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Clinical Workflow Overview

Document Purpose: This document maps how patients move through the oncology care journey and where Entheory.AI integrates to improve clinical workflows.


Executive Summary

Entheory.AI supports oncology care across the entire patient journey—from initial diagnosis through treatment and long-term survivorship. By unifying data from fragmented systems and providing AI-powered insights, we help clinicians make faster, better-informed decisions.

Related Documentation: - Personas – Detailed user profiles and needs - User Journeys – Step-by-step workflow scenarios - Vision & Strategy – Platform goals and objectives


1. User Personas

Primary Users

Persona Role Key Needs Related Use Cases
Oncologist Treatment decision maker Unified patient view, time savings UI-002, UI-003
Tumor Board Member Multidisciplinary specialist Case packets, recommendations tracking ONC-050, ONC-052
Clinical Coordinator Care manager Scheduling, follow-up tracking APPT-002, NOTIF-002
Oncology Nurse Care delivery Protocols, vitals, safety checks PHRM-002, ONC-023
Medical Scribe Documentation AI note review, corrections DCT-001, DCT-002
IT Administrator System management Integration monitoring, user mgmt OPS-001, OPS-002

See: Detailed Personas for in-depth profiles, pain points, and how Entheory.AI addresses each user's needs.


2. Patient Journey Stages

2.1 Journey Overview

┌─────────────┐    ┌─────────────┐    ┌─────────────┐    ┌─────────────┐    ┌─────────────┐
│ Registration│ ──▶│  Diagnosis  │ ──▶│  Staging &  │ ──▶│  Treatment  │ ──▶│ Follow-up & │
│ & Referral  │    │  & Workup   │    │  Planning   │    │  Execution  │    │ Survivorship│
└─────────────┘    └─────────────┘    └─────────────┘    └─────────────┘    └─────────────┘
       │                  │                  │                  │                  │
       ▼                  ▼                  ▼                  ▼                  ▼
   Entheory.AI        Entheory.AI        Entheory.AI        Entheory.AI        Entheory.AI
   Integration        Integration        Integration        Integration        Integration

Interactive Patient Journey

journey
    title Oncology Patient Journey with Entheory.AI
    section Registration
      Patient arrives with referral: 3: Patient
      Coordinator registers in EMR: 4: Coordinator
      Documents OCR'd and indexed: 5: Entheory.AI
    section Diagnosis & Workup
      Order labs, imaging, biopsy: 4: Oncologist
      Results auto-ingested: 5: Entheory.AI
      View unified timeline: 5: Oncologist
    section Staging & Planning
      TNM staging extracted: 5: Entheory.AI
      Tumor board case packet generated: 5: Entheory.AI
      Board recommendations recorded: 4: Coordinator
    section Treatment
      Chemo protocol selected: 4: Oncologist
      Safety checks performed: 5: Entheory.AI
      Adverse events tracked: 4: Nurse
    section Follow-up
      Surveillance scans ordered: 4: Oncologist
      Trends analyzed automatically: 5: Entheory.AI
      Care gap alerts sent: 5: Entheory.AI

2.2 Stage Details

Stage Activities Data Sources Entheory.AI Value
Registration & Referral Patient registration, insurance, referral intake EMR/HIMS, referral letters Patient identity normalization, document OCR
Diagnosis & Workup Biopsy, pathology, imaging, labs LIS, PACS, Path Lab Unified timeline, TNM staging extraction
Staging & Planning Tumor board, treatment protocol selection All sources + guidelines Auto-generated case packets, recommendation tracking
Treatment Execution Chemotherapy, radiation, surgery Pharmacy, OT, nursing notes Adverse event tracking, dose modifications
Follow-up & Survivorship Surveillance imaging, labs, recurrence monitoring LIS, PACS Trend analysis, care gap alerts

3. Entheory.AI Touchpoints

3.1 Data Ingestion

Source System Data Type Integration Method Use Cases
EMR/HIMS Demographics, visits, orders HL7 v2 ADT, FHIR R4 ING-001, INT-001
LIS (Labs) Lab results, panels HL7 v2 ORU, FHIR ING-004, ING-005
PACS Imaging studies, reports DICOM, HL7 ORM/ORU ING-006, IMG-009
Pathology Biopsy reports, IHC panels PDF/OCR, FHIR PROC-001, ONC-002
Genomics Lab NGS reports, variants JSON/FHIR, VCF ONC-040, ONC-041
Pharmacy Prescriptions, dispensing HL7 RDE PHRM-001, ING-018

