Enterprise Architecture for Model-Driven Clinical Operations Management in Value-Based Hospitals

• Main Author: Mouttham, Alain
• Other Authors: Peyton, Liam
• Language: en
• Published: Université d'Ottawa / University of Ottawa 2016
• Subjects: Model-Driven Engineering; Enterprise Architecture; Clinical Operations Management; Value-Based Hospitals
• Online Access: http://hdl.handle.net/10393/35045; http://dx.doi.org/10.20381/ruor-5015

Value-based hospital is a concept that is causing a major transformation of hospitals and their information systems. Currently, hospitals are organized by medical units and by specialties that tend to operate as separate silos, without much communication between them. The transitions of care are not optimal for the patients, thus negatively impacting patient outcomes. Value-based hospitals focus on groups of patients with similar conditions, and end-to-end care pathways like Hip & Knee Replacement. They organize service lines that provide end-to-end care for these patient groups through the Emergency Department, Diagnostic Imaging, Lab tests, the surgical procedure in the Operating Room, the stay in the Surgery unit, Rehabilitation, and then discharge from the hospital. To enact such a transformation, hospitals have to redesign their Clinical Operations Management (care processes and organization) and the supporting information systems. Enterprise Architecture is the discipline, defined by international standards bodies, which concerns itself with transformational change of large complex organizations supported by information technology. Model-Driven Engineering is an approach to designing and generating information systems based on models. This thesis proposes an Enterprise Architecture for Model-Driven Clinical Operations Management (COM) to address the required transformation and improvement of clinical information systems to support value-based hospitals. The first thesis contribution is an Enterprise Architecture for Model-Driven COM in value-based hospitals, including COM Models, UML/BPMN/DMN Models, an Architecture and Design for a Clinical Operations Support System (COSS) for COM, and four COM Diagrams and Templates. The COM Models are the Business Architecture of the Enterprise Architecture; they are the foundation of our model-driven transformation approach. The UML/BPMN/DMN Models are derived from the COM Models, and are the Information System Architecture of the Enterprise Architecture. The COSS for COM, generated from the above models, is the Technology Architecture of the Enterprise Architecture. Finally, the COM Diagrams and Templates enable to better communicate the Enterprise Architecture; they are the COM Functions Table, the COM Enterprise Architecture Diagram, the COM Service Line Template, and the COSS Architecture Diagram. A second thesis contribution is the design of two domain-specific model-driven tools, based on the Eclipse environment, which support the design and generation of information systems support of COM in a value-based hospital. The COMP Tools include a Modeling Tool for COM based on a COM Functions Table for Hospitals, a Domain-Specific Modeling Language for COM (COMP: the COM Profile), and its Meta Model. The COSBench software development workbench provides support to the Model-Driven Engineering of information systems for COM. Finally, a third contribution is examples of COM Models for Joint Replacement service line and for Cardiac Procedures service line, used in our case studies to illustrate and validate the approach. There are also examples of COSS Decision Support Systems for patient flow management, operational business intelligence, full-capacity protocol, demand management, and capacity management.