email: {erich, petrou, orphanou}@ics.forth.gr phone: +30 (81) ... A prerequisite for any kind of workflow automation is a formal description of the processes.
ICS-FORTH
1997
An Approach for the Formal Description of Healthcare-Related Processes
E. Leisch 1, A. Petrou 1, and S. Orphanoudakis 1,2
1
Institute of Computer Science, Foundation for Research and Technology - Hellas, P.O. Box 1385, 711 10 Heraklion, Greece 2
Department of Computer Science, University of Crete, Heraklion, Greece Tel.: +30-81-391600, Fax.: +30-81-391601, E-mail: {erich, petrou, orphanou}@ics.forth.gr
URL: http://www.ics.forth.gr/ICS/acti/cmi_hta/publications/papers.html
Proceedings of EuroPACS’97 The 15th International EuroPACS Meeting pp. 179-182 September, 25-27 Pisa, Italy 1997
E. Leisch, A. Petrou, S.C. Orphanoudakis
Healthcare-Related Processes
An approach for the formal description of healthcare-related processes Erich Leisch 1, Anastasia Petrou 1, Stelios C. Orphanoudakis 1,2 1
Institute of Computer Science, FORTH, P.O. Box 1385, GR-711 10 Heraklion, Greece 2 Dept. of Computer Science, University of Crete, GR-714 09 Heraklion, Greece email: {erich, petrou, orphanou}@ics.forth.gr phone: +30 (81) 391419, fax: +30 (81) 391601
INTRODUCTION Many healthcare providers, especially large regional or district hospitals, have a high degree of specialization at the department level. Usually, a number of healthcare professionals and administrative staff from different departments are involved in the provision of a diagnostic or therapeutic service. In order to manage the resulting complexity of activities and interactions, there are more or less formalized procedures describing interrelated tasks of administrative, diagnostic, or therapeutic nature, that have to be performed in a given order and under given constraints. Such procedures are found in several processes (referral, acquisition, reporting, image management, consultation, etc.). They usually differ from country to country or even from institution to institution. As pointed out in [1], the concepts of business process modeling can be applied to the healthcare domain, in order to enhance the effectiveness (i.e. doing the right things) and efficiency (i.e. doing the things right) of healthcare provision, thus contributing to improved quality of care, while reducing cost. The increasing use of information technology in the healthcare domain and the availability of a modern communication infrastructure support the idea of automated or semi-automated workflow processing, even beyond the hospital boundaries, thus enabling better continuity of care between hospitals, general practitioners, and other healthcare providers. Applying this approach to a HIS-RIS-PACS environment, a high degree of functional integration [2] can be achieved, as far as the distribution of digital image data and other multimedia patient data, and the scheduling of associated activities are concerned. In such an environment, digital patient data are produced by diagnostic modalities, interpreted by radiologists and other specialists, archived in sophisticated storage management systems, and used to enable or support therapeutic decisions or actions. Workflow management techniques provide the means to keep track of the involved activities and to schedule them in an optimal way, taking into account time constraints, availability of resources or specialists, and cost data.
Proceedings of EuroPACS’97, Pisa, Italy, pp. 179-182, September 25-27, 1997
page 1
E. Leisch, A. Petrou, S.C. Orphanoudakis
Healthcare-Related Processes
APPROACH A prerequisite for any kind of workflow automation is a formal description of the processes to be supported. This paper presents an approach for the formal description of healthcarerelated business processes, in compliance with the Workflow Management Coalition’s (WfMC) reference model as specified in [3]. The resulting process definitions can be used by any workflow enactment service that is also compliant with the WfMC reference model. This paper is focused on the build-time functions, which include tools and mechanisms for the definition of healthcare-related business processes. The run-time functions, on the other hand, are responsible for creating and controlling operational instances of the processes, scheduling the various activity steps within the processes, and invoking the appropriate human and IT application resources, in a heterogeneous environment. The build-time components of the WfMC reference model interact with the run-time components by means of the Process Definition Interchange Interface, as defined by the WfMC. As shown in [4], this interface is used to access the contents of a workflow definition pool, which is part of the workflow engine. It provides the ability to list, modify, or delete existing definitions, and to create new ones. In our approach, definitions of healthcare-related processes are expressed in terms of the WfMC’s basic process definition meta-model and in relation to the Healthcare Domain Reference Data Model (HRDM) proposed in [5]. The idea behind the HRDM is to describe the healthcare domain at a meta-level in terms of interrelated but independent facets. Using the entities of this model, it should be possible to describe healthcare-related data, services, and processes. Although the HRDM is dynamically extensible in order to cover new aspects of the healthcare domain, we believe that its main entities (or facets) are quite stable and complete. The facets identified todate are: actor, object, resource, document, event, context, and coordinate. On the other hand, the meta-model of the WfMC can be used to express the entities, their relationships and attributes within a process definition. It uses the terms workflow process definition, workflow process activity, workflow participant definition, transition information, workflow application definition, and workflow process relevant data. In our approach, the WfMC meta-model was used to extend the HRDM, in order to create a reference model that can be used for the definition of healthcare-related processes.
