Interplay between Clinical Guidelines and Organizational Workflow Systems. Experience from the MobiGuide Project

Area of Science:

• Health Informatics
• Clinical Decision Support Systems
• Workflow Management

Background:

• Healthcare systems require integrating clinical knowledge with operational constraints for effective decision support.
• Computer-interpretable guidelines (CIG) address clinical aspects, while business process management (BPM) handles organizational logistics.

Purpose of the Study:

• To orchestrate patient care pathways across the continuum of care, from acute to community or home settings.
• To integrate clinical guidelines with organizational workflows for seamless healthcare execution.

Main Methods:

• Explored three integration strategies: extending CIG/BPM languages, extending engines, or creating interplay.
• Implemented an interplay approach using a CIG for Atrial Fibrillation use cases.
• Utilized Cross-Enterprise Document Workflow Integration Profile for a scalable, standards-based solution.

Main Results:

• Demonstrated a proof-of-concept with five use cases, integrating the Activiti BPM engine and Picard CIG engine.
• Employed a loosely-coupled approach using Personal Health Records and polling for changes.
• Developed workflow documents using IHE profiles for cross-enterprise cardioversion execution.

Conclusions:

• The interplay between CIG and BPM engines effectively supports the orchestration of care flows within healthcare organizations.
• This integration facilitates smoother transitions and management of patient care across different settings.