Starting a Clinical Workflow Community

by Jerome Carter on August 12, 2013 · 5 comments

Well, here is the forum promised in the last post.   As with any forum, the main goal is to build a community where ideas, tips, and techniques can be shared and debated.   This being new territory for me, I worry about security issues as well as whether the forum will catch on.  The initial forum will focus on a single domain because I need time to determine how demanding hosting a forum will be.   However, I am willing to add additional forum domains if readers request them in advance of the scheduled date. (For those who are interested, EHR design is next.)

I have chosen to focus initial discussions on clinical workflow for a few reasons, the most important being that workflow-related posts and resources account for about 50% of visits.    In addition, review of search terms reveals that those related to workflow dominate (consistently the #1 term is workflow-related).    Given that so many are searching for workflow information, it seems to be a good place to start.

Another reason for starting with clinical workflow is that I have always felt it is a major determinant of implementation success. The ability to assess processes and plan their redesign is a key organizational capability. Unfortunately, it is one that is often lacking.   Clinical workflow analysis/redesign is about more than choosing the best graphical tool or terminology; it is an abstract way of looking at how things work and what happens.   However, tools are important.   Petri nets (especially colored nets) are far superior to flow charts, swim lane diagrams, and other documentation tools in capturing the dynamic nature of workflows.  Yet, I am finding that Petri nets are unfamiliar to most who are involved in EHR implementation.   Hopefully, EHR Science is helping to change this.

The final reason for starting with clinical workflow should be obvious to frequent visitors—workflow representation has been a personal interest for many years.

Accessing the forum
Forum rules are simple.  Registration is required for posting and replying to questions.   I am not interested in collecting data on visitors, so nothing beyond the basics –name, email, and password—are required for registration.   Please, keep language and comments on a professional level because I will not have time to review every post.   However, should I spot violations, or if any are made known to me, the violating account will be deleted.

If there is a domain for which you would like to create a forum, please use the contact form to make the suggestion, and explain why it should be added.   The contact form should be used only for communications about EHR Science.  (Anyone interested in consulting services should use the contact information at Informatics Squared.)

Kick-off Topics/Questions
Below are three topics/questions that arose out of analyzing EHR Science visit data and search terms.   Answers will help me improve the site and plan future posts and resources.   Please feel free to register and post your own topics/questions.   

Topic Area Question
Formal methods for workflow analysis, representation, and simulation View Do you have an interest in formal approaches to workflow such as directed graphs, Petri nets, and BPMN?
Workflow documentation tools/techniques  View What do you use to document workflows (e.g., flow charts, Petri nets, swim lane diagrams, activity diagrams), and why did you choose that method?
Clinical workflow analysis issues  View What problems have you encountered while trying to perform a workflow analysis prior to EHR implementation?

I hope this forum is the beginning of a robust community that, while focusing initially on clinical workflow, becomes a place where everyone interested in the range of issues surrounding the design and implementation of clinical systems feels comfortable pulling up a chair and joining in.  Let the discussions begin!

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{ 5 comments… read them below or add one }

Heidi Immel October 7, 2014 at 6:06 PM

Did this forum not catch on? How can I subscribe if it’s still being used?
Thank you!

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Jerome Carter October 7, 2014 at 9:48 PM

The forum did not make it through a software update. Once it was down, I decided to evaluate other software and start again. After I finish the final assessments, the forum will come back on line. I will let you know when it becomes available. It should be only a matter of weeks now. Thanks for your interest.

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Keith Butler August 20, 2013 at 11:38 AM

Thanks for organizing this.
At Univ of WA we have several clinical workflow projects:
– Development of MATH, an integrated toolsuite for modeling and analyzing clinical workflow based on BPMN, funded by SHARP-C;
– “Modeling & Analysis of Clinical Care for HIT Improvement” for MS, chronic pain management, and hospital admissions;
– Priority Contact, an evidence-based web app to contact patients about test results and treatment changes, funded by UW C4C

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Jerome Carter August 20, 2013 at 3:06 PM

Keith, thanks for your comment. I am very happy to hear of the MATH project and your use of BPMN. Have you published on this project yet?

Before deciding on BPMN, what other modeling tools or workflow languages did you evaluate? As you know, I am fond of Petri nets and YAWL because they have a very well defined basis in graph theory.

Jerome

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Jerome Carter August 12, 2013 at 2:48 PM

Chuck, thanks for being so supportive. WF technology is a great idea that has not quite caught on in health care. I see it as the basis for re-imagining EHR design.

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