s55: introduction to workflow technology

8/9/2019 S55: Introduction to Workflow Technology

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Introduction to workflow technologyRepresentation of healthcare processes in a workflow

e or an e r execu on n a wor ow eng ne

Vojtech Huser MD PhD

AMIA NOW, Small Group session, Tutorial (1hr)


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Part 1: Introduction histor overview

Part 2: Standards, SDO, related theories

converted to 1 hour tutorial (with focus on introduction andstandards)

Accompanying bibliography document

Vojtech Huser, MD, PhD Vojtech Huser, MD, PhD

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Need for specifying workflow within IT systems

History of workflow technologyprior 1960s-1980sdevelo ment after 1990

Components of workflow technology (process definition,

execution engine, analytical components) generic IT systemMajor workflow vendors and open-source workflowtec no ogy too sWorkflow Technology applied industries and healthcare


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, ,

Workflow management coalitions (WfMC)

standardsDefinition of WT termsXML process definition language (XPDL)

Other standardization effortsus ness rocess xecu on anguageBusiness Process Modeling Notation (BPMN)Research-ori inated WT standards

Petri Nets theory and its relationship toworkflows


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Demo of an editor and engine

xamp e :Representing a surgical procedure, discharge and RCT trialenrolment process

Two rheumatology decision support processes (TB screening,

Pneumococcal vaccine)

Example 3:Mining a progression of a chronic kidney disease from EHR data

Case studies of use in healthcare/informatics researchWorkflow engines and Decision support engines


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Need for specifying workflow w ithin IT systems

History of workflow technologyprior 1960s-1980sdevelo ment after 1990


execution engine, analytical components) generic IT systemMajor workflow vendors and open-source workflow

tec no ogy too sWorkflow Technology applied industries and healthcare


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BPM = business rocess mana ement

Adaptive workflow (Adaptive CaseMana ementComputer supported collaborative work CSCW

Why workflow?Se aration of data into databasesSeparation of UI from IT system coreSe aration of rocess knowled e


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Koetter (2007)


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Parallel Split: When an intrusion alarm is received,tr gger t e spa c -pa ro act v ty an t e n orm-po ce activity immediately.

Exclusive Choice: After the review election activity is

complete, either the declare results or the recount votes .

M ulti Choice: Depending on the nature of the

emergency ca , one or more o e espa c -po ce ,despatch-fire-engine and despatch-ambulance activitiesis immediately initiated.


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Need for specifying workflow within IT systemsHistory of w orkflow technology

prior 1960s-1980sdevelo ment after 1990


execution engine, analytical components) generic IT systemMajor workflow vendors and open-source workflow



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1960s

Petri Nets (Carl A. Petri PhD work)1960s-present

Workflow components of various systems

1999 2000s

2002: XPDL 1.0 2005 XPDL 2.02008 XPDL 2.1


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Need for specifying workflow within IT systemsHistory of workflow technology


Components of w orkflow technology (process

definition, execution engine, analytical components) generic IT systemMajor workflow vendors and open-source workflow



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Coalition (WfMC). .

erm no ogy an ossaryhttp://www.wfmc.org/standards/docs/TC-

_ erm_g ossary_v .p


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The automation of a business process, inwhole or art durin which documentsinformation or tasks are passed from one

participant to another for action, according toa set of procedural rules.

WfMS = Workflow Management System

BPM = Business Process ManagementBPMS = Business Process Management System


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Minimum componentseditor


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Components of workflow technology (process definition,execution engine, analytical components)

a generic IT systemMajor workflow vendors and open-source workflow



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Workflow engine


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Engine


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Need for specifying workflow within IT systems

story o wor ow tec no ogyprior 1960s-1980sdevelopment after 1990

omponents o wor ow tec no ogy process e n t on,execution engine, analytical components)

Benefits of implementing a workflow server within agener c sys emMajor workflow vendors and open-source workflowtechnology tools

W or ow Tec no ogy app ie in ustries anhealthcareFuture development and research challenges


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Banking

Shipping

Pharmaceutical

rGartner 2008 report:


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Examples of WT use in healthcareBed management

Infections control (MR SA)

J. Emanuele and L. Koetter, " Workflow Opportunities and Challenges in Healthcare ," in 2007 BPM& Workflow Handbook, 2007.L. Koetter, " MRSA infection control with workflow technology ," Spring AMIA Conference, Orlando,

Vojtech Huser, MD, PhD Vojtech Huser, MD, PhD42

, .R. Hess, " The Chester County Hosp ital: Case Study ," in 2007 Excellence in Practice: Moving theGoalposts., 2007.

