EP1866854A1

EP1866854A1 - Workflow set-up for healthcare process

Info

Publication number: EP1866854A1
Application number: EP06708332A
Authority: EP
Inventors: Geert c/o AGFA-GEVAERT MACHTELINCK
Original assignee: Quadrat NV
Current assignee: Agfa Healthcare Inc
Priority date: 2005-03-04
Filing date: 2006-02-17
Publication date: 2007-12-19
Also published as: JP2008532153A; RU2007136605A; WO2006094887A2

Description

WORKFLOW SET-UP FOR HEALTHCARE PROCESS.

[DESCRIPTION]

FIELD OF THE INVENTION

The present invention relates to a method of creating workflows for healthcare processes and to an associated user interface.

BACKGROUND OF THE INVENTION

Healthcare processes consist of the most complex processes and on top of that, they need to be continuously reviewed, updated and optimised.

It is also among the recommendations of the Committee on the Quality of Health Care in America to "redesign care processes based on best practices' (source : Crossing the Quality Chasm, Institute of Medicine, US, pl2, 2001) . They tend to be different between healthcare facilities and between specialities. Even within one speciality, there are differences between procedures and there are different protocols established.

The role of information technology (IT) is inevitable to optimise these healthcare processes: ^λ Information technology can reduce errors and harm from errors, make up-to-date evidence and decision support systems available at the point of patient care, support research, help make quality measurement timely and accurate, improve coordination among clinicians, and increase accountability for performance.' (source : Crossing the Quality Chasm, Institute of Medicine, US, pl27, 2001)

The challenge is now to create a method that puts these defined (by law, by facility, by speciality, by procedure protocol) healthcare processes into practice, under following conditions : it should be transparent, intuitive in use it should be easily adaptable (in case of review) it must force upon certain processes or sometimes leave room for deviations, depending on the process or on the person in charge - contextual adaptations : depending on the outcome of certain steps, other options must be forced upon working on parallel processes for multiple patients must be possible a generic system : there should be preferably no limits concerning length or complexity of processes

Some existing applications make use of what is called "workflow engines' . They automate certain aspects of a workflow, but they currently lack in fulfilling : - the need for transparency : workflow engines are processes being run in the back and sometimes interfere in the user interface - but they are not intuitive in the user interface the need for easy adaptability : workflow engines typically automate a certain complex process and they are by nature difficult to be adapted the need for overruling : workflow engines impose a workflow, which you can accept or ignore, but there are no alternatives proposed the need for parallel processes : this part is currently being ignored - parallel processes involving different patients is not being tackled, although multi-tasking is a day-to-day concern in healthcare the need for a generic system : workflow engines are axed on specific parts of the global process - they don't incorporate a generic way for handling a healthcare process

It is an aspect of the present invention to provide an improved workflow method for healthcare processes in which the above- described problems are avoided.

SUMMARY OF THE INVENTION The above-mentioned aspects are realized by a method as set out in claim 1.

Specific features for preferred embodiments of the invention are set out in the dependent claims .

In the workflow method according to the present invention the process is defined as a sequence of successive steps starting from an entry point, or from one of set of possible entry points and terminating at an end point. Allowable transitions from one step to another are also defined in advance. Such transitions may be default or optional or conditional .

Entry points are displayed on a screen as user selectable items.

Examples of entry points of different procedures are: patients , appointment scheduling, resources. (See fig. 2)

When a user selects an entry point, a first window is displayed which comprising a number of actions pertaining to a first step of the process. (See fig. 3)

Examples of actions are filling in or selecting names of patients or resources such as doctors, examination rooms, examination equipment etc .

When the user performs these actions the next steps of said procedure defined by allowable transitions are displayed as selectable items. So the user is guided through the procedure. Upon selection of one of said steps defined as allowable transitions, a next window is displayed comprising actions regarding the selected step of said process. Again the actions shown in the window are to be completed.

Selection of allowable transitions and completion of windows shown as a result of the selection is repeated until the end of the process is reached.

The embodiments of the methods of the present invention are generally implemented in the form of a computer program product adapted to carry out the method steps of the present invention when run on a computer. The computer program product is commonly stored in a computer readable carrier medium such as a CD-ROM. Alternatively the computer program product takes the form of an electric signal and can be communicated to a user through electronic communication.

