Evidence-based careflow management systems

The case of post-stroke rehabilitation

S. Panzarasa, S. Maddè, S. Quaglini, C. Pistarini, M. Stefanelli

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

The activities of a care providers' team need to be coordinated within a process properly designed on the basis of available best practice medical knowledge. It requires a rethinking of the management of care processes within health care organizations. The current workflow technology seems to offer the most convenient solution to build such cooperative systems. However, some of its present weaknesses still require an intense research effort to find solutions allowing its exploitation in real medical practice. This paper presents an approach to design and build evidence-based careflow management systems, which can be viewed as components of a knowledge management infrastructure each health care organization should be provided with to increase its performance in delivering high quality care by efficiently exploiting the available knowledge resources. The post-stroke rehabilitation process has been taken as a challenging care problem to assess our methodology for designing and developing careflow management systems. Then a system was co-developed with a team of rehabilitation professionals who will be committed to use it in their daily work. The system's main goal is to deliver a full array of rehabilitation services provided by an interdisciplinary team. They are related to identify which patients are most likely to benefit from rehabilitation, manage a rehabilitation treatment plan, and monitor progress both during rehabilitation and after return to a community residence. A model of the rehabilitation process was derived from an international guideline and adapted to the local organization of work. It involves different organizational units, such as wards, rehabilitation units, clinical laboratories, and imaging services. Several organizational agents work within them and play one or more roles. Each role is defined by the goals' set that she/he must fulfill. Special effort has been given to the design and development of a knowledge-based system for managing exceptions, which may occur in daily medical work as any deviation from the normal flow of activities. It allows either avoiding or recovering automatically from expected exceptions. When they are not expected, organizational agents, with enough power to do that, are allowed to modify the scheduled flow of activities for an individual patient under the only constraint of justifying their decision. After an intensive testing in a research laboratory, the system is now in the process of being transferred in a real working setting with the full support of its future users.

Original languageEnglish
Pages (from-to)123-139
Number of pages17
JournalJournal of Biomedical Informatics
Volume35
Issue number2
DOIs
Publication statusPublished - 2002

Fingerprint

Patient rehabilitation
Rehabilitation
Health care
Clinical Laboratory Services
Organizations
Delivery of Health Care
Knowledge Management
Clinical laboratories
Workflow
Quality of Health Care
Stroke Rehabilitation
Practice Guidelines
Research
Medical imaging
Knowledge based systems
Research laboratories
Knowledge management
Guidelines
Technology
Testing

Keywords

  • Care delivery process
  • Careflow management systems
  • Evidence-based medicine
  • Exceptions management
  • Knowledge management
  • Practice guidelines
  • Stroke

ASJC Scopus subject areas

  • Computer Science Applications
  • Health Informatics
  • Computer Science (miscellaneous)
  • Catalysis

Cite this

Evidence-based careflow management systems : The case of post-stroke rehabilitation. / Panzarasa, S.; Maddè, S.; Quaglini, S.; Pistarini, C.; Stefanelli, M.

In: Journal of Biomedical Informatics, Vol. 35, No. 2, 2002, p. 123-139.

Research output: Contribution to journalArticle

Panzarasa, S. ; Maddè, S. ; Quaglini, S. ; Pistarini, C. ; Stefanelli, M. / Evidence-based careflow management systems : The case of post-stroke rehabilitation. In: Journal of Biomedical Informatics. 2002 ; Vol. 35, No. 2. pp. 123-139.
@article{cb22dcb09e61451aa05be25c451c7ba2,
title = "Evidence-based careflow management systems: The case of post-stroke rehabilitation",
abstract = "The activities of a care providers' team need to be coordinated within a process properly designed on the basis of available best practice medical knowledge. It requires a rethinking of the management of care processes within health care organizations. The current workflow technology seems to offer the most convenient solution to build such cooperative systems. However, some of its present weaknesses still require an intense research effort to find solutions allowing its exploitation in real medical practice. This paper presents an approach to design and build evidence-based careflow management systems, which can be viewed as components of a knowledge management infrastructure each health care organization should be provided with to increase its performance in delivering high quality care by efficiently exploiting the available knowledge resources. The post-stroke rehabilitation process has been taken as a challenging care problem to assess our methodology for designing and developing careflow management systems. Then a system was co-developed with a team of rehabilitation professionals who will be committed to use it in their daily work. The system's main goal is to deliver a full array of rehabilitation services provided by an interdisciplinary team. They are related to identify which patients are most likely to benefit from rehabilitation, manage a rehabilitation treatment plan, and monitor progress both during rehabilitation and after return to a community residence. A model of the rehabilitation process was derived from an international guideline and adapted to the local organization of work. It involves different organizational units, such as wards, rehabilitation units, clinical laboratories, and imaging services. Several organizational agents work within them and play one or more roles. Each role is defined by the goals' set that she/he must fulfill. Special effort has been given to the design and development of a knowledge-based system for managing exceptions, which may occur in daily medical work as any deviation from the normal flow of activities. It allows either avoiding or recovering automatically from expected exceptions. When they are not expected, organizational agents, with enough power to do that, are allowed to modify the scheduled flow of activities for an individual patient under the only constraint of justifying their decision. After an intensive testing in a research laboratory, the system is now in the process of being transferred in a real working setting with the full support of its future users.",
keywords = "Care delivery process, Careflow management systems, Evidence-based medicine, Exceptions management, Knowledge management, Practice guidelines, Stroke",
author = "S. Panzarasa and S. Madd{\`e} and S. Quaglini and C. Pistarini and M. Stefanelli",
year = "2002",
doi = "10.1016/S1532-0464(02)00505-1",
language = "English",
volume = "35",
pages = "123--139",
journal = "Journal of Biomedical Informatics",
issn = "1532-0464",
publisher = "Academic Press Inc.",
number = "2",

