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

Context-Aware Information Retrieval for Enhanced Situation Awareness

In the coalition forces, users are increasingly challenged with the issues of information overload and correlation of information from heterogeneous sources. Users might need different pieces of information, ranging from information about a single building, to the resolution strategy of a global conflict. Sometimes, the time, location and past history of information access can also shape the information needs of users. Information systems need to help users pull together data from disparate sources according to their expressed needs (as represented by system queries), as well as less specific criteria. Information consumers have varying roles, tasks/missions, goals and agendas, knowledge and background, and personal preferences. These factors can be used to shape both the execution of user queries and the form in which retrieved information is packaged. However, full automation of this daunting information aggregation and customization task is not possible with existing approaches. In this paper we present an infrastructure for context-aware information retrieval to enhance situation awareness. The infrastructure provides each user with a customized, mission-oriented system that gives access to the right information from heterogeneous sources in the context of a particular task, plan and/or mission. The approach lays on five intertwined fundamental concepts, namely Workflow, Context, Ontology, Profile and Information Aggregation. The exploitation of this knowledge, using appropriate domain ontologies, will make it feasible to provide contextual assistance in various ways to the work performed according to a user’s taskrelevant information requirements. This paper formalizes these concepts and their interrelationships

Elastic Business Process Management: State of the Art and Open Challenges for BPM in the Cloud

With the advent of cloud computing, organizations are nowadays able to react rapidly to changing demands for computational resources. Not only individual applications can be hosted on virtual cloud infrastructures, but also complete business processes. This allows the realization of so-called elastic processes, i.e., processes which are carried out using elastic cloud resources. Despite the manifold benefits of elastic processes, there is still a lack of solutions supporting them. In this paper, we identify the state of the art of elastic Business Process Management with a focus on infrastructural challenges. We conceptualize an architecture for an elastic Business Process Management System and discuss existing work on scheduling, resource allocation, monitoring, decentralized coordination, and state management for elastic processes. Furthermore, we present two representative elastic Business Process Management Systems which are intended to counter these challenges. Based on our findings, we identify open issues and outline possible research directions for the realization of elastic processes and elastic Business Process Management.Comment: Please cite as: S. Schulte, C. Janiesch, S. Venugopal, I. Weber, and P. Hoenisch (2015). Elastic Business Process Management: State of the Art and Open Challenges for BPM in the Cloud. Future Generation Computer Systems, Volume NN, Number N, NN-NN., http://dx.doi.org/10.1016/j.future.2014.09.00

A Framework for QoS-aware Execution of Workflows over the Cloud

The Cloud Computing paradigm is providing system architects with a new powerful tool for building scalable applications. Clouds allow allocation of resources on a "pay-as-you-go" model, so that additional resources can be requested during peak loads and released after that. However, this flexibility asks for appropriate dynamic reconfiguration strategies. In this paper we describe SAVER (qoS-Aware workflows oVER the Cloud), a QoS-aware algorithm for executing workflows involving Web Services hosted in a Cloud environment. SAVER allows execution of arbitrary workflows subject to response time constraints. SAVER uses a passive monitor to identify workload fluctuations based on the observed system response time. The information collected by the monitor is used by a planner component to identify the minimum number of instances of each Web Service which should be allocated in order to satisfy the response time constraint. SAVER uses a simple Queueing Network (QN) model to identify the optimal resource allocation. Specifically, the QN model is used to identify bottlenecks, and predict the system performance as Cloud resources are allocated or released. The parameters used to evaluate the model are those collected by the monitor, which means that SAVER does not require any particular knowledge of the Web Services and workflows being executed. Our approach has been validated through numerical simulations, whose results are reported in this paper