Further advantages and embodiments of the present invention will become apparent from the following description and drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

Figure 1 illustrates an example of a patient scheduling workflow.

Figure 2 is a screen shot illustrating a user interface according to the present invention, Figure 3 is another screen shot pertaining to a user interface.

Figure 4 describes a set of actions related to resources and connected by comprising, relational and sequential links;

Figure 5 describes a reduced set of actions that is left after working out the relational links according to a preferred embodiment ;

Figure 6 describes a reduced set of actions that is left after working out the relational and comprising links according to a preferred embodiment;

Figure 7 describes a reduced set of actions that is left over after working out the relational, comprising and sequential links according to a preferred embodiment;

Figure 8 describes a set of time windows associated with actions;

Figure 9 demonstrates the processing of a relational link according to a preferred embodiment; Figure 10 demonstrates the processing of a comprising link according to a preferred embodiment;

Figure 11 demonstrates the processing of a sequential link with a preceding action according to a preferred embodiment;

Figure 12 demonstrates the processing of a sequential link with a following action according to a preferred embodiment; Figure 13 demonstrates the processing of a sequential link with a following action, taking into account slack time according to a preferred embodiment;

Figure 14 shows an example of processing a relational link according to a preferred embodiment;

Figure 15 shows another example of processing a relational link according to a preferred embodiment;

Figure 16 shows three examples of processing a comprising link according to a preferred embodiment; Figure 17 shows an example of the processing of time windows according to a preferred embodiment;

Figure 18 shows an example of using deductive logic;

Figure 19 shows an example of using inductive logic;

Figure 20 shows a data processing system according to a preferred embodiment of the current invention.

DETAILED DESCRIPTION OF THE INVENTION

Hereinafter an embodiment of a user interface pertaining to workflows in an appointment scheduling system is described as well as an embodiment of a set-up to create workflows for processes.

An example of a scheduling engine for an appointment scheduling system is described extensively in an application entitled 'Method for processing linked lists of time segments', filed by the same applicant on the day of filing of the present application.

A process commonly consists of :

1. an entry point or initialization 2. a sum up of successive steps (all being contextual), including: a. a default step b. optional steps

3. a new step in the process

4. an undefined number of repetitions of steps 2 and 3 5. a final step in the workflow or summary on the outcome of the workflow - S -

To concretise this, an example is described of a process for scheduling an appointment.

There are many ways the appointment scheduling process (although easy on a first look) can differ between healthcare facilities, departments, groups of users or by type of procedure.

Some examples :

1) differences by healthcare facilities : a. some facilities will indicate that appointment scheduling must start with patient selection - others with procedure selection. b. some would allow for parallel scheduling for different patients, others will not c. mandatory parts can be required to be checked (e.g. patient's occupation) or to be entered (e.g. requesting entities) as quality elements in the process 2) differences by departments : a. for some departments, orders must be placed, appointments cannot be made b. specific questionnaires may be required to be filled in at a certain step in the workflow (e.g. just after patient selection) - depending on the result c. specific letters/certificates must be printed at certain steps

3) differences by user groups : a. secretaries will have strict workflows b. for physicians, the defaults can be similar, but the options (deviations) can be multiple c. administrators can have a complete range of options

4) differences by procedure types : a. depending on the outcome of questionnaires, certain procedure types are proposed or are avoided b. depending on the clinical path, certain procedures can be proposed or not supported A typical schedule workflow is illustrated in figure 1.

The default workflow could be :

1) patient selection 2) procedure selection

3) search possible appointments

4) confirm appointment but as shown, many deviating flows are possible.

In an embodiment of a user interface this is solved as follows:

Each entry point of a workflow is shown on top of the screen, next to each other. In the example illustrated in figure 2 there are 3 workflows : patients, appointment scheduling and resources.

Remark that these workflows can be defined on system (enterprise) , department, user group, workstation or even user level. Workflows defined on a lower level (e.g. department), generally overrule the workflow definition of a higher level (e.g. enterprise) .

The same workflow can be opened in parallel to an existing workflow. In case of appointment scheduling, this is needed because in parallel a user can have : a patient in front of the user (e.g. at the desk) a patient at the phone a physician at the side of the user requiring appointment verification or scheduling

When such an entry point is selected, a first window is shown. The healthcare process (in this case, appointment scheduling) is regulated by a succession of windows.

