A PDA based system with exception handling scheme for outpatient workflow

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NO FULL TEXT AVAILABLE. Access is restricted indefinitely. ----- Hospitals around the world are taking advantage of wireless LAN-based computing technologies in view of their mobility, flexibility, and speed to improve the quality and reduce the cost of patient care. The adoption of mobile technology in healthcare opened new horizons in various existing applications of healthcare. Handheld computers have evolved into a viable platform for these organizations to access and manage the patients' information wirelessly from any point of care. In general, mobile health can be defined as "providing the right information to the right health care provider about the right patient at the right time and at the right place". The potential benefits of mobile health includes rapid access to patient information, automated data transfer to and from medical instruments, messaging, notification, telemetry, asset location and tracking within hospital wards. The true value of the mobile health strategy is enabling healthcare professionals to make better quality decisions and to provide on-demand access to clinical information. Mobile health systems are able to challenge the unique requirements of clinical information, but none of these systems are able to address the complexity and integration of workflows in different wards. Documents are lost, instructions are unclear, data is incomplete and information has to be retrieved explicitly. However, among these limitations, our research focuses on three crucial factors that hinder the deployment of handheld technology in healthcare. The first factor is the lack of efficient communication between the client and server applications due to thick client system architecture. The second factor which hinders these mobile health systems is inefficient management and automation of workflows in the wards. That is, these mobile health systems do not provide the information automatically on the basis of workflow of the patient and daily routines of the health care professionals. The professionals have to design the workflow process manually and retrieve the information explicitly. The third crucial factor that hinders these mobile systems is lack of support for exception handling relative to current workflow management systems. On addressing the first problem, we designed a PDA based health system with thin client architecture. The architecture is flexible because it by supports both implicit and explicit access to the clinical information. The system focuses on exchanging information with existing legacy systems, updating data in real time, and making information available to healthcare professionals by organizing daily routines in the ward. On addressing the second problem, we integrated the intelligent work flow agent with the designed system architecture to manage the workflows efficiently. The workflow agent monitors the workflow instance, and keeps track of the instance. It also coordinates the workflow execution of the instance in such a way that all the constraints such as interactivity dependencies are enforced as specified. The workflow agent alerts the appropriate professional with the task to be performed, and sends the remainder to the healthcare professionals for ensuring processes completion. It also assigns and schedules tasks for healthcare professionals in their daily routine duties. The system is not intended to replace the workflows in the hospital but to facilitate the health care professionals to receive useful and relevant information on time with greater flexibility than before. Finally, on addressing the third problem, we propose a novel exception handling architecture and a scheme for handling the exceptions. The proposed scheme scans through earlier exception records from a dynamic knowledge base, evaluates and suggests an appropriate solution for the current exception on the mobile handheld device. We also described the attributes of exceptions, the degree of similarity between two exceptions. The scheme is evaluated in terms of time and accuracy compared with previously known schemes. The improved accuracy and reduced execution time of our approach is demonstrated on the system prototype.
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