Patent Application
20060031095
1. Field of the Invention
The present invention relates generally to a method and apparatus for analysis of clinical work flow such as in a medical clinic and, in particular, to a method and apparatus for analyzing workflow of use of a technical medical device in a medical facility.
2. Description of the Related Art
Medical clinics addressing patient health concerns are required to purchase expensive equipment, handle often heavy patient loads, and operate within a budget. The expensive equipment should be fully utilized in order to maximize patient benefit, reduce overhead costs, and maximize return on investment. Current attempts to analyze utilization of the expensive technical equipment in the medical clinic includes preparation of user reports which are referred to as utilization management reports containing pure user statistical data such as operating hours, operating days, number of examinations, patient throughput, average examination duration, average time between two examinations, and scan seconds. Even if efforts are expended to expand this report to provide additional data from customers, these reports cannot provide the clinical workflow analysis and benchmarking.
The present invention provides a method and an apparatus by which clinical workflow is analyzed and benchmarking of workflow is provided for clinical treatment of patients for example in a computer tomography apparatus or other technical medical scanning device. Data is collected with time stamp information for the workflow steps and are analyzed for possible improvement. A display of the time lines of the workflow events, either per patient process or in a combined (for example, averaged) view is provided in some embodiments. Utilizing the present invention with its expanded analysis and evaluation capabilities enables bottlenecks to be identified and recognized and improvements to be realized in clinical workflow. The present invention provides not only statistical evaluation but also provides a graphically prepared analysis of the clinical workflow. Workflow is displayed in a graphical display to operators and managers of medical clinics.
According to preferred embodiments of the invention, the computer tomography scanner or other technical medical device is operated and, during its operation, the workflow related events are recorded and stored in a data file with a time stamp. A targeted analysis of the data is performed to obtain retrospective information about the functions of the medical clinic. Evaluations of the workflow are displayed in a report in which the data is statistically evaluated and graphically prepared to graphically reduce the data for display to the clinic management relating to the clinic functioning and possible issues for improvement.
In a further, and potentially separate, aspect of the invention, the present method enables the quality of the workflow to be compared between medical facilities, in particular as it relates to use of the technical medical device. This is achieved by a benchmarking engine, utilizing as one of its core components an expanded workflow analysis. The survey data is combined into clusters of similar customer profiles depending upon the issue being addressed. Within each cluster, national as well as international benchmarking and ranking can take place. In other words, a best practices medical facility and a worst practices medical facility are identified along with the ranking of those between.
Referring to
In one embodiment, the data files are transferred as indicated by the arrows in the illustration of
A workflow report 28 is provided by the analysis of the event logging for the computer tomography apparatus. The results file is evaluated for different complimentary types. A goal of the analysis is to provide to the clinic a comprehensive insight into the workflow at the clinic. Utilizing the present method, the possibility is provided to recognize optimization potentials and to adapt clinic functioning to these optimized potentials. For example, it may be desired to reduce the duration of the examination times to enable a higher patient through put or even to reduce the time that the computer tomography scanner is in operation. By analyzing the workflow report, it is possible to direct attention to the those function blocks which are longer than average and to target pauses in the workflow since these provide the possibility for the desired improvement.
The workflow report 28 may be comprised of a plurality of components. One such component is a short report. The short report is a first step which is created from the results files which are received from the clinic. A statistical preparation is provided in the form of tables from which the utilization or a load on the computer tomography scanner is visible by a brief overview.
Also shown in
The analysis of the cluster 40 results in a benchmarking report 42. The generation of a benchmarking report is provided by the access to the central customer workflow data bank 30. In the benchmarking report, the workflow of a customer, or clinic, is contrasted with the workflow of other customers or clinics within its cluster. A ranking of the clinics or customers within a cluster is performed so that it can be shown how the customer or clinic is positioned within the customer rank for the cluster. The preparation of the benchmarking report is followed by a consultation talk 44 with the customer, or clinic in which the benchmarking report 32 reaches the hands of the customer.
