DOCTORAL THESIS

TITLE:	
PROPOSAL OF AN INFORMATION SYSTEM INTEGRATED MODEL FOR THE MANAGEMENT OF NURSING BASIC UNITS WITHIN THE IE-GIP FRAMEWORK. APPLICATION TO THE SPANISH ARMY HEALTH SYSTEM. 



PRESENTED BY:	Gonzalo Grau Gadea
DIRECTED BY:		Dr. Lorenzo Ros McDonnell
				Dr. Ángel Ortiz Bas

RESUME:
The Health Information System for the Army is based on the consideration of the health assistance as a whole, identifying a system whose main quality comes from the interdependency of the parts that integrate it and the order in which such interdependency underlies. This approach of the assistance providing process leads to propose the fact that the flow of a patient throughout the health system generates a high amount of information about his assistance process, and this information should be structured and schematised in the way it can be easily and quickly accessed. 

The achievement of this goal requires setting up a new health organisational system. The initial point for the design of such a new integrated system is the Enterprise Integration concepts, checking firstly the existing methodologies about Enterprise Integration and secondly the existing models of integration for Health Systems. 

The presented model is focused on the first assistance level, the one about the Nursing Units, which is the one closer to the person, being supported by the Processes Mapping and the Nursing Unit Data Mapping that allow the design of an information system that can easily interconnect the different assistance levels responsible of the health assistance. 

The proposal, once defined the Assistance Process, goes further by getting inside a health organisation where the processes are identified and divided into three levels (Strategic, Keys and Supportive). 

On the other hand, the data model must respond to the flow or information exchange produced among the different implied processes during the assistance in a clinic process. When defining this model, it was taken into account the fact that the global result gathered from the assistance attention delivered to a patient, will conform the Health Electronic History. 

The field work that supports this thesis has been carried out over the year 2002 through interviews, and posterior analysis of the used processes and documents, in twelve Nursing Units at the Valencia and Cartagena Army Basic General Hospitals. 

The proposal of the new system has been carried out from the detected deficiencies of the current working system, building the management, data and processes model for the Army Nursing Units. 

Concretely, a concrete proposal is presented: 
•	Detailed development in two unit’s key processes, 
•	Development of a data model as a base for the elaboration of the Health Electronic History, which goes further a simple Electronic Clinic History. 

The proposed model solves the mentioned problems gathered during the nursing working analysis and it can be generalised to any health system’s assistance first level.