Clinical pathway is an approach to standardise care processes to support the implementations of clinical guidelines and protocols. It is designed to support the management of treatment processes including clinical and non-clinical activities, resources and also financial aspects. It provides detailed guidance for each stage in the management of a patient with the aim of improving the continuity and coordination of care across different disciplines and sectors. However, in the practical treatment process, the lack of knowledge sharing and information accuracy of paper-based clinical pathways burden health-care staff with a large amount of paper work. This will often result in medical errors, inefficient treatment process and thus poor quality medical services. This paper first presents a theoretical underpinning and a co-design research methodology for integrated pathway management by drawing input from organisational semiotics. An approach to integrated clinical pathway management is then proposed, which aims to embed pathway knowledge into treatment processes and existing hospital information systems. The capability of this approach has been demonstrated through the case study in one of the largest hospitals in China. The outcome reveals that medical quality can be improved significantly by the classified clinical pathway knowledge and seamless integration with hospital information systems.

Clinical pathways have been adopted for various diseases in clinical departments for quality improvement as a result of standardization of medical activities in treatment process. Using knowledge-based decision support on the basis of clinical pathways is a promising strategy to improve medical quality effectively. However, the clinical pathway knowledge has not been fully integrated into treatment process and thus cannot provide comprehensive support to the actual work practice. Therefore this paper proposes a knowledgebased clinical pathway management method which contributes to make use of clinical knowledge to support and optimize medical practice. We have developed a knowledgebased clinical pathway management system to demonstrate how the clinical pathway knowledge comprehensively supports the treatment process. The experiences from the use of this system show that the treatment quality can be effectively improved by the extracted and classified clinical pathway knowledge, seamless integration of patient-specific clinical pathway recommendations with medical tasks and the evaluating pathway deviations for optimization.

In order to improve the quality of healthcare services, large-scale medical information systems should be integrated with adaptability in response to the changing medical environment. In this paper, we propose a requirement-driven architecture for healthcare information systems that will be able to respond to new requirements. The system operates through the mapping mechanism between these layers and thus can organize functions dynamically adapting to user’s requirement. Furthermore, we introduce the organizational semiotics methods to capture and analyze user’s requirement through ontology chart and norms. Based on these results, the structure of user’s requirement pattern (URP) is established as the driving factor of our system. Finally, we propose an integration framework for data sharing amongst different hospital organizations and also present the HL7 based virtual database to realize the data integration. Our research makes a contribution to the design and implementation of the architecture of healthcare systems which can adapt to the changing medical environment

Clinical pathway (CP) is the standard way to manage medical activities in order to improve the efficiency and minimize the cost of healthcare service. However current application of CPs can hardly adapt to the dynamic and complex clinical processes which involve the coordination of social agents in hospital. This paper focuses on developing a multi-agent modeling method to build up the system that can increase the execution efficiency of clinical pathway. In particular, we present a semiotic approach to analyze the requirement of clinical pathway. Furthermore we describe how the EDA (Epistemic, Deontic, and Axiological) agent and the negotiation model are realized and applied to support the clinical pathway management. Finally, the clinical pathway of breast cancer is presented to demonstrate our method

This study puts forward a method to model and simulate the complex system of hospital on the basis of multi-agent technology. The formation of the agents of hospitals with intelligent and coordinative characteristics was designed, the message object was defined, and the model operating mechanism based on the mechanism of autonomous activities and coordination mechanism was also designed. In addition, the Ontology library and Norm library etc. were introduced using semiotic method and theory, to enlarge the method of system modeling. Swarm was used to develop the multi-agent based simulation system, which is favorable for carrying out test and optimization of the model. It is also favorable for making guidelines for hospital's improving its organization and management, optimizing the working procedure, improving the quality of medical care as well as reducing medical charge costs.