Computerization of workflows, guidelines, and care pathways: a review of implementation challenges for process-oriented health information systems
Identifieur interne : 000378 ( Main/Exploration ); précédent : 000377; suivant : 000379Computerization of workflows, guidelines, and care pathways: a review of implementation challenges for process-oriented health information systems
Auteurs : Phil Gooch [Royaume-Uni] ; Abdul Roudsari [Royaume-Uni, Canada]Source :
- Journal of the American Medical Informatics Association : JAMIA [ 1067-5027 ] ; 2011.
Abstract
There is a need to integrate the various theoretical frameworks and formalisms for modeling clinical guidelines, workflows, and pathways, in order to move beyond providing support for individual clinical decisions and toward the provision of process-oriented, patient-centered, health information systems (HIS). In this review, we analyze the challenges in developing process-oriented HIS that formally model guidelines, workflows, and care pathways.
A qualitative meta-synthesis was performed on studies published in English between 1995 and 2010 that addressed the modeling process and reported the exposition of a new methodology, model, system implementation, or system architecture. Thematic analysis, principal component analysis (PCA) and data visualisation techniques were used to identify and cluster the underlying implementation ‘challenge’ themes.
One hundred and eight relevant studies were selected for review. Twenty-five underlying ‘challenge’ themes were identified. These were clustered into 10 distinct groups, from which a conceptual model of the implementation process was developed.
We found that the development of systems supporting individual clinical decisions is evolving toward the implementation of adaptable care pathways on the semantic web, incorporating formal, clinical, and organizational ontologies, and the use of workflow management systems. These architectures now need to be implemented and evaluated on a wider scale within clinical settings.
Url:
DOI: 10.1136/amiajnl-2010-000033
PubMed: 21724740
PubMed Central: 3197986
Affiliations:
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Le document en format XML
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wicri:level="3"><nlm:aff id="aff1">Centre for Health Informatics, School of Informatics, City University London, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Health Informatics, School of Informatics, City University London, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2">School of Health Information Science, University of Victoria, Victoria, British Columbia, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>School of Health Information Science, University of Victoria, Victoria, British Columbia</wicri:regionArea><wicri:noRegion>British Columbia</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21724740</idno><idno type="pmc">3197986</idno><idno 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sortKey="Gooch, Phil" sort="Gooch, Phil" uniqKey="Gooch P" first="Phil" last="Gooch">Phil Gooch</name><affiliation wicri:level="3"><nlm:aff id="aff1">Centre for Health Informatics, School of Informatics, City University London, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Health Informatics, School of Informatics, City University London, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Roudsari, Abdul" sort="Roudsari, Abdul" uniqKey="Roudsari A" first="Abdul" last="Roudsari">Abdul Roudsari</name><affiliation wicri:level="3"><nlm:aff id="aff1">Centre for Health Informatics, School of Informatics, City University London, London, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Health Informatics, School of Informatics, City University London, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="aff2">School of Health Information Science, University of Victoria, Victoria, British Columbia, Canada</nlm:aff><country xml:lang="fr">Canada</country><wicri:regionArea>School of Health Information Science, University of Victoria, Victoria, British Columbia</wicri:regionArea><wicri:noRegion>British Columbia</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of the American Medical Informatics Association : JAMIA</title><idno type="ISSN">1067-5027</idno><idno type="eISSN">1527-974X</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objective</title><p>There is a need to integrate the various theoretical frameworks and formalisms for modeling clinical guidelines, workflows, and pathways, in order to move beyond providing support for individual clinical decisions and toward the provision of process-oriented, patient-centered, health information systems (HIS). In this review, we analyze the challenges in developing process-oriented HIS that formally model guidelines, workflows, and care pathways.</p></sec><sec><title>Methods</title><p>A qualitative meta-synthesis was performed on studies published in English between 1995 and 2010 that addressed the modeling process and reported the exposition of a new methodology, model, system implementation, or system architecture. Thematic analysis, principal component analysis (PCA) and data visualisation techniques were used to identify and cluster the underlying implementation ‘challenge’ themes.</p></sec><sec><title>Results</title><p>One hundred and eight relevant studies were selected for review. Twenty-five underlying ‘challenge’ themes were identified. These were clustered into 10 distinct groups, from which a conceptual model of the implementation process was developed.</p></sec><sec><title>Discussion and conclusion</title><p>We found that the development of systems supporting individual clinical decisions is evolving toward the implementation of adaptable care pathways on the semantic web, incorporating formal, clinical, and organizational ontologies, and the use of workflow management systems. These architectures now need to be implemented and evaluated on a wider scale within clinical settings.</p></sec></div></front></TEI><affiliations><list><country><li>Canada</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Gooch, Phil" sort="Gooch, Phil" uniqKey="Gooch P" first="Phil" last="Gooch">Phil Gooch</name></region><name sortKey="Roudsari, Abdul" sort="Roudsari, Abdul" uniqKey="Roudsari A" first="Abdul" last="Roudsari">Abdul Roudsari</name></country><country name="Canada"><noRegion><name sortKey="Roudsari, Abdul" sort="Roudsari, Abdul" uniqKey="Roudsari A" first="Abdul" last="Roudsari">Abdul Roudsari</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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