ORIGINAL ARTICLE Sebastian Garde Æ Petra Knaup Requirements engineering in health care: the example of chemotherapy planning in paediatric oncology Received: 15 November 2004 / Accepted: 25 January 2006 / Published online: 21 February 2006 Ó Springer-Verlag London Limited 2006 Abstract Health care is characterized by highly complex processes of patient care that require unusual amount of communication between different health care profes- sionals of different institutions. Sub-optimal processes can significantly impact on the patient’s health, increase the consumption of services and resources and in severe cases can lead to the patient death. For these reasons, requirements engineering for the development of infor- mation technology in health care is a complex process as well: without constant and rigorous evaluation, the im- pact of new systems on the quality of care is unknown and it is possible that badly designed systems signifi- cantly harm patients. To overcome these limitations, we present and discuss an approach to requirements engi- neering that we applied for the development of appli- cations for chemotherapy planning in paediatric oncology. Chemotherapy planning in paediatric oncol- ogy is complex and time-consuming and errors must be avoided by all means. In the multi-hospital/multi-trial- centre environment of paediatric oncology, it is espe- cially difficult and time-consuming to analyse require- ments. Our approach combines a grounded theory approach with evolutionary prototyping based on the constant development and refinement of a generic do- main model, in this case a domain model for chemo- therapy planning in paediatric oncology. The prototypes were introduced in medical centres and final results show that the developed generic domain model is adequate. Keywords Requirements engineering Æ Chemotherapy planning Æ Paediatric oncology Æ Grounded theory Æ UML 1 Introduction The handbook of medical informatics defines Health Informatics as ‘‘the science that studies the use and processing of data, information, and knowledge applied to medicine, health care and public health’’ [1]. It is stated that Health Informaticians design systems to support tasks for which there is little analogy or prece- dent outside medicine [2]. On the other hand, Health Informatics as a discipline is often neglected to be a discipline of its own. And indeed, why do we coin the term Health Informatics, but not, e.g. bank industry informatics or even aviation industry informatics? After all, in most other industries software and requirements engineering techniques are the same, the research results in these areas largely industry independent and the education of professionals similar. It is usually acknowledged that processes of patient care are highly complex and extremely variable: typically health care is characterized by many and many different relatively short yet complex processes like physician order entry (POE, e.g. [3]), on the one hand, and long- running and potentially even cyclic treatment processes like chemotherapy for in- and out-patients, on the other hand [4]. Further, nowadays, health care provider organizations and individual health care professionals (HCPs) typically are highly specialized. For optimal patient care, the various providers and HCPs have to cooperate during patient care, often called shared care or integrated care. Shared care is defined as the contin- uous patient-oriented cooperation of hospitals, general practitioners (GPs), specialists and other HCPs during patient care ([1] p. 596, [5]). It is crucial for good and cost-efficient health care; however, it imposes great challenges on the availability and processing of infor- mation including trusting the information, the righteous S. Garde (&) Health Informatics Research Group, Faculty of Business and Informatics, Central Queensland University, Rockhampton, QLD 4702, Australia E-mail: s.garde@cqu.edu.au Tel.: +61-7-49306542 Fax: +61-7-49309729 P. Knaup Department of Medical Informatics, Institute for Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany Requirements Eng (2006) 11: 265–278 DOI 10.1007/s00766-006-0029-6