Marjan Askari1, Richard Westerhof2, Saied Eslami3, Stephanie Medlock3, Sophia E de Rooij4, Ameen Abu-Hanna3. 1. Department of Medical Informatics, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: m.askari@amc.uva.nl. 2. Dutch College of General Practitioners, The Netherlands. 3. Department of Medical Informatics, Academic Medical Center, Amsterdam, The Netherlands. 4. Department of Internal and Geriatric Medicine, Academic Medical Center, Amsterdam, The Netherlands.
Abstract
OBJECTIVES: To propose a combined disease management and process modeling approach for evaluating and improving care processes, and demonstrate its usability and usefulness in a real-world fall management case study. METHODS: We identified essential disease management related concepts and mapped them into explicit questions meant to expose areas for improvement in the respective care processes. We applied the disease management oriented questions to a process model of a comprehensive real world fall prevention and treatment program covering primary and secondary care. We relied on interviews and observations to complete the process models, which were captured in UML activity diagrams. A preliminary evaluation of the usability of our approach by gauging the experience of the modeler and an external validator was conducted, and the usefulness of the method was evaluated by gathering feedback from stakeholders at an invitational conference of 75 attendees. RESULTS: The process model of the fall management program was organized around the clinical tasks of case finding, risk profiling, decision making, coordination and interventions. Applying the disease management questions to the process models exposed weaknesses in the process including: absence of program ownership, under-detection of falls in primary care, and lack of efficient communication among stakeholders due to missing awareness about other stakeholders' workflow. The modelers experienced the approach as usable and the attendees of the invitational conference found the analysis results to be valid. CONCLUSIONS: The proposed disease management view of process modeling was usable and useful for systematically identifying areas of improvement in a fall management program. Although specifically applied to fall management, we believe our case study is characteristic of various disease management settings, suggesting the wider applicability of the approach.
OBJECTIVES: To propose a combined disease management and process modeling approach for evaluating and improving care processes, and demonstrate its usability and usefulness in a real-world fall management case study. METHODS: We identified essential disease management related concepts and mapped them into explicit questions meant to expose areas for improvement in the respective care processes. We applied the disease management oriented questions to a process model of a comprehensive real world fall prevention and treatment program covering primary and secondary care. We relied on interviews and observations to complete the process models, which were captured in UML activity diagrams. A preliminary evaluation of the usability of our approach by gauging the experience of the modeler and an external validator was conducted, and the usefulness of the method was evaluated by gathering feedback from stakeholders at an invitational conference of 75 attendees. RESULTS: The process model of the fall management program was organized around the clinical tasks of case finding, risk profiling, decision making, coordination and interventions. Applying the disease management questions to the process models exposed weaknesses in the process including: absence of program ownership, under-detection of falls in primary care, and lack of efficient communication among stakeholders due to missing awareness about other stakeholders' workflow. The modelers experienced the approach as usable and the attendees of the invitational conference found the analysis results to be valid. CONCLUSIONS: The proposed disease management view of process modeling was usable and useful for systematically identifying areas of improvement in a fall management program. Although specifically applied to fall management, we believe our case study is characteristic of various disease management settings, suggesting the wider applicability of the approach.
Authors: Elizabeth M Cutting; Casey L Overby; Meghan Banchero; Toni Pollin; Mark Kelemen; Alan R Shuldiner; Amber L Beitelshees Journal: AMIA Annu Symp Proc Date: 2015-11-05
Authors: M Askari; S Eslami; M van Rijn; S Medlock; E P Moll van Charante; N van der Velde; S E de Rooij; A Abu-Hanna Journal: Osteoporos Int Date: 2015-07-21 Impact factor: 4.507