Tracebook: A Dynamic Checklist Support System

It has recently been demonstrated that checklists can enable significant improvements to patient safety. However, their clinical acceptance is significantly lower than expected. This is due to the lack of good support systems. Specifically, support systems are too static: this holds for paper-based support as well as for electronic systems that digitize paper-based support naively. Both approaches are independent from clinical process and clinical context. In this paper, we propose a process-oriented and context-aware dynamic checklist support system: Trace book. This system supports the execution of complex clinical processes and rules involving data from Electronic Medical Record systems. Workflow activities and forms are specific to individual patients based on clinical rules and they are dispatched to the right user automatically based on a process model. Besides describing the Trace book functionality in general, this paper demonstrates the support system specifically on an example application that we are preparing for a controlled clinical evaluation. At last we discuss the limitations of Trace book.