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RetroGuide  (new name: HealthFlow) a knowledge representation and execution system for clinical research informatics alert...
Agenda <ul><li>Introduction </li></ul><ul><ul><li>Background </li></ul></ul><ul><ul><li>Workflow Technology (WT) </li></ul...
Background <ul><li>Knowledge representation </li></ul><ul><ul><li>decision support, quality improvement, research </li></u...
Workflow Technology <ul><li>Business process management system (BPMS) </li></ul><ul><li>Workflow  = The automation of a bu...
HealthFlow System code.google.com/p/HealthFlow
HealthFlow: RetroGuide, FlowGuide code.google.com/p/HealthFlow
HealthFlow: RetroGuide, FlowGuide HealthcareWorkflow.wordpress.com
Screenshot tour HealthcareWorkflow.wordpress.com
HealthFlow: RetroGuide, FlowGuide HealthcareWorkflow.wordpress.com
HealthcareWorkflow.wordpress.com
HealthcareWorkflow.wordpress.com
Code Layer  (node; right click properties) HealthcareWorkflow.wordpress.com
code.google.com/p/HealthFlow HealthcareWorkflow.wordpress.com
HealthFlow: RetroGuide, FlowGuide HealthcareWorkflow.wordpress.com
Together Workflow Engine (Community edition) HealthcareWorkflow.wordpress.com
Together Workflow Engine (Community edition) HealthcareWorkflow.wordpress.com
HealthFlow: RetroGuide, FlowGuide HealthcareWorkflow.wordpress.com
Example of execution 0.9% of patients with high risk patients with subsequent MI
Example of execution
Example of execution
Results HealthcareWorkflow.wordpress.com
Implemented processes <ul><li>RetroGuide (v2)  (2004-2008) (published) </li></ul><ul><ul><li>Quality improvement </li></ul...
FlowGuide - Validation (RA, LDL) HealthcareWorkflow.wordpress.com
Final Slides
Discussion <ul><li>Advantages </li></ul><ul><ul><li>cross industry technology </li></ul></ul><ul><ul><li>graphical represe...
Workflow technology workshop <ul><li>AMIA NOW!, May 2010 </li></ul>
Summary <ul><li>Successful integration of a workflow engine with an EHR system </li></ul><ul><li>Knowledge representation ...
Thank you <ul><li>[email_address] </li></ul><ul><li>http://healthcareworkflow.wordpress.com </li></ul><ul><li>http://code....
HealthcareWorkflow.wordpress.com
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HealthFlow, AMIA summit

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  • Transcript of "HealthFlow, AMIA summit"

    1. 1. RetroGuide (new name: HealthFlow) a knowledge representation and execution system for clinical research informatics alerts based on workflow technology Vojtech Huser MD PhD RetroGuide + FlowGuide = HealthFlow
    2. 2. Agenda <ul><li>Introduction </li></ul><ul><ul><li>Background </li></ul></ul><ul><ul><li>Workflow Technology (WT) </li></ul></ul><ul><li>Methods </li></ul><ul><ul><li>Our architecture </li></ul></ul><ul><li>Results </li></ul><ul><ul><li>Implemented processes </li></ul></ul><ul><li>Discussion/Conclusion </li></ul>
    3. 3. Background <ul><li>Knowledge representation </li></ul><ul><ul><li>decision support, quality improvement, research </li></ul></ul><ul><li>Institutions </li></ul><ul><ul><li>Marshfield Clinic (+Intermountain Healthcare) </li></ul></ul><ul><li>Workflow technology </li></ul><ul><ul><li>engine, editor </li></ul></ul>Huser (2010) J Biomed Inform HealthcareWorkflow.wordpress.com
    4. 4. Workflow Technology <ul><li>Business process management system (BPMS) </li></ul><ul><li>Workflow = The automation of a business process, in whole or part, during which documents, information or tasks are passed from one participant to another for action, according to a set of procedural rules. </li></ul><ul><li>Workflow Process = A set of one or more linked procedures or activities which collectively realize a business objective or policy goal, normally within the context of an organizational structure defining functional roles and relationships (definition vs. instance) </li></ul><ul><li>Worklist Handler = A software component that manages the interaction between the user and the worklist maintained by a workflow engine (task display, completion, acceptance, referral) </li></ul>WfMC: Terminology & Glossary, Document Number WFMC-TC-1011, Feb 99 http://www.wfmc.org/index.php?option=com_docman&task=doc_download&gid=93&Itemid=74 HealthcareWorkflow.wordpress.com
    5. 5. HealthFlow System code.google.com/p/HealthFlow
    6. 6. HealthFlow: RetroGuide, FlowGuide code.google.com/p/HealthFlow
    7. 7. HealthFlow: RetroGuide, FlowGuide HealthcareWorkflow.wordpress.com
    8. 8. Screenshot tour HealthcareWorkflow.wordpress.com
