Computerization of workflows, guidelines and care pathways: a review of implementation challenges for process-oriented health information systems

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. 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. 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. 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

Change Support in Process-Aware Information Systems - A Pattern-Based Analysis

In today's dynamic business world the economic success of an enterprise increasingly depends on its ability to react to changes in its environment in a quick and flexible way. Process-aware information systems (PAIS) offer promising perspectives in this respect and are increasingly employed for operationally supporting business processes. To provide effective business process support, flexible PAIS are needed which do not freeze existing business processes, but allow for loosely specified processes, which can be detailed during run-time. In addition, PAIS should enable authorized users to flexibly deviate from the predefined processes if required (e.g., by allowing them to dynamically add, delete, or move process activities) and to evolve business processes over time. At the same time PAIS must ensure consistency and robustness. The emergence of different process support paradigms and the lack of methods for comparing existing change approaches have made it difficult for PAIS engineers to choose the adequate technology. In this paper we suggest a set of changes patterns and change support features to foster the systematic comparison of existing process management technology with respect to process change support. Based on these change patterns and features, we provide a detailed analysis and evaluation of selected systems from both academia and industry. The identified change patterns and change support features facilitate the comparison of change support frameworks, and consequently will support PAIS engineers in selecting the right technology for realizing flexible PAIS. In addition, this work can be used as a reference for implementing more flexible PAIS

An approach to control collaborative processes in PLM systems

Companies that collaborate within the product development processes need to implement an effective management of their collaborative activities. Despite the implementation of a PLM system, the collaborative activities are not efficient as it might be expected. This paper presents an analysis of the problems related to the collaborative work using a PLM system. From this analysis, we propose an approach for improving collaborative processes within a PLM system, based on monitoring indicators. This approach leads to identify and therefore to mitigate the brakes of the collaborative work

Process time patterns: A formal foundation

Companies increasingly adopt process-aware information systems (PAISs) to model, execute, monitor, and evolve their business processes. Though the handling of temporal constraints (e.g., deadlines or time lags between activities) is crucial for the proper support of business processes, existing PAISs vary significantly regarding the support of the temporal perspective. Both the formal specification and the operational support of temporal constraints constitute fundamental challenges in this context. In previous work, we introduced process time patterns, which facilitate the comparison and evaluation of PAISs in respect to their support of the temporal perspective. Furthermore, we provided empirical evidence for these time patterns. To avoid ambiguities and to ease the use as well as the implementation of the time patterns, this paper formally defines their semantics. To additionally foster the use of the patterns for a wide range of process modeling languages and to enable pattern integration with existing PAISs, the proposed semantics are expressed independently of a particular process meta model. Altogether, the presented pattern formalization will be fundamental for introducing the temporal perspective in PAISs

Context-based task ontologies for clinical guidelines

Evidence-based medicine relies on the execution of clinical practice guidelines and protocols. A great deal of of effort has been invested in the development of various tools which automate the representation and execution of the recommendations contained within such guidelines and protocols by creating Computer Interpretable Guideline Models (CIGMs). Context-based task ontologies (CTOs), based on standard terminology systems like UMLS, form one of the core components of such a model. We have created DAML+OIL-based CTOs for the tasks mentioned in the WHO guideline for hypertension management, drawing comparisons also with other related guidelines. The advantages of CTOs include: contextualization of ontologies, providing ontologies tailored to specific aspects of the phenomena of interest, dividing the complexity involved in creating ontologies into different levels, providing a methodology by means of which the task recommendations contained within guidelines can be integrated into the clinical practices of a health care set-up

Towards Generalizing Visual Process Patterns

Visual Process Patterns (VPP) is a visual language to describe constraints on the behavior of UML Activities. They have been developed for the sake of formulating and verifying requirements on business process models in a visual, intuitive way (with UML Activities being one possible description language). In the VPP approach, a visual process pattern is translated into an LTL formula, which can then be verified against a transition system describing the behavior of the Activity under consideration. In this paper, we aim at generalizing VPP. We show how to formulate patterns more generally, using an enhanced version of the concrete syntax of the behavioral model under consideration. Additionally, we describe how these more general patterns can be verified against a modelâs behavior