Alerts for Healthcare Process and Data Integration Dickson K.W. Chiu, Benny Kwok, Ray Wong Dept. of Computer Science & Engineering, Chinese University of Hong Kong kwchiu@acm.org, {bennykok2000, digitalray}@yahoo.com S.C. Cheung Dept. of Computer Science, Hong Kong University of Science & Technology scc@cs.ust.hk Eleanna Kafeza Department of Marketing and Communications, Athens University of Economics and Business kafeza@aueb.gr Marina Kafeza Pepagni University Hospital of Iraklion and Medical School, University of Iraklion, Crete, Greece mkafeza@yahoo.com Alerts for Healthcare

Introduction Process integration and data integration are required among health service providers in healthcare chain workflow management Practitioners, administrators, and patients are also involved Large number of messages require timely communication Alerts - urgent requests and critical messages Alert Management System (AMS) Routing, monitoring, and logging the alerts Find suitable service - application specific considerations like costs, waiting time, service time Alerts for Healthcare

Case Study – Medical House-call System Both human and computerized systems involved Different degree of computerization Web Services supports both type of interaction in a single framework Alerts for Healthcare

Overall Approach Objective: robust, efficient, cost effective, simple, and user friendly AMS to improve the communications detailed requirements were elicited and formulated into an alert conceptual model sketched an overall system architecture worked out the detailed mechanisms for each components of the system alert management policies could be adapted to handle various situations Prototyping with phases: establish a computerized call center to manage all the alerts, replacing the current manual system extend the system to connect to medical partners to form a service grid include further intelligence into the system, e.g., advanced capability reasoning, scheduling with mobile location dependent information, service negotiation, integration with traffic routing Alerts for Healthcare

Role of Alerts in Healthcare IS Healthcare Information Systems and Workflows Event / Exception Handling Data/Process Requirements Alerts Managed by AMS Web Services and Mobile Devices What are Alerts? Different from general events, alerts have more specific attributes, e.g., urgency and service requirements. Different from exceptions, they need not relate to abnormal behaviors. asynchronously received by external events / exceptions, incoming E-service requests synchronously generated by internal E-service application. handled by the AMS by requesting services: internal information systems human service provider external E-service providers Alerts for Healthcare

Alert Conceptual Model Alerts for Healthcare

System Architecture Alerts for Healthcare

Alert Life Cycle Alerts for Healthcare

Sample alert acknowledgement user interface Alerts for Healthcare

Alert Urgency Strategy Definition Defining the policies according to which the urgencies of the alert will evolve Example Urgency002 Action Urgent default Very Urgent Submit a second alert to the same service provider, notifying about the approaching deadline Critical Redirect the alert to another SP that has the best response time Very Critical Send the alert to several SPs and accept the results of the one that response first, notify an administrator Alerts for Healthcare

Service Provider Matchmaking Algorithm searches for those service providers that can play the role required for the alert Selects those that have a response time that is less than the deadline If the matching is successful, one service provider is selected according to a user-supplied cost function In case no matching is available, the algorithm upgrades the alert by expanding the roles whenever possible Alerts for Healthcare

Workflow of the Call Center Alerts for Healthcare

Example Workflow for Data Integration Alerts for Healthcare

Evaluation by Medical Professionals AMS Advantages Make sure that an alert can reach the person who has to be notified The inclusion of multiple mobile devices and platforms helps both the medical professions and the patients The implementation of an urgency policy that uses concurrently multiple devices to communicate the alert can increase the probability to inform the person on time An automated alert can make sure that the information is passed accurately and completely Capability to choose the kind of received information, reception devices, and desired time slots Infrastructure Benefits Total solution healthcare chain workflow integration Save much paper work and administration guides call center operators to choose the right medical professionals to minimize possible specialty mismatch Alerts for Healthcare

Conclusions A conceptual model for specifying alerts based on the requirements of medical processes and a set of routing parameters A practical architecture for the AMS based on contemporary Web Services – supports human and programmatic interfaces An algorithm for matching service providers to alert requirements A mechanism for (re-)routing alerts and increasing their urgency when alerts are not acknowledged or processed within deadline. Applicability for a medical house-call system with prototyping and medical professional’s evaluation Flexible and reusable AMS can be plug into other systems Alerts for Healthcare

Future Work Healthcare process and data integration Interfacing and platform-specific issues Location dependent applications Workforce management Mobile CRM Inter-relations among alerts. Failure of commitments and their relation to contract enforcement Impact of cancellations, other possible exceptions Tradeoff between quality/response time and cost, and service negotiation Alerts for Healthcare

Q&A Thank you! Alerts for Healthcare

Advantage of an AMS The urgency requirements, associated interactions with service providers, and the monitoring required by the administrators can be systematically and modularly captured into an AMS, instead of scattering around in the main workflow specification. The logic for sending, routing, and monitoring these alerts is supported in the AMS and can be heavily reused. AMS evolves from the exception handling and user-interface mechanisms of our ME-ADOME WFMS, by factoring out and extending, in particular, urgency requirements. Physical execution of individual tasks of regular processes is outside the scope of the AMS and is in capture in the application logic of individual information systems which can be a WFMS as well An AMS is light-weight and highly coherent, but loosely coupled with other sub-systems, enabling it to be plugged into any information system that needs such services Alerts for Healthcare