Depending on the status or outcome of a window, other actions are shown . In the above example, there is default the possibility to register a new patient, because it has been defined as such. If this is not possible in this workflow, no actions would be visible in this action part of the window. s

If a patient is selected, other actions may come up, such as : create an appointment for patient X (default) show existing appointments for patient X

o In this way, a process is constructed as shown above in the workflow diagram of figure 1.

The result is that : the user has a clear offering of the possibilities s - the offerings are secure, since controlled the system is generic it includes options and as such, deviations from the default workflow the set-up can be done on different levels of the healthcare 0 enterprise it includes the possibility for parallel workflows

Similar workflows can be generated to regulate other healthcare processes, such as : 5 - other administrative processes, such as patient registration, order entry, billing clinical processes within the electronic patient record departmental processes, for example technologist's workflow in radiology, nurse's workflow in care departments, physician's 0 workflow for standardised procedures or protocols

The present invention is based on the following underlying process.

The process is described as a graph, where each step is a node. 5 The transition from one node to another is defined in three ways :

1) through defaults

2) through optional ways to other nodes - S -

3) through conditions

This transition phase can be defined in a set-up by an administrator . Typically, the administrator will define at the end of each window :

1) what is the succeeding default node and what the conditions are

2) what are the optional succeeding nodes and what the conditions are to allow them in the user interface

Related to the user interface, for each action a shortcut key can be defined - this will allow to speed up the workflow. Typically, the default workflow action will always be on top of the action part of the window.

Below aspects of the underlying scheduling method, more specifically of the method of generating a solution space, are described extensively.

Before explaining the general principles of the scheduling method, the method is first explained by working out a specific example, which is also one specific embodiment of the current invention.

According to the example, an appointment needs to be scheduled to examine a patient by means of a scanner. The patient needs to undress before and to dress again after the scan.

The exam itself takes 2 hours. Both for undressing and dressing one hour is provided. After the patient has undressed, he does not want to wait for the exam. When the exam is finished, he accepts that he may have to wait up to one hour before he can dress again.

Figure 4 describes the actions that are part of the appointment and the relations between them. The appointment (100) action comprises three other actions: the undressing (110) action, the actual exam (120) action and the dressing (130) action. This comprising relationship is represented by three comprising links (190, 191, 192) between the individual actions (110, 120, 130) and the appointment (100) action. The appointment (100) action is called a parent relative to the undressing (110), the actual exam (120) and dressing (130) actions which are called children. Because of the parent-child relationship of a comprising link (190, 191, 192), it is not symmetrical.

An action is defined as being "atomic" when it does not comprise other actions. For example, the undress (110) action is atomic, but the appointment (100) action is not.

The undressing (110) , the actual exam (120) and dressing (130) actions follow sequentially and this relationship is represented by the sequential links (193, 194) . The sequential nature implies that such a link is not symmetrical, as the arrows in Figure 4 also indicate .

The exam (120) can only be carried out when the scanner (140) is available. This kind of relationship is represented by a relational link (183) . In addition does carrying out the exam require the availability of an operator, so a relational link (184) also exists between the exam and the operator (150) . A relational link between two actions indicates that both actions can only be carried out at the same time. From this follows that such a link is by nature symmetrical and transitive. The transitivity is expressed in Fig. 4 by the dotted line (185) between the scanner and operator action.

In a more general case, a procedure or exam is preceded by a pre-op action and followed by a post-op action. In a more general case an action refers to an activity related to a resource. Such a resource can be a patient, a physician, a nurse, an operator a diagnostic or treatment apparatus, a examination or treatment room, or any other kind of resource with which an activity can be associated. The resource can or can not be related to the domain of healthcare. The activity can be the use of equipment, the presence of a person, the occupation of a facility or any other activity that refers to the use or availability of any resource. In a more general case any topology of any number of actions related by comprising, relational or sequential links is possible.

Figure 8 shows how with each action (100, 110, 120, 130, 140, 150, 160, 170) in Figure 4 a corresponding time window (501-507) is associated. A time window consists of a linked list of non contiguous time segments, each segment having a beginning and an ending time. For example, for the patient (160) action, the linked list consists of the time segments (510, 511, 512) .

