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Introduction to workflow technologyRepresentation of healthcare processes in a workflow
e or an e r execu on n a wor ow eng ne
Vojtech Huser MD PhD
AMIA NOW, Small Group session, Tutorial (1hr)
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Part 1: Introduction histor overview
Part 2: Standards, SDO, related theories
converted to 1 hour tutorial (with focus on introduction andstandards)
Accompanying bibliography document
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Need for specifying workflow within IT systems
History of workflow technologyprior 1960s-1980sdevelo ment after 1990
Components of workflow technology (process definition,
execution engine, analytical components) generic IT systemMajor workflow vendors and open-source workflowtec no ogy too sWorkflow Technology applied industries and healthcare
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, ,
Workflow management coalitions (WfMC)
standardsDefinition of WT termsXML process definition language (XPDL)
Other standardization effortsus ness rocess xecu on anguageBusiness Process Modeling Notation (BPMN)Research-ori inated WT standards
Petri Nets theory and its relationship toworkflows
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Demo of an editor and engine
xamp e :Representing a surgical procedure, discharge and RCT trialenrolment process
Two rheumatology decision support processes (TB screening,
Pneumococcal vaccine)
Example 3:Mining a progression of a chronic kidney disease from EHR data
Case studies of use in healthcare/informatics researchWorkflow engines and Decision support engines
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Need for specifying workflow w ithin IT systems
History of workflow technologyprior 1960s-1980sdevelo ment after 1990
Components of workflow technology (process definition,
execution engine, analytical components) generic IT systemMajor workflow vendors and open-source workflow
tec no ogy too sWorkflow Technology applied industries and healthcare
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BPM = business rocess mana ement
Adaptive workflow (Adaptive CaseMana ementComputer supported collaborative work CSCW
Why workflow?Se aration of data into databasesSeparation of UI from IT system coreSe aration of rocess knowled e
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Koetter (2007)
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Parallel Split: When an intrusion alarm is received,tr gger t e spa c -pa ro act v ty an t e n orm-po ce activity immediately.
Exclusive Choice: After the review election activity is
complete, either the declare results or the recount votes .
M ulti Choice: Depending on the nature of the
emergency ca , one or more o e espa c -po ce ,despatch-fire-engine and despatch-ambulance activitiesis immediately initiated.
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Need for specifying workflow within IT systemsHistory of w orkflow technology
prior 1960s-1980sdevelo ment after 1990
Components of workflow technology (process definition,
execution engine, analytical components) generic IT systemMajor workflow vendors and open-source workflow
tec no ogy too sWorkflow Technology applied industries and healthcare
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1960s
Petri Nets (Carl A. Petri PhD work)1960s-present
Workflow components of various systems
1999 2000s
2002: XPDL 1.0 2005 XPDL 2.02008 XPDL 2.1
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Need for specifying workflow within IT systemsHistory of workflow technology
prior 1960s-1980sdevelo ment after 1990
Components of w orkflow technology (process
definition, execution engine, analytical components) generic IT systemMajor workflow vendors and open-source workflow
tec no ogy too sWorkflow Technology applied industries and healthcare
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Coalition (WfMC). .
erm no ogy an ossaryhttp://www.wfmc.org/standards/docs/TC-
_ erm_g ossary_v .p
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The automation of a business process, inwhole or art durin which documentsinformation or tasks are passed from one
participant to another for action, according toa set of procedural rules.
WfMS = Workflow Management System
BPM = Business Process ManagementBPMS = Business Process Management System
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Minimum componentseditor
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Need for specifying workflow within IT systemsHistory of workflow technology
prior 1960s-1980sdevelo ment after 1990
Components of workflow technology (process definition,execution engine, analytical components)
a generic IT systemMajor workflow vendors and open-source workflow
tec no ogy too sWorkflow Technology applied industries and healthcare
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Workflow engine
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Engine
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Need for specifying workflow within IT systems
story o wor ow tec no ogyprior 1960s-1980sdevelopment after 1990
omponents o wor ow tec no ogy process e n t on,execution engine, analytical components)
Benefits of implementing a workflow server within agener c sys emMajor workflow vendors and open-source workflowtechnology tools
W or ow Tec no ogy app ie in ustries anhealthcareFuture development and research challenges
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Banking
Shipping
Pharmaceutical
rGartner 2008 report:
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Examples of WT use in healthcareBed management
Infections control (MR SA)
J. Emanuele and L. Koetter, " Workflow Opportunities and Challenges in Healthcare ," in 2007 BPM& Workflow Handbook, 2007.L. Koetter, " MRSA infection control with workflow technology ," Spring AMIA Conference, Orlando,
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, .R. Hess, " The Chester County Hosp ital: Case Study ," in 2007 Excellence in Practice: Moving theGoalposts., 2007.
