggests that the ideas developed in the earlier generations have not been supplanted by ideas from subsequent generations. Instead, the ideas represent a continuum of progress along the three dimensions of workflow, structure, and extraction.

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