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Posts Tagged ‘BPMN’

The Plans View

There are times that every clinical or administrative staff member will need to search for a plan that was completed in the past for various reasons. In typical oncology information systems this can be challenging, especially if the plan was cancelled or put on hold. To assist in this search and provide much needed information, RO Dynamics has the Plans View of our Whiteboard Module.

When initially opening the Plans View, it looks very similar to the other views of the Whiteboard Module. This view operates differently than the other views. Instead of displaying plans in progress, or automatically loading all plans, which would take a longer time as more and more plans are added into the RO Dynamics system, the Plans View providers filters to search for just the type of plans you are looking for.

The standard filters from other views are available such as plan phase, technique, treatment site, machine, treatment organization, date ranges, and plan care team members. In addition to the standard filters, there is also a status filter that is specific to the plans view that allows you to select the status of the plan such as if it was completed, on hold, cancelled before complete or cancelled after complete. Current Oncology Information Systems can make this information tough to quickly find and might involve some detective work to see what happened or even find the plan if you don’t know the patients name.

When combined with the Plan Details and the Course Details Views, sorting through any plan still in progress or from the past is very simple. You have access to all the standard plan and care team information along with plan status and history of the plan to help take the detective work out of the equation.

The Plans View of the Whiteboard Module
Hannah Shappell

Hannah Shappell is an ARRT certified radiation therapist with years of clinical experience who graduated with a Bachelor of Science in radiation therapy from Texas State University. She now currently resides in beautiful Central Oregon where you will typically find her outside trying to keep up with her sons, crazy dog, and husband.

The Power of Tags Part 1: Patient Tags

There is certain key patient information that will always been necessary when treating any patient. These are the answers to the questions that every patient must answer almost as soon as they walk through the door of any medical facility and will be most likely asked repeatedly. Instead of having to copy notes over to each course, simulation, or plan; RO Dynamics has created patient specific tags.

These are a group of tags that apply to a patient and all plans associated with that plan. Patient tags can be customized based on the needs of your department. RO Dynamics comes with two standard patient tags that include: Previous Radiation and Pacemaker. For each of these tags and all custom additional tags within RO Dynamics, tasks and workflows are able to be started once a tag has been selected and saved to a patient.

For example, the pacemaker tag triggers a workflow that is based off the latest standard in the AAPM TG-203 guidelines released in 2019. By adding the pacemaker tag at any point during the treatment planning process, a workflow will be triggered which will then send out tasks to the responsible parties. Not only does this guarantee that this does not get missed but also that you are following the latest standards that have been set forth.

The location of the patient tags makes it easy to always see. Whenever you simply click on the patient, task, plan, or simulation you can see it in the plan details view or when you double click and open the patient dialog. In other systems, while this information may be listed it is not always readily shown or has to be copied down in multiple locations which allows human error to easily take the front seat.

Patient Tags in the Plan Details view
Patient Tags in the Patient Dialog

Through the use of our advanced workflow engine, tags are no longer simple labels, they are able to automatically trigger emails, tasks and workflows that pull together all needed staff roles to streamline your patient care approach. Patient tags are yet another way that you are able to customize RO Dynamics to the needs of your department as well as simplify the incorporation of new standards in patient care.

Hannah Shappell

Hannah Shappell is an ARRT certified radiation therapist with years of clinical experience who graduated with a Bachelor of Science in radiation therapy from Texas State University. She now currently resides in beautiful Central Oregon where you will typically find her outside trying to keep up with her sons, crazy dog, and husband.

Shareable Clinical Pathways Tutorial Part 1 – Basic BPMN Events, Tasks, and Gateways

We will first begin with modeling shareable clinical pathways using the Business Process Model and Notation (BPMN) standard. If you want to follow along, please see the introductory post to this series for links to free modeling tools you can immediately use.

In this tutorial we will model a basic radiation therapy consult workflow from the perspective of the radiation oncologist. The final end result of the workflow is shown beneath.

Basic Radiation Therapy Consult Workflow in BPMN

To create the workflow yourself follow the tutorial using a BPMN modeling tool such as at bpmn.io. If you need help, watch the video beneath where we show the entire model creation.

