In order to maintain consistency in terminology and concepts, the following clinical workflow definitions will be used on Clinical Workflow Center.

Clinical Work - Actions performed by clinicians to assess, change, or maintain the health of a patient.


Clinical Workflow - The directed series of steps comprising a clinical process that 1) are performed by people or equipment/computers and 2) consume, transform, and/or produce information. (Note that patient outcomes count as information.)
 
Clinical Process - Clinical work undertaken by one or more clinical professionals that has a specific start point, endpoint, and an expected clinical outcome.   
 
Clinical Process List - There are no formal definitions of specific clinical processes that are used and accepted by all researchers or software developers.  This list is offered as a starting point for discussion.  Future aricles and posts on CWC will use the defintions provided here. 
 
Order and Results Management – tracking of any test from initial order until final disposition
    • Notifications
      • Test not done
      • Results
      • Patient
      • Abnormal
    • Tracking
      • Not Done
      • Abnormal Follow – up
    • Review
      • To Do
      • Flag

Referral Management – tracking and notification for all referrals to other clinicians (similar to above)

Patient Visit – support for activities that occur within a visit

    • Information gathering
      • History & Patient Concerns
      • Vitals
      • Exam
    • Patient Education
    • Care Plan
      • Medications
      • Labs
      • Referrals
      • Education


Patient Engagement/Communication – interactions with patients outside of standard visits

    • Notifications
    • Feedback
      • Direct
      • Medical Device
      • Application (mobile/web)
    • Patient-initiated queries
    • Care Plan
      • Medications
      • Labs
      • Referrals
      • Education

Care Coordination/Collaboration – interactions with other clinicians that are centered around a common patient or group of patients

    • Messaging
    • Intervention requests
    • Notifications
    • Patient Information Sharing
    • Synchronization

Population Management – oversight and interaction with a defined set of patients.

    • Disease registry
      • Set-based queries
      • Status
      • Common Issue (all with result “X”)
    • Preventive care
      • Notifications/Tracking
      • Required Interventions
      • Planned Intervention Initiation (e.g. Flu shots)

Problem/ Diagnosis Management – capture and management of patient problems, concern, and diagnoses

    • Logging
      • Presumptive/Definitive Diagnosis (linked)
      • Complications (complication from disease directly linked in timeline)
      • Interventions (linked to diagnosis)
    • Notification
      • Care Team Update
    • Knowledge Access
      • Direct Access
      • CDS


Medication Management – capture and management of medication usage history and outcomes

    • Logging
      • Side Effects
      • Adverse Reactions
    • Management
      • Reconciliation
    • Knowledge Access
      • Direct
      • CDS

Note Management – Creation and management of care intervention and patient interactions

    • Create
    • Review
    • Search
    • Update/Append
 
Healthcare Process - Within health care, there are two main categories of processes: those that involve patient care (direct) and those that support care delivery (indirect).

Direct Care Process- what clinicians do on behalf of patients. Direct care is comprised of clinical processes, which include everything from creating nursing care plans to doing procedures and reviewing lab results. (Direct Care Process = Clinical Process)
 
Indirect Care Process - An administrative, legal, finanicial, or regulatory process.
 
Information Metabolism - The movement of information in and out of clinical processes.  


Clinical Workflow Model - A human-readable, visual representation of a clinical workflow that can be executed by a workflow engine.
 
Clinical Workflow Analysis - Methods/tools/techniques used to deconstruct clinical processes in order to determine their exact steps, control-flow, participants, resources, and information metabolism.

The clinical workflow terms defined above are based on concepts and definitions from following sources.

However, as is, the terms and concepts offered in these excellent publications, having been created for general business environments,  require refinement in order to be used to model clinical care in detail.   As such, these clinical workflow definitions have been crafted to serve as a foundation for additional clinical workflow terms and concepts that will be introduced in future articles.