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At present, the clinical pathways (CP) is developed and implemented manually by filling predefined paper. Computerization and automatic or semi-automatic implementation of CP based on workflow is one of the possible solutions. By introducing the rule places based on object-oriented Petri net, we build the CP workflow model to solve the workflow route decision-making. However, there are still some unavoidable and frequent variations in the execution process of CP. Therefore, this paper presents the framework of clinical pathway adaptive workflow management system (CPWAMS) based on extended workflow-nets(EWF-nets). And the integrated modeling is established to describe communicating with and exchanging the medical information among the disparate medical systems (HIS, RIS, PACS and LIS) during the computerized clinical pathway executing.