Towards an information-centric architecture framework for health information logistics: a design science research study.

Abstract

Background: Integrated care depends on timely awareness of parallel treatment activities and safe access to distributed patient records. However, multimorbid patients often navigate complex, non-linear pathways across care levels, resulting in information fragmentation that compromises decision-making, safety, and coordination. Existing electronic health record systems and interoperability initiatives offer limited support for pathway-oriented information logistics, particularly with respect to governance, provenance, and the integration of the patient's voice. This study aims to design a conceptual information-centric architecture framework to address these systemic gaps in awareness and access.

Methods: Applying Design Science Research (DSR), the study synthesized rigor from a scoping review with relevance derived from a longitudinal analysis of medical records from 14 multimorbid patients (1954-2024) in Northern Norway. A representative 19-year user scenario, validated by clinical expertise, together with stakeholder and root-cause analyses, informed the identification of recurrent failures in information logistics. High-level non-functional and functional requirements were iteratively derived, foregrounding Information Governance (IG), Data Management (DM), Security and Privacy, and Health Information Quality (HIQ) as essential socio-technical constraints. The resulting architecture was examined through a scenario-based demonstration and an early-stage ex-ante evaluation.

Results: The study produced a prescriptive information-centric architecture framework (Meta-artifact) organized into layered, modular components that separate user interaction, pathway logic, and secure storage. Information tokens, consisting of metadata, clinical codes, and location pointers, enable governed, read-only virtual access to source records, reducing duplication and avoiding traditional replication burdens. HIQ operationalizes DM/IG by enforcing requirements for accuracy, currency, consistency, completeness, and contextual relevance across inter-organizational access. In a hospitalization-discharge scenario, the architecture provided timely notifications, governed access to distributed records, and transparent consent and audit controls, demonstrating conceptual feasibility and alignment with the identified problem and requirements.

Conclusions: This study contributes early-stage prescriptive design knowledge to improve inter-organizational information logistics. By embedding IG, DM, HIQ, and Security and Privacy as structural pillars and decoupling information from application constraints, the architecture provides a governance-aligned foundation for pathway-oriented coordination, proactive awareness, and safe, on-demand virtual access. This information-centric, token-based architecture, with a modular, standards-neutral design, supports adaptability and provides a foundation for future prototyping and empirical evaluation.