Please note that in BPMN the term “process” is used, rather than workflow. We may use the terms interchangeably throughout this series, but in the BPMN terminology we use processes to implement the workflows.

One of the great aspects of BPMN is it makes workflows transparent, and easily understandable by even those without training in BPMN. If you have no experience in BPMN, you can probably understand the workflow in the diagram. Even better, is the workflow isn’t hard-coded and embedded in software code that is not available to the user, and would be difficult to understand even if it were available.

In this process we have a single lane denoting the radiation oncologist as the participant. We could have other participants with their own lanes, such as the patient, and other clinical staff such as nurses. For now we will stick with one participant.

Step 1: Create a lane and name it “Radiation Oncologist”.

This process starts with a New Patient Consult Started event. In BPMN events are depicted by a circle. In this case we have a start event, denoting the start of the process. In a process being executed by software, the start event could be triggered manually through a user interface, or automatically when a patient checks in for their consult. Once started, the workflow executes.

Step 2: In the lane create a start event and label it “New Patient Consult Started”.

Once the process starts the first step is a consult between the radiation oncologist and the patient. This is modeled as a user task in BPMN. Tasks of various kinds all have a rounded rectangle. The person icon indicates this is a user task, to be performed by a person. The process waits until this task is complete before proceeding. In software this could be completed manually from a task list, or it could be completed automatically when the patient checks out from the consult. These are implementation details beyond the current scope.

Step 3: Create a new user task, and label it “Consult with Patient”. Make sure the start event is connected to this task.

Once the consult task is complete, the radiation oncologist must determine if radiation therapy is indicated. In the present example we will assume that if radiation therapy is indicated the patient also decides to undergo radiation therapy. In a more realistic model we would also handle the decision from the patient. The decision if radiation therapy is indicated would be selected by the radiation oncologist in a user interface as a simple Yes/No choice.

Step 4: Create a new user task and label it “Determine if Radiation Therapy Indicated”. Make sure the consult task is connected to this new task.

Once the decision is made regarding if radiation therapy is indicated, there are two different flows. BPMN uses gateways with a diamond shape to direct flows within a process. Decisions are not made in gateways, but must happen before the gateway. In this example an exclusive gateway, also know as XOR is used, which only allows one path to be executed out of the gateway.

Step 5: Create a new XOR gateway, and connect the previous task to it. Set the label for the gateway to “Radiation Therapy Indicated?”.

In the current example if radiation therapy is not indicated, we end the consult and for the sake of this example, assume there is nothing further to do in this workflow. If radiation therapy is indicated, a Start Radiation Therapy event will be generated, using a BPMN signal event depicted by two circles with a solid triangle in the middle. Signal events broadcast to other processes to react to. In this case a separate process could be triggered from this signal to start a new radiation course workflow automatically. Finally, once the signal is generated, the process ends with an end event.

Step 6: Create an end event beneath the gateway and label it “Patient Consult Ended”. Connect the gateway to the event, and mark the flow as the default. Finally, label the flow “No”.

Step 7: Create a signal event to the right of the gateway and label it “Start Radiation Therapy Course”. Finally, create an end event and label it “Patient Consult Ended”.

Your workflow should now look like our diagram, and you have created a basic clinical workflow. To make it executable, one would normally add a few more details, such as the candidate group for the task (radiation oncologist), as well as create the implementation details for the start new radiation course signal.

In this tutorial you have been introduced to the following BPMN symbols: lanes, start/signal/end events, user tasks, and XOR gateways. To learn more, follow our blog and we also encourage you to sign up for our mailing list.

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Gabe Colburn

Gabe strives to create innovative solutions to solve real-world problems effectively. Currently he’s focused on improving Radiation Oncology and healthcare workflow and interoperability, with previous experience in the defense industry, quantum computing, and healthcare. He holds a B.S. in Engineering Physics from Colorado School of Mines and an M.S. in Medical Physics from Oregon Health & Science University. He is also certified by the American Board of Radiology in Therapeutic Medical Physics. He resides in Bend, OR where he enjoys the beautiful outdoors hiking, climbing, and camping with his wife and kids.

