Berger Jiri, Bruthans Jan, Kofránek Jiří
Institute of Pathological Physiology, First Faculty of Medicine, Charles University in Prague, Praha, Czech Republic.
Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University in Prague, Kladno, Czech Republic.
JMIR Form Res. 2023 Mar 3;7:e41575. doi: 10.2196/41575.
It is very difficult to find a consensus that will be accepted by most players when creating health care legislation. The Czech electronic prescription system was launched in 2011 and new functions were introduced in 2018. To ensure that these functions will not conflict with any other existing law, a process modeling tool based on the patent "Method and system for automated requirements modeling" was used successfully in the Czech Republic for the first time.
The aim of this project was to develop another successful application of process modeling to add COVID-19 vaccination records to the existing electronic prescription system.
The method employed was based on the mathematical theory of hierarchical state diagrams and process models. In the first step, sketches that record the results of informal discussions, interviews, meetings, and workshops were prepared. Subsequently, the architecture containing the main participants and their high-level interactions was drafted. Finally, detailed process diagrams were drawn. Each semiresult was discussed with all involved team members and stakeholders to incorporate all comments. By repeating this procedure, individual topics were gradually resolved and the areas of discussion were narrowed down until reaching complete agreement.
This method proved to be faster, clearer, and significantly simpler than other methods. Owing to the use of graphic tools and symbols, the risk of errors, inaccuracies, and misunderstandings was significantly reduced. The outcome was used as an annex to the bill in the legislative process. One of the main benefits of this approach is gaining a higher level of understanding for all parties involved (ie, legislators, the medical community, patient organizations, and information technology professionals). The process architecture model in a form of a graphic scheme has proven to be a valuable communication platform and facilitated negotiation between stakeholders. Moreover, this model helped to avoid several inconsistencies that appeared during workshops and discussions. Our method worked successfully even when participants were from different knowledge areas.
The vaccination record process model was drafted in 3 weeks and it took a total of 2 months to pass the bill. In comparison, the initial introduction of the electronic prescription system using conventional legislative methods took over 1 year, involving immediate creation of a text with legislative intent, followed by paragraph-by-section wording of the legislation that was commented on directly. These steps are repeated over and over, as any change in any part of the text has to be checked and rechecked within the entire document. Compared with conventional methods, we have shown that using our method for the process of modification of legislation related to such a complex issue as the integration of COVID-19 vaccination into an electronic prescription model significantly simplifies the preparation of a legislative standard.
在制定医疗保健立法时，很难找到一个能被大多数参与者接受的共识。捷克电子处方系统于2011年推出，并于2018年引入了新功能。为确保这些功能不会与任何其他现行法律冲突，捷克首次成功使用了基于专利“自动需求建模方法和系统”的流程建模工具。
本项目的目的是开发流程建模的另一个成功应用，将新冠疫苗接种记录添加到现有的电子处方系统中。
所采用的方法基于层次状态图和流程模型的数学理论。第一步，准备记录非正式讨论、访谈、会议和研讨会结果的草图。随后，起草包含主要参与者及其高层互动的架构。最后，绘制详细的流程图。每个中间结果都与所有相关团队成员和利益相关者进行讨论，以纳入所有意见。通过重复这个过程，各个主题逐渐得到解决，讨论范围逐渐缩小，直到达成完全一致。
事实证明，这种方法比其他方法更快、更清晰、也显著更简单。由于使用了图形工具和符号，错误、不准确和误解的风险显著降低。该结果在立法过程中用作法案的附件。这种方法的一个主要好处是让所有相关方（即立法者、医学界、患者组织和信息技术专业人员）有了更高层次的理解。以图形方案形式呈现的流程架构模型已被证明是一个有价值的沟通平台，促进了利益相关者之间的谈判。此外，该模型有助于避免在研讨会和讨论中出现的一些不一致情况。即使参与者来自不同的知识领域，我们的方法也能成功发挥作用。
疫苗接种记录流程模型在3周内起草完成，法案总共花了2个月才通过。相比之下，最初采用传统立法方法引入电子处方系统花了一年多时间，包括立即创建带有立法意图的文本，随后逐段拟定立法措辞并直接进行评论。由于文本任何部分的任何更改都必须在整个文档中反复检查，所以这些步骤要反复进行。与传统方法相比，我们已经表明，对于像将新冠疫苗接种纳入电子处方模型这样复杂的问题，使用我们的方法进行立法修改过程可显著简化立法标准的制定。
