Research in Healthcare Informatics

Clinical Pathway Management

Industry Partners: Ottawa Hospital, IBM.

Patients go through pre-defined clinical pathways as they go from admission, diagnosis, to treatment, discharge, and follow-up. Such clinical pathways can span a few hours (such as in emergency care), multiple weeks, and years (in cases of diseases such as cancer that may require procedures and follow up care).

Unfortunately, clinical pathway execution in practice faces multiple unnecessary delays. For example, a cancer patient who is candidate for surgery, may become ineligible by the time his surgery is scheduled. Those patients are then pushed onto another queue for other type of treatments, such as chemotherapy. Again, delays threaten patients treatment effectiveness and some patients, due to the prolonged wait time, miss their opportunity for a successful treatment.

We are working with Ottawa Hospital and IBM to leverage methodologies and technologies that streamlines care processes, removes unnecessary or duplicate steps, and ensures patients receive a diagnosis and treatment within agreed upon medical and regulatory guidelines.

Integrated Technology Architecture for Real Time Care Process Management

Public Abstract

Patients are facing excessive wait times at hospitals, especially within Emergency Departments. Long wait times expose patients to unnecessary risks, and are very costly to hospitals. In addition, a number of governmental and medical guidelines impose limits on patient wait times. This has prompted hospitals to explore technologies that can enhance patients flow and reduce wait times.

This research aims to address patients wait time issues by deploying a Care Process Management system (CPM) that models and monitor clinical pathways as a process model. The proposed approach provides real time dashboards where hospital administrators can view current patient states and can predict when a patient wait time will exceed a specified limit. This enables the administrator to take corrective action in a timely manner to address the cause of the delay.

When completed, such a system will improve patient safety, reduce wait times, enhance patient satisfaction, and maximize resource utilization.

Application Driven Application Development Framework for Healthcare Institutions 

Industry Partners: Ottawa Hospital, IBM.

Health Care institutions in Canada are struggling to improve the quality of care provided to patients, while at the same time reduce the cost of delivery of health services. In essence, healthcare providers are being asked of “doing more with less”. This is due, at least in part, to the aging population, improved health care diagnostics and treatments, and the publicly funded care system. This situation manifest itself in a number of ways. For example, increased number of hospital visits, over-capacity operations of most Emergency Departments, and the exploding demand for advanced diagnostics.

Healthcare providers are being asked to deal with these operational realities, while at the same time focus on clinical excellence. Care providers, therefore, must deal with delayed care delivery, adverse events that arises from the ambiguity of clinical processes, and systematic human and medical errors to avoid poor patient outcomes.

Clinical pathways are complex, involve multiple care providers, with overlapping and conflicting responsibilities. Process improvements have been proposed to deal with such unintended consequences. The community is increasingly adopting process improvement programs as means to achieve operational objectives. Patient-centered care and evidence based medicine have proven to be key approaches for improving quality of care, but ignore efficiency of care delivery and the associated costs.

Business Process Management (BPM) programs are specifically designed to help care providers improve patient outcomes while reducing the associated time and cost. BPM is a suite of technologies that are well positioned to support the efficient delivery of patient-centered and evidence based medicine

BPM has witnessed significant success in a number of industries. However, the uptake in the healthcare domain remains limited. We believe the reasons for this limited uptake to be; BPM technologies are not designed to handle the level of exceptions and variations present in many of the care processes; Care institutions environments impose additional restrictions, where stakeholders may not be able or available to interact with the system at key process points. Care providers are sensitive to adopting technologies that require alteration of their existing, and working, operations. Risk aversion on the part of care providers is compounded with the history of multiple unsuccessful and costly abandoned systems in many hospitals.

In previous work, we explored a number of minimally invasive systems that relies on automated location data to replace the need for system interactions. When system interaction is still required, we found that a minimalist approach to work best which encouraged adoption. The proposed research program in this proposal focuses on the development of specialized process models coupled with business analytics tools. The scope of our work includes process models that may or may not involve humans, span across organizational boundaries, and require high degree of flexibility, especially in terms of exception handling. This work entails exploration of tools and techniques to develop, deploy, and evaluate such technologies in hospital environments.