1. Introduction:
The process of assisting a patient can be conceived as a series of activities aimed at improving the patient's clinical condition.
In this sense, and for the purpose of giving an example we can cite:
- Paraclinical studies Indication of medications Surgical Interventions Food Hospitality.
Likewise, each of these activities involves multiple tasks that make up the activity itself, for example, if we take into account a paraclinical study, it will involve:
- Extraction of the sample Preparation of the sample Laboratory analysis Preparation of the report Printing of the report.
As we see the number of tasks carried out by each activity multiplied by the number of activities, it generates an extremely high volume of events related to the patient.
Each of the events that we mention has an impact on the patient and in turn an associated cost, however, in the face of an undesirable event with respect to the patient, for example a complication of his condition, a prolonged stay, etc., what was the reason ?
2) Flow of activities
Starting from the concepts previously handled, we conceptualize the activities carried out during the care of a patient as a “flow” of activities, which interact with each other and generate consequences in the evolution of the same.
We believe that a healthcare management system can be really efficient to the extent that it can manage all the activities carried out with the patient, recording each stage of each activity and controlling it with respect to certain values in itself and in relation to the preceding activities or later.
Following this concept, we believe that computer systems should take control of all activities related to the patient, in such a way as to detect early any possible variations in each process with respect to a predetermined standard.
In previous works (Accounting for Costs in Health Institutions. Kaplan Montico - Velarde. II Congress of Costs and Management) we have defined the healthcare process as a productive process, in which there are final products, for example a bed day of CTI, a surgical procedure, etc., and intermediate products, for example a food ration.
Following the concept of the production process, we firmly believe that the new computer systems must control each stage of said process, monitoring each stage of the process in relation to the previous one, and in turn controlling the ranges of variability of the associated variables in each stage.
In order to exemplify, let us define conceptually what is the process of a patient who undergoes a surgical coordination intervention, namely:
Process 1: Entering the patient's data
Process 2: Technical - Administrative authorization
Process 3: Coordination of the Procedure
Process 4: Carrying out the procedure
Process 5: Hospitalization
Process 6: Patient discharge
Each of these processes has associated tasks that will have an impact on the following, for example, for the Administrative Technical Authorization stage (Process 2), a series of requirements will be necessary that, if not fulfilled, the Coordination of the Procedure (Process 3) will not be carried out. Therefore, the system, applying intelligence, must control that all coordinated patients (Process 3) have completed Process 2, that is, Administrative Technical Authorization.
At the same time, when data are entered in the Coordination, for example the type of intervention, for example Coronary Cardiac Surgery, the system will control that when the data of the Procedure is entered (Process 4), they are compatible with the data of coordination.
On the other hand, when the data of the Carrying out of the Procedure (Process 4) are entered, the system must record clinical control data, which must be subject to certain ranges of values, for example, it is not possible to enter a Glycemia with a value of -120.00 since there are no negative values from said analysis.
In sum, we believe that the system should control all activities among themselves and the ranges of values of each variable. In turn, applying a certain degree of intelligence to the system, it can either warn or block the performance of some activities.
The logic of the system operation is as follows:
The system controls compliance with the requirements of the previous stage, if it complies, it advances in the stage, otherwise it requires compliance with the above and reports it.
Once the fulfillment of the previous stage is verified, the system verifies the entry of each variable in relation to a data range.
The system conceived in this way avoids going ahead with stages if there are unfulfilled prerequisites, and also controls the ranges of each variable.
3) Data Matrix:
The system, through the entry of each variable of the process, generates a data matrix that allows, in the event of eventual variations in costs, complications, or other deviations, to analyze the different variables and perform correlation analysis between groups of patients that may have the same deviations.
In short, the system conceived as a flow of activities with built-in intelligence makes it possible to find the cause of certain deviations, isolate it and eventually prevent it.
From a graphic point of view, the process of preparing the matrix and analysis would be as follows:
4) Conclusion:
We firmly believe that this type of management system conception can help control medical care and reduce costs derived from patient care due to the contribution of intelligence technologies and intelligent agents.
Likewise, today with the development of Web Browser Intelligence (Weby) technology, the different systems will be able to communicate with each other and make the care process even more efficient.