In
Turning now to
A summary timeline 58 is also provided which identifies patient processing activity that applies to all of the four timelines 50-56 lying thereabove. A bottom line 60 of the display plots the events against the actual time that they occurred.
The workflow event browser of
From the user interface interaction relating to the patient registration and to the examination transmission, the examinations can be distinguished from one another by reference to the patient using a unique patient examination identification. Additional information such as that on Mondays, only one medical technical assistant is on duty, or that a different workflow is performed on the early shift compared to the late shift, can also be recorded for display in the workflow event browser.
A standard, or combined, workflow analysis is performed according to another aspect of the invention. An example of a standard workflow browser according to the present invention is shown in
It is possible to select for review at a glance any desired type of examination, such as heart examination, standard thorax examinations, etc. The different types of examination may be visualized in the workflow analysis display using a standard format. In the illustrated workflow analysis of
Using the graphical illustrations of the workflow analysis shown in
Referring now to
The graphical representation of the workflow browser displays the times at which an examination is implemented and the particular panels on which the examination is processed. The workflow browser thus shows the entire workflow of the computer tomograph installation facility in a clear and compressed form. In addition to displaying the duration of the function blocks and the pause intervals, an assessment may also be made as to whether work steps are distributed among the consoles in an effective and efficient manner. For example, it may be recognized from an examination of the system browser that the post-processing is performed on the control panel of the computer tomograph equipment which leads to a delay in examination of the next patient or, it may be apparent that the duration between the examination and the finding or results of the examination may be shortened by additional consoles because the post-processing is performed on the existing consoles and this represents a bottleneck due to overloading of the existing consoles. A result of the examination could reveal that the existing consoles are sufficient in number but are not be optimally utilized, for example, by a lack of personnel. A corresponding scenario may be present in which higher patient through put or shortened working times may be accomplished by adding personnel.
As noted above, a benchmarking engine is provided which accesses data that has been supplied to a central customer workflow data bank in which a number of customer profiles are contained. The customer profiles include the demographic data relating to the particular clinic or customer being monitored according to the present method. Workflow data is recorded for each customer or clinic. These workflow events are triggered by the software and include the following parameters which are stored in a log file with a time stamp. The parameters include, patient positioning, which includes positioning of the patient on the computer tomograph apparatus and then moving the patient from the computer tomograph or assisting the patient in getting up from the computer tomograph apparatus. Further information logged in the workflow data includes the average operating time of the scanner noted in detailed per work step. This includes patient registration, examination protocol selection, examination preparation, examination planning, scanning or eradiating of the patient, protocol specific reconstructions, examination conclusions, protocol-specific examination durations, or protocol-specific number of images per examination. An additional item of workflow data includes the ratio of post-processing to examination times, which may be sorted per each examination type. A further items of information recorded may include minimum and maximum examination times which may likewise be sorted per examination type. The consumption of materials utilized in the examination, such as the quantity of contrast agent administered to the patient is likewise recorded. Another important item of information recorded in the present method is the duration of time in which the device is not being used. This may include the time from the end of the scan until the start of a reconstruction, the time from the end of the scan until the conclusion of the examination, the time from the conclusion of the examination until the next patient is registered, etc.
Yet another workflow data item recorded is the number of actions or events performed during the work flow. These include the number of scan terminations by the operator, the number of the protocol selections from the protocol list, the number of changes to the examination parameters, the number of mouse clicks (or other point or device activations) in the selection of the examination protocol, the number of mouse client (or other pointing apparatus activations) for reconstruction jobs, the number of automatically or manually started reconstructions, the number of reconstructions per scan range, the number of thin slice reconstructions (which may be up to 1.5 millimeters in thickness, the number of images per examination or scan range or reconstruction job, the number of automatic transfers per scan range, the number of images per automatic transfer, the number of automatic recordings per scan range, the number of images per automatic recording, and the number of loaded images per computer tomograph application.
