AMIA2014 Workflow Paper (Monday) A Framework for Incorporating Patient Preferences to Deliver Participatory Medicine via Interdisciplinary Healthcare Teams

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[CW: Fantastic domain ontology. DMed this around.]

1:45PM Monday

“Facilitating workflow execution is a significant challenge for participatory medicine because of the need to integrate IHT members into a common workflow. A further challenge is that patient preferences should be considered when executing a workflow. To date there is limited research on supporting patient workflow as part of participatory medicine practices.

….

we need more formal approaches for developing distributed models of IHTs that support the dynamic integration an IHT and a workflow including assignment of tasks and team leadership and maintenance. Second, we need to incorporate patient preferences into the models to enable true participatory medicine. Third, we need approaches to enable us to operationalize the model in clinical settings.

….

The workflow-related concepts and relations between them have been inspired by Business Process and Model Notation (BPMN) [22]; however, they have been expanded to address the specificity of IHTs and participatory medicine. The central concept is clinical workflow that is specialized into specific workflow and generic sub workflow. The former represents a “top-level” workflow that is associated with a specific presentation that is executed upon arrival of a patient with this presentation. The latter is a generic workflow (i.e., not associated with any presentation) that may be invoked by other workflows as a supporting workflow. Each clinical workflow is composed of arcs and nodes, so it can be seen as a directed graph. The node concept is specialized into a gateway node, event node and activity node, depending on its purpose. The gateway node is further specialized into decision gateway node and parallel gateway node, which allows for conditional branching and parallel paths respectively. Event nodes are used to indicate starting and ending nodes in a workflow (via start event node and end event node). Finally, an activity node is specialized into task node, sub-workflow node and leadership node, corresponding to the three types of basic activities in a workflow – executing a clinical task, invoking a sub-workflow, and appointing the team leader, respectively. A clinical task can be delegated to a single practitioner who satisfies a requirement specified in terms of valued capabilities. Such a requirement is defined by associating valued capabilities with a task node.

….

[see Figure 2. Overall IHT workflow for palliative care pain management]

The next step in our research is translating our framework into a prototype multi-agent system (MAS). This will be done in two stages. First we first we assume that the practitioners are represented by the agents. Second, we will use the domain ontology (fig. 1) and follow ontology-driven design combined with O-MaSE [18] to design a prototype participatory medicine HIS. The HIS will be implemented using Workflows and Agent Development Environment (WADE) [31] for workflow execution.”

http://jade.tilab.com/wadeproject/

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