Workflow Management in Radiology –past research activities in Philips :Workflow Management in Radiology –past research activities in Philips Thomas Wendler Philips Research Europe – Hamburg, Germany Workshop 'Workflow Management in Healthcare', Nov. 15, 2006


Outline :Outline Motivation and relevance for WfM in Radiology Philips Research projects: WfM in Radiology (1997 – 2001) Conlcusions


WfM: Relevance for health care enterprises :WfM: Relevance for health care enterprises Shrinking budgets and increasing cost pressure Challenges to increase the efficiency and the quality of medical services Competition among hospitals, service orientation towards patient customers (perceived quality) Improvements in efficiency through automation Improvements in quality through modeled guidelines, outcomes analysis Process improvement as key success factor (process improvement programs in many hospitals) Intelligently applied information technology can reduce costs and provide better controls for the healthcare services Workflow management as key base-technology.


WfM: Relevance for Philips :WfM: Relevance for Philips Healthcare institutions ask for integrated information management solutions to improve their quality of services to cope with their financial imperatives Imaging equipment manufacturers move away from the ‘box-business’ to become integrated solution providers Increased efforts and solutions of Philips' competitors are obvious ‘Traditional’ IT environments in radiology (isolated RIS and PACS solutions) will quickly be obsolete Truly integrated solutions will be the wave of the future Orientation towards business processes (workflow management) will be a decisive element of success.


Situation in Radiology :Situation in Radiology Typical: Multi-vendor environments Typical IT infrastructure: Imaging devices, RIS, PACS Typical processes: Well structured, with lots of exception conditions that require flexibility Many achievements for data integration (Standards, HL7, DICOM, IHE, ….) IT solutions are data-driven, current standards focus on data access IT installations do not automatically result in efficiency improvements Workflow aspects are dealt with in (expensive and time-consuming) projects rather than in products and services We lack systems that deal with processes


What we want in health care are systems that ... :What we want in health care are systems that ... … support access to all relevant data and support the key processes in healthcare … support the re-design, improvement and automation of processes … allow the flexible modelling and enactment of processes We want Workflow Management Services in addition to data services.


What is Workflow ? :What is Workflow ? ...a frequently used keyword ! Workflow is... ...the automation of a business process, in whole or part... ...during which documents, information or tasks are passed from one participant to another... ...for action, according to a set of procedural rules.


Workflow dimensions in Radiology: :Workflow dimensions in Radiology: Processes


Slide 9:Workflow Management in Radiology (PR Hamburg project 1997-2001)


WfM in Radiology project (1997-2001) :WfM in Radiology project (1997-2001) Investigate workflow solutions for Radiology Workflow studies in hospitals (about 10 sites in Europe and the US) Workflow models for Radiology Implementation of formal models in a WFM system System architectures for WfM in Radiology and typical workflow-enabled application systems Laboratory WfM demonstration system (virtual radiology environment in the lab), COSA as WfMS.


Radiologie: Imaging modalities / PACS / RIS / HIS :Radiologie: Imaging modalities / PACS / RIS / HIS PACS: Picture Archiving and Communication System RIS: Radiology Information System HIS: Hospital Information System Imaging Modalities: X-ray, CR MRI CT US NM (PET, SPECT, PET/CT, etc.)


Adding Workflow Management to Radiology :Adding Workflow Management to Radiology


Radiology: Typical sub-processes and activities :Radiology: Typical sub-processes and activities


Workflow-Centric View on Radiology :Workflow-Centric View on Radiology


Workflow Management Terminology :Workflow Management Terminology


The Systems / Interfaces View :The Systems / Interfaces View Workflow Interfaces (WfMC) Data Interfaces (DICOM, HL-7) Request Registration


Workflow-Enabled Application Systems :Workflow-Enabled Application Systems Application System Component Application System Component Application System Component Application System Component


Workflow Management Demonstration :Workflow Management Demonstration


Workflow-enabled application systems :Workflow-enabled application systems


Worklist generation :Worklist generation Build time: Process Definition Run time: Process Instances Worklists


Workflow Enabled RIS User Interface Example :Workflow Enabled RIS User Interface Example Worklist Patient Navigator Application Components


Workflow Management demonstration system :Workflow Management demonstration system


Workflow Management demonstration system (2001) :Workflow Management demonstration system (2001)


Workflow management demonstration system :Workflow management demonstration system


Workflow management systems (WfMS) :Workflow management systems (WfMS) Dedicated systems to model and execute processes Independent of application systems Build time tools: Graphical editors to model processes and organisations Simulation tools to optimize processes Run time tools/workflow engines: Execute and control processes, generate worklists Interfaces to the real world (application systems).


Commercial WfM systems :Commercial WfM systems More than 100 commercially available systems on the market Usefulness proven in typical application areas (e.g. for banking, insurance companies,...) Systems for dedicated application areas No dedicated systems for health care applications Application independent systems Very different implementation strategies and modelling paradigms COSA as WfM for lab demonstration system.


Workflow Standards (WfMC) :Workflow Standards (WfMC) Workflow Enactment Service Workflow-Enabled Application System


Workflow standards (WfMC) :Workflow standards (WfMC) The WfMC interfaces are in various states of definition Some interfaces are not mature enough to be used in real systems Only few implementation through WfM systems manufacturer Proprietory solutions.


The Continuum of Processes :The Continuum of Processes ad hoc well structured not automated highly automated Emergency case Standard study Difficult case Study with complex, difficult examination Study with spontaneous, additional examination Target for Groupware Target for Workflow Management


Benefits of a Workflow-Centric Approach :Benefits of a Workflow-Centric Approach Improved efficiency - re-engineering and automation of processes reduces cost and saves time Better process control - formal workflow modeling improves the management of business processes, introduces optimal working methods and makes audit trails available Improved customer service – consistency in the processes leads to greater predictability in levels of response to customers Flexibility – software control over processes enables their re-design in line with changing business needs.


Conclusions from WfM in Radiology project :Conclusions from WfM in Radiology project Structures, well defined processes with many exception conditions Variation in process policies among different institutions in different countries In principle promising environment for WfM Difficulties in WfM implementation Multi-vendor environment, integration standards focus on data Workflow-enabled application systems needed but accepted international standards missing.


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