Transitional complexity of health information system of systems: Managing by the engineering systems multiple-domain modeling approach

A health information system is a system of systems that serves as a foundation of health information used for the evidence-based decision making of public health actions. Since practical solutions for addressing system transformation and its effect on system management have not been extensively discussed, this study examines an approach to model and analyze the transforming health information system of systems. The process and architecture in the case of the Cambodian malaria surveillance system were modeled using the engineering system multiple-domain matrix modeling framework. By using the attributes of the process, architecture, and the risk associated with the environment within the model, relative weights of the constituent systems were scored at each interval of time. The simulated confidence intervals of the absolute difference in the scores indicated that this approach yields the transformation of the system under investigation. By comparing the calculated scores with the results of the simulation test employing an agent-based modeling method, further insights into the process, the limitations, and advantages of the scoring approach were discussed. This approach provides the first step in analyzing the transitional conditions of constituent systems as well as the entire health information system, whereby informed decision making for optimizing continuous system management is facilitated.