S k id li (WfMS)


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Stroke guideline (WfMS)



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Workflowmining(ProM)

Workfloweditor(JaWE)

EHR system

EventListener

Notifications

Knowledge Base(workflow process

definitions)

WorkflowExecution

Prospective mode(FlowGuide):

Host EHR PassiveInteraction Model

Host EHR ActiveActions

Data Inquiry

(Shark) Retrospective mode(RetroGuide):

Data WarehouseData Visualization

Event Data Model

Additional External Services(Terminology services, NLP services,

Statistical Analysis)

ReportsOntology Model

Workflow log analysis


HealthcareWorkflow.wordpress.com


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Components of workflow technology (process definition,execution engine, analytical components)

generic IT systemMajor workflow vendors and open-source workflow




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Improvements

Adoption is growingSoftware tools sophistication is improvingCom etition consolidation

Future similar to a database server inclusion inIT systems

an ar s conso a onResearch challenges

Process model cross-vendor portability

Adaptive workflow



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http:/ /workflowpatterns.com/



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, ,Workflow management coalitions (WfMC)standardsDefinition of WT termsXML process definition language (XPDL)Other standardization efforts

us ness rocess xecu on anguageBusiness Process Modeling Notation (BPMN)Research-ori inated WT standards




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, ,W orkflow management coalitions (WfMC)standardsDefinition of WT termsXML process definition language (XPDL)Other standardization efforts





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5 interfaces. , . , .

Yearly Workflow handbook



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, ,Workflow management coalitions (WfMC)standardsDefinition of W T termsXML process definition language (XPDL)Other standardization efforts





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Business process management system (BPMS)

Workflow = The automation of a business process, in whole orpart, during which documents, information or tasks are passed fromone participant to another for action, according to a set of

.

Work flow Process = A set of one or more linked procedures oractivities which collectivel realize a business ob ective or olic oalnormally within the context of an organizational structure definingfunctional roles and relationships (definition vs. instance)

interaction between the user and the worklist maintained by aworkflow engine(task display, completion, acceptance, referral)


WfMC: Terminology & Glossary, Document Number WFMCTC1011, Feb 99 http://www.wfmc.org/index.php?option=com_docman&task=doc_download&gid=93&Itemid=74

HealthcareWorkflow.wordpress.com


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, ,Workflow management coalitions (WfMC)standardsDefinition of WT termsXM L process definition language (XP DL)Other standardization efforts





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http://wfmc.org/xpdl.html

Conformance testing availablehttp://www.xpdl.org/Validate/ValidateXpdl

Exchange format

Adoption (70+ products)htt : wfmc.or x dl-im lementations.html


Standards Timeline


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Historical

WSDL

Current majorXPDL, BPMN, BPELProprietary (vendor specific):

JBPM JBossWin Workflow Foundation (Microsoft)T2Flow->SCUFL2 (Taverna)internal format (Weka)

Research ones YAWL



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Mathematical theoryBasics

Petri net consist two types of nodes: placesan trans t ons.

A place may have zero or more tokens.rap c represen a ons : aces c rc es ,

transitions (bars), arcs (arrows), andtokens dots

t



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C = P T I O

PlacesP = { p1, p2, p3, , pn}

ransitionsT = { t1, t2, t3, , tn}

In utI : T Pr (r = number of places)OutputO : T Pq (q = number of places)



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xamp e :

Representing a surgical procedure, discharge and RCT trialenrolment process

Two rheumatology decision support processes (TB screening,Pneumococcal vaccine)





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xamp e :







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JaWE Together Workflow Editor (TWE). , ,

Engine

Web-based modulen egra on w u oo



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Vojtech Huser, MD, PhD Vojtech Huser, MD, PhD 76


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xamp e :Representing a surgical procedure, discharge and RCT trialenrolment process






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Demo of an editor and enginexamp e :







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Vojtech Huser, MD, PhD Vojtech Huser, MD, PhD 86http://www.marshfieldclinic.org/birc/pages/default.aspx?page=mcrf_birc_pubs_presentations


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softwareCase studies of use in healthcare/informatics research


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or ow eng nes an ec s on suppor eng nes


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Monitoring (exception)

Analysis (bottleneck finding)

Workflow simulationWorkflow mining


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Case studies of use in healthcare/ informaticsresearch


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or ow eng nes an ec s on suppor eng nes


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MainLine Health

Einthoven University (NL)Chester County hospital

See bibliography for references


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Case studies of use in healthcare/informatics researchW orkflow engines and Decision support engines


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Clear overlapMany decision support engines have workflow featuresMany workflow engines have decision support features

Workflow support vs. decision supportWhat to do and when

Published case studies of use of WT for decision support

Related work Peleg at al.Guidelines and workflow modelsDesi n Patterns of Clinical Guidelines 2010 Bonita wf editor

Mulyar at al.Comparison of Guidelines formalisms and workflow patterns


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93Mulyar at al (2007)

GLIFgu e ne


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Part 1: Basic terms histor usePart 2: Standards

Cross-industry modelingand execution platformwith growing vendor andtool base and healthcareuse examp es

http://healthcareworkflow.wordpress.comhuser.vojtech@marshfieldclinic.org


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http://healthcareworkflow.wordpress.com. .

[email protected]


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s55: introduction to workflow technology

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