Reconstruction of clinical workflows based on the ihe integration profile "cross-enterprise document workflow"

Process-oriented workflow management in healthcare is a prerequisite to deliver high quality of care and to decrease treatment costs. Clinical workflow management systems (WfMS) cover the definition, execution and reconstruction of healthcare processes, which aims to identify main causes of high medical costs. Nevertheless, almost all existing clinical WfMS share one common drawback: they build upon proprietary hospital information systems (HIS). This paper presents a HIS independent workflow reconstruction approach based on the IHE integration profile "Cross-Enterprise Document Workflow" (XDW). XDW addresses the management of clinical, cross-enterprise workflows and makes use of a specific document, the Workflow Document. This document tracks every step of a workflow (e.g. ePrescription) including control information as well as input and output documents. Therefore it is ideally suited to reconstruct a fine-grained clinical workflow including associated documents and metadata. Furthermore this approach enables a nominal-actual comparison between a clinical workflow and a process definition.