Thanks Eric, I was wondering whether I would need to explain this! Eric Browne wrote:
I should say about this that all it is is an attempt to see what would be needed in the EHR to support workflow. We envisage a workflow engine outside the EHR to perform the steps, and expect that this engine will have a formal representation of the workflow. In our example, we have shown it as a state machine, which I know is not generally strong enough, but it may be strong enough just to represent what state the workflow is in for the purposes of noting in the EHR (i,e, the "real" Wf execution in the engine will probably have a representation in a more sophisticated formalism).Andrew, There is a huge leap in functionality in moving from a "passive" recording system to an "active" workflow management system. Traditionally, WfMs deal with highly repeatable processes, utilising pre-defined static process schemas. They depend on a rich organisational model, incorporate sophisticated notification mechanisms, and possess the ability to relate and alter participant workload across cases. Their routing primitives are usually simple and their schemas are applied to deterministic processes. The object of a case is normally only subject to one Wf schema ( contrast with comorbidity in health ), in one organisational setting. Whilst it might be possible to store per-patient dynamically changing Wf schemas in a health record, the ability to make use of such schemas via sophisticated Wf engines is a problem orders of magnitude more difficult. But it is interesting to see openEHR approach the challenge for a simple recall system.
One of the problems to consider is where a Wf engine will have a trustworthy persistence mechanism for each patient - should it maintain its own, should it use the EHR? Do we want the Wf to be represented transparently in the EHR so clinical users can tell what things are beiing done to/for the patient by the workflow execution system? etc
I have a web site devoted to Workflow in Healthcare. In particular I refer you to :- http://workflow.healthbase.info/wf_in_healthcare.html and http://workflow.healthbase.info/monographs/index.html
aha - good resources! - thomas beale