A time window can represent the range of time when an action can potentially occur. However, a time window can also represent a range of time when the action can start or when it can end.

In the example in Figure 8, the time windows (500-503) of the patient (150), the dressing room (170), the scanner (140) and the operator (150) are part of the problem definition data. These time windows represent constraints imposed by the corresponding resources. The time windows (504-507) of the undressing (110), exam (120) and dressing (130) actions and of the appointment (100) as a whole, however, are initially undetermined, as they are the subject of the solution that has to be calculated for the scheduling problem. An undetermined time window is represented as one contiguous time segment with the length of the time window. For example, 508 is the initial time window associated with the exam action (120) . As a solution for the time scheduling problem is being processed according to the current invention, the number of segments of an undetermined time window may change and the beginning and end times of the remaining time segments may become increasingly more focused, until they represent a situation that is consistent with all the constraints imposed by the resources.

Since the constraints imposed by the resources are represented by relational (180-185), comprising (190-192) and sequential (193, 194) links, processing the solution essentially comes down to working out these links.

When working out the links, a number of different cases are to be distinguished that correspond with the different nature of the links (relational, comprising or sequential), the interpretation of the time window of the action (start times, end times or action times), and the relative location of the time segments (the way that the time segments in the time windows of the linked actions overlap) . The result of processing a link involves adjusting the time segments in the time windows corresponding to the linked actions in a way that they become consistent with the constraints imposed by the corresponding resources .

In the following paragraphs the processing of the different links is discussed.

First case: time window processing for actions connected through relational links

Figure 9 illustrates a number of situations for actions connected through relational links, of which the time segments occur in different relative positions (overlapping and non-overlapping) . The interpretation of the time windows (620-623) is that the represent the time during which the action (600-603) can take place. Since the meaning of a relational link is that the two actions (600,601) can only take place simultaneously, the effect of working out the link is that each time window (620,621) should be replaced by a time window (622,623) that consists of time segments (612,613) that are the cross sections of the time segments (610,611) in the original time windows.

Because of the transitive nature of a relational link, if an action has more than one relational link - directly or indirectly - to another action, the time windows of all the actions are to be replaced by a time window of which the time segments are the cross sections of all the time segments of the time windows of all the related actions.

Second case: Time window processing for actions connected through comprising links

Figure 10 illustrates a number of situations for actions connected through comprising links, of which the time segments occur in different relative positions (overlapping and non-overlapping) . The interpretation of the time windows (700-702) is that the represent the time during which the action can take place. The meaning of a comprising link is that the time segments (711) of a child action (701) have to occur within the time segments (710) of the time window (720) of the parent action (700) . This is achieved by replacing the time segments (711) of the time window (721) of the child action (701) by the cross section (712) of themselves (711) with the time segments (710) of the time window (720) of the parent action (700) .

Third case: Time window processing for actions connected through sequential links

The following terms are introduced or clarified:

- time window of an action: linked list of time segments describing when an action can take place.

- time window of start times of an action: linked list of time segments describing when said action can start;

- time window of end times of an action: linked list of time segments describing when said action can end;

The time window of an action, the time window of start times of the same action and the time window of end times of that same action are interrelated.

Referring to Figure 12 and according to an embodiment of the current invention, a time window (921) representing start times (911) of an action is calculated from a corresponding time window (920) representing said action, by subtracting from the end times of the time segments (910) in the latter time window (920) the duration (930) of said action.

Referring to Figure 11 and according to an embodiment of the current invention, a time window (821) representing end times is of an action is calculated from a corresponding time window (820) representing said action, by adding to the start times of the time segments (810) in the latter time window (820) the duration (830) of the action.

According to an embodiment of the current invention time windows representing start times and end times of an action are also interrelated by shifting the start and end times in the time segments by the duration of the action.

According to one embodiment of the current invention, when a first preceding action (800, 902) is followed by a second following action (802, 900), certain restrictions are applied on both the start and end times of both actions.

A first restriction involves the start times of a following action in order to achieve that that the start times of a following action can never be earlier than the earliest end time of any of the preceding actions. According to one aspect of the current invention, this effect is achieved by replacing the time segments (813) of the start times (823) of the following action (802) by the cross section (814) between themselves (813) and the time segments (811) of the end times (821) of the preceding action (800) .

