SmartCare – Optimizing Workflow Processes in Critical Care through Automation

Introduction. Improving the quality and efficiency of health care delivery are important objectives in critical care. Process engineering approaches to identify, organize and standardize health care workflows have been employed to meet these goals. Evidence-based clinical guidelines (CGs) for critical care are among these approaches. Their impact on outcome measures have been investigated and quantified in several clinical studies, e.g. [1]. Outcome measures that were studied include the reduction of hospital stay, mortality, human errors, medical device induced complications and workload of clinical staff. A logical next step is now the implementation of standardized health care processes into medical technology by allowing CGs to be executed by medical devices. This could provide automated standardized workflow process support. Dräger Medical's SmartCare TM technology is a platform that allows the implementation and automatic execution of various CGs within a wide range of medical devices. The SmartCare TM expert system comprises a universal engine and a set of executable knowledge bases that each reflects a certain critical care process, as described by a CG. An expert system construction suite (Solvatio, iisy AG, Rimpar, Germany) is used to facilitate efficient, visual-oriented knowledge modeling as well as the transition to the runtime environment. It seamlessly combines process-, knowledgeand software-engineering tasks. The core paradigm is that if a medical device allows for reading access to its measurements, settings, and contextual information as well as for writing access to its settings, then every clinical guideline for that medical device is potentially automatable [2].