Classifications

• • G—PHYSICS
  • G06—COMPUTING OR CALCULATING; COUNTING
  • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
  • G06Q10/00—Administration; Management
  • G06Q10/10—Office automation; Time management

Definitions

• the present invention relates to a method of creating workflows for healthcare processes and to an associated user interface.
• IT information technology
• workflow engines 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
• 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.
• entry points of different procedures are: patients , appointment scheduling, resources. (See fig. 2)
• a first window is displayed which comprising a number of actions pertaining to a first step of the process.
• Examples of actions are filling in or selecting names of patients or resources such as doctors, examination rooms, examination equipment etc .
• next steps of said procedure defined by allowable transitions are displayed as selectable items. So the user is guided through the procedure.
• 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.
• 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.
• the computer program product takes the form of an electric signal and can be communicated to a user through electronic communication.
• 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.
• appointment scheduling process can differ between healthcare facilities, departments, groups of users or by type of procedure.
• 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
• the default workflow could be :
• Each entry point of a workflow is shown on top of the screen, next to each other.
• FIG 2 there are 3 workflows : patients, appointment scheduling and resources.
• 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.
• 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
• a first window is shown.
• the healthcare process (in this case, appointment scheduling) is regulated by a succession of windows.
• 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.
• This transition phase can be defined in a set-up by an administrator .
• the administrator will define at the end of each window :
• a shortcut key can be defined - this will allow to speed up the workflow.
• the default workflow action will always be on top of the action part of the window.
• 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 exam (120) can only be carried out when the scanner (140) is available. This kind of relationship is represented by a relational link (183) .
• 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.
• a procedure or exam is preceded by a pre-op action and followed by a post-op action.
• an action refers to an activity related to a resource.
• 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.
• 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.
• 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) .
• 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.
• 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 .
• 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.
• 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) .
• 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.
• 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.
• 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.
• 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.
• 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.
• 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.
• 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) .
• 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.
• 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) .
• 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.
• 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) .
• 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.
• relational links can be worked out between the exam, the operator and the scanner.
• 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.
• 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.
• 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.
• 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.
• an inductive logic method is used to control the processing of the time windows as opposed to deductive logic.
• 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”).
• deductive logic 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
• 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.
• 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.
• the data of the hypotheses is first gathered and then systematically processed to calculate the final conclusion.
• An inductive step to calculate an (intermediate) conclusion comprises determining what other variables are needed to calculate said (intermediate) conclusion. There are two possibilities:
• 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:
• 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.
• FIG. 19 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.
• 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
• the solution of the scheduling problem stated in the above example is preferably carried out by using an inductive logic method.
• 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
• 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” .
• 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 .
• the method starts by instantiating a variable start times exam, which is the final conclusion of the scheduling problem.
• IS2 first one
• IS3 second one
• 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) .
• 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) .

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• 2006
  • 2006-02-17 RU RU2007136605/09A patent/RU2007136605A/ru not_active Application Discontinuation
  • 2006-02-17 EP EP06708332A patent/EP1866854A1/en not_active Withdrawn
  • 2006-02-17 JP JP2007557461A patent/JP2008532153A/ja active Pending
  • 2006-02-17 WO PCT/EP2006/060041 patent/WO2006094887A2/en not_active Ceased

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