A second restriction involves the end times of the preceding action in order to achieve that the end times of a preceding action can never be later than the latest start times of any of the following actions. According to one aspect of the current invention, this effect is achieved by replacing the time segments (913) of the end times (923) of the preceding action (902) by a cross section (914) between themselves (913) and the time segments (911) of the start times (921) of the following action (900) .

In the case that slack time is allowed between two actions, the end times of the time segments of the preceding action are preferably extended by the maximum allowed slack time, prior to applying said first restriction. Referring to Figure 13, the time window (1020) of the preceding action (1000) is used to calculate the time window (1021) of the end times (1001) of the preceding action (1000) by shifting the start times of the time segments (1010) forward by the duration (1030) of the preceding action (1000) . Following that, the segments (1011) of the time window (1021) of the end times (1001) of the preceding action are extended by the maximum slack time (1040) to yield the time segments (1012) of the time window (1022) of the end times (1002) of the preceding action plus the slack time. To obtain the time window (1024) of the start times of the following action (1004), the end times of the segments (1013) of the time window (1023) of the following action (1003) are shifted backwards by the duration (1050) of the following action (1003) . The segments (1015) of the time window (1025) of the start times of the following action (1005) are obtained by making the cross section between the time segments (1012) and the time segments (1014) .

Working out a sequential link between two actions involves applying the two above restrictions.

Having described how according to the current invention:

- relational links are processed (1) ; - composite links are processed (2);

- the relation between time windows representing actions, start times and end times (3) is processed;

- sequential links are processed (4);

- slack time is processed in sequential links (5) . we proceed next by working out the example that was earlier introduced according to the principles of the current invention.

The problem that has to be resolved is finding the time window representing the start time(s) for the exam.

A first step consists of working out the relational links in Figure 4.

Referring to Figure 14, this is done by using the general principles according to the current invention that were earlier explained by means of Figure 9.

Similarly, referring to Figure 15, the relational links can be worked out between the exam, the operator and the scanner.

After this operation, the graph in Figure 4 can be reduced to the one in Figure 5, with the notion that he time windows associated with the appointment and the exam actions are not the original ones, but the ones that were obtained from the previous step .

A second step consists of working out the comprising links in the graph in Figure 5. According to the current invention, this is achieved by processing the time segments in the time windows of the undress, exam and dress actions so that they fall within the time segments of the time window of the appointment action. This is demonstrated in Figure 16A, 16B and 16C using the general principles of the current invention that were earlier explained by means of Figure 10.

After this operation, the graph in Figure 4 or Figure 5 can be reduced to the one in Figure 6, with the notion that he time windows associated with the undress, exam and dress actions are not the original ones, but the ones that were obtained from the previous step . The third step consists of working out the constraints imposed by the sequential links.

The exam action is preceded and followed by another action. According to one aspect of the current invention, this has implications on start and end times of the time segments of the corresponding time windows.

Referring to Figure 17, the start times (1310) of the exam should never be earlier than the earliest end times (1307) of the undress action, and the end times (1303) of the exam including slack time should never be later than the latest start times (1301) of the dressing action, according to the general principles that were earlier explained by means of Figure 11, 12 and 13.

After this operation, the graph in Figure 4, 5 and 6 can be reduced to the one in Figure 7, with the notion that he time window associated with the exam actions are the ones that were obtained from the previous step.

Introducing deductive and inductive logic

According to a preferred embodiment of the current invention, an inductive logic method is used to control the processing of the time windows as opposed to deductive logic. These terms are explained in more detail.

Generally speaking, deductive logic starts with variables of which the values are known (called "the hypotheses") and deduces step by step according to a predefined flow the value of the variable for which a solution is sought (called the "final conclusion") . This processing occurs through the calculation of the value of intermediate values (called "intermediate conclusions").

