Serviceflow management for health provider networks

Abstract

Introduction: the challenge of supporting health care processes Today, health care providers of all kinds face extreme pressure. Owing to demographic reasons and the availability of better medical facilities and therapy forms, expenses in the health care sector are exploding. Consequently, cost reduction is of prime importance. As a response, drastic changes in reimbursement procedures cause health care providers to act as firms with a business orientation. The ensuing competition compels health care providers either to specialize or merge, or both. A promising alternative is to build networks that enable providers to act in a corporate way vis-à-vis business partners (insurance companies or suppliers) as well as clients (patients). This situation only mirrors developments that already exist in the USA, such as health management organizations (HMOs). The question is whether new Web-based technology can improve the situation. Out of the great number of possibilities in online health provision (cf. Rippen, 2000; Rodrigues, 2000; Tambouris et al., 2000) we are interested in the design and impact of e-business at the joint between networks and patients. Our intention is to support health providers in both a cost effective provision of cross-organizational service processes and a substantial improvement in their quality. Many authors agree in that improving cooperation and coordination among different providers is of critical importance in the health care sector (e.g.

Processing by contract

“…Serviceflow management (Klischewski and Wetzel, 2001a, b; Wetzel and Klischewski, 2002) aims at supporting service processes carried out and managed by heterogeneous actor networks. The approach models process as a series of service points where the customer and the service provider meet and/or the current service situation (including customer concern) is evaluated.…”

“…In the process of the preparation, performance and after‐care of an in‐patient surgical operation (see also Klischewski and Wetzel, 2001a, b) the patient usually moves back and forth between different physicians/specialists and a clinic to receive an in‐depth diagnosis as well as appropriate medical care and treatment. A patient typically starts with consulting a family doctor, is directed to a specialist, chooses a hospital, goes through consultation and registration at the hospital with a schedule for further preparation, passes through all stages of preparation, stays in the hospital where the operation is performed, all of which is followed by aftercare treatment at specialists.…”

“…work place or “service point”, cf. Klischewski and Wetzel, 2001a, b) where an actor/agent is supposed to contribute to the overall workflow process (see Figure 3). In coherent workflow environments it could be the same workflow engine (i.e.…”

Serviceflow Beyond Workflow? Concepts and Architectures for Supporting Inter-Organizational Service Processes

“…Taking a typical example from the healthcare domain for illustration -the description of similar cases are found in [17] [3] -we consider the process of the preparation for, performance and aftercare of an inpatient surgical operation [13]. Based on our analysis in cooperation with a German clinic specialized in bone surgery and endoprothetic, the presented scenario describes a standard procedure for hip replacements.…”