3.2 Clinical Workflow Support

Workflow How Entheory.AI Helps Key Use Cases
Pre-Consultation Review Unified timeline loads in <2s, shows changes since last visit UI-003, ONC-071
During Consultation AI scribe captures audio, generates SOAP note CAP-001, NLP-101
Lab Review Trend charts, critical value alerts UI-004, ALR-001
Imaging Review Integrated viewer, RECIST lesion tracking IMG-011, ONC-012
Tumor Board Prep Auto-generated case packets, completeness check ONC-050, ONC-051
Treatment Ordering Drug interaction checks, protocol suggestions PHRM-002, ONC-021
Follow-up Scheduling Care gap alerts, automatic reminders ONC-053, NOTIF-002

3.3 AI/ML Integration Points

Workflow Step AI Capability Use Cases
Document Processing OCR for scanned reports (Hindi + English) PROC-003
Audio Capture ASR for clinical dictation PROC-006
Entity Extraction NER for medications, diagnoses NLP-102a, NLP-102b
Staging Extraction TNM staging from pathology reports ONC-003
Note Generation SOAP note structuring PROC-012, NLP-101

4. Workflow by User Role

4.1 Oncologist Workflow

┌─────────────────────────────────────────────────────────────────────────────┐
│                         ONCOLOGIST CONSULTATION FLOW                         │
├─────────────────────────────────────────────────────────────────────────────┤
│                                                                              │
│  1. PRE-CONSULTATION (2-3 min)                                              │
│     ├── Open patient timeline [UI-003]                                      │
│     ├── Review "Changes Since Last Visit" [ONC-071]                         │
│     └── Check pending alerts [UI-005]                                       │
│                                                                              │
│  2. DURING CONSULTATION (10-15 min)                                         │
│     ├── Start audio capture [CAP-001]                                       │
│     ├── Review labs with trend charts [UI-004]                              │
│     ├── View imaging with RECIST tracking [ONC-012]                         │
│     └── Stop recording [CAP-002]                                            │
│                                                                              │
│  3. POST-CONSULTATION (2-5 min)                                             │
│     ├── Review AI-generated SOAP note [DCT-001]                             │
│     ├── Edit/approve note [DCT-002]                                         │
│     ├── Order follow-up tests/meds [PHRM-001]                               │
│     └── Schedule next appointment [APPT-008]                                │
│                                                                              │
└─────────────────────────────────────────────────────────────────────────────┘

Time Saved: 5-10 minutes per patient (from data gathering and documentation)

4.2 Tumor Board Workflow

┌─────────────────────────────────────────────────────────────────────────────┐
│                           TUMOR BOARD WORKFLOW                               │
├─────────────────────────────────────────────────────────────────────────────┤
│                                                                              │
│  1. CASE PREPARATION (Coordinator)                                          │
│     ├── Cases auto-routed to board [ONC-051]                                │
│     ├── Generate case packet [ONC-050]                                      │
│     └── Completeness check (flag missing reports) [ONC-075]                 │
│                                                                              │
│  2. DURING MEETING (Board Members)                                          │
│     ├── Present unified patient view                                        │
│     ├── Display imaging comparisons [ONC-078]                               │
│     └── Record recommendations [ONC-052]                                    │
│                                                                              │
│  3. POST-MEETING (Coordinator)                                              │
│     ├── Distribute recommendations                                          │
│     ├── Track implementation [ONC-053]                                      │
│     └── Flag non-compliance                                                 │
│                                                                              │
└─────────────────────────────────────────────────────────────────────────────┘

Time Saved: 30-60 minutes per case (from manual packet preparation)