S k id li (WfMS)
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Stroke guideline (WfMS)
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,
Workflowmining(ProM)
Workfloweditor(JaWE)
EHR system
EventListener
Notifications
Knowledge Base(workflow process
definitions)
WorkflowExecution
Prospective mode(FlowGuide):
Host EHR PassiveInteraction Model
Host EHR ActiveActions
Data Inquiry
(Shark) Retrospective mode(RetroGuide):
Data WarehouseData Visualization
Event Data Model
Additional External Services(Terminology services, NLP services,
Statistical Analysis)
ReportsOntology Model
Workflow log analysis
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HealthcareWorkflow.wordpress.com
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Need for specifying workflow within IT systemsHistory of workflow technology
prior 1960s-1980sdevelo ment after 1990
Components of workflow technology (process definition,execution engine, analytical components)
generic IT systemMajor workflow vendors and open-source workflow
tec no ogy too sWorkflow Technology applied industries and healthcare
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Improvements
Adoption is growingSoftware tools sophistication is improvingCom etition consolidation
Future similar to a database server inclusion inIT systems
an ar s conso a onResearch challenges
Process model cross-vendor portability
Adaptive workflow
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http:/ /workflowpatterns.com/
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, ,Workflow management coalitions (WfMC)standardsDefinition of WT termsXML process definition language (XPDL)Other standardization efforts
us ness rocess xecu on anguageBusiness Process Modeling Notation (BPMN)Research-ori inated WT standards
Petri Nets theory and its relationship toworkflows
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, ,W orkflow management coalitions (WfMC)standardsDefinition of WT termsXML process definition language (XPDL)Other standardization efforts
us ness rocess xecu on anguageBusiness Process Modeling Notation (BPMN)Research-ori inated WT standards
Petri Nets theory and its relationship toworkflows
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5 interfaces. , . , .
Yearly Workflow handbook
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, ,Workflow management coalitions (WfMC)standardsDefinition of W T termsXML process definition language (XPDL)Other standardization efforts
us ness rocess xecu on anguageBusiness Process Modeling Notation (BPMN)Research-ori inated WT standards
Petri Nets theory and its relationship toworkflows
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Business process management system (BPMS)
Workflow = The automation of a business process, in whole orpart, during which documents, information or tasks are passed fromone participant to another for action, according to a set of
.
Work flow Process = A set of one or more linked procedures oractivities which collectivel realize a business ob ective or olic oalnormally within the context of an organizational structure definingfunctional roles and relationships (definition vs. instance)
interaction between the user and the worklist maintained by aworkflow engine(task display, completion, acceptance, referral)
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WfMC: Terminology & Glossary, Document Number WFMCTC1011, Feb 99 http://www.wfmc.org/index.php?option=com_docman&task=doc_download&gid=93&Itemid=74
HealthcareWorkflow.wordpress.com
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, ,Workflow management coalitions (WfMC)standardsDefinition of WT termsXM L process definition language (XP DL)Other standardization efforts
us ness rocess xecu on anguageBusiness Process Modeling Notation (BPMN)Research-ori inated WT standards
Petri Nets theory and its relationship toworkflows
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http://wfmc.org/xpdl.html
Conformance testing availablehttp://www.xpdl.org/Validate/ValidateXpdl
Exchange format
Adoption (70+ products)htt : wfmc.or x dl-im lementations.html
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Standards Timeline
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.
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, ,Workflow management coalitions (WfMC)standardsDefinition of WT termsXML process definition language (XPDL)Other standardization efforts
us ness rocess xecu on anguageBusiness Process Modeling Notation (BPMN)Research-ori inated WT standards
Petri Nets theory and its relationship toworkflows
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Historical
WSDL
Current majorXPDL, BPMN, BPELProprietary (vendor specific):
JBPM JBossWin Workflow Foundation (Microsoft)T2Flow->SCUFL2 (Taverna)internal format (Weka)
Research ones YAWL
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, ,Workflow management coalitions (WfMC)standardsDefinition of WT termsXML process definition language (XPDL)Other standardization efforts
us ness rocess xecu on anguageBusiness Process Modeling Notation (BPMN)Research-ori inated WT standards
Petri Nets theory and its relationship toworkflows
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Mathematical theoryBasics
Petri net consist two types of nodes: placesan trans t ons.