In deductive logic, the information processing flow itself is the subject of the programming and as a result, once it has been programmed, it is fixed. Therefore, deductive logic programming is efficient for those problems of which the taxonomy of relations between variables is fixed, and only the values of the hypotheses are subject to change, s

An example of a deductive logic method is shown in Figure 18. Hl, H2 and H3 are the basic hypotheses. Processing (151) the hypothesis H2 results in the intermediate conclusion Cl. Processing (152) the conclusion Cl and the hypothesis Hl results in the intermediate o conclusion C2. Processing (153) the conclusion C2 and the hypothesis H3 then leads to the final conclusion C3.

In contrary, the entry point for an inductive logic method according to the current invention is the final conclusion itself of which the s value is initially unknown. By means of a set of inductive steps that take the form of an exploration process, the data of the hypotheses is first gathered and then systematically processed to calculate the final conclusion.

0 An inductive step to calculate an (intermediate) conclusion comprises determining what other variables are needed to calculate said (intermediate) conclusion. There are two possibilities:

1) Either the values of the variables that are needed are known because they are either hypotheses or intermediate conclusions 5 of which the value has been earlier determined; in that case the variables can be processed to obtain the (intermediate) conclusion.

2) Or at least one of the variables that are needed is an intermediate conclusion of which the value has not been 0 determined yet; in that case this (intermediate) conclusion initiates a new inductive step.

The subject of the programming in an inductive logic method is not a deductive information processing flow, but a rule set that manages 5 the inductive steps. Developing a rule set for an inductive method involves determining:

1) the nature (classes) of the variables (intermediate conclusions) that are needed to calculate a conclusion;

2) for each nature (class) of a variable (intermediate s conclusion) determining what kind of processing on what other variables (other intermediate conclusions or hypotheses) is needed to calculate the result of said (intermediate) conclusion.

o Unlike in a deductive logic method, the problem definition now not only states the values of the hypothesis, but also the taxonomy of the relations between the variables. This allows for far greater flexibility when solving problems that have different taxonomies of relations between variables. Once the rule set has been programmed, s problems with a wide variety of taxonomies of relations between the above variables can be solved using the same program.

An example of using an inductive logic method is presented in Figure 19. The entry point is a call to calculate the value of the variable 0 C3. The rule set dictates that the variable C3 requires the processing of two other variables being H3 , of which the value is known since it is a hypothesis, and the intermediate conclusion C2 , of which the value at this point is unknown. The latter causes a new inductive step to calculate the unknown variable C2. The rule set 5 dictates that the variable C2 requires the processing of two other variables Hl, of which the value is known since it is a hypothesis, and of the intermediate conclusion Cl, of which the value at this point is unknown. The latter causes a new inductive step to calculate Cl. The rule set dictates that the variable Cl requires 0 the processing of the variable H2 , of which the value is known. This results in the processing of H2 to obtain Cl. Now that Cl is known, this results in the processing of Cl and Hl to calculate C2. Now that C2 is known, this results in the processing of C2 and H3 to calculate the final conclusion C3. 5 Preferred embodiment based on inductive logic

According to the current invention, the solution of the scheduling problem stated in the above example is preferably carried out by using an inductive logic method.

According to one embodiment, the following classes or variables are used for managing resources : time window related to an action - time window related to the start times of an action

- time window related to the end times of an action

According to the same embodiment the inductive logic is managed by a set of three rules : - a first rule dictates that obtaining the value of a variable of the type "start times of an action" requires the processing of the value of the "end times of that action" and the value of "the previous action" . a second rule dictates that obtaining the value of a variable of the type "action" requires the processing of the values of the "parent actions" and the "related actions" . a third rule dictates that obtaining the value of a variable of the type "end times of an action" requires the processing of that same "action", the "slack time" and "the following action" .

In a more general case other sets of rules can be selected that however yield equivalent results and also fall within the scope of the current invention. This follows from the fact that the classes of variables in the above rule set are related to each other by simple relationships.

We have found that the above set of three classes of variables in combination with the above three rules provides a self contained method than enables resource scheduling and management of a wide variety of situations.

The method according to the current invention processes time windows and results in a time window that generally comprises a plurality of time segments, each one indicating a single solution of when the corresponding action can take place (or start) . The method hence produces not just one solution for the scheduling problem, as in the prior art, but a complete set of solutions also called a solution space.

The method according to the current invention can be used for any resource scheduling and management problem that can be modelled as a set of actions corresponding to resources that are related by a combination of comprising, relating and sequential links and slack time .