4.3 Nursing Workflow

┌─────────────────────────────────────────────────────────────────────────────┐
│                         CHEMOTHERAPY ADMINISTRATION                          │
├─────────────────────────────────────────────────────────────────────────────┤
│                                                                              │
│  1. PRE-CHEMO CHECK                                                         │
│     ├── Verify patient identity [UI-001]                                    │
│     ├── Check lab clearance (ANC, platelets) [ONC-032, ALR-001]             │
│     └── Review current protocol and cycle [ONC-020]                         │
│                                                                              │
│  2. DURING ADMINISTRATION                                                   │
│     ├── Document vitals                                                     │
│     ├── Monitor for reactions [ONC-023]                                     │
│     └── Record any dose modifications [ONC-022]                             │
│                                                                              │
│  3. POST-ADMINISTRATION                                                     │
│     ├── Document completion                                                 │
│     ├── Schedule next cycle [APPT-008]                                      │
│     └── Patient education on side effects                                   │
│                                                                              │
└─────────────────────────────────────────────────────────────────────────────┘

5. Data Flow Architecture

5.1 Ingestion to Timeline

External Systems          Entheory.AI Platform              User Interface
━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━━

┌─────────┐     ┌──────────────┐     ┌──────────────┐     ┌──────────────┐
│   EMR   │────▶│ HL7 Adapter  │────▶│    Patient   │────▶│   Timeline   │
└─────────┘     └──────────────┘     │    Bundle    │     │     View     │
                                     │   (Unified)  │     └──────────────┘
┌─────────┐     ┌──────────────┐     │              │     ┌──────────────┐
│   LIS   │────▶│ HL7 Adapter  │────▶│              │────▶│  Lab Trends  │
└─────────┘     └──────────────┘     │              │     └──────────────┘
                                     │              │
┌─────────┐     ┌──────────────┐     │              │     ┌──────────────┐
│  PACS   │────▶│DICOM Adapter │────▶│              │────▶│   Imaging    │
└─────────┘     └──────────────┘     │              │     │    Viewer    │
                                     │              │     └──────────────┘
┌─────────┐     ┌──────────────┐     │              │
│  Scans  │────▶│  OCR Engine  │────▶│              │
│ (PDF)   │     └──────────────┘     │              │
└─────────┘                          │              │
                                     │              │
┌─────────┐     ┌──────────────┐     │              │
│  Audio  │────▶│  ASR Engine  │────▶│              │
└─────────┘     └──────────────┘     └──────────────┘

5.2 Cross-System Alerts

Lab Result (LIS) ──▶ Critical Value Check ──▶ Alert Generated ──▶ Notification
                            │                        │
                            ▼                        ▼
                    ┌──────────────┐         ┌──────────────┐
                    │ Rule Engine  │         │ Multi-Channel│
                    │ [ALR-001]    │         │ [NOTIF-001]  │
                    └──────────────┘         └──────────────┘

6. Integration with Hospital Systems

6.1 Typical Hospital Ecosystem

System Category Common Vendors (India) Integration Status
EMR/HIMS eHospital, Practo, BahmniCare, custom HL7 v2 / FHIR adapters ready
LIS Roche, Abbott, Siemens, in-house HL7 v2 ORU support
PACS Philips, GE, Agfa, local vendors DICOM / HL7 adapters
Pharmacy In-house, HIS modules HL7 RDE / FHIR MedicationRequest
Billing HIS integrated Display-only (no write-back MVP)

6.2 Deployment Scenarios

Scenario Data Flow Deployment Time
Full Integration Real-time HL7/FHIR 4-6 weeks
Hybrid HL7 for labs + CSV for legacy data 2-4 weeks
Fallback CSV/JSON batch upload 1-2 weeks

7. Clinical Value Metrics

7.1 Time Savings

Activity Before Entheory.AI With Entheory.AI Savings
Pre-consultation data gathering 10-15 min 2-3 min 8-12 min
SOAP note documentation 5-10 min 1-2 min 4-8 min
Tumor board packet preparation 45-60 min 5-10 min 40-50 min
Lab trend analysis 5 min 30 sec 4.5 min

7.2 Quality Improvements

Metric Target Measurement
Data completeness >90% of modalities ingested Automated audit
Missed care gaps <5% Follow-up compliance tracking
Alert acknowledgment 100% within SLA Alert analytics
Documentation quality >95% complete SOAP notes NLP validation


Document Owner: Clinical Product Team
Last Updated: 2024-12-09
Next Review: Quarterly (aligned with pilot feedback)