Order Trajectory Analysis for Monitoring Clinical Process

A hospital information system (HIS) is an information system developed to manage the administrative, financial and clinical aspects of a hospital. Introduced in the 2000’s in large-scale hospitals, HIS has resulted in a dramatic change in the the clinical environment. HIS stores all the histories of clinical activities in a hospital, including electronic patient records, laboratory data, and X-rays, for example. The advantage of HIS is that all the data are input through the network service and can be retrieved from the terminals inside the hospital. Two of the most important roles of HIS is to transfer clinical orders issued by doctors and nurses to other division and to store results of executed orders. Thus, the numbers of issued and executed orders will reflect the clinical activities in large hospitals. This paper proposes a visualization technique, called order trajectory analysis which visualize the temporal sequences of the number of orders. We applied this technique to monitoring clinical workflow: comparison of order trajectories of different divisions confirmed a problem with issuance of orders in one division. We developed the solutions to the problems and used the order trajectories to check whether the problem was solved or not. Transitions of order trajectories show that the proposed technique can be used for monitoring whether the solution is effective or not.