    9. 9. HealthFlow: RetroGuide, FlowGuide HealthcareWorkflow.wordpress.com
    10. 10. HealthcareWorkflow.wordpress.com
    11. 11. HealthcareWorkflow.wordpress.com
    12. 12. Code Layer (node; right click properties) HealthcareWorkflow.wordpress.com
    13. 13. code.google.com/p/HealthFlow HealthcareWorkflow.wordpress.com
    14. 14. HealthFlow: RetroGuide, FlowGuide HealthcareWorkflow.wordpress.com
    15. 15. Together Workflow Engine (Community edition) HealthcareWorkflow.wordpress.com
    16. 16. Together Workflow Engine (Community edition) HealthcareWorkflow.wordpress.com
    17. 17. HealthFlow: RetroGuide, FlowGuide HealthcareWorkflow.wordpress.com
    18. 18. Example of execution 0.9% of patients with high risk patients with subsequent MI
    19. 19. Example of execution
    20. 20. Example of execution
    21. 21. Results HealthcareWorkflow.wordpress.com
    22. 22. Implemented processes <ul><li>RetroGuide (v2) (2004-2008) (published) </li></ul><ul><ul><li>Quality improvement </li></ul></ul><ul><ul><ul><li>Osteoporosis </li></ul></ul></ul><ul><ul><ul><li>Cholesterol management </li></ul></ul></ul><ul><ul><ul><li>Blood pressure control in diabetics </li></ul></ul></ul><ul><ul><li>Decision support </li></ul></ul><ul><ul><ul><li>Computerized glucose management protocol </li></ul></ul></ul><ul><ul><ul><li>Adverse Drug Events </li></ul></ul></ul><ul><ul><li>Research </li></ul></ul><ul><ul><ul><li>Hodgkin's lymphoma and pregnancy </li></ul></ul></ul><ul><ul><ul><li>Hepatitis C </li></ul></ul></ul><ul><li>+ several other experimental </li></ul><ul><li>RetroGuide (v3) (2008 – now) IRB 1 </li></ul><ul><ul><li>20+ scenarios </li></ul></ul><ul><ul><ul><li>US Prev. Services TF </li></ul></ul></ul><ul><ul><ul><li>Health plan rules </li></ul></ul></ul><ul><ul><ul><li>hsCRP </li></ul></ul></ul><ul><ul><ul><li>Genetic counseling </li></ul></ul></ul><ul><ul><ul><li>Thyroid disease, ACEi monitoring </li></ul></ul></ul><ul><ul><ul><li>osteoporosis </li></ul></ul></ul><ul><li>FlowGuide – validation (IRB 2) </li></ul><ul><ul><li>Implemented (Nov 2009) </li></ul></ul><ul><ul><ul><li>Surgical patient discharge (feasibility) (Sep 2009) </li></ul></ul></ul><ul><ul><ul><li>Cholesterol management </li></ul></ul></ul><ul><ul><ul><li>Rheumatoid arthritis </li></ul></ul></ul><ul><ul><li>Planned (IRB) </li></ul></ul><ul><ul><ul><li>Hearth failure </li></ul></ul></ul><ul><ul><ul><li>Medical home recommendations </li></ul></ul></ul><ul><li>FlowGuide – production (IRB 3) </li></ul><ul><ul><ul><li>IRB writing stage </li></ul></ul></ul>HealthcareWorkflow.wordpress.com Huser (2010) J Biomed Inform
    23. 23. FlowGuide - Validation (RA, LDL) HealthcareWorkflow.wordpress.com
    24. 24. Final Slides
    25. 25. Discussion <ul><li>Advantages </li></ul><ul><ul><li>cross industry technology </li></ul></ul><ul><ul><li>graphical representation </li></ul></ul><ul><ul><li>stand alone solution </li></ul></ul><ul><ul><li>applicable to several domains (query problem, alert problem) </li></ul></ul><ul><ul><li>retrospective/prospective switch </li></ul></ul><ul><li>Disadvantages </li></ul><ul><ul><li>required technical infrastructure is complex </li></ul></ul><ul><ul><li>complex logic will remain complex even if expressed as a flowchart </li></ul></ul><ul><ul><li>Not all logic is supported by a given workflow suite - externalized (web-service, other engines) </li></ul></ul><ul><li>Future work </li></ul><ul><ul><li>More robust set of HealthFlow External Applications (FindEvent) </li></ul></ul><ul><ul><li>Representation of phenotypes </li></ul></ul><ul><ul><li>Better linkage to EHR system </li></ul></ul><ul><ul><li>Support for all relevant standards (e.g., HL7 vMR, Terminology Services, HL7 DSS) </li></ul></ul>HealthcareWorkflow.wordpress.com
    26. 26. Workflow technology workshop <ul><li>AMIA NOW!, May 2010 </li></ul>
    27. 27. Summary <ul><li>Successful integration of a workflow engine with an EHR system </li></ul><ul><li>Knowledge representation using cross-industry technology </li></ul><ul><li>Other institutions can implement a similar framework, sharing of logic is possible </li></ul>code.google.com/p/HealthFlow
    28. 28. Thank you <ul><li>[email_address] </li></ul><ul><li>http://healthcareworkflow.wordpress.com </li></ul><ul><li>http://code.google.com/p/healthflow </li></ul><ul><li>Questions? </li></ul><ul><li>http://marshfieldclinic.org/birc </li></ul><ul><li>Acknowledgement: programmers: Luke Rasmussen, Ryan Oberg </li></ul>
    29. 29. HealthcareWorkflow.wordpress.com
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