Careflow: Theory and Practice

Abstract

In this presentation we shall review different ways of describing the processes of delivering patient care, and relate these to traditional workflow in business processes, and the concept of “careflow” proposed by Panzarasa and her colleagues in Pavia. We shall discuss the problem of designing a careflow application as a form of process modelling, to be contrasted with older paradigms ranging from rule-based alerts and reminders to Petri nets and Critical path analysis. We shall also consider the need for specialised formalisms for describing clinical processes, drawing on experience with workflow languages (e.g. BPEL4WS, BPMN), guideline modelling languages (e.g. GLIF, PROforma), AI planning languages (e.g. PDDL, OCL) and “agent” programming systems (e.g. LALO, 3APL). The adoption of clinical workflow technology will greatly benefit from the availability of appropriate languages for declaratively representing processes of care. To explore some of the requirements for a clinical workflow technology we will review and critique the PROforma process modelling language and the Arezzo® and Tallis toolsets which use it. The discussion will be illustrated with deployed applications and operational prototypes.