Care Workflow Platform: A Definition

Health IT is laying down a layer of workflow technology on top of database technology. Terminology varies, including Care Management Systems, Healthcare Operating Systems, Healthcare or Care Process Management. I speak of process-aware information systems (after the academics), workflow management systems (historical designation for workflow engine-based software), and healthcare business process management (BPM used within healthcare).

I’d like to propose a new phrase: Care Workflow Platform. Let’s understand the meaning of each of these three words. Then put them together into a definition for care workflow platform.

  • A computing “platform” is the software and/or hardware an application is designed to run within, obeying its constraints, and using its facilities (Wikipedia). Examples include operating systems (Windows running Windows applications), web browsers (Chrome, running Javascript), and smartphones (Android versus iOS).
  • Workflow is a series of tasks, consuming resources, achieving goals. (my definition)
  • Care (as in medical care) is the diagnosis, treatment, and prevention of disease, illness, injury, and impairment. (Dictionary)

Now combine meanings. A “care workflow platform” is a cognitive system designed to run workflows (represent, execute, and support workflow tasks, resources, and goals) relevant to diagnosis, treatment, and prevention of disease, illness, injury, and impairment.

Notice I introduced two concepts into my definition of care workflow platform:

I added “represent, execute, and support.” This is the link between workflow and platform. Platforms are designed to do and support specific things. In this case the “thing” is workflow. Database platforms represent, execute, and support data. Workflow platforms represent, execute, and support workflows.

I replaced “software and/or hardware” with “cognitive system”. As a healthcare systems engineer (MSIE, Industrial Engineering) I am acutely aware that healthcare systems, including healthcare workflow systems, are not just about software and hardware. They are also about peopleware. Users and applications combine together into cognitive systems. They have memory and perceive, reason, react, and act. The most important decision, when designing cognitive systems, is what tasks the computer will perform versus what tasks the human will perform. The combination of human and computer tasks constitute workflows. Representing, executing, and supporting these healthcare workflows is what care workflow platforms do.

This proposed definition is somewhat elastic. My root definition of “platform” comes from the Wikipedia definition of computing platform. However, in healthcare, “platform” is sometimes used to refer to more than just software and/or hardware resources and constraints for executing software programs.

Workflow management systems, business process management suites, and case management systems rely on software workflow engines. These engines execute or consult representations of work and workflow. These are the “programs” that the workflow “platform” executes. However, there are many health IT software systems that either lack, or, only recently rely on rudimentary workflow engines. In these systems, it is often one or more human users who play the role of intelligent “workflow engines”. The clear trend is for more-and-more health IT software to leverage more-and-more sophisticated software-based workflow engines. However, human workflow engines increasingly influence the design of software-based workflow engines being incorporated into healthcare software.

Care workflow platforms have four primary benefits over non-workflow care platforms.

  • Automaticity: Workflows and tasks can be triggered automatically.
  • Transparency: Workflow and task state can be continually visible.
  • Flexibility: Workflows and tasks can be “programmed” by non-programmers.
  • Improvability: Workflows and tasks can be systematically improved.

(For a more complete discussion, see Interoperability benefits of task workflow: Pragmatic interoperability series, part 5.)

I am now a two-decade advocate for using healthcare workflow technology to help manage, even solve, healthcare workflow problems. Thinking through the meaning of “care”, “workflow”, and “platform”, and how they relate each other is a valuable exercise, one to which I can point other healthcare workflowistas, in a growing discussion of healthcare workflow and workflow technology.

By the way, this Friday, March 18, join our Blab about Care Workflow Platforms!

@wareFLO On Periscope!


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