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J Am Med Inform Assoc 18:738-748 doi:10.1136/amiajnl-2010-000033
  • Review

Computerization of workflows, guidelines, and care pathways: a review of implementation challenges for process-oriented health information systems

Table 3

Frequency and description of knowledge model types used by studies

Knowledge model Description
Document model (5 studies, 1 system implemented93) Human readable document with concepts represented in situ, usually preserving the original structure of the source document (Guideline Elements Mode (GEM) or other document-centric extensible mark-up language (XML) schema)
Semantic web (9 studies, 6 systems implemented64 69 74 89 108 119) Models proposed by the world wide web consortium (W3C) for representing information on the web (web ontology language (OWL) ontologies, Semantic Web Rule Language (SWRL) rules, OWL-S web services)
Formal workflow model (8 studies, 3 systems implemented4 71 92) Formalized workflow constructs underpinned by a formal mathematical model (Petri Nets, Yet Another Workflow Language (YAWL))
Object model (8 studies, 2 systems implemented36 110) Object-oriented techniques to model collection of hierarchical, interacting classes that represent guideline, workflow, or pathway concepts (Unified Modeling Language (UML), HL7 Reference Information Model (RIM), openEHR)
General task-network model (14 studies, 4 systems implemented14 50 103 104) Flowcharts or process maps without formal semantics (Program Evaluation Review Technique/Critical Path Method (PERT/CPM), activity-on-node)
General workflow model (14 studies, 11 systems implemented3 39 74 91 93 103 104 114 118 129 134) General workflow semantics (Business Process Modeling Notation (BPMN), Business Process Execution Language (BPEL))
Block-structured, procedural, logic rules (20 studies, 11 systems implemented3 43 51 65 72 84 96–98 101 109) Block-structured, procedural programming languages, and IF…THEN rules (Arden Syntax; decision tables)
Formal task-network model (48 studies, 23 systems implemented4 36 40 45 54 57 59 61 62 71 75 78 79 87 89 95 99 111 118 121 126 131 135) Guideline-based clinical tasks—actions, decisions, queries—that unfold over time, with a formal syntax and semantics (Guideline Interchange Format (GLIF), PROforma, Asbru)

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