Healthcare BPM

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[I've stopped updating this page in favor of almost daily updates of the EHR.BZ Report on Workflow, Usability, (Patient) Safety and Productivity. Over a thousand links so far, with hundreds specifically about BPM in healthcare.]

I am reserving this page for links that address both EHR (or HIT in general) and WfMS/BPM topics:

(Newest material appended to the end of this page…), gratuitous, I know.)

Which EMRs Offer Workflow Management Systems? 

We Need Workflow-Driven Systems, Not Just the Buzzword


I created a flash presentation based on my TEPR (2004-2006) tutorials:


Jeff Cooper, MD, HIMSS Davies Award Winner (uses an EHR WfMS)
2003 HIMSS Presentation


Healthcare Workflow(Vojtech Huser, MD, PhD)

Proceedings of the 1st International Workshop on Process-oriented Information Systems in Healthcare (ProHealth’07), Workshop held in conjunction with the 5th Int’l Conf. on Business Process Management (BPM’07)

Pre-Proceedings of the 2nd International Workshop on Process-oriented Information Systems in Healthcare (ProHealth’08) - Workshop held in conunction with BPM’08 conference.

Workflow management systems: the healthcare technology of the future? A. Dwivedi, R.K. Bali, A.E. James, R.N.G. Naguib, 23rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society, October 25-28, 2001, held in Istanbul, Turkey.

 The Impact of Workflow Management Systems on the Design of Hospital Information Systems, S. Graeber, Proc AMIA Annu Fall Symp. 1997; 856.

General Workflow Management Systems/Business Process Management Systems Links:

If you have a background in electronic health records and are interested in learning more about workflow management systems you may find some of the following links useful:

(Not much here yet, hope you’ll check back later when there’s more.)

Workflow Management Coalition

Process Mining

Workflow Management: Models, Methods, and Systems, by Wil van der Aalst and Kees van Hee


Electronic Health Record Links:


Random Bits and Pieces

Interesting comment about EMRs, workflow management, and business process management at The Blog That Ate Manhattan:

(Warning: Generous use of ellipses!)

“Most existing EMR systems are a combination of data collection and storage (the facts) and the workflows associated with these facts (e.g the follow-ups, ticklers etc.). The facts can be standardized but the workflows will vary from practice to practice and physician to physician….Most existing EMRs handle workflows as if every physician/practice were identical….There is a whole separate class of software products with names like workflow management or business process management which are focused on how facts flow between people and what happens when flows are interrupted (e.g. ticklers & follow-ups)….Once you’ve seen a general workflow system in action you never want to go back…”

 (Four ellipses (”….”) separate different portions of the same passage while three ellipses (”…”) separate different portions of the same sentence, per Wiki.)


Toward Careflow Management Systems

Keith Miller and Wendy MacCaull
Centre for Logic and Information
St. Francis Xavier University

Presented at

E-health: Towards System Interoperability through Process Integration and Performance Management
A Workshop as part of MCETCH 2009
Ottawa, Ontario, Canada, May 4-6, 2009


Interesting discussion about the active nature of workflow management systems versus the passive nature of EHRs.

See also:

Table 2.1: Comparing Clinical Guidelines, Care Plans and Work
ow Systems


Workflow Modelling of Coordinated Inter-Health-Provider Care Plans
School of Computer and Information Science

Ph.D. Thesis
Eric Donald Browne


Bioinformatics Workflow Management Systems


Changing the Way Business Is Done

CSI “created a system that uses artificial intelligence and business process management (BPM) software (which is new to health care but has been used in other sectors for years) to remove large doses of that subjectivity, thus reducing errors, enhancing revenues, and ultimately allowing physicians to focus on health care, not revenues and billing….Those at CSI worked to essentially plug BPM into EMR in an effort to cut down on errors involving both under- and overpayment of claims that result from simple human error.”


Clinical Pathways and the Computer Information System

Computer-Based Physician Order Entry:
Implementation of Clinical Pathways
Mathias TSCHOPP 1, Magali DESPOND, Damien GRAUSER,
Jean-Christophe STAUB, Christian LOVIS
Service of Medical Informatics,
Unit of Clinical Informatics, Geneva University Hospital, Switzerland

“The architecture of the clinical information system used in the Geneva University Hospitals is particularly well suited to painless implementation of clinical pathways. Built on multiple service-based components, communicating through a message-driven middleware, the CIS functionalities can be thought of as musicians ready to play a musical score: the clinical pathway. This musical ensemble needs a conductor, a workflow engine, which will organize and direct all the components of the clinical information system (orders, lab results, clinical documentation) in a coherent way inside a process of care, from admission to discharge. For the workflow engine, we turned to JBoss jBPM. BPM (business process management) offers a programmatic structure for designing transactions and executing those using automated decisions, tasks and sequence flows. jBPM is free software, written in Java, which made it the ideal solution to be integrated into our modular Java-based computer information system. In addition to the workflow engine, it offers simple programmatic interfaces and allows graphical representation of the different milestones of a process [7].” [CW: my emphasis]


BPM-enabled solutions for collaboration between Sponsor and Contract Research Organizations

“A BPM approach for the planning and execution of clinical trials and collaboration between the parties is needed to gain visibility, agility, and efficiency throughout the clinical development phases.”


