Abstract
In recent years, the safety and reliability of information technology (IT) systems in the healthcare industry are of increasing importance. In this paper, we propose an approach for monitoring and predicting reliability degradation in Health IT (HIT) using Markov chain (MC). A MC model provides an opportunity to represent highly dynamic systems, such as HIT, in a succinct manner to simulate the evolution of the system over time in discrete time steps. The model can also represent system behavior that varies over along duration. Consequently, using electronic health records (EHR) data from systems such as the Veterans Affairs’ Corporate Data Warehouse systems, we defined clinical workflow as a Transaction Process Model (TPM). The TPM represents a set of states in the Consult workflow. It is also an ideal workflow description and has several degrees of freedom. The TPM is then converted into a MC representation and the EHR data is used to compute transition probabilities between the nodes in the MC. The original MC representation is perturbed by changing the transition probabilities to simulate alternative system workflow paths and identifying scenarios that could impact system reliability. We present scenarios that illustrate the proposed approach and discuss some of the insights from the results.
