António Carvalho Brito

Abstract
Hospital Information System is the most fragile component of the health care system in the countries in development process. The modernization of the health care system does not integrate a rigid reflection on the installation of these tools into hospitals, which remain foreign with the strategies of these countries. The main objective of this research is to present a systematic review on the relationship between process approach and continuous improvement with the development and continuity of hospital information systems. Hospital Information System and its sustainability are key factors for the functioning of services in Hospital Institutions which requires principles respect of quality management as the process approach among others. The main question to be treated in this paper is " Which reasons have been given for the views that the process approach is or isn't helping to have and give a Hospital Information System in continuous development?", in order to contribute to the systematization of knowledge in this area, the main objective of this research is to present a systematic review on the relationship between process approach and continuous improvement with the development and continuity of hospital information systems. The systematic review methodology was the PRISMA Statement (R), the search granted to find 7735 based on defined key-words, and after a preliminary examination, according to the exclusion conditions and the eligibility criteria 20 papers were considered relevant to a more detailed study. After an analysis of all relevant documents we have tried to reveal the important gap, which we will try to explore more in future investigations.

Abstract
A cancer registry is a standardized tool to produce population-based data on cancer incidence and survival. Cancer registries can retrieve and store information on all cancer cases occurring in a defined population. The main sources of data on cancer cases usually include: treatment and diagnostic facilities (oncology centres or hospital departments, pathology laboratories, or imaging facilities etc.) and the official territorial death registry. The aim of this paper is to evaluate the north regional cancer registry (RORENO) of Portugal using a qualitative research. We want to characterize: the main functionalities and core processes, team involved, different healthcare institutions in the regional network and an identification of issues and potential improvements. RORENO links data of thirteen-two healthcare institutions and is responsible for the production of cancer incidence and survival report for this region. In our semi-structure interviews and observation of RORENO we identified a serious problem due to a lack of an automatic integration of data from the different sources. Most of the data are inserted manually in the system and this implies an extra effort from the RORENO team. At this moment RORENO team are still collecting data from 2011. In a near future it is crucial to automatize the integration of data linking the different healthcare institutions in the region. However, it is important to think which functionalities this system should give to the institutions in the network to maximize the engagement with the project. More than a database this should be a source of knowledge available to all the collaborative oncologic network. © 2017 AISTI.

Abstract
Objectives: To understand and build a collective vision of all existing institutions in the Portuguese National Health Service as well as to perceive how and how far the interaction between those multiple institutions is supported by Information Systems (IS). Methods: Upon identification of the institutions involved in the healthcare process, a set of interviews with experienced people from those institutions was conducted, which produced about five hours of tape. The research was focused exclusively on processes involving two different organizations and any internal processes were altogether excluded from it. Results: The study allowed the identification of about 50 recurrent interaction processes, which were classified into four different varieties in accordance with the nature of the information flow: administrative, clinical, identificational and statistical. In addition, these processes were divided in accordance with the way how that integration is achieved, from completely automated to email or telephone-based. Conclusions: Funds/Money related processes are technologically more rigid and standardized, whereas auditing and inspection ones are less supported by automatic systems. There emerged an interesting level of sharing and integration in clinical processes, although the integration is mostly made at the interface level. The authors identified 5 particularly relevant and dominant actors (2 classes of individuals and 3 institutions) with which there is a need for coordination and cooperation. The authors consider that, in future works, an effort should be made to provide the various institutions with guidelines/interfaces and prompt such institutions to elaborate upon these.

Abstract
Despite the technological advances, healthcare systems still face several issues. One of the most important is the lack of communication between systems or the communication process speed. If the information about a patient is not promptly shared in time between services, it may jeopardise the practicioner-pacient relationship. In a worse scenario, the system can even become a handicap and turn the Healthcare processes down into a state of total uselessness. A lot has been done in Portugal to enable the interconnection of external healthcare applications with the ones used in the National Health Service. In this article we present an architecture to facilitate this interconnection. Based on a REST architecture and HL7 communication standards, it connects two current solutions, one for melanoma and one for blood donors, with a central healthcare data repository of the National Healthcare Service. © 2015 AISTI.

Abstract