IMPLEMENTATION The build-time components within the proposed workflow management architecture are responsible for the creation and maintenance of healthcare-related process definitions. They are based on the HRDM, extended by the WfMC process definition meta-model. In our approach, this extended HRDM as well as the individual process definitions are implemented by the Semantic Indexing System (SIS) described in [6, 7]. As shown in Fig. 1, the SIS, through its customizable native interfaces, is used for the maintenance of an external process definition pool. The workflow engine’s (internal)
Proceedings of EuroPACS’97, Pisa, Italy, pp. 179-182, September 25-27, 1997
page 2
E. Leisch, A. Petrou, S.C. Orphanoudakis
Healthcare-Related Processes
definition pool, which is part of the WfMC reference model, is updated by means of an SIS workflow compiler through the Process Definition Interchange Interface. This compiler reads the contents of the SIS database and performs the necessary changes in the (internal) definition pool via a set of standardized functions.
SIS process process definitions definitions
HRDM HRDM
other other workflow workflow definition definition tool tool
SIS SIS workflow workflow compiler compiler
interface interface 11 (WfMC (WfMC reference reference model) model)
build-time run-time
workflow engine workflow workflow definition definition pool pool
Fig. 1 - The build-time components of the proposed architecture
REFERENCES 1.
Amberg M, Graeber S. Specifying Hospital Information Systems Using Business Process Modeling. In: Brender J, Christensen JP, Scherrer JR, McNair P (eds.). Medical Informatics Europe ’96. IOS Press, Amsterdam, 1996, pp. 1037-1041.
2.
Leisch E, Tsiknakis M, Orphanoudakis SC. An Architectural Framework for the Integration of Geographically Distributed Heterogeneous Autonomous Medical Information Systems. Proceedings of EuroPACS ’96, Heraklion, Crete, Greece, Oct. 3-5, 1996, pp. 73-77.
3.
Hollingsworth D. Workflow Management Coalition: The Workflow Reference Model. The Workflow Management Coalition, Doc. No. TC00-1003, Issue 1.1, Brussels, 1994.
Proceedings of EuroPACS’97, Pisa, Italy, pp. 179-182, September 25-27, 1997
page 3
E. Leisch, A. Petrou, S.C. Orphanoudakis
Healthcare-Related Processes
4.
WfMC Work Group 1. Workflow Management Coalition - Interface 1: Process Definition Interchange. The Workflow Management Coalition, Doc. No. WfMC TC1016, Version 1.0 Beta, Brussels, 1996.
5.
Leisch E, Sartzetakis S, Tsiknakis M, Orphanoudakis SC. A Framework for the Integration of Distributed Autonomous Healthcare Information Systems. Submitted as an invited paper for a special issue of the Journal of Medical Informatics, 1997.
6.
Constantopoulos P, Doerr M. The Semantic Index System: A Brief Presentation. Institute of Computer Science, Foundation of Research and Technology - Hellas, Heraklion, Crete, Greece, 1993.
7.
Constantopoulos P, Doerr M. The Semantic Indexing System. Technical Report, Institute of Computer Science, Foundation for Research and Technology - Hellas, 1995.
Proceedings of EuroPACS’97, Pisa, Italy, pp. 179-182, September 25-27, 1997
page 4