The Power of Tags Part 2: Patient Tags

In our previous blog, we discussed patient tags, which should only convey information specific to a patient regardless of plan information. Plan tags are just the opposite and complete the collection of tags in RO Dynamics. Plan tags should only convey information for a specific plan. While they can be manually duplicated or copied over if you are creating a secondary plan or boost off an existing plan, they will not do that automatically since the new plan may need different tags.

Plan tags have endless applications and possibilities. They can be used for things such as treatment devices, imaging modalities, techniques, and anything else that your oncology system may need. These tags make it easy to track and gain analytics on different aspects of the plan and devices used. The analytics pulled from the plan tags has the power to help departments really concentrate or validate the need for equipment or training.

Much like the patient tags, these are quickly and easily viewable using either the plan details view or by opening the patient dialog. Each tag and tag group are able to be customized within the Administration Module and can be color-coded to your needs. Between the plan tags and the patient tags, staff members are quickly able to see the “highlights” of a patient and their treatment plan depending on how your oncology system chooses to utilize this tool. The wonderful thing about tags is that it is fully up to the user on how they are utilized. There is no right or wrong way to utilize the tags. At Quantek Systems, our only goal is to help you to improve your processes so that you are better able to focus on the needs of the patient and their treatment.

Hannah Shappell

Hannah Shappell is an ARRT certified radiation therapist with years of clinical experience who graduated with a Bachelor of Science in radiation therapy from Texas State University. She now currently resides in beautiful Central Oregon where you will typically find her outside trying to keep up with her sons, crazy dog, and husband.

The Need for Shareable Clinical Pathways

In the paper beneath, we present the need for shareable clinical pathways in healthcare. If you want to get involved, contact us and also join our mailing list!

The-Need-for-Shareable-Clinical-Pathways

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Gabe Colburn

Gabe strives to create innovative solutions to solve real-world problems effectively. Currently he’s focused on improving Radiation Oncology and healthcare workflow and interoperability, with previous experience in the defense industry, quantum computing, and healthcare. He holds a B.S. in Engineering Physics from Colorado School of Mines and an M.S. in Medical Physics from Oregon Health & Science University. He is also certified by the American Board of Radiology in Therapeutic Medical Physics. He resides in Bend, OR where he enjoys the beautiful outdoors hiking, climbing, and camping with his wife and kids.

Tutorials for Creating Shareable Clinical Pathways in Healthcare

Before starting our tutorials on creating shareable clinical pathways, hopefully you have already read our post on A Vision for the Future of Workflow in Healthcare. If not, you should check it out to set the context of the standards we will use in these tutorials such as Business Process Model and Notation, Decision Model and Notation, Case Management Model and Notation, and Fast Healthcare Interoperability Resources to create shareable clinical pathways. The models in these tutorials may be deployed and executed in our RO Dynamics platform, or in other commercial or opensource BPM tools. For more information visit our product page at https://quanteksystems.com.

In this series we will work with examples in the context of Radiation Oncology, which uses radiation to treat cancer. The goal is to help those involved in healthcare to understand how to read and create basic workflows using BPMN. Knowledge of radiation oncology is not required, but will make the workflows more interesting. We will start with simple workflows, and over time get more elaborate to handle the nuances of real-world workflows.

Often the best way to learn something new is by doing it. Perhaps the easiest way to get started is using the free web-based modeler at http://bpmn.io. To create a new BPMN model you may use this link: https://demo.bpmn.io/new. Alternately, you may download a free modeler such as the Camunda Modeler.

Let’s now dive in to creating shareable clinical pathways. As more tutorials are added, they will be accessible beneath for easy navigation.

Part 1 – Basic BPMN Events, Tasks, and Gateways

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We will never send you spam and you can unsubscribe anytime.
Gabe Colburn

Gabe strives to create innovative solutions to solve real-world problems effectively. Currently he’s focused on improving Radiation Oncology and healthcare workflow and interoperability, with previous experience in the defense industry, quantum computing, and healthcare. He holds a B.S. in Engineering Physics from Colorado School of Mines and an M.S. in Medical Physics from Oregon Health & Science University. He is also certified by the American Board of Radiology in Therapeutic Medical Physics. He resides in Bend, OR where he enjoys the beautiful outdoors hiking, climbing, and camping with his wife and kids.