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

End-to-End QoS Support for a Medical Grid Service Infrastructure

Quality of Service support is an important prerequisite for the adoption of Grid technologies for medical applications. The GEMSS Grid infrastructure addressed this issue by offering end-to-end QoS in the form of explicit timeliness guarantees for compute-intensive medical simulation services. Within GEMSS, parallel applications installed on clusters or other HPC hardware may be exposed as QoS-aware Grid services for which clients may dynamically negotiate QoS constraints with respect to response time and price using Service Level Agreements. The GEMSS infrastructure and middleware is based on standard Web services technology and relies on a reservation based approach to QoS coupled with application specific performance models. In this paper we present an overview of the GEMSS infrastructure, describe the available QoS and security mechanisms, and demonstrate the effectiveness of our methods with a Grid-enabled medical imaging service

Towards a Smarter organization for a Self-servicing Society

Traditional social organizations such as those for the management of healthcare are the result of designs that matched well with an operational context considerably different from the one we are experiencing today. The new context reveals all the fragility of our societies. In this paper, a platform is introduced by combining social-oriented communities and complex-event processing concepts: SELFSERV. Its aim is to complement the "old recipes" with smarter forms of social organization based on the self-service paradigm and by exploring culture-specific aspects and technological challenges.Comment: Final version of a paper published in the Proceedings of International Conference on Software Development and Technologies for Enhancing Accessibility and Fighting Info-exclusion (DSAI'16), special track on Emergent Technologies for Ambient Assisted Living (ETAAL

Addressing the Quality and Safety Gap Part II: How Nurses Are Shaping, and Being Shaped by, Health Information Technologies

Explores the role of health information technologies (HIT) in improving patient safety and the role of nurses in designing, implementing, and educating clinicians to use HIT, including electronic health records and bar code medication administration

Organizing for Higher Performance: Case Studies of Organized Delivery Systems

Offers lessons learned from healthcare delivery systems promoting the attributes of an ideal model as defined by the Fund: information continuity, care coordination and transitions, system accountability, teamwork, continuous innovation, and easy access