}

TY - JOUR

T1 - Evidence-based careflow management systems

T2 - The case of post-stroke rehabilitation

AU - Panzarasa, S.

AU - Maddè, S.

AU - Quaglini, S.

AU - Pistarini, C.

AU - Stefanelli, M.

PY - 2002

Y1 - 2002

N2 - The activities of a care providers' team need to be coordinated within a process properly designed on the basis of available best practice medical knowledge. It requires a rethinking of the management of care processes within health care organizations. The current workflow technology seems to offer the most convenient solution to build such cooperative systems. However, some of its present weaknesses still require an intense research effort to find solutions allowing its exploitation in real medical practice. This paper presents an approach to design and build evidence-based careflow management systems, which can be viewed as components of a knowledge management infrastructure each health care organization should be provided with to increase its performance in delivering high quality care by efficiently exploiting the available knowledge resources. The post-stroke rehabilitation process has been taken as a challenging care problem to assess our methodology for designing and developing careflow management systems. Then a system was co-developed with a team of rehabilitation professionals who will be committed to use it in their daily work. The system's main goal is to deliver a full array of rehabilitation services provided by an interdisciplinary team. They are related to identify which patients are most likely to benefit from rehabilitation, manage a rehabilitation treatment plan, and monitor progress both during rehabilitation and after return to a community residence. A model of the rehabilitation process was derived from an international guideline and adapted to the local organization of work. It involves different organizational units, such as wards, rehabilitation units, clinical laboratories, and imaging services. Several organizational agents work within them and play one or more roles. Each role is defined by the goals' set that she/he must fulfill. Special effort has been given to the design and development of a knowledge-based system for managing exceptions, which may occur in daily medical work as any deviation from the normal flow of activities. It allows either avoiding or recovering automatically from expected exceptions. When they are not expected, organizational agents, with enough power to do that, are allowed to modify the scheduled flow of activities for an individual patient under the only constraint of justifying their decision. After an intensive testing in a research laboratory, the system is now in the process of being transferred in a real working setting with the full support of its future users.

AB - The activities of a care providers' team need to be coordinated within a process properly designed on the basis of available best practice medical knowledge. It requires a rethinking of the management of care processes within health care organizations. The current workflow technology seems to offer the most convenient solution to build such cooperative systems. However, some of its present weaknesses still require an intense research effort to find solutions allowing its exploitation in real medical practice. This paper presents an approach to design and build evidence-based careflow management systems, which can be viewed as components of a knowledge management infrastructure each health care organization should be provided with to increase its performance in delivering high quality care by efficiently exploiting the available knowledge resources. The post-stroke rehabilitation process has been taken as a challenging care problem to assess our methodology for designing and developing careflow management systems. Then a system was co-developed with a team of rehabilitation professionals who will be committed to use it in their daily work. The system's main goal is to deliver a full array of rehabilitation services provided by an interdisciplinary team. They are related to identify which patients are most likely to benefit from rehabilitation, manage a rehabilitation treatment plan, and monitor progress both during rehabilitation and after return to a community residence. A model of the rehabilitation process was derived from an international guideline and adapted to the local organization of work. It involves different organizational units, such as wards, rehabilitation units, clinical laboratories, and imaging services. Several organizational agents work within them and play one or more roles. Each role is defined by the goals' set that she/he must fulfill. Special effort has been given to the design and development of a knowledge-based system for managing exceptions, which may occur in daily medical work as any deviation from the normal flow of activities. It allows either avoiding or recovering automatically from expected exceptions. When they are not expected, organizational agents, with enough power to do that, are allowed to modify the scheduled flow of activities for an individual patient under the only constraint of justifying their decision. After an intensive testing in a research laboratory, the system is now in the process of being transferred in a real working setting with the full support of its future users.

KW - Care delivery process

KW - Careflow management systems

KW - Evidence-based medicine

KW - Exceptions management

KW - Knowledge management

KW - Practice guidelines

KW - Stroke

UR - http://www.scopus.com/inward/record.url?scp=0036433078&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036433078&partnerID=8YFLogxK

U2 - 10.1016/S1532-0464(02)00505-1

DO - 10.1016/S1532-0464(02)00505-1

M3 - Article

VL - 35

SP - 123

EP - 139

JO - Journal of Biomedical Informatics

JF - Journal of Biomedical Informatics

SN - 1532-0464

IS - 2

ER -