This document discusses using a Business Process Management (BPM) approach to improve cancer care through integrated care pathways. A BPM system could help implement best practices according to clinical guidelines and monitor patients' progress. A pilot project in Apulia, Italy is using BPM technology to manage chemotherapy pathways both in hospitals and at home. The goals are to standardize processes, monitor deviations, reduce risks and costs, and provide a platform for training users. BPM represents clinical pathways as workflows to coordinate tasks among roles and can integrate with electronic health records.

1. AN ADVANCED APPROACH TO CANCER INTEGRATED CARE
PATHWAYS
WITH BUSINESS PROCESS MANAGEMENT (BPM) TECHNOLOGY
10° MOS Conference – Taranto, Nov 11-13 2013

2. Who is Crikhet

3. «Apulian ICT Living Labs»
A Living Lab is a system for building a future economy in
which real-life user-centric innovation and research will be the
normal co-creation technique for new products, services and
company structures
A Living Lab stimulates ”pilot users” to take active part in the
research and innovation process and use them to take
benefits for their real life/work contexts.

4. Main Actors
Users
• Ospedale Moscati (TA) - Oncology Dept led by prof. Pisconti
Network of ICT Leading Companies (CRIKHET NET)
• Openwork (capofila)
• Insoft2000
• Links MT
• Sincon
Research Labs
• DHITECH Scarl
• Bari Politecnico

5. Scenario
• Strong support worldwide to change the healthcare delivery
model from a disease-centred to a patient-centred approach
• Patient treatment is delivered through an Integrated Care
Pathway (ICP) in a modern healthcare delivery model, where
ICPs are “structured multidisciplinary care plans, which detail
essential steps in the care of patients with a specific clinical
problem”

6. Scenario
• Use of a Business Process Management (BPM) will help
support the implementation of best practice according to the
national guidelines and understanding the patient progress
along the dynamic care pathway
• Cancer care is considered to be a key model that will improve
with a patient-centric delivery model

7. Pill of BPM
Business Process
(i.e. what is intended to happen)
Is defined in a
Is managed by a
Workflow Management
System
Process Definition
Sub-Processes
(a representation of what is
intended to happen)
(controls automated aspects
of the business process)
Used to create
& manage
Activities
Process Instances
(a rapresentation of what is
actually happening)
which may be
Include one or more
or
Manual Activities
(which are not managed as part
of the Workflow System)
Automated Activities
Activity Instances
during execution
are represented by
which include
and/or
Work Items
Invoked Applications
(tasks allocated to a
workflow participant)
(computer tools/applications
used to support an activity)

8. Clinical pathways
“Structured multidisciplinary care plans ... for a specific clinical
problem ...implementing local protocols based on clinical
guidelines” (Campbell et al 1998)
• Describe tasks to be carried out together the timing, task sequence
and role that completes each task.
• Should form a single, multidisciplinary record that becomes part of
the patient’s overall clinical record.
• Task timing, sequencing, and role-based task enactment are all
features of BPM systems.
•

9. Sample of Cancer Care Pathway
Primary care
Consultation & referral
Follow-up
Follow-up
Home nursing
Symptomatic care
Hospice
Hospital unit
Diagnostic unit
Specialist palliative care
Specialist consultation
Investigations
Radio/chemotherapy centre
Surgical centre
Multidisciplinary team
Follow-up
Pre-operative tretment
Second treatment
Surgery
First case conference
Second case conference

10. Chemotherapy Pilot Application: how it works
Crikhet Framework
Integrated Care Pathway
Deviations
STEP of Hospital PDTA
Hospital PDTA
Doctor
Electronic Health
Record
Business Intelligence
RISK Management
Adverse Events, Deviations
Therapy
LOG
STEP of Domiciliary PDTA
Domiciliary PDTA
Events
Doctor
Smart Phone
Agenda Management
Patient
Nurse

11. Expected benefits
• Implementation of experienced and affordable medical
•
•
•
•
organizational processes
Monitoring of the gaps between expected and experienced
situation for a better quality approach
Compliance evaluation from user-patient, clinical and
economical point of view
Clinical and economical risks reduction
Platform for user training

12. Thanks for your attention
piero.cosoli@openworkbpm.com