Inferring Clinical Workflow Efficiency via Electronic Medical Record Utilization
Inferring Clinical Workflow Efficiency via Electronic Medical Record Utilization
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发表时间：
2015
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通讯作者：
You Chen;W. Xie;Carl A. Gunter;David M. Liebovitz;S. Mehrotra;He Zhang;B. Malin
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作者：
You Chen;W. Xie;Carl A. Gunter;David M. Liebovitz;S. Mehrotra;He Zhang;B. Malin
临床工作流程的复杂性可能导致诊断效率低下、治疗计划无效以及医疗保健组织（hco）的不知情管理。管理工作流程复杂性的传统策略是基于衡量HCO管理员定义的工作流程与诊所工作人员遵循的实际流程之间的差距。然而，现有的方法往往忽视了EMR系统对工作流利用的影响，可以利用这些影响来优化通过EMR促进的工作流。在本文中，我们引入了一个框架，通过利用电子病历来推断临床工作流程，并展示了这些工作流程如何根据其效率大致分为四种类型。我们的框架通过数据挖掘技术推断出几个粒度级别的工作流。我们研究了一家大型医疗中心四个月的EMR事件日志，其中包括16,569名住院患者，并说明超过95%的工作流程是有效的，80%的患者都在这样的工作流程上。同时，我们表明，由于各种因素，如复杂的患者，剩余的5%的工作流程可能是低效的。
Complexity in clinical workflows can lead to inefficiency in making diagnoses, ineffectiveness of treatment plans and uninformed management of healthcare organizations (HCOs). Traditional strategies to manage workflow complexity are based on measuring the gaps between workflows defined by HCO administrators and the actual processes followed by staff in the clinic. However, existing methods tend to neglect the influences of EMR systems on the utilization of workflows, which could be leveraged to optimize workflows facilitated through the EMR. In this paper, we introduce a framework to infer clinical workflows through the utilization of an EMR and show how such workflows roughly partition into four types according to their efficiency. Our framework infers workflows at several levels of granularity through data mining technologies. We study four months of EMR event logs from a large medical center, including 16,569 inpatient stays, and illustrate that over approximately 95% of workflows are efficient and that 80% of patients are on such workflows. At the same time, we show that the remaining 5% of workflows may be inefficient due to a variety of factors, such as complex patients.