title: Building an inter-organizational communication network and challenges for preserving interoperability.
abstract: BACKGROUND
  The ideal scenario for information technology to bridge information gaps between primary and secondary healthcare and to improve the quality of healthcare in the medication process is to build an interoperable communication network. This type of undertaking requires diverse information systems to be integrated, and central to this are the preservation of data integrity and the integration of different pieces of patient data. OBJECTIVES AND METHODOLOGY: In this study, we focused on sources of challenges to the integration process and to the building of an interoperable communication network. Interviews, document analysis, and observations were conducted to evaluate the integration process in a project that involved medication data communication between primary healthcare providers (i.e., general practitioners and community pharmacists) and secondary healthcare providers (i.e., hospital pharmacists and specialist physicians).
  
  
  RESULTS
  The project encountered numerous integration problems, many of which persisted even after extensive technical intervention. An analysis of the problems revealed that they were mostly rooted either in problematic integration of work processes or in the way the system was used. Despite the project's ideal technical condition, the integration could be accomplished only by applying human interfaces.
  
  
  CONCLUSIONS
  The main challenge to building interoperable communication network does not lie in technical integration. The real problem occurs when the technical linkage is implemented without the work processes being aligned and integrated.
authors.affiliation: Healthcare Governance, Institute of Health Policy and Management, Erasmus University Medical Center, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands. h.pirnejad@erasmusmc.nl
authors.forename: H
authors.initials: H
authors.lastname: Pirnejad
authors.forename: R
authors.initials: R
authors.lastname: Bal
authors.forename: M
authors.initials: M
authors.lastname: Berg
mesh_terms: D003195:Computer Communication Networks; D006739:Hospital Administration; D006801:Humans; D008491:Medical Informatics Applications; D010595:Pharmacists / Q000458:organization & administration*; D012984:Software; D013997:Time Factors