Information and communication technology for process management in healthcare: a contribution to change the culture of blame

Statistics on medical errors and their consequences has astonished, during the previous years, both healthcare professionals and ordinary people. Mass-media are becoming more and more sensitive to medical malpractices. This paper elaborates on the well-known resistance of the medical world to disclose actions and processes that could have caused some damages; it illustrates the possible causes of medical errors and, for some of them, it suggests solutions based on information and communication technology. In particular, careflow management systems and process mining techniques are proposed as a means to improve the healthcare delivery process: the former by facilitating task assignments and resource management, the latter by discovering not only individuals' errors, but also the chains of responsibilities concurring to produce errors in a complex patient's pathway. Both supervised and unsupervised process mining will be addressed. The former compares real processes with a known process model (e.g., a clinical practice guideline or a medical protocol), whereas the latter mines processes from raw data, without imposing any model. The potentiality of these techniques is illustrated by means of examples from stroke patient management. Copyright © 2010 John Wiley & Sons, Ltd. Historically, medical errors have been a kind of ‘professional secret’, something to hide for preserving the institutions image and the individuals credibility. However, sharing error experience was perceived as a need among ‘good’ physicians even when the culture of blame was dominating. Learning from errors is now a well-agreed-on motto, and the paper focuses on methods for pursuing it. Process mining and careflow managament systems are proposed as methodological and technical solutions and a real-world implementation is illustrated. Copyright © 2010 John Wiley & Sons, Ltd.