Clinical Workflow Center—It’s Alive!

Well, six weeks later than expected, Clinical Workflow Center (CWC) is finally up and running! I had no idea it would take this long–the original target date was December 8th. Such is the way of software projects, no matter how simple they seem at the outset.

Q & A forum
The site has a minimal set of features, reflecting the YAGNI principle.   As such, the Q & A forum is a central focus of the site because I need a way to gauge how much interest there really is in clinical workflow analysis and applications.   This is where you come in.   Let me know how the site should grow and what content you would like to see.   Register, ask a few questions, or perhaps answer a few.   Should you wish to ask me a question directly, use the contact form.

I have included a set of question categories to get started. Most should be self-explanatory. “Workflow Applications” refers to using workflow models to solve/study/understand usability, safety, decision support, and similar problems. “Workflow Technology” should be used for questions about workflow products, BPM, etc. Attachments are not permitted; however, links are allowed.

The tutorials from EHR Science have been reorganized to make them easier to use as teaching materials. In their current form, the tutorials provide a good introduction to both conducting workflow analyses and making practical use of them, say for selecting an EHR system.    When published as posts, the tutorials were broken into smaller pieces suitable for a blog.   However, future tutorials on Clinical Workflow Center will retain their original form (anywhere from 3500-6000 words) and be made available as PDFs and/or eBook formats.

Articles & Blogs
Unlike EHR Science, which is my personal soapbox, CWC is a commercial offering and will accept outside content. Authors who submit content grant CWC/Informatics Squared, Inc. the right to perpetually publish that content on CWC. Authors retain copyrights.   Submission inquiries should use the contact form.

All clinical workflow and Petri net resources will appear exclusively on CWC after January 26th.   At some point, if there is sufficient interest, resource types will be expanded to include product listings and links to trade publications and other blogs. Once I figure out how I want to manage them, product announcements will be accepted as well.

It costs time and effort to host and maintain a site. With this in mind, CWC will accept limited sponsorships on a first-come basis. Use the contact form for more information.

Goals and wishes
Clinical workflow issues play a key role in usability, patient safety, decision support, productivity, and software design. This reality is gradually seeping into the general consciousness.   Even so, that awareness is more along the lines of “workflow is important” rather than “workflow is a defining aspect of clinical care. “

One thing that seems important to address from the outset is the definition of clinical workflow.   There are many definitions of workflow concepts available. I favor those provided by way of workflow patterns. Here are the definitions provided by Russell, et al. (1).

A workflow or workflow model is a description of a business process in sufficient detail that it is able to be directly executed by a workflow management system. A workflow model is composed of a number of tasks which are connected in the form of a directed graph.

These definitions are focused on automation and not clinical work. I would like to adapt these definitions, and workflow patterns in general, for clinical work.  Should these efforts be successful, the result would be a set of shared conventions (e.g., definitions, analysis methods, terminology, modeling representations) for clinical workflow analyses and models that are easily shared and understood across clinical sites and application domains—usability, CDS, patient safety, software design.   And, in keeping with the definitions provided by Russell et al., these models would also be executable by workflow technology. Flowcharts and swim lanes are great for discussions, but they are not executable.

Here are the definitions that will be used on CWC.

Clinical Work – Activities performed to assess, change or maintain the health of a patient.

Clinical Process – A specific clinical work activity undertaken by one or more clinical professionals with a specific start point, end point, and an expected outcome.

Clinical Workflow – The directed series of steps comprising a clinical process that 1) are performed by people/equipment/computers and 2) consume, transform and/or produce information. (Note that patient outcomes count as information.)

Clinical Workflow Model – A human-readable visual representation of a clinical workflow that can be executed by workflow technology.

I will explore more detailed, formal definitions of these terms in the future. However, these should suffice for now.

My interest in clinical workflow grew out of the desire to design better software and to make software implementation and practice optimization easier and more predictable.   As such, analyzing and representing what clinical professionals do, their information needs, and their interactions with patients, one another, and technology are all of interest to me, and Clinical Workflow Center content will reflect these topics.  The workflow tutorials from EHR Science represent the initial attempts in this direction. Obviously, there is much more that can be done.   Perhaps, one day I will do a series on workflow models and software design.

I have no idea how successful Clinical Workflow Center will be. There are a few dream projects that I would like to try should the opportunity arise. For example, it would be great to have a group of practices that could test out workflow concepts, sort of a workflow research network. The goal would be to help practices that do not have ready access to workflow capability, be able to recognize and solve workflow issues.   Another project would be creating a workflow model library that could be used as a teaching tool for those learning to do analyses and as a reference for those wanting to check their work. In any case, how CWC grows and develops will rest with those of you who become involved.

Visit Clinical Workflow Center and let me know what aspects of clinical workflow interest you. In the meantime, I have six weeks of work to catch up on and an 800-page iOS programming book to finish…

  1. Russell N, ter Hofstede AHM, Edmond D, van der Aalst WMP. Workflow Data Patterns.  QUT Technical report, FIT-TR-2004-01, Queensland University of Technology, Brisbane, 2004.



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