Mapping care processes within a hospital: from theory to a web-based proposal merging enterprise modelling and ISO...

Today, the economic and regulatory environment, involving activity-based and prospective payment systems, healthcare quality and risk analysis, traceability of the acts performed and evaluation of care practices, accounts for the current interest in clinical and hospital information systems. The structured gathering of information relative to users' needs and system requirements is fundamental when installing such systems. This stage takes time and is generally misconstrued by caregivers and is of limited efficacy to analysts. We used a modelling technique designed for manufacturing processes (IDEF0/SADT). We enhanced the basic model of an activity with descriptors extracted from the Ishikawa cause-and-effect diagram (methods, men, materials, machines, and environment). We proposed an object data model of a process and its components, and programmed a web-based tool in an object-oriented environment. This tool makes it possible to extract the data dictionary of a given process from the description of its elements and to locate documents (procedures, recommendations, instructions) according to each activity or role. Aimed at structuring needs and storing information provided by directly involved teams regarding the workings of an institution (or at least part of it), the process-mapping approach has an important contribution to make in the analysis of clinical information systems.