Methods Inf Med 2016; 55(06): 488-494
DOI: 10.3414/ME16-01-0006
Original Articles
Schattauer GmbH

Interplay between Clinical Guidelines and Organizational Workflow Systems[*]

Experience from the MobiGuide Project
Amnon Shabo (Shvo)
1   University of Haifa, Haifa, Israel
,
Mor Peleg
1   University of Haifa, Haifa, Israel
,
Enea Parimbelli
2   University of Pavia, Pavia, Italy
,
Silvana Quaglini
2   University of Pavia, Pavia, Italy
,
Carlo Napolitano
3   IRCCS Foundation S. Maugeri, Pavia, Italy
› Author Affiliations
Further Information

Publication History

received: 11 January 2016

accepted: 12 March 2016

Publication Date:
08 January 2018 (online)

Summary

Background: Implementing a decision-support system within a healthcare organization requires integration of clinical domain knowledge with resource constraints. Computer-interpretable guidelines (CIG) are excellent instruments for addressing clinical aspects while business process management (BPM) languages and Workflow (Wf) engines manage the logistic organizational constraints.

Objectives: Our objective is the orchestra -tion of all the relevant factors needed for a successful execution of patient’s care pathways, especially when spanning the contin -uum of care, from acute to community or home care.

Methods: We considered three strategies for integrating CIGs with organizational work-flows: extending the CIG or BPM languages and their engines, or creating an interplay between them. We used the interplay approach to implement a set of use cases arising from a CIG implementation in the domain of Atrial Fibrillation. To provide a more scalable and standards-based solution, we explored the use of Cross-Enterprise Document Workflow Integration Profile.

Results: We describe our proof-of-concept implementation of five use cases. We utilized the Personal Health Record of the MobiGuide project to implement a loosely-coupled approach between the Activiti BPM engine and the Picard CIG engine. Changes in the PHR were detected by polling. IHE profiles were used to develop workflow documents that orchestrate cross-enterprise execution of cardioversion.

Conclusions: Interplay between CIG and BPM engines can support orchestration of care flows within organizational settings.

* Supplementary material published on our website http://dx.doi.org/10.3414/ME16-01-0006