BPM, FHIR, Interoperability, and the Healthcare Services Platform Consortium at HIMSS16

There’s a great fit between BPM (Business Process Management) and FHIR (Fast Healthcare Interoperability Resources) when it comes Achieving Task and Workflow Interoperability in Healthcare. FHIR provides access to EHR data. BPM orchestrates tasks and workflows across EHRs and other health IT systems, potentially in different healthcare organizations. I’m delighted to see Healthcare Services Platform Consortium (HSPC) combine these technologies and that they will be represented at HIMSS16. I still have a lot of questions about how FHIR and BPM will play nicely (see my ten questions in Health IT Workflow Integration: Whither FHIR?). But I suspect FHIR and non-FHIR EHR API initiatives will play important roles in ushering into healthcare the kind of process-aware BPM-style workflow technology it so desperate needs.

I’ve been tracking diffusion of process-aware workflow technology, such as business process management, into healthcare for decades. See I’m Looking For Healthcare Workflow & Workflow Tech Stories at #HIMSS16 for links going all the way back to HIMSS00 (2000 HIMSS conference in Dallas). Healthcare Services Platform Consortium popped on my radar in 2014 (occasioning my 2014 Healthcare Services Platform Consortium Business Process Management Marketecture). In the following tweets I highlighted elements of the proposed HSPC architecture that correspond to BPM elements (BPM, workflow, orchestration, process engines, etc.)… but click here to skip them and move directly on to more recent HSPC/BPM content…

I poked around the HSPC wiki looking for process-aware BPM-style workflow technology, and found lots. Enjoy!

The following are from Peter Haug’s Workflow Modeling for Medicine: An experience with BPMN2 at Intermountain.

human-task-client-framework

From Tier-2 Functionality and Development Sandbox Initiatives (Greenes) (green oval is my emphasis)

appworks2

Glance at this BPMN 2.0 model of pulmonary embolism but then read the very interesting speaker notes.

ebolism-workflow1

“Developed with docs.
Started with pencil and paper workflows, then functional prototypes, then workflow.
Problem with prototype was, all of the logic was not evident.
We really had to work at it to get the docs to concentrate on the workflow and think through it.
They were immediately drawn in to the prototype, like watching a story. You have to think to work through workflow.
Each square here is a subprocess. X’s are gateways. Flowcharting on steroids. Flowcharting with semantics.
3 Levels in the the BPMN process: high level design, happy path; exceptional paths; wiring up services.”

Here are some random extracts from both sets of slides. Please go through the originals! All of the above and below is very much on the path toward what I call task and workflow interoperability AKA (subset of) pragmatic interoperability.

BPMN 2.0

Business Process Model and Notation 2.0
OMG Standard
Roots are in Graphical Modeling Environments for Business Processes
Version 2.0 => Computability
Requires Services
Used for Service Orchestration
Allows Construction of Applications by Integrating Services
Provides Standard Workflow Components
Provides Integration for Custom Services

—–

My emphasis in green…

class-bpm

Framework has Internal Services (services used in managing workflow engine activity)

Start Protocol
Registers patient into protocol, records protocol status.
Save Protocol
Serializes protocol to storage.
Get Protocol State
Recovers protocols and protocol states for a given patient
Alert Service
Build and store Alert Event/attach to relevant user task
Get active user tasks
Finds protocol associated active user tasks
Complete user tasks
Signals completion of user tasks/updates protocol data
Etc.

—-

BPMN-Frameworks Consume Services (provided by EHR-based environment to workflow engine-HSP)

Security
Patient Lookup/Retrieval
Clinical Data Access
Clinical Data Storage
Order Query
Order Communications
User Communications
Client Integration
Alert Delivery
Etc.

—–

Two Examples

Pulmonary Embolism Workup
Built using BPMN 2.0 authoring
Delivered using BPMN 2.0 runtime
Used Activiti (open-source version)
Pneumonia Protocol
Originally build in Java/Drools
Conversion to BPMN 2.0
Uses Complex Event Processing Framework

——–

My emphasis in green…

cds-workflow

Advanced CDS Delivery Framework

Attributes
Standardized CDS management tools
Multi-component inferencing environment
Broad (standardized) data access
Access to key care-oriented services (ordering, etc.)
Multiple, flexible alerting channels
Standardized, component-based client environment
Formal workflow authoring/delivery system
Broad workflow logging system

——

TIER-2 BPM/CDS services

Current area of focus of subgroup – for care coordination / care pathway use cases
Focus on services to:
Identify possible care pathway(s) for a patient
Evaluate status of a patient with respect to a care pathway
Determine next steps/actions or need to change to another pathway
Orchestrate subsequent actions
Record data for tracking pathway status
Analytics for dashboards, outcomes reports, etc.


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