Business Process Management (BPM) and Healthcare

“Improve efficiency by optimizing the flow of your back-office and clinical documents. Business process management (BPM) integrates with EMR/EHR systems, allowing you to automate processes for improved services to patients and staff.”


BPM, the “Glue” Connecting Disparate Systems

“Although EMR applications are vital for HIT, you need the “glue” that connects all of your healthcare systems. If a patient’s information only has to be entered one time, you significantly reduce your chances of entering incorrect information and increase the level of quality care you can provide to each patient.

This is where Business Process Management (BPM) becomes an important resource. BPM is the “glue” that connects systems allowing for seamless integration and communication….a technology platform that integrates systems, organizes data across those systems, and optimizes EMRs to ensure they work together efficiently. These needs are exactly in line with a quality Business Process Management Suite (BPMS). Where BPM can add value to the EMR is:

  • Analyze and improve critical patient safety processes
  • Coordination of information across systems
  • Integration of information across Healthcare Providers
  • Simple to use, web based, use from anywhere
  • Instant feedback and approval  within processes
  • Assists in maintaining compliance”


Pallas Athena to implement enterprise-wide BPM|one solution at Yeshiva University, Albert Einstein College of Medicine

“Pallas Athena, a global leader of BPM technology, announced today that it will implement its award winning Business Process Management suite BPM|one at Albert Einstein College of Medicine of Yeshiva University, in New York.”


Benenden Healthcare Society Deploys Appian BPM Suite

Does not appear to be clinical application, however there is a “”innovative graphical front-end dubbed ‘Where Does it Hurt?’ Society staff view a clickable human figure and drill down to pinpoint the source of a member’s ailment”, which is somewhat reminiscent of a screen sometimes used in an EMR/EHR.


BPM in Healthcare

“Built-in rules embedded in BPM engine provide alerts and reminders if a drug is recommended that has potential negative interactions within the prescribed cure process. Similarly, time-bound actions, if not completed on time, could be raised as alarms. Process stakeholder (usually a senior doctor) can immediately determine the bottlenecks hindering the process, and accordingly remodel and redistribute work so as not to impact the overall procedural effectiveness. This is required because important resources like doctors could be allocated to more than one process. In addition, processes users can provide their comments for particular stage of treatment. Since everyone can view changes immediately, the information is immediately communicated in an unambiguous manner to everyone. Detailed analytics enable process stakeholders to evolve a more efficient and effective process in future…The power of BPM lies in its ability to be used effectively by hospital staff having no knowledge of coding. Process designing is as simple as dragging and dropping elements on the screen. Also, no customization of code for re-designed processes is required. Simulation provides process owners flexibility to analyse the real-life situation beforehand.” [CW: my emphasis]


BPM for Healthcare from Pegasystems


Pegasystems’ Healthcare Solution Frameworks provide foundational elements for developing industry-specific applications work types, data structures, business processes, user interfaces, decision tables and more. Built on Pegasystems’ industry-leading BPM platform, frameworks leverage powerful process and rule management capabilities and apply them to specific business areas, enabling organizations to build BPM applications that best capitalize on the strengths, extensibility, and agility of Build for Change technology.


Workflow Opportunities and Challenges in Healthcare


Workflow technology has expanded substantially into the healthcare industry over the last year. Hospitals are embracing this technology as a means to improve operational efficiency, achieve patient safety goals, and positively influence the quality of care. This paper will explore the opportunities Business Process Management (BPM) and workflow technology have to make a profound impact on patient care while examining the challenges that are present in the healthcare arena.


Introduction to Workflow Technology: Representation of Healthcare Processes in a Workflow Editor and their Execution in a Workflow Engine

AMIA Now! 2010

V. Huser, Marshfield Clinic/University of Wisconsin-Madison

This workshop will provide an introduction to workflow technology, also known as Business Process Management (BPM). In the first part, the workshop will provide historical overview, evolution and introduction into Workflow Management Systems and introduce the benefits of formal representation of processes. The second part will provide overview of the current process representation standards and in detail describe the XPDL standard (XML process definition language) from Workflow Management Coalition. Finally, in the third part, the participants will be able to see (and follow) a hands-on demonstration of use of an open source workflow editor, engine, workflow mining tool and view and modify examples of healthcare process definitions. Relationship of decision support engines to workflow engines will also be discussed.


Feel free to suggest a link.