Int J Med Inform - A combined disease management and process modeling approach for assessing and improving care processes: a fall management case-study.

Tópicos

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Resumo

JECTIVES: 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.

Resumo Limpo

jectiv propos combin diseas manag process model approach evalu improv care process demonstr usabl use realworld fall manag case studymethod identifi essenti diseas manag relat concept map explicit question meant expos area improv respect care process appli diseas manag orient question process model comprehens real world fall prevent treatment program cover primari secondari care reli interview observ complet process model captur uml activ diagram preliminari evalu usabl approach gaug experi model extern valid conduct use method evalu gather feedback stakehold invit confer attendeesresult process model fall manag program organ around clinic task case find risk profil decis make coordin intervent appli diseas manag question process model expos weak process includ absenc program ownership underdetect fall primari care lack effici communic among stakehold due miss awar stakehold workflow model experienc approach usabl attende invit confer found analysi result validconclus propos diseas manag view process model usabl use systemat identifi area improv fall manag program although specif appli fall manag believ case studi characterist various diseas manag set suggest wider applic approach

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