RetroGuide
Encyclopedia
Workflow technology
Workflow technology is a new field of software products designed to improve the design of information systems. It involves use of workflow engine to execute models of processes....
in healthcare. In 2009, RetroGuide became a component in a larger project/system called HealthFlow
HealthFlow
HealthFlow is a name of a framework in clinical informatics focusing on healthcare workflow . The framework can represent retrospective search logic as well as prospective decision support logic .HealthFlow has been tested at Marshfield Clinic HealthFlow is a name of a framework in clinical...
This is an ongoing project. Several past phases could be described. Initial phase was at Intermountain Health Care in Utah
Utah
Utah is a state in the Western United States. It was the 45th state to join the Union, on January 4, 1896. Approximately 80% of Utah's 2,763,885 people live along the Wasatch Front, centering on Salt Lake City. This leaves vast expanses of the state nearly uninhabited, making the population the...
, USA and happened during 2004-2007. The main mode was retrospective use. The development continues at Marshfield Clinic
Marshfield Clinic
Marshfield Clinic is a health care system in northern, central and western Wisconsin, with 2 hospitals and 52 community care centers as of June, 2010. It was founded in 1916 by six local physicians: K.W. Doege, William Hipke, Victor Mason, Walter G. Sexton, H.H. Milbee, and Roy P...
(Marshfield Clinic Biomedical Informatics Research Center
Marshfield Clinic Biomedical Informatics Research Center
Marshfield Clinic Biomedical Informatics Research Center is a research center funded by Marshfield Clinic focusing on biomedical informatics research. It is located in Marshfield, Wisconsin, USA....
) during 2008-2010. The prospective version of the RetroGuide system has been developed (called FlowGuide) and the overal system which is using a workflow engine within an EHR system is called HealthFlow
HealthFlow
HealthFlow is a name of a framework in clinical informatics focusing on healthcare workflow . The framework can represent retrospective search logic as well as prospective decision support logic .HealthFlow has been tested at Marshfield Clinic HealthFlow is a name of a framework in clinical...
.
RetroGuide uses a flowchart paradigm to represent knowledge. Knowledge represented can be a prospective alert logic or retrospective EHR query question.
RetroGuide has been used on several clinical problems
- investigating blood pressure control in diabetics patients
- investigating pregnancy rate in female patients after treatment of Hodgkin lymphoma
- investigating HEDIS quality improvement measures from NCQA
- osteoporosis measure (OMW)
- cholesterol control in cardiovascular patients (CMC)
- investigating alternative glucose protocol logic for blood glucose control in ICU patients
- course of care for diabetes
- course of care for AMIMyocardial infarctionMyocardial infarction or acute myocardial infarction , commonly known as a heart attack, results from the interruption of blood supply to a part of the heart, causing heart cells to die...
- course of care for chronic kidney disease
- detecting adverse drug events (respiratory failure after use of narcotics, NaloxoneNaloxoneNaloxone is an opioid antagonist drug developed by Sankyo in the 1960s. Naloxone is a drug used to counter the effects of opiate overdose, for example heroin or morphine overdose. Naloxone is specifically used to counteract life-threatening depression of the central nervous system and respiratory...
)
Evaluation
RetroGuide graphical approach to model queries has been formally evaluated in a study involving 18 human subjects with limited database expertise . The study compared RetroGuide technology with SQLSQL
SQL is a programming language designed for managing data in relational database management systems ....
. Each subject had to solve 14 analytical tasks using both compared technologies. The qualitative comparison of average test scores showed that the study subjects achieved significantly higher scores using the RG technology.
Each subject also filled a follow-up questionnaire which compared both technologies qualitatively. The results of this qualitative study showed that 94% of subjects preferred RG to SQL because RetroGuide was easier to learn, it better supported temporal tasks, and it seemed to be a more logical modeling paradigm. The second part of the follow-up qualitative questionnaire also asked RG-specific questions based on validated constructs from the Unified Theory of Acceptance and Use of Technology
Unified Theory of Acceptance and Use of Technology
-Background:Unified theory of acceptance and use of technology is a technology acceptance model formulated by Venkatesh and others in "User acceptance of information technology: Toward a unified view". The UTAUT aims to explain user intentions to use an information system and subsequent usage...
. The results of this second part suggested that a fully developed, RetroGuide-like technology would be well accepted by users.
Scientific Articles
- Huser V, Rocha RA, James BC, "Use of Workflow Technology Tools to Analyze Medical Data," pp. 455-460, 19th IEEE Symposium on Computer-Based Medical Systems (CBMS'06), 2006. article (doi)
- Huser V, "Running Decision Support Logic Retrospectively to Determine Guideline Adherence: a Case Study With Diabetes," Spring AMIA2007 symposium poster conference
- Huser V, Rocha, RA, "Analyzing medical data from multi-hospital healthcare information system using graphical flowchart models," BMIC Symposium, Orlando, 2007 (accepted).
- Huser V, Rocha RA, Huser M, "Conducting Time Series Analyses on Large Data Sets: a Case Study With Lymphoma," MedinfoMedinfoMEDINFO is the name of the international medical informatics conference organized every 3 years by the International Medical Informatics Association. It is the most important international conference in the field with 3000+ health and medical informatics professions attending from all over the world...
2007, Brisbane, 2007.
- Huser V, Rocha RA, "Retrospective Analysis of the Electronic Health Record of Patients Enrolled in a Computerized Glucose Management Protocol," CBMS 2007 DOI link
- Huser V, Rocha RA, "Graphical Modeling of HEDIS Quality Measures and Prototyping of Related Decision Support Rules to Accelerate Improvement", AMIAAmiaAmia, AMIA, or AMiA can refer to:*American Medical Informatics Association*Bowfin, a fish genus*Anglican Mission in the Americas*Asociación Mutual Israelita Argentina, a Jewish community center located in Buenos Aires, Argentina...
Fall Symposium, 2007, Chicago, USA poster
- Huser V, Rocha RA, "Graphical Modeling of HEDIS Quality Measures and Prototyping of Related Decision Support Rules to Accelerate Improvement", AMIAAmiaAmia, AMIA, or AMiA can refer to:*American Medical Informatics Association*Bowfin, a fish genus*Anglican Mission in the Americas*Asociación Mutual Israelita Argentina, a Jewish community center located in Buenos Aires, Argentina...
Fall Symposium, 2007, Chicago, USA poster
- Huser V, Peissig PL, Christensen CA, Starren JB. Evaluation of commercial workflow engine for modeling clinical processes in quality improvement and decision support. Proc of 15th Annual HMO Research Network Conference 2009.
- Huser V, Rocha RA, Narus SP. Evaluation of a flowchart-based EHR query system: a case study of RetroGuide. J Biomed Inform 2009;ePub ahead of print PubMed DOI link
- Huser V, Rasmussen L, Starren JB. Representing clinical processes in XML process definition language (XPDL). AMIA Spring Symp 2009.
- Huser V, Starren JB. EHR Data Pre-processing Facilitating Process Mining: an Application to Chronic Kidney Disease. AMIA Annu Symp Proc 2009 (accepted) 2009.
External links
- http://workflow.minfor.net
- http://minfor.wikispaces.com/RetroGuide
- http://retroguide.blip.tv
- RetroGuide on SourceForge (RetroGuide Express)
- http://healthcareworkflow.wordpress.com