Content Management System for health

Developed countries have rapidly evolved from the delivery of online medical content towards the adoption of generic e-commerce solutions to the processing of health related administrative transactions and the logistical support of clinical tasks (Rodrigues, 2003; Salazar, 2004). Health organisations are information-based organisations. Thus, their successful operation requires a highly managed information and communication technology (ICT) infrastructure.

The integration of health services has become a major policy issue due to an increasing awareness of the costs and limitations of provision, and a desire for a more comprehensive and coordinated range of health services (Salazar, 2004). It is increasingly clear that health information systems development has an important role to play in facilitating the success of the integration of health services, as well as in reducing the health information divide.

A review of literature related to information services and ICT in health organisations such as hospitals shows that these organisations have access to information services provided by health science libraries and information centres (Khudair, 2005). Within and between various environments, a clearly shared aim is to enable health information consumers to gain access to and make use of the information that they need (Bryson, 1997; Fecko, 1997).

The concern today is about information management and use; hence the increasing interest in the development of Content Management Systems (CMSs). An effective CMS enables better management of information and eliminates costly processes that fail to make effective and consistent re-use of content. The conversion to a structured CMS can be quite challenging; however, it has clear advantages, as noted by Ethier and Abel (2004), which include:

1. Making content more retrievable and re-usable;
2. Reducing the costs and complexity of translation;
3. Enforcing authoring, style and branding guidelines;
4. Improving information interchange.

Structured documents differ significantly from unstructured ones in that the former include rules and specifications which formalise the order and the structure in which data (text, graphics and tables) may be entered into a document. These are known as Schemas and Document Type Definitions (DTDs). Ethier and Abel (2004) state that both Schemas and DTDs provide considerable modeling power and can help facilitate content reuse and multi-channel publishing.

One example of a successful CMS currently in use is the British National Formulary (BNF), published jointly by the British Medical Association (BMA) and the Royal Pharmaceutical Society of Great Britain (RPSGB). At present, electronic delivery is mainly through the BNF website, Intranet BNF, and the Local Formulary toolkit (allowing local customisation of content). Chelsom and Connor (2001) note that for several years the RPSGB published the BNF from a relational database using a proprietary format publishing package. However, the most important requirement was recognised as being to deliver content as both documents and data, and Extensible Markup Language (XML) allowed the RPSGB to handle the content in both modes. In addition, the new means of presentation allowed the re-use of content from one publication cycle to the next and between different publications, as well as encouraging a cultural change from a publication-oriented way of working to a knowledge orientation.

Looking towards the future of CMSs, Robertson (2003) expects that many of the current CMS projects will fail, due to the current poor standard of implementation and lack of understanding of usability, information architecture, knowledge management and content issues. Gantz (2003) confirms that many organisations fail to realise the need for, or benefits of, metadata standards until they are already in the midst of a content management initiative and find that they have no guidance, no commonality, and little opportunity to automate the process of data migration.

In brief, Valle et al. (2005) express the view that the healthcare industry has been slow to adopt technology as a way to improve delivery of its services, and for a strong reason: that health care practice has life-and-death implications, and thus the adoption of new processes involving technology must meet the highest standards of accuracy and effectiveness.

Although there is a rapidly increasing realisation of the need to improve ICT implementation and usage, there are no widely-used interoperability standards that address the complete capabilities of CMSs and the Semantic Web. The need is recognised for common standards and specifications.


References:

Bryson, J. 1997, Managing information services: an integrated approach, Gower, London.

Chelsom, J. & Conner, E. 2001, "Implementing an XML Content Management System for Drug Information", XML Europe 2001Internationales Congress Centrum (ICC)May 21-25Berlin, Germany. http://www.gca.org/papers/xmleurope2001/papers/html/sid-04-02.html.

Ethier, K. & Abel, S. 2004, Introduction to Structured Content Management with XML [Homepage of CMSWorks, Inc.], [Online]. Available: http://www.cmswatch.com/Feature/112-Structured-CMS [2005, 11/1] .

Fecko, M. 1997, Electronic resources: access and issues in topics in Library and Information Studies, Bowker-Saur, London.

Gantz, S. 2003, "XML Unifies Content Migration", XML conference and exposition 2003Pennsylvania Convention CenterDecember 7-12Philadelphia, PA. http://www.idealliance.org/papers/dx_xml03/papers/03-06-01/03-06-01.html.

Khudair, A. 2005, Health Sciences Libraries: Information Services and ICTs, PhD Thesis, City University, London.

Robertson, J. 2003, Looking towards the future of CM [Homepage of KM Briefing, James Robertson], [Online]. Available: http://www.steptwo.com.au/papers/cmb_future/index.html [2005, 10/20] .

Rodrigues, R. 2003, "Opportunities and challenges in the deployment of global e-health", International Journal of healthcare technology and management, vol. 5, no. 5/6, pp. 157-178.

Salazar, A. 2004, "Challenges to information systems implementation and organisational change management: insights from the health sector in Ecuador", The Electronic Journal of information systems in developing countries, vol. 16, no. 5, pp. 1-16.

Valle, E. et al. 2005, The Need for Semantic Web Service in the eHealth [Homepage of W3.org], [Online]. Available: http://www.w3.org/2005/04/FSWS/Submissions/46/SWS4HC.pdf [2005, 11/13] .