Further, data items recorded in the workflow analysis include the frequency of examination protocols used, the frequency of temporary adaptations of standard protocols, the frequency of automatic patient instructions utilized (such as breathing commands for each type of examination), the frequency of automatic or manual reconstructions, the frequency of automatic transfer, the frequency of automatic recording, the frequency of use of the applications, and the frequency of non-examination specific functions per examination (these may include viewer functions, recording functions, 3-D image functions, browser functions, etc.
A further item of information includes statements concerning the capacity of the various devices in the clinic facility. For example, the load on the computer tomograph scanner is recorded, along with the load on the various control panels, the load on the workstation, the load on the Leonardo and the load on the network or public access computer system.
Thus, by an evaluation of the workflow browser displays as shown in
The workflow analysis according to the present invention provides various advantages. Among them, is a transparency in clinical workflow. The workflow report is comprehensive and clearly informs the users of the workflow. Four different representation forms are automatically generated according to a preferred embodiment. In particular, a short report is generated to provide an overflow of the workflow in the form of tables with statistical evaluations. This short report form serves as an introduction to the analysis being performed in the workflow. A standard representation is to show the standard workflow analysis by combining the data from a plurality of examinations taken over an arbitrarily set observation time span. Such time span may be one month, one day, one week, etc. A standard evaluation is performed and the display of averaged function blocks is provided in contract to the workflow event browser. This form of representation is particularly well suited to implement the analysis steps of comparing different examination types.
A third representation according to the present invention is a workflow event browser. This shows the work flow at predefined points in time. This representation helps to provide a targeted analysis of specific examination steps. The analysis performed on the standard workflow may be analyzed exactly by looking at the potential for improvement and identifying such potential.
A further representation is that of the system workflow browser, which shows the entire workflow for a computer tomograph installation in an overview form. The load and the distribution of function blocks on the various consoles can be readily assessed and optimized.
The types of reports which are provided according to the present method are optimally complementary to one another and provide a total overview image of the workflow. Improvements may be readily made which help the customer to optimize the workflow himself or to implement the optimization with the support of a consulting service.
An aspect of the present method is to provide individual feedback to the clinic or user. The data acquired from the workflow analysis allows conclusions to be made about the efficiency and operating performance of the customer or clinic. The customer or clinic may have individual functions reproduced via the display in an objective manner. In addition to being provided with the workflow report, a consulting service may be called to assist the customer or clinic in identifying erroneous usage or sub-optimal work processes and in recognizing and implementing common possible improvements (such as software or hardware upgrades or restructuring of personnel assignments.
A further aspect of the present method is to provide benchmarking. The customer or clinic may evaluate the workflow using various criteria found in the benchmarking report. The benchmarking report identifies the position of the particular customer or clinic in comparison with other similarly situated clinics, and may be able to implement improvement through such comparison. Clinics which have an optimal workflow (referred to as best practices) may be identified as desired.
A further aspect of the present method is to provide sharing of knowledge concerning the workflow for the computer tomograph. Contacts are arranged with existing installations of computer tomograph apparatus. A clinic or customer obtains information about the workflow practices of others, assuming approval for such contact is obtained.
A further advantage of the present method is available to the manufacturers of the computer tomography equipment. The possibility is provided to acquired targeted data about the workflow practices of a customer or clinic. With this knowledge, an equipment manufacturer may offer a customer the support for workflow optimization in the form of consulting services in the field of workflow and applications. An additional business option is to provide scalable usage fees for an expanded utilization management business report. By studying the cost effectiveness for the utilization management using the present reports, other things may be revealed about the customer or clinic which is of interest since the clinic workflow and analysis of improvement potential is transparent. Referring to
Although other modifications and changes may be suggested by those skilled in the art, it is the intention of the inventors to embody within the patent warranted hereon all changes and modifications as reasonably and properly come within the scope of their contribution to the art.
