P ro D oc: an Electronic Patient Record to Foster Process-Oriented Practices (original) (raw)
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Lecture Notes in Business Information Processing, 2009
Healthcare Processes are characterized by knowledge-intensive tasks. In contrast to this, most of the efforts for business process management in healthcare do not refer to this quality, and software engineering in healthcare relies on an unspecific process-oriented approach. In this contribution, we present a method of capturing and analysis of a knowledge-intensive process, from which we derive requirements to a knowledge-as well as process-oriented information system for the example of general medical documentation. We present the resulting implementation of a knowledge-based electronic patient record and discuss the potentials and open issues for our proposal.
Journal of the American Medical Informatics Association, 2011
Objective There is a need to integrate the various theoretical frameworks and formalisms for modeling clinical guidelines, workflows, and pathways, in order to move beyond providing support for individual clinical decisions and toward the provision of process-oriented, patient-centered, health information systems (HIS). In this review, we analyze the challenges in developing process-oriented HIS that formally model guidelines, workflows, and care pathways. Methods A qualitative meta-synthesis was performed on studies published in English between 1995 and 2010 that addressed the modeling process and reported the exposition of a new methodology, model, system implementation, or system architecture. Thematic analysis, principal component analysis (PCA) and data visualisation techniques were used to identify and cluster the underlying implementation 'challenge' themes. Results One hundred and eight relevant studies were selected for review. Twenty-five underlying 'challenge' themes were identified. These were clustered into 10 distinct groups, from which a conceptual model of the implementation process was developed. Discussion and conclusion We found that the development of systems supporting individual clinical decisions is evolving toward the implementation of adaptable care pathways on the semantic web, incorporating formal, clinical, and organizational ontologies, and the use of workflow management systems. These architectures now need to be implemented and evaluated on a wider scale within clinical settings.
Transforming a Paper based Process to a Natural user Interfaces Process in a Chronic Care Hospital
Procedia Computer Science, 2012
We are investigating the use of natural user interfaces (NUI) applied to information and communication technologies (ICT) supporting workplace dynamics in partnership with mental health providers at a hospital in Brazil. We are using a participatory design (PD) process to uncover their paper-based workflow, defined here as paper user interface workflow (PUI) and their appropriation of mobile technologies supporting patients' socialization process. We chose this group as they have no experience with graphical user interface (GUI) based interaction, are highly nomadic, have a refined workflow, have a high level of interdependence and are appropriating mobile technologies and social media into their workplace; thus, we believe their perspective within a PD setting provide unique insights into NUI design to provide high fidelity data and real time communication, enhancing data accessibility and fidelity on communication among the professionals. Our PD process has produced workflow representations and we are presenting two scenarios; from them we are proceeding to lowfidelity prototyping.
From paper based clinical practice guidelines to declarative workflow management
Business Process …, 2009
We present a field study of oncology workflow, involving doctors, nurses and pharmacists at Danish hospitals and discuss the obstacles, enablers and challenges for the use of computer based clinical practice guidelines. Related to the CIGDec approach of Pesic and van der Aalst we then describe how a sub workflow can be described in a declarative workflow management system: the Resultmaker Online Consultant (ROC). The example demonstrates that declarative primitives allow to naturally extend the paper based flowchart to an executable model without introducing a complex cyclic control flow graph.
Documentation of Flexible Business Processes-A Healthcare Case Study
2009
In many industries, such as manufacturing and logistics, semi-formal process models have become a common means to reason and communicate about business processes. However, in a dynamic and flexible environment the suitability of semiformal process models as an instrument of process documentation may be challenged. Hospital processes are typical examples of business processes that are characterized by both the existence of well-defined procedures and the need for operational flexibility. This research investigates the current practice of process documentation in healthcare by means of a case study in a German hospital. We aim at getting an understanding of how flexible processes may be documented to give medical staff effective guidance and how this documentation has to be managed in order to provide value in everyday routine. On the basis of our findings we give suggestions on how to effectively implement process documentations in similar settings.
Healthcare Process Support: Achievements, Challenges, Current Research
2012
Healthcare organizations are facing the challenge of delivering high-quality services to their patients at affordable costs. To tackle this challenge, the Medical Informatics community targets at formalisms for developing decision-support systems (DSSs) based on clinical guidelines. At the same time, business process management (BPM) enables IT support for healthcare processes, e.g., based on workflow technology. By integrating aspects from these two fields, promising perspectives for achieving better healthcare process support arise. The perspectives and limitations of IT support for healthcare processes provided the focus of three Workshops on Process-oriented Information Systems (ProHealth). These were held in conjunction with the International Conference on Business Process Management in 2007-2009. The ProHealth workshops provided a forum wherein challenges, paradigms, and tools for optimized process support in healthcare were debated. Following the success of these workshops, this special issue on process support in healthcare provides extended papers by research groups who contributed multiple times to the ProHealth workshop series. These works address issues pertaining to healthcare process modeling, process-aware healthcare information system, workflow management in healthcare, IT support for guideline implementation and medical decision support, flexibility in healthcare processes, process interoperability in healthcare and healthcare standards, clinical semantics of healthcare processes, healthcare process patterns, best practices for designing healthcare processes, and healthcare process validation, verification, and evaluation.
2005
Healthcare organizations are sufficiently rich in their infrastructure to handle the internal administrative and clinical processes, but the need to integrate the processes of geographically distributed and organizationally independent organizations is evident. Building business processes in the health care sector from a local process is a new challenge. We propose an extension of UML Language to model processes in the health care domain using workflow modelling techniques and examining interoperability concepts among heterogeneous environments. We extend the UML Activity Diagram –to HWADD diagramto support workflow topics as well as standardized Clinical Documents that are handled by the processes. The diagram can be used to identify the activities in the processes in health care and also the resources for the execution of the activities. Adding also the concept of clinical documents the diagram can represent, in a sound way, the processes in a regional health network and the requi...
Healthcare processes require the cooperation of different healthcare providers and medical disciplines. In such an environment, the quality and safety of care rely heavily on the ability to exchange information from one software to another, and from one person to another. However, information systems that support a seamless flow of information along healthcare processes are not broadly used in healthcare environments. Usually, healthcare organizations have their own autonomously developed information systems that do not support the cooperation of different organizational units and medical disciplines. This has led to the fragmentation of the patients’ information in proprietary heterogeneous systems across healthcare organizations. The aim of this paper is to: (1) explore how healthcare practitioners´ in Sweden experience information system support in their daily work activities, and (2) present and illustrate how key design principles of a process support system prototype can suppo...
International Journal of Medical Informatics, 2001
As computers become more and more an aid in the management of medical information, some specialists, such as anesthesiologists, demand tuned applications to support their own activity. The development of these specific applications is based upon the user's requirements analysis, and functional and technical specifications. But some failures show that a better understanding of human factors of acceptance could improve the usability and utility of these tools. In this study, we demonstrated that when the management of medical information is closely intertwined with the physician's activity, it is necessary to perform a precise analysis of this activity in order to identify the cognitive and organizational constraints that affect the usability and acceptance of the tool. We focused our study on the pre-operative anesthetic consultation. After recording and analyzing 50 consultations, we were able to identify the key points to fulfill in order to meet users' acceptance. From this study, we propose some strong recommendations to handle the constraints imposed by the anesthesiologists' activity in their daily working environment. We applied this method to evaluate an electronic patient record (EPR) for the pre-anesthetic consultation. The results of this evaluation validate our hypotheses and the importance of the activity constraints. In conclusion, human factors, and particularly those linked with the activity of healthcare professionals, have to be carefully studied before any development and installation of an EPR into a specialty domain.