A place may have zero or more tokens.rap c represen a ons : aces c rc es ,
transitions (bars), arcs (arrows), andtokens dots
t
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C = P T I O
PlacesP = { p1, p2, p3, , pn}
ransitionsT = { t1, t2, t3, , tn}
In utI : T Pr (r = number of places)OutputO : T Pq (q = number of places)
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Demo of an editor and engine
xamp e :
Representing a surgical procedure, discharge and RCT trialenrolment process
Two rheumatology decision support processes (TB screening,Pneumococcal vaccine)
Example 3:Mining a progression of a chronic kidney disease from EHR data
Case studies of use in healthcare/informatics researchWorkflow engines and Decision support engines
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Demo of an editor and engine
xamp e :
Representing a surgical procedure, discharge and RCT trialenrolment process
Two rheumatology decision support processes (TB screening,Pneumococcal vaccine)
Example 3:Mining a progression of a chronic kidney disease from EHR data
Case studies of use in healthcare/informatics researchWorkflow engines and Decision support engines
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JaWE Together Workflow Editor (TWE). , ,
Engine
Web-based modulen egra on w u oo
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Demo of an editor and engine
xamp e :Representing a surgical procedure, discharge and RCT trialenrolment process
Two rheumatology decision support processes (TB screening,Pneumococcal vaccine)
Example 3:Mining a progression of a chronic kidney disease from EHR data
Case studies of use in healthcare/informatics researchWorkflow engines and Decision support engines
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Demo of an editor and enginexamp e :
Representing a surgical procedure, discharge and RCT trialenrolment process
Two rheumatology decision support processes (TB screening,Pneumococcal vaccine)
Example 3:Mining a progression of a chronic kidney disease from EHR data
Case studies of use in healthcare/informatics researchWorkflow engines and Decision support engines
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Vojtech Huser, MD, PhD Vojtech Huser, MD, PhD 86http://www.marshfieldclinic.org/birc/pages/default.aspx?page=mcrf_birc_pubs_presentations
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Demo of an editor and enginexamp e :
Representing a surgical procedure, discharge and RCT trialenrolment process
Two rheumatology decision support processes (TB screening,Pneumococcal vaccine)
Example 3:Mining a progression of a chronic kidney disease from EHR data
softwareCase studies of use in healthcare/informatics research
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or ow eng nes an ec s on suppor eng nes
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Monitoring (exception)
Analysis (bottleneck finding)
Workflow simulationWorkflow mining
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Demo of an editor and enginexamp e :
Representing a surgical procedure, discharge and RCT trialenrolment process
Two rheumatology decision support processes (TB screening,Pneumococcal vaccine)
Example 3:Mining a progression of a chronic kidney disease from EHR data
Case studies of use in healthcare/ informaticsresearch
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or ow eng nes an ec s on suppor eng nes
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MainLine Health
Einthoven University (NL)Chester County hospital
See bibliography for references
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Demo of an editor and enginexamp e :
Representing a surgical procedure, discharge and RCT trialenrolment process
Two rheumatology decision support processes (TB screening,Pneumococcal vaccine)
Example 3:Mining a progression of a chronic kidney disease from EHR data
Case studies of use in healthcare/informatics researchW orkflow engines and Decision support engines
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Clear overlapMany decision support engines have workflow featuresMany workflow engines have decision support features
Workflow support vs. decision supportWhat to do and when
Published case studies of use of WT for decision support
Related work Peleg at al.Guidelines and workflow modelsDesi n Patterns of Clinical Guidelines 2010 Bonita wf editor
Mulyar at al.Comparison of Guidelines formalisms and workflow patterns
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GLIFgu e ne
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Part 1: Basic terms histor usePart 2: Standards
Cross-industry modelingand execution platformwith growing vendor andtool base and healthcareuse examp es
http://healthcareworkflow.wordpress.comhuser.vojtech@marshfieldclinic.org
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http://healthcareworkflow.wordpress.com. .
huser.vojtech@gmail.com
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