The Alpha-Flow Approach to Inter-Institutional Process Support in Healthcare

Inter-institutional collaboration among physicians becomes increasingly important and yet, it’s unrealistic to assume that cooperation can be supported via a homogeneous system which is pre-installed in every organization. Instead physicians will typically have their own autonomous systems that support internal processes. Traditional activity-oriented workflow models or content-oriented process models do not resolve inter-institutional integration challenges. The authors present the a-Flow approach for distributed process management, which enables ad hoc collaboration via active electronic documents without the need to integrate local systems. A distributed case file, the a-Doc, is used to coordinate cooperating parties. Using this case file does not require any preinstalled system components, so true ad-hoc information interchange is enabled. The case file contains both, the inter-organizational process schema as a document, as well as arbitrary content documents that are shared among the cooperating parties. To illustrate the approach an inter-institutional use case is provided by cooperative breast-cancer treatment. The authors explain the rationale behind separating content, decision support, and coordination work and in large-scale inter-institutional scenarios its necessary to decouple collaboration functionality from the existing applications and to resolve the duality between content-oriented and activity-oriented process models.