Having described the general principles of the current invention we proceed by working out the example that was earlier introduced.

Referring to Figure 17, the method starts by instantiating a variable start times exam, which is the final conclusion of the scheduling problem.

The symbols in the circles on one of the figures 14 to 17 indicate references to the same symbols in circles in one of the other figures .

Since the value of the variable start times exam at this point is unknown, this induces an inductive step (ISl) . The first rule according to the current invention dictates that in order to calculate the value (1410) of the start times of the exam, the values (1408=1405) of the end time of the exam action and (1406=1302) of the undress action are needed. Since none of these values are known at this time, this causes two new inductive steps: a first one (IS2) to enable the calculation of the value (1406=1302) of the undress action and a second one (IS3) for the calculation of the value (1408=1405) of the end times of the exam.

We proceed by first explaining the inductive step (IS2) . Referring to Figure 14 to 17, the second rule dictates that in order to calculate the value (1406=1302) of the undress action requires the processing of the value (1300=1103) of the appointment action which is the parent action. Since the value (1300=1103) of the appointment action is not known at this time, this induces again an inductive step (IS4) for the calculation of that variable. Since this variable (1300=1103) appointment is of the type "action", the same (second) rule applies, requiring the processing of the values of related dressing room (1101) and patient (1100) actions. The values of these actions are known since they are hypotheses, so this enables to calculate the value of the appointment (1300=1103) action and subsequently of the undress (1406=1302) action.

We next proceed by describing the inductive step (IS3) . Referring to Figure 14 to 17, the third rule dictates that the calculation of the value (1408=1405) of the end times of the exam requires the processing of the value (1402=1308) of the exam action and of the value (1400=1305) of the dress action. Since the variable (1402=1308) of the exam action is of the type "action", the second rule applies, and this requires the processing of the values of the parent appointment (1306=1103) action, and of the related scanner (1200) and operator (1201) actions. The value (1306=1103) of the parent appointment action is calculated the same way as in the inductive step (IS2). The values (1200, 1201) of the relating actions are known, since they are hypotheses, so this enables to calculate the value of the exam (1402=1308) action. Since the variable (1400=1305) is also of the type action, the second rule is applied once more, leading to the processing of the values of the variables (1303=1103) and (1304=1101). At this point the calculation of the value (1408=1405) of the end times of the exam can be completed and subsequently the calculation of the value (1410) of the start times of the exam. The above mentioned invention is preferably implemented using a data processing system such as a computer. An embodiment of such a system (1700) is shown in Figure 20. A computer comprises a network connection means (1750, a central processing unit (1760) and memory means (1770) which are all connected through a computer bus (1790) . The computer typically also has a computer human interface for inputting data (1710, 1720) and a computer human interface for outputting data (1730) . According to one embodiment, the computer program code is stored on a computer readable medium such as a mass storage device (1740) or a portable data carrier (1790) which is read by means of a portable data carrier reading means (1780) .

Having described in detail preferred embodiments of the current invention, it will now be apparent to those skilled in the art that numerous modifications can be made therein without departing from the scope of the invention as defined in the appending claims. ■

Claims

[CLAIMS]

1. Workflow method for a healthcare process comprising the following s steps:

- (i) define said process as a sequence of successive steps starting from at least one entry point and terminating at an end point,

- (ii) define allowable transitions from one step to another,

- (iii) display said entry point (s) on a screen as a user selectable o item,

- (iv) display upon selection of an entry point, a first window, said first window comprising a number of actions pertaining to a first step of said process,

- (v) display, upon completion of said actions, the next steps of s said procedure defined by allowable transitions, as selectable items,

- (vi) upon selection of one of said steps defined as an allowable transitions, display a window comprising actions regarding the selected step of said process, o - (vii) complete said actions,

- (viii) repeat from (v) to (vii) until said end point is reached.

2. A workflow method according to claim 1 wherein a transition is one of the following: a default transition, an optional transition, 5 a conditional transition.

3. A workflow method according to any of the preceding claims wherein said process is an appointment scheduling process.

0 4. A computer program product adapted to carry out the method of any of the preceding claims when run on a computer.

5. A computer readable medium comprising computer executable program code adapted to carry out the steps of any of claims 1 to 3.B 5