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Do Healthcare Process Models Need Attended Tasks?

By Dr. John Svirbely, MD

Read Time: 2 Minutes

Several challenges may be encountered when creating process models in healthcare:

coping with the clinical variability seen in people and their conditions.
needing to make adjustments for the patient’s real-time status.
needing to avoid the over-complexity that can arise when trying to handle all possibilities that may be encountered.
crafting a model that is viewed with trust, comfort and acceptance by providers, patients, and regulators.

All of these challenges can be addressed using attended tasks.

What is an attended task?

An attended task is a task or decision that has an attribute which:

temporarily stops the execution of the process.
allows the user to review the task or decision and make changes to inputs or outputs.

The review, changes, and user are recorded, confirming with timestamp that a person has approved the task or decision results.

In a Trisotech BPMN model, an attended task is indicated by the presence of a small check box in the lower left corner, as shown in Figure 1. This example shows a decision task for the diagnosis of anemia based on criteria from the World Health Organization that uses three data inputs (age, sex, and hemoglobin).

Figure 1

What happens in an attended task?

As mentioned above, when execution of a process comes to an attended task or decision, it stops and allows the provider to interact with it in ways that have been configured by the model developer. The settings for the attended task are shown in Figure 2.

Figure 2

The users able to make changes can be restricted. This allows a provider who is familiar with the patient to individualize the patient’s care based upon information known or observed about the patient. For example, the significance of a hemoglobin value may vary depending on whether or not the patient was transfused prior to the specimen being collected. Similarly, a certain pattern of clinical findings may not fully capture the patient’s current state, while a clinician at the bedside can observe it. Things in life may look different than they do on paper.

Since data and decisions are all recorded, retrospective analysis of decisions relative to outcomes can be performed. This gives insights into care and interventions, supporting the development of a learning health system.

Caveats in Using Attended Tasks

Attended tasks are useful at key decision points that can significantly impact the patient. Not every task in a process should be an attended task, since an attended task requires interaction with a user, thereby slowing the process. Deciding which tasks should be treated as an attended task requires weighing the pros and cons of the choice.

Conclusion

Healthcare process models may seem like a black box to users. An attended task can shed light on the process and allows clinicians to interact with a model at key decision points. If used judiciously they can improve healthcare, as well as provide insights into how clinical decisions impact outcomes.