2006 EHR WfMS Tutorial Slides 103-108: To Be, or Not to Be (the Workflow Engine) That is the Question

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These are the closing slides from the 2006 EHR Workflow Management Systems: Key to Usability slide deck. They are dense. But, if you’ve referred all or most of the preceding slides they should make complete sense.

wfms-usability-ehr-108_0

Workflow Engine (1)

  • Provides run-time execution environment for workflow instance
  • Interprets process definition
  • Controls [sic] of process instances – creation, activation, suspension, termination, etc.
  • Navigates between process activities, including sequential or parallel operations, deadline
  • Schedules, interprets workflow relevant data
  • Signs-on/off specific participants

wfms-usability-ehr-109

Workflow Engine (2)

  • Indentifies workitems for user attention and an interface to support user interactions
  • Maintains workflow control data & workflow relevant data, passing workflow relevant data to/from applications or users
  • Interfaces to external applications and links any workflow relevant data/li>
  • Supervises actions for control, administration and audit purposes

wfms-usability-ehr-110

Workflow Engine Uses Process Definition to Reason About…

  • Who (Dr. Jones: personal preferences)
  • What (role: physcian, nurse…)
  • Why (vist reason: well child, chronic Rx)
  • When (position in workplan [AKA process definition])
  • Where (exam room, tech station…)
  • How (specialty-specific)

wfms-usability-ehr-111

EMR EHR Workflow Engine Presents Right Screen & Data & Order Entry Options…

  • Present the right screen
  • To the right person
  • At the right time
  • Containing the right data
  • Right order entry options
  • (and to execute many tasks automatically without need for any user intervention)

wfms-usability-ehr-112

Ask Yourself…

  • Who or what is the workflow engine?
    • If the answer is “who”…(Bad)
    • If the answer is “what”…(Good)

wfms-usability-ehr-113

Discussion after the tutorials was interesting. What stands out are the number of people from the workflow management systems AKA business process management industry who attended the tutorial and came up afterwards. They, or the organization that sent them, saw an opportunity to bring workflow automation to healthcare, but actually seemed dismayed. They saw a lot of session titles that used the word workflow but when they attended the presentation they noted that “workflow” in healthcare didn’t seem to be used the same way as it was and is in the workflow/BPM industry.

In each case I would sympathize. And I would tell them that they were not alone in this puzzlement. Wil van der Aalst is a well known business process management researcher, about which I’ve written:

Prof. van der Aalst gave one of the main keynotes at the 2004 MedInfo conference in San Francisco where he said that while he had looked through the two thick volumes of 300 hundred or so medical informatics papers and saw the word “workflow” a lot, it did not seem to be used in the way in which it is usually understood within workflow management systems research and industry. (By the way, I did catch up with Prof. van der Aalst afterward to confirm that my paper and poster did indeed discuss workflow in the workflow management systems sense.) This is consistent with my own experience.

Process-aware technologies, from workflow engines to process definitions and process mining are diffusing into healthcare. The technology has had great promise for a long time. This potential has been written about for two decades. I think we are finally getting close to critical mass. There are wide array of usability and productivity problems with EMRs and EHRs that are due to the fact that most EMRs and EHRs are not particularly (if at all) process aware. At the same time, workflow/process researchers better understand these problems and how to articulate the potential benefits of process-aware information systems for what ails healthcare and healthcare IT. To follow this increasing activity, check out The EHR.BZ Report on EMR and EHR Workflow, Usability, and Productivity. There are more and more headlines (linked to sources) that implicate EMR and EHR usability and productivity problems, but, at the same time, more and more headlines (again, linked to sources) that illustrate how process-aware EMR and EHR technology can address these very issues.

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The End!

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