Object Management Group (OMG) Field Guide to Shareable Clinical Pathways

Today, our ability to author, share, and comply with establish clinical best-practices is often limited, exacerbated by ambiguities in natural language and amplified as a result of having inconsistent representations.  This makes it harder to share pathways among health providers, harder to implement best-practices, and harder to manage care transitions among healthcare systems as they occur in the natural course of care delivery. The objective of this project was the development of a recommended approach to facilitating this goal given the high complexity of clinical pathways. 
 	
To produce the “Field Guide to Shareable Clinical Pathways”, a community-of-interest was assembled comprising experts from both the clinical domain and business process modeling technical domain.  VA was the primary government sponsor of the activity, with provider participation from Intermountain Health Care and Mayo Clinic, and a host of industry participants. Key use-case work was sponsored by the American College of Obstetricians  and Gynecologists (ACOG). The work took place under the auspices of the Object Management Group as an informal working community, with expectations of maturing into a formal community of practice upon successful conclusion of the effort.  

The project utilized the industry’s current standards modeling notations (Business Process Modeling Notation (BPMN), Case Management Modeling Notation (CMMN), and Decision Model and Notation (DMN)) to form the foundation for their recommendations while addressing the complexity of the clinical domain. 

The resulting Field Guide serves as a “style guide” for developing and implementing Shared Clinical Pathways that are readily sharable, using an Antenatal Care use case as an exemplar.   

Future work will involve developing new Shared Clinical Pathways while refining industry standards and the Field Guide’s recommendations.

For more information, please contact: kenneth.rubin@va.gov.