Information and communication technology for process management in healthcare: a contribution to change the culture of blame

Abstract

Abstract. Statistics on medical errors and their consequences has astonished, during last years, both healthcare professionals and ordinary people. Mass-media are more and more sensitive to medical malpractice. This paper elaborates on the well-known resistance of the medical world to disclose actions and processes that could have caused some damages; it illustrates the possible causes of medical errors and, for some of them, it suggests solutions based on information and communication technology. In particular, careflow management systems and process mining techniques are proposed as a mean to improve the healthcare delivery process: the former by facilitating task assignments and resource management, the latter by discovering not only individuals' errors, but also chains of responsibilities concurring to produce errors in a complex patient's pathway. Both supervised and unsupervised process mining will be addressed. The former compares real processes with a known process model (e.g. a clinical practice guideline or a medical protocol), while the latter mines processes from raw data, without imposing any model. Potentiality of these techniques is illustrated by means of examples from stroke patient management.

What Do Doctors Need for Effective Adoption and Integration of Clinical Guidelines into Daily Practice?

“…To this end, the Gewel tool allows the doctor to map the concepts of CG and EHR to a WF model. Workflow based models are one of the most widely accepted formalisms for clinical processes [12]. Again, considering that standardization is a must, Gewel also allows to map the basic elements to their HL7 message correspondence.…”

“…Due to this fact, we decided to use standards such as GEM [9] for CG structure, HL7 [10] for clinical messaging, and workflow models (WF) for clinical processes. Despite the fact that for the modeling of CG there exist a number of specific languages [11] such as ProForma, GLIF3, ASBRU or GLARE, one of the most widely accepted models is the workflow model [12]. Workflows are collections of organized tasks to carry out some process made by software systems, groups of people, or the combination of both [13].…”

Computing Problem Oriented Medical Records

“…On the other hand, other activity models have been proposed. For general process, the workflow models, Business Process Management and clinical processes management have been successfully introduced in the hospital organisation [16,20]. More specific clinical processes, such as surgery process models [18] or clinical temporal workflows [9] have also been considered.…”

Efficiency Losses in Healthcare Organizations Caused by Lack of Interpersonal Relationships

“…In addition to not stimulating spontaneous notifications, they double punish the professional who, when recognizes his/her mistake, starts to feel so guilty that is strongly and emotionally affected (Ullström, Sachs, Hansson, Øvretveit, & Brommels, 2014). If the human errors can lead to serious complications to patients, to healthcare organizations, they generate not only financial losses that are in general difficult to be measured (Tucker, 2004), but also efficiency losses due to extending the length of stay (Quaglini, 2010).…”