Sutherland Jeffrey V, van den Heuvel Willem-Jan, Ganous Tim, Burton Matthew M, Kumar Animesh
PatientKeeper, Inc., Brighton, MA, USA.
Stud Health Technol Inform. 2005;118:278-312.
Patients, providers, payers, and government demand more effective and efficient healthcare services, and the healthcare industry needs innovative ways to re-invent core processes. Business process reengineering (BPR) showed adopting new hospital information systems can leverage this transformation and workflow management technologies can automate process management. Our research indicates workflow technologies in healthcare require real time patient monitoring, detection of adverse events, and adaptive responses to breakdown in normal processes. Adaptive workflow systems are rarely implemented making current workflow implementations inappropriate for healthcare. The advent of evidence based medicine, guideline based practice, and better understanding of cognitive workflow combined with novel technologies including Radio Frequency Identification (RFID), mobile/wireless technologies, internet workflow, intelligent agents, and Service Oriented Architectures (SOA) opens up new and exciting ways of automating business processes. Total situational awareness of events, timing, and location of healthcare activities can generate self-organizing change in behaviors of humans and machines. A test bed of a novel approach towards continuous process management was designed for the new Weinburg Surgery Building at the University of Maryland Medical. Early results based on clinical process mapping and analysis of patient flow bottlenecks demonstrated 100% improvement in delivery of supplies and instruments at surgery start time. This work has been directly applied to the design of the DARPA Trauma Pod research program where robotic surgery will be performed on wounded soldiers on the battlefield.
患者、医疗服务提供者、支付方和政府都要求提供更有效和高效的医疗服务，而医疗行业需要创新方法来重塑核心流程。业务流程再造（BPR）表明，采用新的医院信息系统可以推动这一变革，工作流管理技术可以实现流程管理自动化。我们的研究表明，医疗保健领域的工作流技术需要对患者进行实时监测、检测不良事件，并对正常流程中的故障做出适应性反应。适应性工作流系统很少得到实施，这使得当前的工作流实施方式不适用于医疗保健领域。循证医学、基于指南的实践的出现，以及对认知工作流的更好理解，再加上包括射频识别（RFID）、移动/无线技术、互联网工作流、智能代理和面向服务的架构（SOA）在内的新技术，为业务流程自动化开辟了新的、令人兴奋的途径。对医疗活动的事件、时间和地点的全面态势感知可以促使人类和机器的行为发生自组织变化。为马里兰大学医学中心的新温伯格外科大楼设计了一种新型连续流程管理方法的试验台。基于临床流程映射和患者流瓶颈分析的早期结果表明，手术开始时物资和器械的交付效率提高了100%。这项工作已直接应用于美国国防部高级研究计划局（DARPA）创伤舱研究项目的设计中，该项目将在战场上对受伤士兵进行机器人手术。
