Anne Zieger ,Fierce IT

Something Close to my heart.
I couldnt have expressed it better.

Digital records are good, but what about all that paper?
By Anne Zieger

Electronic medical records are a unique proposition. While just about any IT installation has to integrate with existing databases or networks, very few are crippled without uploading a bunch of data stored on paper. Right now, physicians and hospitals with EMRs are forced to use ad-hoc solutions when they want to access paper records, but that approach isn't sustainable.
Today, some tech-savvy physicians are capturing the records they need for a particular patient with their iPhone or a handheld document scanner, a short-term solution that has some value. And hospitals can manually pull records when needed by a particular provider, such as an emergency services team, if the patient's history isn't in their EMR.
The thing is, adding manual or patient-specific processes to the mix does nothing to standardize the process of bringing past records online. In fact, looked at one way, they actually make the health system's problems worse, as any additional layer of processes can only add confusion to the mix. For example, if a doctor photographs a patient record, there's no way to update it, which undermines their ability to respond to changing patient needs.
While I have no hard data on this, my sense is that most providers have decided to punt, relegating the issue of paper records to the "we'll handle it someday" bin. It's telling that on the vast exhibit floor at HIMSS this year, OCR scanning and document management solutions weren't very common. Vendors have their ear to the ground--they have to in order to survive--and know what their customers are worried about. Apparently, they aren't being deluged with requests to get that paper-based data online.
I'd argue, however, that the humble, time-consuming grunt work of getting paper records into your clinical data systems is just as important as putting the systems in place. If the purpose of installing those systems is to offer rich data to physicians--and to HIE partners--it makes no sense to only provide information that gets entered after your EMR gets cut over to production status.
Sure, digitizing paper-based data of any kind is a pain in the neck, requires a host of moderately-skilled coders who may require close supervision and costs a great deal over time. Worse, over the short term the efficiencies you generate may rebound more to health insurance companies, who save money as you get more efficient.
Still, it's just about impossible to meet the goals of a digital health record without including history and context. After all, there's no point in truncating medical data if the idea is to make a complete picture available to everyone. So it's time to bite the bullet and get those massive piles of paper charts online. Just grit your teeth and get it done; you'll be glad that you did. - Anne

Types of workflows...Can patient workflow fit into such a simle model ..its like an I with several spikes

Plant types
There are four primary types of plants in the TOC lexicon.
Draw the flow of material from the bottom of a page to the top, and you get the four types.
They specify the general flow of materials through a system, and they provide some hints about where to look for typical problems.
The four types can be combined in many ways in larger facilities.
I-Plant: Material flows in a sequence, such as in an assembly line. The primary work is done in a straight sequence of events (one-to-one). The constraint is the slowest operation.
A-Plant: The general flow of material is many-to-one, such as in a plant where many sub-assemblies converge for a final assembly. The primary problem in A-plants is in synchronizing the converging lines so that each supplies the final assembly point at the right time.
V-Plant: The general flow of material is one-to-many, such as a plant that takes one raw material and can make many final products. Classic examples are meat rendering plants or a steel manufacturer. The primary problem in V-plants is "robbing" where one operation (A) immediately after a diverging point "steals" materials meant for the other operation (B). Once the material has been processed by A, it cannot come back and be run through B without significant rework.
T-Plant: The general flow is that of an I-Plant (or has multiple lines), which then splits into many assemblies (many-to-many). Most manufactured parts are used in multiple assemblies and nearly all assemblies use multiple parts. Customized devices, such as computers, are good examples. T-plants suffer from both synchronization problems of A-plants (parts aren't all available for an assembly) and the robbing problems of V-plants (one assembly steals parts that could have been used in another).
For non-material systems, one can draw the flow of work or the flow of processes and arrive at similar basic structures. A project, for example is an A-shaped sequence of work, culminating in a delivered project.

I have never let my schooling interfere with my education.

Mark Twain (1835 - 1910)

Isnt that credible...something mentioned in 'a beautiful mind' to that affect too