Process Oriented Knowledge Management to Support Clinical Pa

Abstract. Processes play an important role in modern hospital settings. Both cost pressure and increasing quality requirements force hospitals to redesign their processes and to document their execution and results. Clinical Pathways are evidence based and

Process Oriented Knowledge Management to Support

Clinical Pathway Execution1

Stefan Jablonski, Christian Meiler, Sascha Müller, Rainer Lay

Institute for Computer Science – Department of Database Systems

University of Erlangen-Nuernberg

Martensstr. 3, D- 91058 Erlangen

{stefan.jablonski, christian.meiler, sascha.mueller, http://y}

@informatik.uni-erlangen.de

Abstract. Processes play an important role in modern hospital settings. Both cost pressure and increasing quality requirements force hospitals to redesign their processes and to document their execution and results. Clinical Pathways are evidence based and interdisciplinary treatment processes for specific diagnosis. Along such treatment processes a lot of documents – both patient specific and unspecific – are produced. All these documents contain knowledge which is interesting for further reuse. This paper presents an approach for process oriented knowledge management along clinical pathways by using semantic document tagging generated by rules in the pathway models.

1 Situation

The public health system in Germany is currently undergoing major changes caused by several factors [3]. The goal of this effort is to reduce cost and at the same time improve efficiency and quality of patient treatment. Both goals can be achieved by using information technology in medical environments [2].

In a typical hospital setting, the medical staff has to deal with several different information systems such as hospital information systems (HIS) [7], tool specific software or laboratory systems. The ideal conception - to collect, store and analyze all information in a single big HIS - is often not put into practice and the medical staff has to spend time and effort to collect the required information from several IT systems [6].

The requested information can be divided into various categories by certain criteria such as type of the disease, date of the patient treatment, clinical ward or responsible physician. In order to improve clinical processes, this type of information has to be easily and quickly accessible. In practice, this is problematic because relating data across system boundaries requires either a lot of time or detailed IT knowledge. In consequence, the medical staff has to be supported by a knowledge management system (KMS) that allows performing similarity searches in the existing clinical data.

1 Acknowledgement: Part of this work is funded by the Deutsche Forschungsgemeinschaft (DFG)

Abstract. Processes play an important role in modern hospital settings. Both cost pressure and increasing quality requirements force hospitals to redesign their processes and to document their execution and results. Clinical Pathways are evidence based and

Clinical data is often contained in documents2 like for example findings, patient records, measurements, etc. Most of these documents are created, maintained and analyzed by the medical staff using existing clinical IT systems. Thus, the medical staff knows this kind of documents very well and can effectively extract the needed information. The remaining documents are from other sources and often used for reference, like medical guidelines [1], lookup tables, medical terminologies or checklists. This kind of documents must be easily accessible for the medical staff, as well.

A clinical pathway [4] describes the patient’s treatment process within a hospital and therefore is a very characteristic and well known means of orientation for the medical staff. Thus, a clinical pathway can be regarded as one common criterion to structure the medical knowledge. Clinical pathways are built on evidence based medicine [4] and clinical practice knowledge adapted to a specific organizational environment. Documents play an important role in both stages of a clinical pathway: Design and execution. For example, medical guidelines are needed to set up a valid clinical path in the design phase. During the execution of a clinical pathway documents are stored and requested as well, e.g. a physician needs to take a look at a radiograph during the examination or a nurse needs a checklist to prepare the operation room for the next surgery. The documents provide both background information and context data.

2 Semantic tagging along the clinical pathway

The situation described in the first section implies that a knowledge management solution for a hospital should be based upon the existing medical documents that are used along the patient treatment process. In fact, using existing documents has several advantages: In contrary to a newly generated representation of extracted knowledge, a more efficient comprehension of the presented knowledge is guaranteed. Accordingly, the acceptance is raised as there is no need for the medical staff to understand the structure of new documents. Furthermore, existing documents can simply be reused and the expensive creation of new documents can be omitted.

The medical documents originate from very different sources and need to be organized and related to each other. A basic principle to structure the knowledge is to tag the documents with different characteristic attributes (e.g. key words) [5]. By adding predefined attributes, the documents gain semantic information that can be automatically processed by a KMS. Typical examples for such attributes are the type of the disease or the responsible physician. What criteria are to be used throughout the KMS depends on the individual needs of the organization. It is very important to define a common understanding of the classification throughout the orga …… 此处隐藏：9550字，全部文档内容请下载后查看。喜欢就下载吧 ……