Querying Clinical Workflows by Temporal Similarity

The degree of fulfillment of clinical guidelines is considered a key factor when evaluating the quality of a clinical service. Guidelines can be seen as processes describing the sequence of activities to be done. Consequently, workflow formalisms seem to be a valid approach to model the flow of actions in the guideline and their temporal aspects. The application of a guideline to a specific patient (guideline instance) can be modeled by means of a workflow case. The best (worst) application of a guideline, represented as a reference workflow case, can be used to evaluate the quality of the service, by comparing the optimal case with specific patient instances. On the other hand, the correct application of a guideline to a patient involves the fulfillment of the guideline temporal constraints. Thus, the evaluation of the temporal similarity degree between different workflow cases is a key aspect in evaluating health care quality. In this work, we represent a portion of the stroke guideline using a temporal workflow schema and we propose a method to evaluate the temporal similarity between workflow cases. Our proposal, based on temporal constraint networks, consists of a linear combination of functions to differentiate intra-task and inter-task temporal distances.